Energy density,diet quality,and central body fat in a nationwide survey of young Spaniards

ObjectivesTo determine the impact of energy density on diet quality and anthropometric proxy measures for central body fat in young Spaniards.MethodsData were obtained from a representative national sample of 2513 young Spaniards aged 10 to 24 y. Dietary assessment was performed with a 24-h recall. Adherence to the Mediterranean diet was measured by the KIDMED index. Reduced rank regression analysis was used to identify energy-density dietary patterns. Waist circumferences and height were measured.ResultsPastries and sausages showed the strongest loading for the dietary energy density factor score (DED-FS), with fruits and vegetables at the opposite end of the scale. Multiple linear regression analysis showed a positive association (P < 0.01) of dietary energy density (DED) and the DED-FS with waist circumferences regressed on height and age (WC_height+age) and waist-to-height ratio (WHtR). The adjusted odds ratio for elevated WC_height+age and WHtR increased across quartile distribution of DED (P < 0.001) and DED-FS (P < 0.05). Diet quality characterized by the KIDMED index was negatively associated (P < 0.001) with DED and the DED-FS.ConclusionsHigher DED is a risk for increased central fat distribution and is associated with low adherence to the Mediterranean diet.     

The critical appraisal of focus group research articles

Objectives: To determine whether the three mailings routinely used by researchers for epidemiological surveys are useful and appropriate, by comparing social characteristics and selected disease histories to find out if there are differences between individuals responding at different times.

Methods: Social characteristics and selected disease histories of 11,797 British women still under general practitioner observation in the Royal College of General Practitioners' Oral Contraception Study were compared. The women aged 40-78 at December 1992 were sent health survey questionnaires via their general practitioners between November 1994 and July 1995.

Results: Significant differences in the characteristics of first, second and third mailing respondents and non-respondents were found for smoking habits, social class, parity, area of residence, further contact, bronchitis, hysterectomy and mental illness. First mailing respondents were more likely to be from a non-manual social class, have a parity of less than three, live in England, and be happy to be contacted again, but were less likely to have had bronchitis or mental illness and were less likely to have been smokers at the time of recruitment than second mailing respondents. A comparison of second and third mailing respondents on the above factors showed no significant differences between the two groups.

Conclusions: The inclusion of third mailing respondents did not significantly change the social or health characteristic profile of the cohort and suggests that the effort and resources expended in carrying out a third mailing may not be justified.     

Using Personal Digital Assistants in post-conflict health surveys: Potential and constraints

Abstract

Compared to their counterparts in wealthier nations, managers and front-line health care workers in non-industrialised countries make more limited use of information technology to assist their decision-making. This is particularly true in conflict-affected countries, which tend to be even poorer, and have a greater scarcity of infrastructure and qualified personnel, than other developing countries. At the same time, more stakeholders are recognising the potential of electronic information management in resource-poor settings, as well as the value of investing in conflict-affected countries more generally. We present here the experience of the International Rescue Committee (IRC) with the use of handheld personal digital assistants (PDAs) for health surveys in conflict-affected sub-Saharan African countries, and discuss lessons learned and potential for further development of this tool. The use of PDAs for surveys has lowered costs, made data available for analysis much faster, and reduced errors. Conflict-specific obstacles, such as insecurity, have not proven to be a significant barrier to PDA use in practice. There have also been limitations. Using PDAs requires survey managers to have some technical proficiency, and PDAs are less helpful for qualitative surveys. Overall, the experience has been positive, and we have found PDAs to be equally appropriate in conflict-affected countries as in other settings. We recommend taking several steps to prevent problems and extend benefits, including using checklists and memory cards to simplify the process, and taking advantage of the same PDAs for other purposes beyond surveys, including supervision, quality assurance, and routine data entry. Finally, it is important to note that PDA use does not dispense survey organisers from the usual principles of good survey implementation.     

Burden of Noncommunicable Diseases and National Strategies to Control Them in Korea

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.     

