Although social housing provides access to safe and affordable housing, recent studies have found that social housing tenants consistently have lower levels of health and well-being compared to other ...people. Given this, there is a need to examine multimorbidity for social housing tenants.
Secondary data analysis of the 2017-18 Australian National Health Survey (n = 14,327) compared the health of adults residing in social housing compared to people in other housing types (private rentals, homeowners, and homeowners/mortgagees).
Most health factors examined were more prevalent in social housing tenants compared to those living in other housing types. Individual health problems identified as more highly prevalent in social housing tenants compared to all other housing types included mental health issues (43%), arthritis (36%), back problems (32%), hypertension (25%), asthma (22%) and COPD (11%). 24% of social housing tenants reported five or more health factors compared to 3-6% of people in other housing types.
Although these findings are not unexpected, they provide more detailed evidence that social housing providers and policy makers should consider when planning future initiatives.
This study assessed the effectiveness of a school‐based intervention in reducing adolescents’ sugar‐sweetened beverage (SSB) consumption and percentage of energy from SSBs. Secondary outcomes were ...SSB consumption within school, average daily energy intake, and body mass index z‐scores.
Six secondary schools located in New South Wales, Australia were recruited to participate in a six‐month pilot randomised controlled trial (1:1). The intervention included components targeting the school nutrition environment, curricula and community. Outcomes were collected via online surveys, observations, anthropometric measurements and project records. Between‐group differences were assessed via linear mixed models.
At the six‐month intervention endpoint (n=862) there were no statistically significant differences between students in intervention or control schools for mean daily intake of SSBs (8.55mL; CI −26.77, 43.87; p=0.63), percentage daily energy from SSBs (0.12% kJ; CI −0.55, 0.80; p=0.72), or for secondary outcomes. Acceptability of the school‐based strategies were high, however intervention fidelity varied across schools.
While acceptable, improving fidelity of implementation and increasing the duration or intensity of the intervention may be required to reduce SSB intake.
Engaging parents and education stakeholders in the development phase to co‐design interventions may prove beneficial in improving intervention fidelity and enhance behavioural outcomes.
Recent reviews have synthesised the psychometric properties of measures developed to examine implementation science constructs in healthcare and mental health settings. However, no reviews have ...focussed primarily on the properties of measures developed to assess innovations in public health and community settings. This review identified quantitative measures developed in public health and community settings, examined their psychometric properties, and described how the domains of each measure align with the five domains and 37 constructs of the Consolidated Framework for Implementation Research (CFIR).
MEDLINE, PsycINFO, EMBASE, and CINAHL were searched to identify publications describing the development of measures to assess implementation science constructs in public health and community settings. The psychometric properties of each measure were assessed against recommended criteria for validity (face/content, construct, criterion), reliability (internal consistency, test-retest), responsiveness, acceptability, feasibility, and revalidation and cross-cultural adaptation. Relevant domains were mapped against implementation constructs defined by the CFIR.
Fifty-one measures met the inclusion criteria. The majority of these were developed in schools, universities, or colleges and other workplaces or organisations. Overall, most measures did not adequately assess or report psychometric properties. Forty-six percent of measures using exploratory factor analysis reported >50 % of variance was explained by the final model; none of the measures assessed using confirmatory factor analysis reported root mean square error of approximation (<0.06) or comparative fit index (>0.95). Fifty percent of measures reported Cronbach's alpha of <0.70 for at least one domain; 6 % adequately assessed test-retest reliability; 16 % of measures adequately assessed criterion validity (i.e. known-groups); 2 % adequately assessed convergent validity (r > 0.40). Twenty-five percent of measures reported revalidation or cross-cultural validation. The CFIR constructs most frequently assessed by the included measures were relative advantage, available resources, knowledge and beliefs, complexity, implementation climate, and other personal resources (assessed by more than ten measures). Five CFIR constructs were not addressed by any measure.
This review highlights gaps in the range of implementation constructs that are assessed by existing measures developed for use in public health and community settings. Moreover, measures with robust psychometric properties are lacking. Without rigorous tools, the factors associated with the successful implementation of innovations in these settings will remain unknown.
Secondary schools provide an opportune setting for interventions addressing excessive sugar-sweetened beverage (SSB) intake in adolescence. This trial aimed to assess the impact of school ...environmental strategies, delivered as part of a broader intervention, among Year 7-9 students' SSB consumption.
Between March and July 2018, we conducted a cluster randomised controlled trial with 862 students attending six secondary schools (3 intervention and 3 control) in New South Wales. The intervention targeted SSB availability, placement, promotion and pricing, and increased availability and promotion of water. Control schools followed their usual programmes. Primary outcomes included mean daily SSB consumption (millilitres) and mean daily percentage energy from SSB (kilojoules). Sub-group analysis explored primary outcomes for gender, school year level and frequency of canteen use.
