Sources of Information about Dietary Fibre: A Cross-Country Survey

Problem statement: Dietary fibre (DF) has been recognized as a major determinant for improvement of health. Hence the means of information through which people become aware of its benefits are crucial. Research questions: Where do you usually find information about dietary fibre? What means of communication do you consider the most appropriate to encourage the consumption of dietary fibre? Purpose of the study: This work aimed at studying the sources of information about dietary fibre, as a means to educate people about aspects related to healthy eating. Factors such as gender, level of education, living environment or country were evaluated as to their effect on the selection of sources and preferences.   Research Methods: Descriptive cross-sectional study by means of a questionnaire, applied to a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America), answered after informed consent by all participants. For the analysis were used several descriptive statistics tools, crosstabs and chi square test to assess the relations between some of the variables under study. Findings: Mostly the information about DF comes from the internet, but television is recognized as suitable. Differences were found between genders, levels of education, living environments and countries. The internet (preferred source), got highest scores for Hungary, urban areas, university education and female gender. The radio (least scored source) was preferred in Egypt, for men and with lower education (primary school). Conclusions: People get information through the internet due to easy access. However, it is to some extent a risk given the impossibility to control de information made public on the internet. The role of health centres and hospitals as well as schools should definitely be increased, as a responsible way to ensure correct information.

Perceção dos cuidadores informais sobre o planeamento da alta

Enquadramento: Conhecer a perceção que os cuidadores informais possuem sobre o planeamento da alta dos idosos internados, permite que os enfermeiros conheçam as reais necessidades do cuidador e do idoso, contribuindo assim, para a diminuição da ansiedade, prevenção de complicações e consequentemente uma maior satisfação pelos cuidados recebidos. Objetivos: Conhecer a perceção dos cuidadores informais sobre o planeamento da alta hospitalar do idoso, e analisar associações entre as variáveis sociodemográficas, profissionais, familiares, clínicas e psicossociais e a referida perceção. Métodos/ Procedimentos: Realizou-se um estudo quantitativo, transversal, descritivo e correlacional, utilizando uma amostra não probabilística por conveniência, constituída por 41 cuidadores informais de idosos internados no serviço de Medicina 1 do Centro Hospitalar do Algarve – Unidade de Faro. Recorreu-se ao questionário de caracterização sociodemográfica, profissional, familiar e clínica, bem como a utilização do Índice de Barthel, questionário de Planeamento da Alta (PREPARED) e a escala de Ansiedade e Depressão Hospitalar (HADS). Resultados: Dos 41 cuidadores informais,73,17 % são do género feminino, 78% são casados/ união de fato, 39,0% mantêm-se ativos profissionalmente a tempo inteiro e em 51,2% são filhos do idoso, que apresentam uma média de idade de 78,78 anos. A maioria (82,9%) reside na mesma habitação que o idoso, sendo cuidadores informais há menos de 3 meses (58,5%). Os cuidadores apresentam um nível de ansiedade leve a moderada, sendo superior para o género feminino, embora não se verificasse diferenças estatisticamente significativas. Relativamente à perceção dos cuidadores relacionados com o planeamento da alta, a maioria privilegia as informações relacionadas como conseguir fazer as AVD, afirmando que se sentem preparados para regressar a casa, contudo a maioria não sente confiança para executar as tarefas diárias no domicílio. Constatou-se que a presença de apoio da rede formal influencia significativamente a perceção do planeamento da alta (p< 0,05), sendo que o género, agregado familiar e grau de dependência, embora de forma parcial (apenas para um indicador) também são preditivas da perceção. Conclusões: Apesar do número reduzido da amostra, os resultados obtidos evidenciam a relevância de organização dos cuidados face à satisfação das necessidades dos idosos e seus cuidadores em cuidados de saúde, no que dizem respeito ao planeamento da alta, como busca da qualidade. Palavras-chave: perceção do planeamento da alta, cuidadores informais, idosos.

