Gastric adenocarcinoma presenting with thromboembolism in a 13-year-old boy.

Abdominal pain is a frequent complaint in the pediatric emergency department. A 13-year-old boy presented with complaints of abdominal pain, hematemesis, headache, and leg pain. Further investigation revealed an advanced-stage gastric adenocarcinoma with multiple thromboembolism including the greater saphenous vein and nonbacterial thrombotic endocarditis. This case points out the challenges of diagnosing this rare condition and treating the primary tumor and thromboembolism in the setting of both hypercoagulable state and gastrointestinal bleeding.

Similar but different. Health behaviour pathways differ between men and women.

The purpose of the study was to examine middle to older aged Australians' healthy eating, eating out, and physical activity behaviours and to investigate their relationships with likely antecedents such as demographics, personal values, health background, and attention to weight and health habits. A mail survey was conducted among a random sample of men and women aged between 38 and 79 years; 1105 usable questionnaires were obtained. Structural equation modelling was used to examine relationships between the variables. The results showed that there were distinct relationships between predictive variables and behavioural and BMI outcomes for men and women. For example, healthy eating, eating out behaviours were positively associated with body weight for women but not men while attention to weight and health habits was positively related to hedonism values for women but not for men. The interrelationships among the predictors and the outcome variables appear to be more complex for women than men. The implications of the findings for nutrition communication are discussed.

The relationships between eating habits, smoking and alcohol consumption, and body mass index among baby boomers.

The study was to examine the eating habits of baby boomers and to investigate the relationship of these and other lifestyle habits on their reported body mass indices (BMI). A questionnaire was administered by mail to a random sample of people aged 40 years and above, drawn from the Electoral Rolls in Victoria, Australia. Part of the questionnaire contained questions about the respondents' eating habits, smoking status and alcohol use, as well as self reported heights and weights and demographic characteristics. Eight hundred and forty-four people (out of 1470) returned usable questionnaires. Statistically significant differences were found between the eating habits of men and women. Generally, more women snacked on high energy dense foods (e.g., confectionery). More men took larger mouthfuls than women. The eating habits of women appeared to be more formal than men's. Four constructs named: unconstrained eating, traditional eating style, gulping, and chocolate and junk food were derived from the eating behaviour literature. Structural equation modelling showed that eating behaviour was associated with BMI along with current smoking, ex-smoking status, alcohol consumption, and demographics. Eating habits and other lifestyle behaviours appear to be associated with BMI though in different pathways for men and women.

Impact of living arrangements and nationality on food habits and nutrient intakes in young adults.

The influence of living arrangements and nationality on nutrient intakes and food habits and beliefs were explored in young adults. Two hundred and thirty-two participants (20.4±2.8 years) completed a food questionnaire and two 24-h food records. Sixty-nine percent were living at home, and 72% described their nationality as Australian. Most participants performed their own food preparation (84%); those living away from home were significantly more likely to purchase and prepare their meals than those living at home, and no differences were observed between nationalities. The importance of healthy eating behaviours was recognised by over 80% of participants, with no differences observed between living arrangements or nationalities. Those living away from home and those who identified themselves as Australian consumed significantly more alcoholic drinks than those living at home and non-Australians. Eighty-four percent perceived their diets as healthy, however high saturated fat (13.4±3.9% energy) and sodium (2382±1166mg) and low fibre (23±9g) diets were consumed. Overall, few differences were observed between nationalities indicating assimilation of food cultures. Future interventions need to address the disconnect between nutrition knowledge and behaviour, irrespective of living arrangements and need to be appropriate for a range of nationalities.

Investigation of population heterogeneity of diet use among middle-aged Australians.

The purpose of the study was to determine patterns of diet use among middle-aged Australian men and women and the relationships between these different usage patterns and demographic characteristics, health status and health habits. A cross-sectional mail survey was conducted among a random sample of 2975 people aged 40-71 years in Victoria, Australia. A total of 1031 usable questionnaires were obtained which included information about the use of diets (e.g. low-fat and low-salt) during the past 3 months along with demographic information, health status and health habits. Based on the responses about the use of thirteen diets for both sexes, latent class analysis was employed to identify the optimal number of use of diets and the assignment of participants to particular groups. Three types of diet uses were identified and provisionally named: diet use, selected diet use and non-diet use. This classification was associated with demographics, health status and health habits, and these associations differed between men and women. The findings suggest that nutrition education programmes should be tailored to the different needs of the diet use groups.

