The associations of vegetable consumption with food mavenism, personal values, food knowledge and demographic factors.

BACKGROUND: Poor dietary choices, in particular low consumption of fruits and vegetables are associated with the prevalence of diet related diseases. Ways to increase consumption are urgently required. This paper examines the associations of demographic, psychographic and food knowledge variables with reported vegetable consumption. METHODS: An online questionnaire was administered in late 2012 to a national sample 2146 Australians who were selected to represent the Australian population in terms of age, sex, education and location of residence. It was divided into sections which assessed food knowledge, food involvement, food mavenism, personal values and personality factors, demographic characteristics and reported consumption of 13 vegetables and the total number of servings of vegetables per day. Principal components analyses of the individual vegetable consumption ratings derived three forms of vegetable consumption scores. These and total serving per day were used as dependent variables in a structural equation model to identify pathways between them and their likely antecedents. MAJOR FINDINGS: Three types of vegetable consumption were formed:Salad vegetables (onion, tomato and lettuce);Dinner vegetables (carrot, peas and beans); and'Green' vegetables (cabbage, spinach broccoli and cauliflower). Food mavenism, food knowledge, food involvement and equality-universalist values mediated the relationships between demographics and conscientiousness and the vegetable consumption variables. CONCLUSIONS: The three types of vegetable consumption and total servings per day were associated with different antecedent pathways. The mediating roles of food mavenism, food knowledge, food involvement and equality-universalist values may present opportunities for health promotion and the horticultural industry to increase population vegetable intake. Further research is required to test these associations via experimental and longitudinal studies and qualitative investigation of the meaning and place of the three forms of vegetable consumption in people's daily lives is recommended.

Food concerns and support for environmental food policies and purchasing.

Consumer support for pro environmental food policies and food purchasing are important for the adoption of successful environmental policies. This paper examines consumers' views of food policy options as their predisposition to purchase pro environmental foods along with their likely demographic, educational and cognitive antecedents including food and environmental concerns and universalism values (relating to care for others and the environment). An online survey to assess these constructs was conducted among 2204 Australian adults in November 2011. The findings showed strong levels of support for both environmental food policies (50%-78% support) and pro environmental food purchasing (51%-69% intending to purchase pro environmental foods). Confirmatory factor analysis and structural equation modelling showed that different cognitive mediators exist along pathways between demographics and the two outcome variables. Support for food policy was positively related to food and environment concerns (std. Beta = 0.25), universalism (0.41), perceived control (0.07), and regulatory issues (0.64 but negatively with food security issues (-0.37). Environment purchasing intentions were positively linked to food and nutrition concerns (0.13), food and environment concerns (0.24), food safety concerns (0.19), food and animal welfare concerns (0.16), universalism (0.25), female gender (0.05), education (0.04), and perceived influence over the food system (0.17). In addition, health study in years 11 and 12 was positively related to the beginning of both of these pathways (0.07 for each). The results are discussed in relation to the opportunities that communications based on the mediating variables offer for the promotion of environmental food policies and purchasing.

Retirement patterns of Australian doctors aged 65 years and older.

OBJECTIVE: To investigate retirements over a 4-year period among Australian general practitioners (UPs) and specialists aged 65 years and over, and factors influencing retirement. METHODS: Data from Medicine in Australia: Balancing Employment and Life (MABEL) for the years 2009-12 were analysed for 435 GPs and 643 specialists aged 65 years and over at the time of entry to the MABEL survey. Discrete time survival analysis was used. RESULTS: The retirement rates were 4.1% (2009), 5.1% (2010), 4.2% (2011) and 10.4% (2012). Retirement was associated with: (1) the intention to leave medical work in 2009 and 2010; (2) working fewer hours in private consulting rooms in 2010 and 2012; (3) having lower job satisfaction in 2009 and 2011; (4) being older in 2009; (5) working fewer hours in a public hospital in 2012; and (6) working fewer hours in a private hospital in 2010. Doctors who intended to reduce their working hours were less likely to retire in 2009. CONCLUSIONS: Strategies to support doctors at the late career stage to provide their valued contributions to the medical workforce for as long as possible may include increasing job satisfaction and addressing barriers to reducing work hours.

