Prescription and over-the-counter pain medication in arthritis: awareness of active ingredients and attitudes to medication borrowing and sharing

Background:
Many Australians with arthritis self-manage their pain with prescription and/or over-the-counter pain medications, containing paracetamol. If taken appropriately, these medications are relatively safe; however, if mismanaged through patients' iinability to understand medication labels and instructions, these medications may cause adverse drug events and/or toxicities.
Aim:
This study explored the prescription and over-the-counter pain medications most commonly used by people with arthritis and the ability of these patients to correctly identify paracetamol as an active ingredient in commonly available preparations. The study also investigated the functional health literacy of these patients and their inclination to borrow and/or share pain medications.
Method:
Adult participants diagnosed with arthritis were invited to complete an anonymous survey which included questions about their prescription and over-the-counter pain medications; their medication borrowing and sharing behaviours; their functional health literacy; and their knowledge about preparations containing paracetamol as an active ingredient.
Results:
Most of the 254 participants used analgesic agents containing paracetamol, as combination tablets (paracetamol 500 mg and codeine 30 mg) or paracetamol-only tablets (paracetamol 665 mg) to self-manage their pain. Respondents with low functional health literacy scores were significantly less likely to identify paracetamol as an active ingredient in both combination and paracetamol-only pharmaceutical products, and were more likely to guess or did not know how to identify that paracetamol was an active ingredient in these products. Almost 30% of the respondents indicated that they had and/or intended to borrow/share their over-the-counter
pain medications whereas less than 10% suggested that they had and/or intended to borrow/share their prescription pain medication.
Conclusion:
Australians with arthritis, especially those with low functional health literacy scores, self-managing their pain with paracetamol-containing products, do not always recognise paracetamol as an active ingredient in combination products, and may risk potential paracetamol-related adverse effects and/or toxicities.

Factor structure and measurement invariance of the Health Education Impact Questionnaire: does the subjectivity of the response perspective threaten the contextual validity of inferences?

Objective:
On-going evidence is required to support the validity of inferences about change and group differences in the
evaluation of health programs, particularly when self-report scales requiring substantial subjectivity in response generation are used as outcome measures. Following this reasoning, the aim of this study was to replicate the factor structure and investigate the measurement invariance of the latest version of the Health Education Impact Questionnaire, a widely used health program evaluation measure.
Methods:
An archived dataset of responses to the most recent version of the English-language Health Education Impact
Questionnaire that uses four rather than six response options (N=3221) was analysed using exploratory structural equation
modelling and confirmatory factor analysis appropriate for ordered categorical data. Metric and scalar invariance were
studied following recent recommendations in the literature to apply fully invariant unconditional models with minimum
constraints necessary for model identification.
Results:
The original eight-factor structure was replicated and all but one of the scales (Self Monitoring and Insight) was
found to consist of unifactorial items with reliability of ⩾0.8 and satisfactory discriminant validity. Configural, metric and scalar
invariance were established across pre-test to post-test and population sub-groups (sex, age, education, ethnic background).
Conclusion:
The results support the high level of interest in the Health Education Impact Questionnaire, particularly for use as a pre-test/post-test measure in experimental studies, other pre–post evaluation designs and system-level monitoring and evaluation.

Development and validation of the awareness of narrative identity questionnaire (ANIQ)

