We assessed the evidence for a conceptual "hierarchy of effects" of marketing, to guide understanding of the relationship between children's exposure to unhealthy food marketing and poor diets and ...overweight, and drive the research agenda. We reviewed studies assessing the impact of food promotions on children from MEDLINE, Web of Science, ABI Inform, World Health Organization library database, and The Gray Literature Report. We included articles published in English from 2009 to 2013, with earlier articles from a 2009 systematic review. We grouped articles by outcome of exposure and assessed outcomes within a framework depicting a hierarchy of effects of marketing exposures. Evidence supports a logical sequence of effects linking food promotions to individual-level weight outcomes. Future studies should demonstrate the sustained effects of marketing exposure, and exploit variations in exposures to assess differences in outcomes longitudinally.
In this review paper, we aim to describe the potential for, and the key challenges to, applying PES projects to mangroves. By adopting a “carbocentric approach,” we show that mangrove forests are ...strong candidates for PES projects. They are particularly well suited to the generation of carbon credits because of their unrivaled potential as carbon sinks, their resistance and resilience to natural hazards, and their extensive provision of Ecosystem Services other than carbon sequestration, primarily nursery areas for fish, water purification and coastal protection, to the benefit of local communities as well as to the global population. The voluntary carbon market provides opportunities for the development of appropriate protocols and good practice case studies for mangroves at a small scale, and these may influence larger compliance schemes in the future. Mangrove habitats are mostly located in developing countries on communally or state-owned land. This means that issues of national and local governance, land ownership and management, and environmental justice are the main challenges that require careful planning at the early stages of mangrove PES projects to ensure successful outcomes and equitable benefit sharing within local communities.
Abstract Early childhood is a critical period for the development of fundamental movement skills (FMS). Children who do not master FMS are more likely to experience failure in the motor domain and ...less likely to participate in sport and games during childhood and adolescence. Studies among primary school aged children report low levels of FMS mastery indicating the need to implement FMS programs during the preschool years. Cross-sectional study of 425 children attending preschools in the Sydney, Australia in 2008. FMS were assessed using the Test of Gross Motor Development-2 including locomotor (run, gallop, hop, horizontal jump) and object control (strike, catch, kick overhand throw) skills. Data were analysed using linear regression and chi-squared analyses. Total locomotor score was higher among girls compared with boys ( p < 0.00); however only the hop was significantly different ( p = 0.01). Boys had higher total ( p < 0.00) and individual object control scores compared with girls, except the catch ( p = 0.6). The prevalence of mastery differed across each FMS. Girls generally had higher mastery of locomotor skills and boys had higher mastery of object control skills. These findings highlight the need to provide structured opportunities which facilitate children's acquisition of FMS, which may include providing gender separated games, equipment and spaces. That mastery of FMS is low in primary school children indicates the importance of early intervention programs in preschools. Preschools and child care centers hold promise as a key setting for implementing FMS programs.
Although guidelines recommend in-person counseling before BRCA1/BRCA2 gene testing, genetic counseling is increasingly offered by telephone. As genomic testing becomes more common, evaluating ...alternative delivery approaches becomes increasingly salient. We tested whether telephone delivery of BRCA1/2 genetic counseling was noninferior to in-person delivery.
Participants (women age 21 to 85 years who did not have newly diagnosed or metastatic cancer and lived within a study site catchment area) were randomly assigned to usual care (UC; n = 334) or telephone counseling (TC; n = 335). UC participants received in-person pre- and post-test counseling; TC participants completed all counseling by telephone. Primary outcomes were knowledge, satisfaction, decision conflict, distress, and quality of life; secondary outcomes were equivalence of BRCA1/2 test uptake and costs of delivering TC versus UC.
TC was noninferior to UC on all primary outcomes. At 2 weeks after pretest counseling, knowledge (d = 0.03; lower bound of 97.5% CI, -0.61), perceived stress (d = -0.12; upper bound of 97.5% CI, 0.21), and satisfaction (d = -0.16; lower bound of 97.5% CI, -0.70) had group differences and confidence intervals that did not cross their 1-point noninferiority limits. Decision conflict (d = 1.1; upper bound of 97.5% CI, 3.3) and cancer distress (d = -1.6; upper bound of 97.5% CI, 0.27) did not cross their 4-point noninferiority limit. Results were comparable at 3 months. TC was not equivalent to UC on BRCA1/2 test uptake (UC, 90.1%; TC, 84.2%). TC yielded cost savings of $114 per patient.
Genetic counseling can be effectively and efficiently delivered via telephone to increase access and decrease costs.