Classification of main meal patterns--a latent class approach.

Relatively little examination of the meals that are prepared in households has been conducted, despite their well-defined properties and widespread community interest in their preparation. The purpose of the present study was to identify the patterns of main meal preparation among Australian adult household meal preparers aged 44 years and younger and 45 years and over, and the relationships between these patterns and likely socio-demographic and psychological predictors. An online cross-sectional survey was conducted by Meat and Livestock Australia among a representative sample of people aged 18­65 years in Australia in 2011. A total of 1076 usable questionnaires were obtained, which included categorical information about the main meal dishes that participants had prepared during the previous 6 months along with demographic information, the presence or absence of children at home, confidence in seasonal food knowledge and personal values. Latent class analysis was applied and four types of usage patterns of thirty-three popular dishes were identified for both age groups, namely, high variety, moderate variety, high protein but low beef and low variety. The meal patterns were associated differentially with the covariates between the age groups. For example, younger women were more likely to prepare a high or moderate variety of meals than younger men, while younger people who had higher levels of education were more likely to prepare high-protein but low-beef meals. Moreover, young respondents with higher BMI were less likely to prepare meals with high protein but low beef content. Among the older age group, married people were more likely to prepare a high or moderate variety of meals than people without partners. Older people who held strong universalist values were more likely to prepare a wide variety of meals with high protein but low beef content. For both age groups, people who had children living at home and those with better seasonal food knowledge were more likely to prepare a high variety of dishes. The identification of classes of meal users would enable health communication to be tailored to improve meal patterns. Moreover, the concept of meals may be useful for health promotion, because people may find it easier to change their consumption of meals rather than individual foods.

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.

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.

Is Blood Pressure Lowering in the Very Elderly With Previous Stroke Associated With a Higher Risk of Adverse Events?

Background We investigated whether blood pressure lowering for secondary prevention is associated with a reduction in recurrent stroke risk and/or a higher risk of adverse events in very elderly compared with younger trial participants. Methods and Results This is a random effects meta-analysis of randomized controlled trials of blood pressure lowering for secondary stroke prevention to evaluate age-stratified (<80, ≥80 years) risk of adverse events. Ovid-MEDLINE was searched for trials between 1970 and 2020. Summary-level data were acquired including outcomes of stroke, cardiovascular events, mortality, and adverse events. Seven trials were included comprising 38 596 participants, of whom 2336 (6.1%) were aged ≥80 years. There was an overall reduction in stroke risk in the intervention group compared with controls (risk ratio [RR], 0.90 [95% CI, 0.80, 0.98], I2=49%), and the magnitude of risk reduction did not differ by age subgroup (<80, ≥80 years). There was no increase in the risk of hypotensive symptoms in the intervention group for patients aged <80 years (RR, 1.19 [95% CI, 0.99], 1.44, I2=0%), but there was an increased risk in those ≥80 years (RR, 2.17 [95% CI, 1.22], 3.86, I2=0%). No increase was observed in the risk of falls, syncope, study withdrawal, or falls in either age subgroup. Conclusions Very elderly people in secondary prevention trials of blood pressure lowering have an increased risk of hypotensive symptoms, but with no statistical increase in the risk of falls, syncope, or mortality. However, evidence is lacking for frail elderly with multiple comorbidities who may be more vulnerable to adverse effects of blood pressure lowering.

Self-reported medication side effects in an older cohort living independently in the community--the Melbourne Longitudinal Study on Healthy Ageing (MELSHA): cross-sectional analysis of prevalence and risk factors.

BACKGROUND: Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community. METHODS: The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk. RESULTS: Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors. CONCLUSION: Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.

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.

