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To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time.
Design:
Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman’s correlations were used to achieve the study objectives.
Setting:
Central Illinois, USA.
Participants:
Participants were 468 children at 24, 36 and 48 months of age.
Results:
Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets.
Conclusion:
These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.
Depression is an important, potentially modifiable dementia risk factor. However, it is not known whether effective treatment of depression through psychological therapies is associated with reduced dementia incidence. The aim of this study was to investigate associations between reduction in depressive symptoms following psychological therapy and the subsequent incidence of dementia.
Methods
National psychological therapy data were linked with hospital records of dementia diagnosis for 119808 people aged 65+. Participants received a course of psychological therapy treatment in Improving Access to Psychological Therapies (IAPT) services between 2012 and 2019. Cox proportional hazards models were run to test associations between improvement in depression following psychological therapy and incidence of dementia diagnosis up to eight years later.
Results
Improvements in depression following treatment were associated with reduced rates of dementia diagnosis up to 8 years later (HR = 0.88, 95% CI 0.83–0.94), after adjustment for key covariates. Strongest effects were observed for vascular dementia (HR = 0.86, 95% CI 0.77–0.97) compared with Alzheimer's disease (HR = 0.91, 95% CI 0.83–1.00).
Conclusions
Reliable improvement in depression across psychological therapy was associated with reduced incidence of future dementia. Results are consistent with at least two possibilities. Firstly, psychological interventions to improve symptoms of depression may have the potential to contribute to dementia risk reduction efforts. Secondly, psychological therapies may be less effective in people with underlying dementia pathology or they may be more likely to drop out of therapy (reverse causality). Tackling the under-representation of older people in psychological therapies and optimizing therapy outcomes is an important goal for future research.
In its first national strategy on dementia, the Government of Canada has highlighted the need to improve quality of care for individuals living with dementia, with emphasis on following best practices and evidence in care delivery and providing care staff access to education and training. It is also known that the design of the physical environment of care homes is integral to the care experience of individuals living with dementia. Therefore, this study aims to identify the best national and international practices implemented in care homes for people living with dementia in: (1) education, training, staffing, and care practices; and (2) environmental design and physical infrastructure, through the review of relevant grey literature. This article highlights key recommendations for improving the quality of care for residents living with dementia in care homes, such as: (1) facilitating translation of training into practice, (2) maintaining consistent staffing levels, and (3) designing care homes to facilitate wayfinding, accessibility, safety, comfort, appropriate sensory stimulation, familiarity, and homelikeness. The findings from this review are expected to inform the development of guidelines for a provincial dementia-friendly care home designation program and various advocacy efforts to help achieve the objectives of the national strategy on dementia.
Paramedics Providing Palliative Care at Home was launched in two provinces, including a new clinical practice guideline, database, and paramedic training. The aim of this study was to evaluate patient/family satisfaction and paramedic comfort and confidence.
Methods
In Part A, we gathered perspectives of patients/families via surveys mailed at enrolment and telephone interviews after an encounter. Responses were reported descriptively and by thematic analysis. In Part B, we surveyed paramedics online pre- and 18 months post-launch. Comfort and confidence were scored on a 4-point Likert scale, and attitudes on a 7-point Likert scale, reported as the median (interquartile range [IQR]); analysis with Wilcoxon ranked sum/thematic analysis of free text.
Results
In Part A, 67/255 (30%) enrolment surveys were returned. Three themes emerged: fulfilling wishes, peace of mind, and feeling prepared for emergencies. In 18 post-encounter interviews, four themes emerged: 24/7 availability, paramedic professionalism and compassion, symptom relief, and a plea for program continuation. Thematic saturation was reached with little divergence. In Part B, 235/1255 (18.9%) pre- and 267 (21.3%) post-surveys were completed. Comfort with providing palliative care without transport improved post launch (p = < 0.001) as did confidence in palliative care without transport (p = < 0.001). Respondents strongly agreed that all paramedics should be able to provide basic palliative care.
Conclusions
After implementation of the multifaceted Paramedics Providing Palliative Care at Home Program, paramedics describe palliative care as important and rewarding. The program resulted in high patient/family satisfaction; simply registering provides peace of mind. After an encounter, families particularly noted the compassion and professionalism of the paramedics.
The present study explored associations between food choice motives, attitudes towards and intention to adopt personalised nutrition, to inform communication strategies based on consumer priorities and concerns.