The utility of a narrative approach to identity and its role in psychological functioning are becoming increasingly recognized across various fields of inquiry. The current study aimed to develop a quantitative, self-report measure of the awareness of narrative identity and how globally coherent one's autobiographical memories are perceived to be, specifically, in terms of temporal ordering, causal associations, and the perception of unifying themes. The construct validity and reliability of the Awareness of Narrative Identity Questionnaire (ANIQ) were assessed across three studies. In the first study, exploratory factor analysis of the responses of a large sample (N = 441, M [age in years] = 33.1, SD = 15.2) to an initial item pool resulted in a 20-item four-factor structure congruent with the proposed subscales, and convergent and divergent validity were established. In the second study, and with a different sample (N = 320, M [age in years] = 26.2, SD = 4.0), further evidence for the factor structure was provided through confirmatory factor analysis. Validity findings from Study 1 were replicated and extended on, and test-retest reliabilities were found to be high (r = .72-.79). Importantly, in the third study (N = 71, M [age in years] = 24.9, SD = 6.9), criterion validity was established, whereby the ANIQ subscales were demonstrated to be associated with dimensions of narrative coherence coded from written turning-point narratives. Across all studies, the internal reliabilities for the subscales were high (α = .86-.96). The ANIQ represents a valid, psychometrically sound, and novel method of assessing the awareness of narrative identity and autobiographical memory coherence.

Predictors of awareness of standard drink labelling and drinking guidelines to reduce negative health effects among Australian drinkers

INTRODUCTION AND AIMS: This study examined rates of awareness of standard drink labelling and drinking guidelines among Australian adult drinkers. Demographic predictors of these two outcomes were also explored.

DESIGN AND METHODS: Online survey panel participants aged 18-45 years(n = 1061; mean age = 33.2 years) completed an online survey assessing demographics, alcohol consumption patterns, awareness of standard drink labels and the National Health and Medical Research Council (NHMRC) guidelines, and support for more detailed labels.

RESULTS: The majority (80%) of participants had seen standard drink labels on alcohol products; with younger drinkers, those from a regional/rural location and high-risk drinkers significantly more likely to have seen such labelling. Most respondents estimated at or below the maximum number of drinks stipulated in the NHMRC guidelines. However, their estimates of the levels for male drinkers were significantly higher than for female drinkers. High-risk drinkers were significantly less likely to provide accurate estimates, while those who had seen the standard drink logo were significantly more likely to provide accurate estimates of drinking levels to reduce the risk of long-term harms only. Just under three-quarters of respondents supported the inclusion of more information on labels regarding guidelines to reduce negative health effects.

DISCUSSION AND CONCLUSIONS: The current standard drink labelling approach fails to address high-risk drinkers. The inclusion of information about NHMRC guidelines on alcohol labels, and placing standard drink labelling on the front of products could improve awareness of what constitutes a standard drink and safe levels of consumption among Australian drinkers.

Feasibility of conducting a randomized trial to promote healthy eating, active play and sustainability awareness in early childhood curricula

We sought to evaluate the feasibility of conducting a randomized trial to evaluate the efficacy of a preschool/kindergarten curriculum intervention designed to increase 4-year-old children's knowledge of healthy eating, active play and the sustainability consequences of their food and toy choices. Ninety intervention and 65 control parent/child dyads were recruited. We assessed the study feasibility by examining recruitment and participation, completion of data collection, realization of the intervention and early childhood educators’ experiences of implementing the study protocol; our findings suggest the intervention was feasible to deliver. In addition, children's sustainability awareness of non-compostable and recyclable items increased. Children in the intervention group significantly reduced their sugary drink consumption and increased their vegetable intake at follow-up compared to control. We conclude with recommendations for revisions to the child interview and parent questionnaire delivery to ensure the roll out of the randomized trial is conducted efficiently and rigorously.

Awareness of nutrition problems among Vietnamese health and education professionals.

Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals.