Inhalation risk assessment of exposure to the selected volatile organic compounds (VOCs) emitted from the facilities of a steel plant.

Concentrations of volatile organic compounds (VOCs) were investigated in the workplace air of four processes: sintering, cokemaking, hot forming, and cold forming in an integrated iron and steel plant. In addition, the cancer risk was measured for workers in these 4 processes. Seven VOCs (chloroform, carbon tetrachloride, 1,1,2-trichloroethane, trichloroethylene, tetrachloroethylene, benzene, and ethylbenzene) were selected for cancer risk measurement. Trichloroethylene concentrations are high in the 4 processes, and carbon tetrachloride and tetrachloroethylene concentrations are high in both the cold and hot forming processes. The sequence of the total cancer risk of the 7 species was as follows: cokemaking > sintering > cold forming congruent with hot forming. About 66-93% of the cancer risk of the four processes was caused by trichloroethylene. The cancer risks (3.7 x 10(-3)-30 x 10(-3)) of the average VOC concentrations suggest that improvement of workplace air quality and protection of workers are necessary to reduce cancer risks.

Blood Pressure, Aortic Stiffness, Hemodynamics, and Cognition in Twin Pairs Discordant for Type 2 Diabetes.

BACKGROUND: Type 2 diabetes (T2D) is associated with an increased risk of cognitive impairment and dementia with poorly understood underlying mechanisms. OBJECTIVE: We examined the role of blood pressure (BP), aortic stiffness, and hemodynamics in this association. METHODS: Cross-sectional sample of late middle-aged twins discordant for T2D from the Australian Twin Registry. Measurements included neuropsychological battery and brain MRI including arterial spin labelling (ASL) to measure cerebral perfusion. Mobil-o-Graph devices were used to non-invasively obtain 24-hour BP, aortic stiffness, and hemodynamic measures. Using mixed modelling, we studied associations of T2D with cognition, MRI measures, BP, aortic stiffness, and hemodynamics. RESULTS: There were 23 twin pairs with mean age 63.7 (SD = 6.1) years. T2D (ß=-0.45, p < 0.001) and age (ß=-0.05, p = 0.022) were independently associated with poorer attention but not with memory or perceptual speed. T2D was associated with reduced nocturnal central systolic BP dipping (ß=-3.79, p = 0.027), but not with BP, aortic stiffness, cerebral perfusion, or other hemodynamic measures. There was a statistically significant interaction between T2D and central systolic BP dipping in predicting attention scores (both p < 0.05 for the interaction term) whereby there was a positive association between BP dipping and attention scores in those with T2D, but not in those without T2D. CONCLUSION: We found an association between T2D and reduced nocturnal central systolic dipping, but not with any other measures of BP, stiffness or hemodynamic measures. Further study of the role of nocturnal central BP dipping in the association between T2D and cognitive impairment may help identify potential mechanisms.

Social ideological influences on reported food consumption and BMI.

BACKGROUND: The purpose of this study was to investigate relationships between ideological beliefs, perceptions of the importance of health behaviours, health attitudes, food consumption, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action (Fishbein & Ajzen, 1975). METHODS: A survey was conducted among shoppers aged between 40 and 70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested with this empirical data (n = 410) for younger (n = 151) and older (n = 259) age groups using structural equation modelling. RESULTS: The findings generally support the study hypotheses. For both groups, egalitarianism had a direct and positive influence on perceptions of the importance of health behaviours. Materialism and masculinity impacted negatively on health attitudes, which positively influenced importance of health behaviours. Perceptions of importance of health behaviours impacted positively on the consumption of healthy foods such as vegetables and fruits, but negatively on consumption of unhealthy foods including sweets and fats. However, BMI was significantly influenced by the consumption of unhealthy foods (e.g., sugar and fats) only for the younger age group. Hence, the associations between beliefs, attitudes, consumption behaviours, and BMI outcomes differed between younger and older age populations. CONCLUSION: Social ideological beliefs appear to influence health attitudes and thereafter, the consumption of healthy and unhealthy foods and BMI via different pathways.