Design/Setting
A survey was administered online which included the Food Choice Questionnaire (FCQ) and items assessing attitudes towards and intention to adopt personalised nutrition.
Subjects
Nationally representative samples were recruited in nine EU countries (n 9381).
Results
Structural equation modelling indicated that the food choice motives ‘weight control’, ‘mood’, ‘health’ and ‘ethical concern’ had a positive association and ‘price’ had a negative association with attitude towards, and intention to adopt, personalised nutrition. ‘Health’ was positively associated and ‘familiarity’ negatively associated with attitude towards personalised nutrition. The effects of ‘weight control’, ‘ethical concern’, ‘mood’ and ‘price’ on intention to adopt personalised nutrition were partially mediated by attitude. The effects of ‘health’ and ‘familiarity’ were fully mediated by attitude. ‘Sensory appeal’ was negatively and directly associated with intention to adopt personalised nutrition.
Conclusions
Personalised nutrition providers may benefit from taking into consideration the importance of underlying determinants of food choice in potential users, particularly weight control, mood and price, when promoting services and in tailoring communications that are motivationally relevant.
Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the ‘framework approach’ described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.
The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that tailored interventions such as those that could be delivered online can be effective in bringing about healthy dietary behaviour change. The present paper brings together evidence from qualitative and quantitative studies that have considered the public perspective of genomics, nutrigenomics and personalised nutrition, including those conducted as part of the EU-funded Food4Me project. Such studies have consistently indicated that although the public hold positive views about nutrigenomics and personalised nutrition, they have reservations about the service providers’ ability to ensure the secure handling of health data. Technological innovation has driven the concept of personalised nutrition forward and now a further technological leap is required to ensure the privacy of online service delivery systems and to protect data gathered in the process of designing personalised nutrition therapies.
Older people are vulnerable to zinc deficiency, which may impact upon their mood. This randomised, placebo-controlled, double-blind intervention study aimed to investigate the effect of oral zinc gluconate supplementation (15 mg/d; 30 mg/d; and placebo) on subjective mood (affect) in older Europeans.
Subjects
Healthy volunteers (n 387) aged 55–87 years were recruited.
Setting
Volunteers in Rome (Italy; n 108) and Grenoble (France; n 91) were aged 70–87 years and those in Coleraine (Northern Ireland; n 93) and Clermont-Ferrand (France; n 95) were aged 55–70 years.
Design
Mood was measured using the Positive and Negative Affect Scale on four occasions per day over 4 d at baseline, 3 and 6 months post-intervention.
Results
Mixed ANOVA indicated that neither positive nor negative affect altered in response to zinc (15 mg/d or 30 mg/d) compared to placebo in either the 55–70 years or the ≥70 years age group.
Conclusions
These results suggest that zinc does not benefit mood in healthy older people.
The growing population of seniors with disabilities experiences unmet support needs and loneliness. Although support deficiencies can be overcome by peers in support groups, most support groups are inaccessible to older adults with limited physical functioning. Accordingly, this project aimed to develop and test the impact of an accessible telephone support group intervention for seniors with disabilities. Six research questions guided the study. Four telephone support groups with five to six participants (n = 23) were created, each with a professional and a peer (senior) leader. The groups met once a week for 12 weeks. Qualitative analyses of the telephone transcripts and post-intervention interviews of participants and leaders revealed decreased support needs, diminished loneliness, and enhanced coping. Selection, training, and support of peer and professional leaders and member control of discussions were important ingredients of successful support groups.
Negative consumer opinion poses a potential barrier to the application of nutrigenomic intervention. The present study has aimed to determine attitudes toward genetic testing and personalised nutrition among the European public. An omnibus opinion survey of a representative sample aged 14–55+ years (n 5967) took place in France, Italy, Great Britain, Portugal, Poland and Germany during June 2005 as part of the Lipgene project. A majority of respondents (66 %) reported that they would be willing to undergo genetic testing and 27 % to follow a personalised diet. Individuals who indicated a willingness to have a genetic test for the personalising of their diets were more likely to report a history of high blood cholesterol levels, central obesity and/or high levels of stress than those who would have a test only for general interest. Those who indicated that they would not have a genetic test were more likely to be male and less likely to report having central obesity. Individuals with a history of high blood cholesterol were less likely than those who did not to worry if intervention foods contained GM ingredients. Individuals who were aware that they had health problems associated with the metabolic syndrome appeared particularly favourable toward nutrigenomic intervention. These findings are encouraging for the future application of personalised nutrition provided that policies are put in place to address public concern about how genetic information is used and held.
