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Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
To examine differences in noticing and use of nutrition information comparing jurisdictions with and without mandatory menu labelling policies and examine differences among sociodemographic groups.
Design:
Cross-sectional data from the International Food Policy Study (IFPS) online survey.
Setting:
IFPS participants from Australia, Canada, Mexico, United Kingdom and USA in 2019.
Participants:
Adults aged 18–99; n 19 393.
Results:
Participants in jurisdictions with mandatory policies were significantly more likely to notice and use nutrition information, order something different, eat less of their order and change restaurants compared to jurisdictions without policies. For noticed nutrition information, the differences between policy groups were greatest comparing older to younger age groups and comparing high education (difference of 10·7 %, 95 % CI 8·9, 12·6) to low education (difference of 4·1 %, 95 % CI 1·8, 6·3). For used nutrition information, differences were greatest comparing high education (difference of 4·9 %, 95 % CI 3·5, 6·4) to low education (difference of 1·8 %, 95 % CI 0·2, 3·5). Mandatory labelling was associated with an increase in ordering something different among the majority ethnicity group and a decrease among the minority ethnicity group. For changed restaurant visited, differences were greater for medium and high education compared to low education, and differences were greater for higher compared to lower income adequacy.
Conclusions:
Participants living in jurisdictions with mandatory nutrition information in restaurants were more likely to report noticing and using nutrition information, as well as greater efforts to modify their consumption. However, the magnitudes of these differences were relatively small.
The transition from residency to paediatric cardiology fellowship is challenging due to the new knowledge and technical skills required. Online learning can be an effective didactic modality that can be widely accessed by trainees. We sought to evaluate the effectiveness of a paediatric cardiology Fellowship Online Preparatory Course prior to the start of fellowship.
Methods:
The Online Preparatory Course contained 18 online learning modules covering basic concepts in anatomy, auscultation, echocardiography, catheterisation, cardiovascular intensive care, electrophysiology, pulmonary hypertension, heart failure, and cardiac surgery. Each online learning module included an instructional video with pre-and post-video tests. Participants completed pre- and post-Online Preparatory Course knowledge-based exams and surveys. Pre- and post-Online Preparatory Course survey and knowledge-based examination results were compared via Wilcoxon sign and paired t-tests.
Results:
151 incoming paediatric cardiology fellows from programmes across the USA participated in the 3 months prior to starting fellowship training between 2017 and 2019. There was significant improvement between pre- and post-video test scores for all 18 online learning modules. There was also significant improvement between pre- and post-Online Preparatory Course exam scores (PRE 43.6 ± 11% versus POST 60.3 ± 10%, p < 0.001). Comparing pre- and post-Online Preparatory Course surveys, there was a statistically significant improvement in the participants’ comfort level in 35 of 36 (97%) assessment areas. Nearly all participants (98%) agreed or strongly agreed that the Online Preparatory Course was a valuable learning experience and helped alleviate some anxieties (77% agreed or strongly agreed) related to starting fellowship.
Conclusion:
An Online Preparatory Course prior to starting fellowship can provide a foundation of knowledge, decrease anxiety, and serve as an effective educational springboard for paediatric cardiology fellows.
Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers.
Design:
Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and ‘High-in’ Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics.
Setting:
Online survey in 2018 among participants from Australia, Canada, Mexico, United Kingdom (UK) and United States.
Participants:
Adults (≥18 years, n 22 140).
Results:
Compared with control, HIWL had the greatest impact in lowering perceived healthfulness (β from −0·62 to −1·71) across all countries. The HIWL and the HSR had a similar effect in Australia. Other labels were effective in decreasing the perceived healthfulness of the drink within some countries only, but to a lower extent. The GDA did not reduce perceived healthfulness in most countries. In the UK, the effect of HIWL differed by age group, with greater impact among older participants (> 40 years). There were no other variations across key demographic characteristics.
Conclusions:
HIWL, which communicates clear, non-quantitative messages about high levels of nutrients of concern, demonstrated the greatest efficacy to decrease the perceived healthfulness of a sweetened fruit drink across countries. This effect was similar across demographic characteristics.
To examine awareness and recall of healthy eating public education campaigns in five countries.
Design:
Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country.
Setting:
Online surveys.