Factors associated with hospital mortality in critically ill patients with exacerbation of COPD.

Introduction: COPD is a leading cause of morbidity and mortality worldwide. Patients with COPD often require admission to intensive care units (ICU) during an acute exacerbation. Objective: This study aimed to identify the factors independently associated with hospital mortality in patients requiring ICU admission for acute exacerbation of COPD. Methods: Patients admitted to the ICU of Frankston Hospital between January 2005 and June 2016 with an admission diagnosis of COPD were retrospectively identified from ICU databases. Patients' comorbidities, arterial blood gas results, and in-patient interventions were retrieved from their medical records. Outcomes analyzed included hospital and ICU length of stay (LOS) and mortality. Results: A total of 305 patients were included. Mean age was 67.4 years. A total of 77% of patients required non-invasive ventilation; and 38.7% required invasive mechanical ventilation (IMV) for a median of 127.2 hours (SD =179.5). Mean ICU LOS was 4.5 days (SD =5.96), and hospital LOS was 11.6 days (SD =13). In-hospital mortality was 18.7%. Multivariate analysis revealed that patient age (odds ratio [OR] =1.06; 95% CI: 1.031-1.096), ICU LOS (OR =1.26; 95% CI: 1.017-1.571), Acute Physiology and Chronic Health Evaluation-II score (OR =1.07; 95% CI: 1.012-1.123), and requirement for IMV (OR =4.09; 95% CI: 1.791-9.324) to be significantly associated with in-hospital mortality. Conclusion: Patient age, requirement for IMV, and illness severity were associated with poor patient outcomes.

Comparison of alternative estimation methods in confirmatory factor analyses of the General Health Questionnaire.

This paper examines the implications of violating assumptions concerning the continuity and distributional properties of data in establishing measurement models in social science research. The General Health Questionnaire-12 uses an ordinal response scale. Responses to the GHQ-12 from 201 Hong Kong immigrants on arrival in Australia showed that the data were not normally distributed. A series of confirmatory factor analyses using either a Pearson product-moment or a polychoric correlation input matrix and employing either maximum likelihood, weighted least squares or diagonally weighted least squares estimation methods were conducted on the data. The parameter estimates and goodness-of-fit statistics provided support for using polychoric correlations and diagonally weighted least squares estimation when analyzing ordinal, nonnormal data.

Changes in Doctors' Working Hours: A Longitudinal Analysis.

The study examined changes in doctors' working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply.

Different patterns of Australian adults' knowledge of foods and nutrients related to metabolic disease risk.

A nationwide survey of 2022 consumers was conducted in Australia in late 2011. A short list of questions about knowledge of the nutrient composition of common foods was administered along with questions about the respondents' food attitudes, demographics, school education and dieting practices. Overall, the results showed that nutrition knowledge was relatively high. Latent class analysis showed two groups of consumers with 'high' and 'low' knowledge of nutrition. Higher knowledge was positively associated with age, female sex, university education, experience of home economics or health education at school, having a chronic disease, and attitudes to food issues, and negatively with type 1 diabetes or the use of diabetes-control diets. The implications of the findings for nutrition communication are discussed.

Patterns of food safety knowledge among Australians: a latent class approach.

This study aimed to examine food safety knowledge and its associations among Australians. An Internet-based nationwide survey of 2,022 consumers was conducted in 2011. Quota sampling was used to ensure that the age, gender, educational background, and state of residence of the respondents were representative of the Australian population. A list of 10 food safety knowledge items was administered along with questions about the respondents' food attitudes, demographics, school education, and diet practices. Overall, the results showed that safety knowledge was relatively poor. Latent class analysis identified two groups of respondents with different levels of food safety knowledge. Poor knowledge was negatively associated with age, the female gender, university education, experience of home economics or health education at school, the use of salt reduction diets, and general interest in food issues. The study's limitations and implications are discussed.