A review of the game-centred approaches to teaching and coaching literature since 2006

Background: In 2006, Oslin and Mitchell published a review of the game-centred approaches (GCAs) to teaching and coaching literature highlighting a number of core concepts thought to provide justification for the use of GCAs including (a) its potential to enhance participant motivation, (b) potential for tactical transfer, and (c) development of decision-making skills and effective decision-makers. Oslin and Mitchell also suggested recommendations for future GCA research.Purpose: The purpose of this paper was threefold: (a) to present a review of Anglophone research into GCAs building on the previous review of Oslin and Mitchell published in 2006; (b) to identify new trends in research since 2006; and (c) to investigate the extent to which the initial suggestions and future research directions suggested by Oslin and Mitchell have been addressed.Data collection: GCA literature since 2006 was searched systematically using a three-phase approach. Phase 1 included initial searches of the EBSCO database using terms associated with GCAs and their acronyms (e.g. TGfU (teaching games for understanding), GS (Game Sense), etc.). Phase 2 expanded the search adopting more generic terms from keywords located in the recent literature (e.g. teaching games, tactical development, game performance, etc.). Multiple searches through the EBSCO database were conducted, whereby key terms were cross-referenced until a saturation point was reached. Phase 3 involved removing those publications that were not empirical, peer reviewed, intervention studies or published in English.Findings: Forty-four studies on GCA implementation were identified and the methodological and substantive nature of these studies was examined. The review noted two positive trends: (a) the expansion of research which included the growth of research on GCAs in Europe and Southeast Asia and (b) an increased amount of research in the affective domain. The review found, however, that a number of key challenges remain within GCA research, which include (a) the need for improved articulation of GCA verification procedures; (b) further assessment of tactical awareness development; (c) extended inquiry about GCAs in coaching contexts; (d) more research into ‘newer’ GCAs (i.e. PP (play practice), IGCM (invasion game competence model) and TDLM (tactical decision learning model)); (e) use of longitudinal research designs; (f) inadequate length of GCA induction and training for teachers and coaches, and (g) examination of GCAs in terms of fitness and special populations.Conclusions: GCA pedagogies are of significant importance as they have the potential to promote change within current adult-centric cultures of youth sport and encourage engagement in physical activity over the life course. To meet these needs, it is recommended that GCA research undergo continued expansion with the use of research designs and data collection techniques that aid the examination of different philosophical understandings of GCAs (e.g. ethnographic, phenomenological and psycho-phenomenological). These are paramount to the exploration of ‘who the individual is’ and ‘how the learner is motivated to continue to participate’ and further permit the in-depth, contextual and ecological analysis of GCA interventions that Oslin and Mitchell recommended in their previous review.

Contextual determinants of intrusions and obsessions: The role of ego-dystonicity and the reality of obsessional thoughts

The current study aimed to investigate whether lack of evidence for the potential reality of the intrusion and ego-dystonicity are contextual determinants of unwanted intrusive thoughts and clinical obsessions. To this end, a total 248 non-clinical participants were asked to report an intrusion they had experienced as well as the context in which the intrusion arose. Utilizing this information, three independent clinicians rated these intrusions on ego-dystonicity and whether the intrusion had occurred with or without any evidence for its potential reality. Results showed that ego-dystonicity and lack of evidence for the intrusions were related, but distinct constructs. In particular, intrusions that occurred without evidence were significantly associated with higher levels of self-reported OC symptoms and related cognitive domains, whereas ego-dystonicity was not related to OC symptoms. Overall, the results are consistent with the notion that abnormal intrusions occur without evidence in the here-and-now, whereas normal intrusions do not. Intrusions that have no evidence to back them up, yet occur without any apparent cause, may be particularly likely to invite further negative cognitive processing, over-interpretation and control attempts. Implications for further research and treatment are discussed.

Developing a measure to understand young children’s internet cognition and cyber-safety awareness: a pilot test

Advancements in technology have increased preschool children’s access to the Internet. Very little research has been conducted to identify pre-school-aged children’s understandings of the Internet and ramifications of being ‘online’. Without an understanding of children’s thinking about the Internet, it is difficult to provide age and pedagogically appropriate cyber-safety education. This study developed and pilot-tested an interview schedule that focuses on the Internet thinking and cyber-safety awareness of Australian children aged 4–5 years. The schedule is informed by sociocultural theory, cyber-safety education research and approaches for researching with young children. The schedule shows potential to elicit children’s understandings of the Internet and cyber-safety awareness. Adjustments are required to allow more contextualised responses from children.