Nivel de sobrecarga y factores asociados de los cuidadores primarios de los/as pacientes del centro de atención ambulatoria 302 del Instituto Ecuatoriano de Seguridad Social, Cuenca Ecuador, 2014

OBJETIVOS: Identificar el nivel de sobrecarga y sus factores asociados en los cuidadores primarios de los /as pacientes del Centro de Atención Ambulatoria 302 del IESS. METODOLOGÍA: Es un estudio cuantitativo analítico-transversal, cuyo universo es 222 cuidadores primarios de adultos mayores, controlados en el Centro de Atención Ambulatoria 302 del Instituto Ecuatoriano de Seguridad Social, Cuenca Ecuador. Los datos se obtuvieron del formulario que consta de un apartado sociodemográfico, variables de estudio, Índice de Katz y Escala del Nivel de Sobrecarga de Zarit. Se tabuló y analizó la información obtenida exponiéndola en los resultados. RESULTADOS: En promedio los cuidadores tienen 53 años, en su mayoría de sexo femenino, 52% de ellos casados, casi el 60% son hijos y un 11% conyugues del adulto mayor. La mayoría los cuida 12 horas en el día, los 7 días de la semana y llevan cuidándolos al menos 5 años. Se observó que 26% de adultos mayores tiene una dependencia moderada y el 38% dependencia severa. De acuerdo al test de Zarit el 18,7% de cuidadores tienen sobrecarga leve y el 14% sobrecarga intensa. CONCLUSIONES: El 18,7% de los cuidadores primarios presentan una sobrecarga leve y el 14% perciben una sobrecarga intensa.

Tackling risky alcohol consumption in sport: a cluster randomised controlled trial of an alcohol management intervention with community football clubs

BACKGROUND: An increased prevalence of risky alcohol consumption and alcohol-related harm has been reported for members of sporting groups and at sporting venues compared with non-sporting populations. While sports clubs and venues represent opportune settings to implement strategies to reduce such risks, no controlled trials have been reported. The purpose of the study was to examine the effectiveness of an alcohol management intervention in reducing risky alcohol consumption and the risk of alcohol-related harm among community football club members.

METHOD: A cluster randomised controlled trial of an alcohol management intervention was undertaken with non-elite, community football clubs and their members in New South Wales, Australia. Risky alcohol consumption (5+ drinks) at the club and risk of alcohol-related harm using the Alcohol Use Disorders Identification Test (AUDIT) were measured at baseline and postintervention.

RESULTS: Eighty-eight clubs participated in the trial (n=43, INTERVENTION; n=45, CONTROL) and separate cross-sectional samples of club members completed the baseline (N=1411) and postintervention (N=1143) surveys. Postintervention, a significantly lower proportion of intervention club members reported: risky alcohol consumption at the club ( INTERVENTION: 19%; CONTROL: 24%; OR: 0.63 (95% CI 0.40 to 1.00); p=0.05); risk of alcohol-related harm ( INTERVENTION: 38%; CONTROL: 45%; OR: 0.58 (95% CI 0.38 to 0.87); p<0.01); alcohol consumption risk ( INTERVENTION: 47%; CONTROL: 55%; OR: 0.60 (95% CI 0.41 to 0.87); p<0.01) and possible alcohol dependence ( INTERVENTION: 1%; CONTROL: 4%; OR: 0.20 (95% CI 0.06 to 0.65); p<0.01).

CONCLUSIONS: With large numbers of people worldwide playing, watching and sports officiating, enhancing club-based alcohol management interventions could make a substantial contribution to reducing the burden of alcohol misuse in communities.

Current and future friends of the earth: assessing cross-national theories of environmental attitudes

Empirical studies of public opinion on environmental protection have typically been grounded in Inglehart’s post-materialism thesis, proposing that societal affluence encourages materially-sated publics to look beyond their interests and value the environment. These studies are generally conducted within, or at best across, Western, democratic, industrialized countries. Absence of truly cross-cultural research means the theory’s limitations have gone undetected. This article draws on an exceptionally broad dataset—pooling cross-sectional survey data from 80 countries, each sampled at up to three different points over 15 years—to investigate environmental attitudes. We find that post-materialism provides little account of pro-environment attitudes across diverse cultures, and a far from adequate explanation even in the affluent West. We suggest that unique domestic interests, more than broad value systems, are driving emerging global trends in environmental attitudes. The environment’s future champions may be the far from ‘post-material’ citizens of those developing nations most at risk of real material harm from climate change and environmental degradation.