Sodium Intakes of US Children and Adults from Foods and Beverages by Location of Origin and by Specific Food Source

Sodium intakes, from foods and beverages, of 22,852 persons in the National Health and Nutrition Examination Surveys (NHANES 2003–2008) were examined by specific food source and by food location of origin. Analyses were based on a single 24-h recall. Separate analyses were conducted for children (6–11 years of age), adolescents (12–19), and adults (20–50 and ≥51 years). Grouping of like foods (e.g., food sources) used a scheme proposed by the National Cancer Institute, which divides foods/beverages into 96 food subgroups (e.g., pizza, yeast breads or cold cuts). Food locations of origin were stores (e.g., grocery, convenience and specialty stores), quick-service restaurant/pizza (QSR), full-service restaurant (FSR), school, or other. Food locations of sodium were also evaluated by race/ethnicity amongst adults. Stores provided between 58.1% and 65.2% of dietary sodium, whereas QSR and FSR together provided between 18.9% and 31.8% depending on age. The proportion of sodium from QSR varied from 10.1% to 19.9%, whereas that from FSR varied from 3.4% to 13.3%. School meals provided 10.4% of sodium for 6–11 year olds and 6.0% for 12–19 year olds. Pizza from QSR, the top away from home food item, provided 5.4% of sodium in adolescents. QSR pizza, chicken, burgers and Mexican dishes combined provided 7.8% of total sodium in adult diets. Most sodium came from foods purchased in stores. Food manufacturers, restaurants, and grocery stores all have a role to play in reducing the amount of sodium in the American diet.     

Logging residue assessment by line intersect sampling

Line intersect sampling is applied in various aspects of forest management. One of the more common applications is to estimate the quantity of logging residue remaining on the ground following harvesting operations. The estimate of residue quantity can be used to develop residue models for yield prediction and to monitor harvesting operations to ensure prescribed utilisation levels are achieved. The application of line intersect sampling to quantifying logging residue has not always been as efficient as may be desired.

Alternatives to the traditional application of the method have been developed using regular polygons with odd numbers of sides and circular sample lines. These shapes are more robust in overcoming the bias in the orientation of logging residue. Monte Carlo simulation was used to develop a model to predict the sample size required to achieve a specified precision of the estimate of residue for nine-sided polygonal (nonagonal) sample lines. Budget functions derived from time studies of logging residue assessment trials provide the basis for planning assessment programs. The improved method is applied to radiata pine (Pinus radiata D.Don) plantations managed in South Australia by Primary Industries South Australia (PISA) Forestry and CSR Softwoods.     

Children’s responses towards alcohol in virtual reality: associations between parental alcohol use,drinking selections and intentions to drink

This article examines public opinion in US alcohol policies during the 1990s and their correlates in 2000, using five national telephone surveys. Trend analyses of public opinion on 11 common alcohol policies is presented and factor‐based policy scales, based on 14 items in 2000, are used to examine demographic correlates of support for various policy areas, using bivariate, linear (OLS) and logistic regression analyses. With the exception of the alcohol warning label policy, national support for alcohol policies declined (eight policies) or was unchanged in the 1990s for 11 measured policies. In 2000, four meaningful policy opinion factors were found with adequate reliabilities (αs 0.65–0.75) for three of four derived scales. In 2000, support for specific policies varies. Warnings on labels and advertisements have highest support (>90%), then interventions like prevention, treatment, and responsible beverage service at 70% (with similar levels seen for improving access to treatment). Alcohol controls show varied, but lower support from 25% (raising minimum drinking age further), to above 60% for banning sales in corner stores; only about a third favor higher alcohol taxes (35%) and more restrictive hours of sale (32%). In general, women and those with lower socio‐economic status show higher alcohol policy support. Multivariate results show heavier drinkers are least supportive of alcohol policy, while ethnic minorities, especially Hispanics are more favorable to alcohol controls and raising alcohol taxes. Since evidence‐based alcohol control policies show mixed, but lower public support than treatment, prevention and consumer warnings, there is a need for community‐based strategies to increase awareness of environmentally orientated alcohol policies and their public health benefits.     

Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame

Lymphatic filariasis (LF) is an important public health problem endemic in 73 countries, where it is a major cause of acute and chronic morbidity and a significant impediment to socioeconomic development. It is targeted for elimination by 2020, through preventive chemotherapy using albendazole in combination with either ivermectin or diethylcarbamazine citrate. Preventive chemotherapy enables the regular and coordinated administration of safe, single-dose medications delivered through mass drug administration (MDA). Many countries are now scaling down MDA activities after achieving 100% geographic coverage and instituting monitoring and evaluation procedures to establish the impact of several consecutive rounds of MDA and determine if transmission has been interrupted. At the same time, countries yet to initiate MDA for elimination of LF will adopt improved mapping and coverage assessment protocols to accelerate the efforts for achieving global elimination by 2020. This review provides an update on treatment for LF and describes the current global status of the elimination efforts, transmission control processes and strategies for measuring impact and continuing surveillance after MDA has ceased.