Baby boomers' food shopping habits. Relationships with demographics and personal values.

The purpose of this study was to examine baby boomers' food shopping behaviours and to investigate their relationships with demographics and personal values. A questionnaire concerning food shopping behaviours, personal values and demographics was mailed to a random sample of 2975 people aged 40-70 years in Victoria, Australia. Usable questionnaires of 1031 were obtained. Structural equation modelling was employed for data analyses. The analyses revealed that demographics and personal values influenced shopping behaviours via different pathways among male and female baby boomers. For example, self-direction positively impacted on shopping planning for men but negatively influenced price minimization for women. Among women only, age was positively related to shopping planning and negatively to price minimization. Thus, both personal values and demographics influenced baby boomers' shopping behaviours. Since values are more likely to be amenable to change than demographics, segmentation of the population via value orientations would facilitate targeted interventions to promote healthy food shopping.

Max: concern with social skills, language and excessive TV viewing in a 3 year old.

CASE: Max is a 3-year-old healthy boy who was brought to the pediatrician's office by his mother for frequent temper tantrums at home. His teachers at the Montessori school are concerned about his communication skills. He is very talkative with his peers, but he constantly speaks about Thomas the Tank Engine. His peers seem to be uninterested in his repetitive stories. His teachers believe that Max has difficulty separating fantasy and reality. At home, his mother describes Max as "difficult to control." When placed in time-out, he hits, kicks and scratches his mother. He has a large vocabulary, but mostly speaks in phrases directly from cartoons. For example, he repeats a particular phrase from a program in which the main character grows in size with fury every time he gets angry and says, "I hate it, leave me alone." Before this exposure, the mother reports that her son had never used the word "hate." Max watches 5 hours of children's programs on television every day; he is not exposed to any news programs. Frequently, he watches the same episode of a program many times. Max's mother believes that he can watch as much TV as he wants as long as it is "good programming," so he only watches PBS kids shows and the Disney channel.

Does food planning mediate the association between living arrangements and fruit and vegetable consumption among women aged 40 years and older?

The objective of this paper was to investigate whether food planning strategies mediate the association between living arrangements and fruit and vegetable consumption amongst women aged 40 years and over. A community sample of 473 women aged 40 years and over from metropolitan Melbourne, Australia, provided survey data on their living arrangements, education, fruit and vegetable consumption and the amount of food planning they undertake. Fruit and vegetable consumption was significantly higher amongst women who lived with others compared to those living alone. Food planning was found to mediate the association between living arrangements and fruit consumption by 8% and vegetable consumption by 13%. This study provides evidence of a mediating effect of food planning on the relationship between living arrangements and fruit and vegetable consumption. With the ageing of the population increasing the potential for a rise in the number of single-occupant households, identifying ways of helping individuals to plan their food purchasing and preparation may increase fruit and vegetable intake.

Women's work. Maintaining a healthy body weight.

This study describes women's perceptions of the supports and barriers to maintaining a healthy weight among currently healthy weight women from urban and rural socio-economically disadvantaged areas. Using focus groups and interviews, we asked women about their experiences of maintaining a healthy weight. Overwhelmingly, women described their healthy weight practices in terms of concepts related to work and management. The theme of 'managing health' comprised issues of managing multiple responsibilities, time, and emotions associated with healthy practices. Rural women faced particular difficulties in accessing supports at a practical level (for example, lack of childcare) and due to the gendered roles they enacted in caring for others. Family background (in particular, mothers' attitudes to food and weight) also appeared to influence perceptions about healthy weight maintenance. In the context of global increases in the prevalence of obesity, the value of initiatives aimed at supporting healthy weight women to maintain their weight should not be under-estimated. Such initiatives need to work within the social and personal constraints that women face in maintaining good health.