Cocaine-specific neuroplasticity in the ventral striatum network is linked to delay discounting and drug relapse

AIMS: To contrast functional connectivity on ventral and dorsal striatum networks in cocaine dependence relative to pathological gambling, via a resting-state functional connectivity approach; and to determine the association between cocaine dependence-related neuroadaptations indexed by functional connectivity and impulsivity, compulsivity and drug relapse. DESIGN: Cross-sectional study of 20 individuals with cocaine dependence (CD), 19 individuals with pathological gambling (PG) and 21 healthy controls (HC), and a prospective cohort study of 20 CD followed-up for 12 weeks to measure drug relapse. SETTING AND PARTICIPANTS: CD and PG were recruited through consecutive admissions to a public clinic specialized in substance addiction treatment (Centro Provincial de Drogodependencias) and a public clinic specialized in gambling treatment (AGRAJER), respectively; HC were recruited through community advertisement in the same area in Granada (Spain). MEASUREMENTS: Seed-based functional connectivity in the ventral striatum (ventral caudate and ventral putamen) and dorsal striatum (dorsal caudate and dorsal putamen), the Kirby delay-discounting questionnaire, the reversal-learning task and a dichotomous measure of cocaine relapse indicated with self-report and urine tests. FINDINGS: CD relative to PG exhibit enhanced connectivity between the ventral caudate seed and subgenual anterior cingulate cortex, the ventral putamen seed and dorsomedial pre-frontal cortex and the dorsal putamen seed and insula (P≤0.001, kE=108). Connectivity between the ventral caudate seed and subgenual anterior cingulate cortex is associated with steeper delay discounting (P≤0.001, kE=108) and cocaine relapse (P≤0.005, kE=34). CONCLUSIONS: Cocaine dependence-related neuroadaptations in the ventral striatum of the brain network are associated with increased impulsivity and higher rate of cocaine relapse.

Sources of Information about Dietary Fibre: A Cross-Country Survey

Dietary fibre (DF) has been recognized as a major determinant for improvement of health. Hence the means of information through which people become aware of its benefits are crucial. This work aimed at studying the sources of information about DF, as a means to educate people about aspects related to healthy eating. Factors such as gender, level of education, living environment or country were evaluated as to their effect on the selection of sources and preferences. For this, a descriptive cross-sectional study by means of a questionnaire, applied to a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America), answered after informed consent by all participants. For the analysis were used several descriptive statistics tools, crosstabs and chi square test to assess the relations between some of the variables under study. The results showed that mostly the information about DF comes from the internet, but the participants recognize that television might be a most suitable way to disseminate information about DF. The results also indicated differences between genders, levels of education, living environments and countries. The internet, the preferred source of information, got highest scores for Hungary, for urban areas, for university level of education and for female gender. The radio, the least scored source of information, was preferred in Egypt, for men and with lower education (primary school). As a conclusion, people get information through the internet due to easy access. However, it is to some extent a risk given the impossibility to control de information made public on the internet. The role of health centers and hospitals as well as schools should definitely be increased, as a responsible way to ensure correct information.

Sobreuso de analgésicos en pacientes con cefaleas primarias de un centro de referencia de Medellín

Introducción: Los pacientes con cefaleas primarias están predispuestos a desarrollar una cefalea secundaria al consumo excesivo de analgésicos. En nuestro medio, la adquisición fácil de medicamentos sin fórmula médica incrementa su frecuencia de presentación. Objetivo: Describir el perfil epidemiológico, clínico y de tratamiento de los pacientes con cefaleas primarias y cefalea secundaria por sobreuso de analgésicos atendidos en el programa especial de cefaleas del Instituto Neurológico de Colombia en el periodo 2014-2015. Pacientes y métodos: estudio descriptivo, retrospectivo. Se evaluaron características de la cefalea, comorbilidades, discapacidad y patrón de consumo de medicamentos. Resultados: Se incluyeron 834 pacientes con diagnóstico de cefalea por sobreuso de analgésicos, 85.1% con migraña crónica. El 87.6% de los pacientes eran mujeres y tenían 44 años en promedio. La mitad de los pacientes tomaba analgésicos todos los días de la semana (P25-P75: 4 – 7 días); consumiendo, en promedio, tres analgésicos/día (DE: 1.9). La mayoría de pacientes presentaba un consumo elevado de analgésicos simples (95.2%), AINES (92.2%) y analgésicos combinados (89.2%); 51% consumían opiodes y sólo 14.6% consumían triptanes. Conclusión: La identificación de esta cefalea secundaria es de vital importancia para un tratamiento adecuado. El uso medicamentos de libre venta afecta el manejo óptimo de esta entidad asociada a las cefaleas primarias, principalmente la migraña.