Neural correlates of impaired self-awareness of apathy, disinhibition and dysexecutive deficits in cocaine-dependent individuals

Cocaine addiction is characterized by impaired self-awareness about cognitive and motivational deficits, leading to poor treatment outcomes. However, there is still limited understanding of the neurophysiological underpinnings of this impairment. We aimed to establish if impaired self-awareness is underpinned by brain structural phenotypes among cocaine-dependent individuals (CDI). Sixty-five CDI and 65 designated informants completed the Frontal Systems Behavior Scale, and a subsample of 40 CDI were scanned via magnetic resonance imaging. We applied multiple regression models to establish the association between levels of self-awareness indexed by Frontal Systems Behavior Scale's discrepancy scores (i.e. informant ratings minus self-reports of apathy, disinhibition and dysexecutive deficits) and gray matter volumes indexed by magnetic resonance imaging voxel-based measures within five brain regions of interest: anterior cingulate cortex, orbitofrontal cortex (OFC), striatum, insula and dorsolateral prefrontal cortex (DLPFC). We also examined the neural underpinnings of underestimation versus overestimation of deficits, by splitting the CDI group according to the positive or negative value of their discrepancy scores. We found that poorer self-awareness of apathy deficits was associated with greater gray matter volume in the dorsal striatum, and poorer self-awareness of disinhibition deficits was associated with greater gray matter volume in the OFC in the whole sample. More underestimation and more overestimation of executive deficits were linked to lower DLPFC volume. We show that impaired self-awareness of cognitive and motivational deficits in cocaine addiction has a neural underpinning, implicating striatum, OFC and DLPFC structural phenotypes.

Validation de l’échelle de mesure de la conscience de l’environnement d’affaires

La conscience de l’environnement d’affaires est définie comme l’ensemble des savoirs détenus par les employés non-cadres par rapport à l’environnement d’affaires interne et externe de leur organisation. Elle se manifeste lorsque l’employé est impliqué dans la prise de décision ou résolution de problème affectant l’entreprise. Ce travail a comme objectifs la validation d’une échelle de mesure du concept à l’étude, ainsi que la vérification de sa validité de construit et nomologique. L’ensemble initial d’items de l’échelle de mesure a été déterminé suite à des entrevues avec les employés d’organisations participantes (Gauvreau-Jean, 2008). L’ensemble initial de 40 items a été testé avec un échantillon de 508 employés d’une manufacture. Suite à des ajustements, l’échelle modifiée couvre quatre dimensions du construit. L’adéquation de son contenu a ensuite été mise à l’épreuve par deux groupes cibles et deux évaluations expertes (Lessard, 2014). Finalement, dans le cadre de notre étude, la validité du contenu et nomologique de l’échelle modifiée (contenant 24 items) a été testée avec 330 employés de première ligne de quatre entreprises. Les quatre dimensions du construit furent supportées, la fiabilité de l’échelle était haute, puis les hypothèses reliant la conscience de l’environnement avec les caractéristiques au travail, l’évaluation de la performance par un superviseur et l’engagement affectif furent supportées également. Un autre sondage complété par les gestionnaires (n=43) avait comme but une évaluation de la performance contextuelle des employés supervisés. Le développement de l’échelle à 24 items sur la conscience de l’environnement d’affaires pourrait répondre aux questions portant sur la participation de l’employé et l’efficacité organisationnelle.