Understanding the older food consumer. Present day behaviours and future expectations.

The main aim of this study was to determine whether Baby boomers know how they would manage to maintain a healthy diet on lower incomes in retirement. A cross-sectional survey was conducted at two shopping centres in Melbourne, Australia with 352 respondents. Contingency table analyses (using chi-square tests) were used to examine differences in present and future cooking habits between gender, age and socio-economic groups as well as anticipated changes to food shopping if they had less money in the future. The findings suggest that the most common food preparation behaviours were making meals from scratch ingredients (approximately 80% of participants) or using a combination of fresh and convenience foods (approximately 55% of participants), with socio-economic and demographic factors significantly influencing specific behaviours. Nearly 50% responded that if they had reduced income they would make a change to their food shopping habits. The most common changes were to the types of food purchased and seeking out special offers or cheaper brands. The results suggest that when faced with a lower standard of living, people will make changes to their food consumption habits. The challenge facing health promotion practitioners, is to ensure that these changes are well informed, leading to healthy options.

Is the perception of time pressure a barrier to healthy eating and physical activity among women?

OBJECTIVES: To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity. DESIGN: A cross-sectional survey of food intake, physical activity and perceived causes of time pressure. SETTING: A randomly selected community sample. SUBJECTS: A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity. RESULTS: Time pressure was reported as a barrier to healthy eating by 41% of the women and as a barrier to physical activity by 73%. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently. CONCLUSIONS: Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women's food and physical activity behaviours.

Retirement planning and expectations of Australian babyboomers: are they ready to retire?

The "babyboomer" generation, those who were born between 1946 and 1965, account for over 30% of the population in Australia, and it is no surprise that the government is concerned about the financial implications for future healthcare costs. While many babyboomers are more financially secure than previous generations have been on account of compulsory superannuation contributions made over the past 15 years, there are still some who are financially vulnerable and expect to rely on government pensions and welfare assistance. Changes to family structures and job security also mean that those who are less financially secure will need social support. Using an ecological framework model, we explored the retirement expectations and experiences of some Australian babyboomers through focus groups and individual interviews to identify key issues and their plans to address these issues. Four main themes are reported in this paper: retirement attitudes and expectations, finances, health, and food. The results suggested that for many persons retirement equated freedom. Little future planning was undertaken for retirement other than contributing to superannuation schemes, and expectations were reported in general terms, such as wanting to remain independent and healthy and to have time to socialize and travel.

Insulin sensitivity in the offspring of women with type 1 and type 2 diabetes.

OBJECTIVE: To determine if insulin sensitivity is altered in prepubertal offspring exposed to a diabetic intrauterine environment. RESEARCH DESIGN AND METHODS: Fifteen control children, 17 offspring of type 1 diabetic women, and 10 offspring of type 2 diabetic women, aged between 5 and 10 years, underwent a frequently sampled intravenous glucose tolerance test (FSIGTT). Weight and height were measured, and body composition was calculated using bioelectrical impedance. Bergman's minimal model was applied to the glucose and insulin measurements to obtain values for insulin sensitivity (Si), acute insulin response (AIR), and glucose effectiveness (Sg). RESULTS: Si was lowest in the offspring of type 2 diabetic mothers, and AIR was highest in this group, although neither of these changes reached significance (Si, P = 0.2, and AIR, P = 0.3). Offspring of type 2 diabetic mothers had higher BMI SD scores (P = 0.004) and percentage fat mass (P = 0.002) than the children in the other two groups. The BMI SD score and percentage fat mass in the subjects, as well as maternal insulin dose, were negatively correlated with offspring insulin sensitivity. CONCLUSIONS: Intrauterine exposure to hyperglycemia by itself was not associated with alterations in glucose regulation in prepubertal offspring. Children of mothers with type 2 diabetes, however, were overweight, and they had a tendency for a reduced Si. The combined effect of genetic and postnatal environmental factors, rather than prenatal exposure to hyperglycemia, may place this group at risk for developing impaired glucose tolerance in later life.