Policies restricting children's exposure to unhealthy food marketing have been impeded by the lack of evidence showing a direct link between food advertising exposure and children's energy intake and ...body weight. Food advertising exposure increases children's immediate food consumption, but whether this increased intake is compensated for at later eating occasions is not known; consequently the sustained effect on diets remains unclear.
We conducted a within-subject, randomised, crossover, counterbalanced study across four, six-day holiday camps in New South Wales, Australia between April 2016 and January 2017. Children (7-12 years, n = 160) were recruited via local schools, email networks and social media. Two gender- and age-balanced groups were formed for each camp (n = 20), randomised to either a multiple- or single- media condition and exposed to food and non-food advertising in an online game and/or a television cartoon. Children's food consumption (kilojoules) was measured at a snack immediately after exposure and then at lunch later in the day. Linear mixed models were conducted to examine relationships between food advertising exposure and dietary intake, taking into account gender, age and weight status.
All children in the multiple-media condition ate more at a snack after exposure to food advertising compared with non-food advertising; this was not compensated for at lunch, leading to additional daily food intake of 194 kJ (95% CI 80-308, p = 0.001, d = 0.2). Exposure to multiple-media food advertising compared with a single-media source increased the effect on snack intake by a difference of 182 kJ (95% CI 46-317, p = 0.009, d = 0.4). Food advertising had an increased effect among children with heavier weight status in both media groups.
Online ('advergame') advertising combined with TV advertising exerted a stronger influence on children's food consumption than TV advertising alone. The lack of compensation at lunch for children's increased snack intake after food advertising exposure suggests that unhealthy food advertising exposure contributes to a positive energy-gap, which could cumulatively lead to the development of overweight.
Australian New Zealand Clinical Trials Registry, number ACTRN12617001230347 (Retrospectively registered).
Objective To compare mortality in children <5 years of age with sickle cell disease (SCD) in Jamaica, a resource-limited country, diagnosed by newborn screening and managed in a comprehensive care ...facility, to that of the general population. Study design The study was carried out at the Sickle Cell Unit in Kingston, Jamaica. We determined the status (dead/alive) at age 5 years in a cohort of 548 children with SCD diagnosed by newborn screening and managed at the Sickle Cell Unit during the period November 1995 to December 2009. The standardized mortality ratio was calculated using World Health Organization life tables for reference mortality. Results Eight deaths (1.5%) occurred in children <5 years of age during the study period. The mean age at death was 2.0 ± 1.5 years. The overall mortality incidence in children <5 years of age was 3.1 (95% CI 1.6, 6.2) per 1000 person-years with a standardized mortality ratio of 0.52 (95% CI 0.3, 1.0). Conclusions Mortality in children <5 years of age with SCD diagnosed at birth and managed at a comprehensive care clinic in Jamaica is equivalent to that of the general population. Children with SCD, a highly vulnerable population, can be effectively managed, even in resource-limited environments.
Objective To assess the feasibility of a problem-solving skills training intervention in improving psychological outcomes in mothers of infants with sickle cell disease (SCD). Design and methods This ...parallel randomized controlled trial recruited 64 babies with SCD, 6 to 12 months of age, and their mothers. Baseline measurements assessed mothers' coping and problem-solving skills, depression, and parental stress before random assignment to intervention or control groups (n = 32 each). Problem-solving skills intervention was delivered through 6 monthly sessions, when babies attended for routine penicillin prophylaxis. All measurements were repeated for both groups at the end of the intervention period. Intention to treat analysis used repeated measures mixed models with the restricted estimation maximum likelihood approach. Results The problem-solving intervention had no significant effect on mothers' problem-solving skills (adjusted treatment effect: -1.69 points (95% CI:-5.62 to 2.25)), coping behaviours (adjusted treatment effect: 0.65 points (95% CI:- -7.13 to 8.41)) or depressive symptoms (adjusted treatment effect: -0.41 (95% CI: -6.00 to 5.19)). It reduced mothers' level of difficulty in managing stressful events by 9.5 points (95% CI (-16.86 to -2.16); effect size: 0.21 SD). In the subgroup of mothers at risk of depression (n = 31 at baseline), the intervention reduced depression scores with treatment effect of 10.4 points (95%CI: -18.83 to -1.88; effect size: 0.67 SD). Conclusion This problem-solving skills intervention study suggests feasibility and possible efficacy in improving some maternal outcomes. Further refinement and culturally appropriate adaptations of the intervention could lead to stronger effects.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Citation of research in policy documents has been suggested as an indicator of the potential longer-term impacts of research. We investigated the use of research citations in childhood obesity ...prevention policy documents from New South Wales (NSW), Australia, considering the feasibility and value of using research citation as a proxy measure of research impact.