Ejecuciones capitales en Libro de Apolonio como estrategia de adecuación contextual

El Libro de Apolonio, compuesto en la primera mitad del siglo XIII en el marco del Mester de Clerecía, retoma la historia del Rey de Tyro directamente desde una versión de Historia Apollonii Regis Tyri y adapta las peripecias del héroe al contexto histórico y cultural del siglo XIII castellano, especialmente en el diseño de los personajes y de los espacios. En este sentido se ha señalado que, como consecuencia de su intencionalidad didáctica-escolar, el autor anónimo cifra en su reelaboración saberes propios del círculo escolar y de la corte, contextos para los cuales la obra habría sido compuesta. Dentro de los pasajes elaborados, centramos nuestra atención sobre las ejecuciones de los antagonistas, el rufián que regentea el burdel de Mitalena y los falsos amigos Estrángilo y su esposa Dionisia. La reelaboración de las escenas responde a discusiones sobre materia legal que estaban siendo llevadas a cabo en la corte castellana a mediados del siglo XIII. Así como el poema cifra conocimientos escolares contemporáneos y contextualiza la narración al entorno de los agentes participantes, escritor y público previsto, también adapta las secuencias legales al marco legal castellano, conservando de esta manera la importancia que las escenas legales poseen en la fuente latina

Ejecuciones capitales en Libro de Apolonio como estrategia de adecuación contextual

El Libro de Apolonio, compuesto en la primera mitad del siglo XIII en el marco del Mester de Clerecía, retoma la historia del Rey de Tyro directamente desde una versión de Historia Apollonii Regis Tyri y adapta las peripecias del héroe al contexto histórico y cultural del siglo XIII castellano, especialmente en el diseño de los personajes y de los espacios. En este sentido se ha señalado que, como consecuencia de su intencionalidad didáctica-escolar, el autor anónimo cifra en su reelaboración saberes propios del círculo escolar y de la corte, contextos para los cuales la obra habría sido compuesta. Dentro de los pasajes elaborados, centramos nuestra atención sobre las ejecuciones de los antagonistas, el rufián que regentea el burdel de Mitalena y los falsos amigos Estrángilo y su esposa Dionisia. La reelaboración de las escenas responde a discusiones sobre materia legal que estaban siendo llevadas a cabo en la corte castellana a mediados del siglo XIII. Así como el poema cifra conocimientos escolares contemporáneos y contextualiza la narración al entorno de los agentes participantes, escritor y público previsto, también adapta las secuencias legales al marco legal castellano, conservando de esta manera la importancia que las escenas legales poseen en la fuente latina

Validation de l’échelle de mesure de la conscience de l’environnement d’affaires

La conscience de l’environnement d’affaires est définie comme l’ensemble des savoirs détenus par les employés non-cadres par rapport à l’environnement d’affaires interne et externe de leur organisation. Elle se manifeste lorsque l’employé est impliqué dans la prise de décision ou résolution de problème affectant l’entreprise. Ce travail a comme objectifs la validation d’une échelle de mesure du concept à l’étude, ainsi que la vérification de sa validité de construit et nomologique. L’ensemble initial d’items de l’échelle de mesure a été déterminé suite à des entrevues avec les employés d’organisations participantes (Gauvreau-Jean, 2008). L’ensemble initial de 40 items a été testé avec un échantillon de 508 employés d’une manufacture. Suite à des ajustements, l’échelle modifiée couvre quatre dimensions du construit. L’adéquation de son contenu a ensuite été mise à l’épreuve par deux groupes cibles et deux évaluations expertes (Lessard, 2014). Finalement, dans le cadre de notre étude, la validité du contenu et nomologique de l’échelle modifiée (contenant 24 items) a été testée avec 330 employés de première ligne de quatre entreprises. Les quatre dimensions du construit furent supportées, la fiabilité de l’échelle était haute, puis les hypothèses reliant la conscience de l’environnement avec les caractéristiques au travail, l’évaluation de la performance par un superviseur et l’engagement affectif furent supportées également. Un autre sondage complété par les gestionnaires (n=43) avait comme but une évaluation de la performance contextuelle des employés supervisés. Le développement de l’échelle à 24 items sur la conscience de l’environnement d’affaires pourrait répondre aux questions portant sur la participation de l’employé et l’efficacité organisationnelle.