To explore the relationship between subjective mood, folate status and homocysteine in healthy individuals.
Design
Subjective mood assessments were completed twice daily over the course of one week using the Positive and Negative Affect Scale (PANAS). The PANAS is a validated scale which considers mood state on two distinct continua, one reflecting positive mood and the other negative mood, each requiring response to 10 adjectives on a Likert scale. A blood sample was taken on one occasion at the start of the week during which subjective mood was assessed and analysed for red-blood-cell (RBC) folate, serum folate and plasma homocysteine concentrations.
Subjects
Male volunteers aged 19–47 years (n = 58) were recruited from local industries.
Results
High concentrations of RBC folate were associated with less variability (lower standard deviation) in negative mood (P = 0.023). Subjective mood, however, was not related to serum folate or homocysteine.
Conclusions
This study appears to be the first to uncover an association between long-term folate status and subjective mood (employing the PANAS) in healthy males. More research is needed to further explore the relationship between nutritional status and mood.
A large-scale study of complex wh-questions with 1,000 subjects aged 4–9 years is reported. The subjects' dialects were Mainstream American English or African American English, and approximately one-third were language impaired. The study examined when children permit long distance wh-movement, and when they respect a variety of syntactic barriers to movement. Thirteen different structures were compared, and the results suggest that typically developing children and disordered children at all the ages studied are capable of long-distance movement and obedience to abstract barriers. In no case was dialect a significant factor in the children's linguistic performance on these tasks.
Taste acuity declines with age and may be dependent upon Zn status. The aim of the present double-blind, randomised controlled intervention trial has been to determine taste acuity in response to Zn supplementation (placebo, or 15 or 30 mg Zn/d). Healthy older European adults aged 70–87 years were recruited within Italy (Rome) (n 108) and France (Grenoble) (n 91) to the European Commission-funded Zenith project. A signal detection theory approach was adopted for taste assessment. The data were converted to R indices and analysed by repeated-measures ANOVA controlling for baseline taste acuity as well as serum and erythrocyte Zn. Serum Zn increased post-intervention, indicating compliance with the intervention. Results differed across geographical region. Salt taste acuity was greater in response to Zn (30 mg) than placebo post-intervention among those recruited in Grenoble. There was no apparent change in acuity for sweet, sour or bitter taste in response to Zn. Supplemented Zn may have potential to enhance salt taste acuity in those over the age of 70 years. Further research is required to determine if enhanced salt taste acuity is reflected in the eating experiences of older individuals.
Metabolic syndrome (MS) is more common among socio-economically disadvantaged individuals and is associated with certain risky lifestyle practices. MS also appears to be triggered by adverse social circumstances and chronic stress. The present paper reviews accumulating evidence to imply that individuals who have certain personality and behaviour traits are particularly predisposed to develop MS, and brings together theories that relate to possible psychological mechanisms underlying MS. It considers how such factors might interact causally to encourage the development of MS. As part of the EU-funded LIPGENE Integrated Project, multi-level modelling will be undertaken to explore potential pathways to MS, taking into consideration the interplay between a range of psycho-social, demographic, cultural and lifestyle factors thought to contribute to the development of MS. Data will be gathered for this purpose from a representative sample of >50-year-olds living in Britain (n 1000) and Portugal (n 500). It is anticipated that this information will assist in the development and targetting of future intervention to prevent and treat MS in the normal population.
A randomised double-blind placebo-controlled design was employed to investigate the effects of Zn supplementation on cognitive function in 387 healthy adults aged 55–87 years. Several measures of visual memory, working memory, attention and reaction time were obtained using the Cambridge Automated Neuropsychological Test Battery at baseline and then after 3 and 6 months of 0 (placebo), 15 or 30 mg Zn/d. Younger adults (<70 years) performed significantly better on all tests than older adults (>70 years), and performance improved with practice on some measures. For two out of eight dependent variables, there were significant interactions indicating a beneficial effect (at 3 months only) of both 15 and 30 mg/d on one measure of spatial working memory and a detrimental effect of 15 mg/d on one measure of attention. Further work is required to establish whether these findings generalise to older adults in poorer mental and physical health and with less adequate Zn intake and status than the present sample.