Clinical Accuracy of the MedGem Indirect Calorimeter for Measuring Resting Energy Expenditure in Cancer Patients

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

Tourism Destination Preferences: A Longitudinal Analysis of Consumer Decision Sets

There have only been a small number of applications of consumer decision set theory to holiday destination choice, and these studies have tended to rely on a single cross sectional snapshot of research participants’ stated preferences. Very little has been reported on the relationship between stated destination preferences and actual travel, or changes in decision set composition over time. The paper presents a rare longitudinal examination of destination decision sets, in the context of short break holidays by car in Queensland, Australia. Two questionnaires were administered, three months apart. The first identified destination preferences while the second examined actual travel and revisited destination preferences. In relation to the conference theme, there was very little change in consumer preferences towards the competitive set of destinations over the three month period. A key implication for the destination of interest, which, in an attempt to change market perceptions, launched a new brand campaign during the period of the project, is that a long term investment in a consistent brand message will be required to change market perceptions. The results go some way to support the proposition that the positioning of a destination into a consumer’s decision set represents a source of competitive advantage.

Does psychological stress mediate social deprivation in tooth loss?

It is unclear which theoretical dimension of psychological stress affects health status. We hypothesized that both distress and coping mediate the relationship between socio-economic position and tooth loss. Cross-sectional data from 2915 middle-aged adults evaluated retention of < 20 teeth, behaviors, psychological stress, and sociodemographic characteristics. Principal components analysis of the Perceived Stress Scale (PSS) extracted 'distress' (a = 0.85) and 'coping' (a =0.83) factors, consistent with theory. Hierarchical entry of explanatory variables into age- and sex-adjusted logistic regression models estimated odds ratios (OR) and 95% confidence intervals [95% CI] for retention of < 20 teeth. Analysis of the separate contributions of distress and coping revealed a significant main effect of coping (OR = 0.7 [95% CI = 0.7-0.8]), but no effect for distress (OR = 1.0 [95% CI = 0.9-1.1]) or for the interaction of coping and distress. Behavior and psychological stress only modestly attenuated socio-economic inequality in retention of < 20 teeth, providing evidence to support a mediating role of coping.

Investigating the links between muscle strength, sun exposure, dietary vitamin D intake and the vitamin D status of ambulatory older adults in South East Queensland

Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

A-REIT seasoned equity offerings : determinants and market reaction

The paper examines the decision by Australian Real Estate Trusts (A-REITs) to issue seasoned equity offerings from 2000 - 2008 and stock market reaction to the offerings using panel data and event study methodologies, respectively. The global financial crisis has resulted in freezing of the Australian bond markets, with several A-REITs left with seasoned equity issuance and asset sales as the only viable modes of raising additional capital. The findings review that leverage and operating risk are negative significant determinants of seasoned equity offerings; profitability and growth opportunities are positive significant determinants. Of the structure and type of properties held by the A-REIT, only stapled management structure and international operations are significant determinants. Type of properties held by A-REITs show inconsistent results. Similar to previous studies of seasoned equity offerings, we find a significant negative abnormal return associated with their announcement and no evidence of excessive leakage of information. Cross-sectional regressions show that the issued amount raised and leverage are significant factors affecting abnormal returns.

Benchmarking introductory accounting curricula : Experience from Australia

Within the context of debate about the state of accounting education in general, introductory accounting subjects have been the target of considerable criticism, particularly in terms of narrow content, technical focus, use of transmissive models of teaching, and inattention to the development of students‟ generic skills. This paper reports on the results of an exploratory study of these issues in introductory accounting and which involved the review of subject outlines and prescribed textbooks, and the conduct of a cross-sectional survey of the introductory accounting teaching coordinators in Australian universities (n=21). The primary aims of the study were to establish and apply benchmarks in evaluating existing curricula with respect to subject orientation, learning objectives, topics, teaching delivery, learning strategies, and assessment. The results of our study suggest that traditional approaches to subject content and delivery continue to dominate, with limited indicators of innovations to enhance the diversity and quality of learning experiences and learning outcomes.

Psychiatric disorder in HIV infection

Objective: This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. Method: A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIVt) (79 CDC stage 1 1/1 11 and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version lllR (DIS-IIIR). Results: Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuseldependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. Conclusions: Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men, In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis, The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.