Participants:
Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and the USA (n 22 463).
Results:
Odds of campaign awareness were higher in Mexico (50·9 %) than UK (18·2 %), Australia (17·9 %), the USA (13·0 %) and Canada (10·2 %) (P < 0·001). Awareness was also higher in UK and Australia v. Canada and the USA, and the USA v. Canada (P < 0·001). Overall, awareness was higher among males v. females and respondents with medium or high v. low education (P < 0·001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P > 0·05), and age was associated with campaign awareness in UK (P < 0·001). Common keywords in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico).
Conclusions:
In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.
This collection of essays by some of the most distinguished historians and literary scholars in the English-speaking world explores the overlap, interplay, and interaction between history and fiction in British imaginative and historical writing from the Tudor period to the Enlightenment. The historians discuss the questions of truth, fiction, and the contours of early modern historical culture, while the literary scholars consider some of the fictional aspects of history, and the historical aspects of fiction, in prose narratives of many sorts. The interests and inquiries of these learned, imaginative, and venturesome scholars cross at many points, casting significant light on and offering numerous insights into the problematic and interdisciplinary areas where 'history' and 'story' meet, interact, and sometimes compete. Despite the theoretical questions posed, the discussions primarily focus on concrete works, including those of Thomas More, John Foxe, Thomas Hobbes, Adam Smith, and Edward Gibbon.
Craig Muldrew has written an imaginatively conceived and richly researched study of the meaning and practice of “credit” in early modern England. “Credit” today is understood almost exclusively in value-neutral terms, and applies principally to functional economic activities. Directed towards individuals, it refers primarily to their financial assets and their capacities to assume interest-bearing debt. This meaning was only entering into use in the later sixteenth century; it became common only in the later seventeenth. “Credit” in the medieval and early modern era referred paradigmatically to a person's moral worth, as this book abundantly demonstrates.
an island nation is, commonly, a seafaring one, dependent for much of its way of life on seaborne enterprise. As Charles Lloyd put it in 1659 during the last Protectorate parliament, in which sat Scottish and Irish as well as English and Welsh members, ‘[w]e are islanders, and our life and soul is traffic’. The existence of a seafaring nation turns in large measure on the history of its ports, great and small – their relations with the rural hinterlands which satisfy their needs for food and labour and serve as important markets for their products and services; the multi-faceted roles they play in the nation’s network of urban places, the fiscal and military resources they supply to the state; and the services they provide in trade and communication with the cultures and civilisations lying over the water.
As island nations, early modern England, Wales and Scotland were simultaneously protected by the sea from potential continental enemies and points of passage. It is the tension between these two aspects of island life – the capacity of island peoples to withdraw behind the moat created by the seas surrounding them and their need to cross those same waters to find markets and supplies – that mark island nations as socially distinctive places. How their inhabitants negotiate this relationship and find a balance among its competing elements forms a defining feature of their society and culture. In early modern England, Wales and Scotland, the emphasis was increasingly on market-oriented enterprise and commercial exchange, thereby enhancing the dynamic role played by seaports.
“History” and “story” are derived from the same root, and they have converged again in modern times, especially through the recognition of their common dependence on imagination. Both history and literature are forms of cultural memory, and in this respect, too, they have a link with imagination. Historians pretend to recapture the past in all its fullness, but in fact they are bound by the limits and conventions of narrative prose. Nor can literary artists, even the most “classic” among them, remain free of the toils of history; for as Shelley admitted, “this is an influence which neither the meanest scribbler nor the sublimest genius of any era can escape.”
Since antiquity the ars historica and the ars poetica were sister genres, with overlapping issues and similar values. From the time of Cicero and Quintilian the art of history has made claims on truth, but like poetry, it has also aimed at beauty, or pleasure (voluptas), and goodness, or utility (utilitas). In more recent times, too, the realization of such a common pedigree and such common purposes has reinforced the ties between historians and literary scholars and opened further what has been called “the open boundary of history and fiction.” As historians have come to recognize the aesthetic dimension of their craft and the necessity to resort to imagination to fill in gaps in the narrative, so literary scholars are acknowledging the historicity of literature, its value as a reflection of bygone worlds not recoverable through conventional documents, and the use of literary criticism for the interpretation of such documentation.