We examined childhood obesity policy documents produced between 2000 and 2015, extracting childhood obesity-related references and coding these according to reference type, geographical origin and type of research. A content analysis of the policy documents examined where and how research was cited in the documents and the context of citation for individual research publications.
Over a quarter (28%) of the policy documents (n = 86) were not publicly available, almost two-thirds (63%) contained references, half (47%) cited obesity-related research and over a third (41%) of those containing references used unorthodox referencing styles, making reference extraction laborious. No patterns, in terms of the types of documents more likely to cite research, were observed and the number of obesity research publications cited per document was highly variable. In total, 263 peer-reviewed and 94 non-peer-reviewed obesity research publications were cited. Research was most commonly cited to support a policy argument or choice of solution. However, it was not always possible to determine how or why individual publications were cited or whether the cited research itself had influenced the policy process. Content analysis identified circumstances where research was mentioned or considered, but not directly cited.
Citation of research in policy documents in this case did not always provide evidence that the cited research had influenced the policy process, only that it was accessible and relevant to the content of the policy document. Research citation across these public health policy documents varied greatly and is unlikely to be an accurate reflection of actual research use by the policy agencies involved. The links between citation and impact may be more easily drawn in specific policy areas or types of documents (e.g. clinical guidelines), where research appraisal feeds directly into policy recommendations.
Early childhood services have been identified as a key setting for promoting healthy eating and physical activity as a means of preventing overweight and obesity. However, there is limited evidence ...on effective nutrition and physical activity programs in this setting. The purpose of this study was to evaluate Munch and Move, a low-intensity, state-wide, professional development program designed to support early childhood professionals to promote healthy eating and physical activity among children in their care.
The evaluation involved 15 intervention and 14 control preschools (n = 430; mean age 4.4 years) in Sydney, New South Wales, Australia and was based on a randomised-control design with pre and post evaluation of children's lunchbox contents, fundamental movement skills (FMS), preschool policies and practices and staff attitudes, knowledge and confidence related to physical activity, healthy eating and recreational screen time.
At follow up, FMS scores for locomotor, object control and total FMS score significantly improved by 3.4, 2.1 and 5.5 points more (respectively) in the intervention group compared with the control group (P < 0.001) and the number of FMS sessions per week increased by 1.5 (P = 0.05). The lunchbox audit showed that children in the intervention group significantly reduced sweetened drinks by 0.13 serves (i.e., 46 ml) (P = 0.05).
The findings suggest that a low intensity preschool healthy weight intervention program can improve certain weight related behaviours. The findings also suggest that change to food policies are difficult to initiate mid-year and potentially a longer implementation period may be required to determine the efficacy of food policies to influence the contents of preschoolers lunchboxes.
Measuring the policy and practice impacts of research is becoming increasingly important. Policy impacts can be measured from two directions - tracing forward from research and tracing backwards from ...a policy outcome. In this review, we compare these approaches and document the characteristics of studies assessing research impacts on policy and the policy utilisation of research.
Keyword searches of electronic databases were conducted in December 2016. Included studies were published between 1995 and 2016 in English and reported methods and findings of studies measuring policy impacts of specified health research, or research use in relation to a specified health policy outcome, and reviews reporting methods of research impact assessment. Using an iterative data extraction process, we developed a framework to define the key elements of empirical studies (assessment reason, assessment direction, assessment starting point, unit of analysis, assessment methods, assessment endpoint and outcomes assessed) and then documented the characteristics of included empirical studies according to this framework.
We identified 144 empirical studies and 19 literature reviews. Empirical studies were derived from two parallel streams of research of equal size, which we termed 'research impact assessments' and 'research use assessments'. Both streams provided insights about the influence of research on policy and utilised similar assessment methods, but approached measurement from opposite directions. Research impact assessments predominantly utilised forward tracing approaches while the converse was true for research use assessments. Within each stream, assessments focussed on narrow or broader research/policy units of analysis as the starting point for assessment, each with associated strengths and limitations. The two streams differed in terms of their relative focus on the contributions made by specific research (research impact assessments) versus research more generally (research use assessments) and the emphasis placed on research and the activities of researchers in comparison to other factors and actors as influencers of change.
The Framework presented in this paper provides a mechanism for comparing studies within this broad field of research enquiry. Forward and backward tracing approaches, and their different ways of 'looking', tell a different story of research-based policy change. Combining approaches may provide the best way forward in terms of linking outcomes to specific research, as well as providing a realistic picture of research influence.
PDF