Of the 2265 eligible students, 1092 (50.2%) provided active parental consent and 940 (86.0%) participated in baseline data collection. No significant differences were observed between groups at follow-up for mean daily SSBs consumed (-10.17 mL, CI: -24.78; 45.12, P = 0.57) or mean daily percentage energy from SSBs (-0.20%, CI: -0.87; 0.47, P = .56). Significant effects were observed among girls in intervention compared to girls in control schools for mean daily SSB consumption (-52.02 mL, CI 99.8; 94.14, P = .03) and mean daily percentage of energy from SSBs (-0.90%, CI: -1.82; 0.02, P = .05).
At 3-month mid-intervention evaluation, the intervention failed to impact on mean daily consumption and mean percentage energy from SSBs, overall. However, an intervention effect was observed in girls. The limited overall effect is likely due to inadequate intervention dose related to the short duration, limiting opportunities for schools to fully implement the environmental strategies. SO WHAT?: A longer intervention duration with additional implementation support to allow adequate time to embed the strategies within the school is recommended. Implementation support strategies would ensure staff are supported throughout the process.
Diet plays a critical role in the development of obesity and obesity-related morbidities. Our study aimed to evaluate the dietary food groups, nutrient intakes and eating behaviors of metabolically ...healthy and unhealthy obesity phenotypes in an Asian cohort of children and adolescents. Participants (
= 52) were asked to record their diet using a 3-day food diary and intakes were analyzed using a nutrient software. Eating behavior was assessed using a validated questionnaire. Metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) were defined based on criteria of metabolic syndrome. Children/adolescents with MUO consumed fewer whole grains (median: 0.00 (interquartile range: 0.00-0.00 g) vs. 18.5 g (0.00-69.8 g)) and less polyunsaturated fat (6.26% kcal (5.17-7.45% kcal) vs. 6.92% kcal (5.85-9.02% kcal)), and had lower cognitive dietary restraint (15.0 (13.0-17.0) vs. 16.0 (14.0-19.0)) compared to children/adolescents with MHO. Deep fried food, fast food and processed convenience food were positively associated with both systolic (β: 2.84, 95%CI: 0.95-6.62) and diastolic blood pressure (β: 4.83, 95%CI: 0.61-9.04). Higher polyunsaturated fat intake (OR: 0.529, 95%CI: 0.284-0.986) and cognitive dietary restraint (OR: 0.681, 95%CI: 0.472-0.984) were associated with a lower risk of the MUO phenotype. A healthier diet composition and positive eating behavior may contribute to favorable metabolic outcomes in children and adolescents with obesity.
We herein reported the first chemoenzymatic synthesis of lacto-
N
-hexaose (LNH) by combining chemical carbohydrate synthesis with a selectively enzymatic glycosylation strategy. A tetrasaccharide ...core structure GlcNH
2
β1→3 (GlcNAcβ1→6) Galβ1→4Glc, a key precursor for subsequent enzymatic glycan extension toward asymmetrically branched human milk oligosaccharides, was synthesized in this work. When the order of galactosyltransferase-catalyzed reactions was appropriately arranged, the β1,4-galactosyl and β1,3-galactosyl moieties could be sequentially assembled on the C6-arm and C3-arm of the tetrasaccharide, respectively, to achieve an efficient LNH synthesis. Lacto-
N
-neotetraose (LN
n
H), another common human milk oligosaccharide, was also synthesized en route to the target LNH.
•Thermo chemical conversion techniques of durian biochar were reviewed.•Sustainable applications of durian biomass waste-derived products were discussed.•Durian biochar applications as mulch film and ...electrode material were highlighted.•Durian biochar applications in Malaysia fulfill global sustainability goals.•Adoption of IR 4.0 in durian industry boosts productivity growth in Malaysia.
Durian with high nutritional value is cultivated mainly in tropical countries especially in Southeast Asia. The high annual durian production volume of approximately 350,000 MT in Malaysia has led to the abundance of durian biomass waste. Biochar derived from durian biomass waste has huge potential for sustainable applications in various fields. In this paper, durian biomass waste generation and management system in Malaysia are first discussed. The estimated potential energy available in Malaysia from durian biomass waste is then presented followed by the discussion on the conversion of durian biomass waste into biochar through pyrolysis and hydrothermal carbonization. Applications of durian biochar as catalysts, bio-sorbents for the removal of organic pollutants from wastewater, biocomposite, fertilizers, supercapacitor electrode material, and briquettes have also been reviewed. Moreover, this paper highlights the potential applications of durian biochar-derived biodegradable mulch film and supercapacitor electrode material in Malaysia to tackle both plastic waste and energy storage issues. Besides biochar, production and applications of bio-oil, biogas and other valuable compounds from durian biomass waste are also discussed. Furthermore, the Fourth Industrial Revolution (IR 4.0) on the durian industry in Malaysia which includes Internet of Things (IoT), Big Data and autonomous systems, sustainability assessment tools as well as the challenges are discussed. Based on the work presented, despite Malaysia has great potential in upcycling the durian biomass waste for several applications, more in-depth researches are necessary to further solidify the promising application in the specific field and improve production planning of durian fruit while valorizing durian biomass waste which makes up about 19% of total durian biomass waste from major durian producers from Southeast Asia.
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To describe the price of Australian school canteen foods according to their nutritional value.
Primary school canteen menus were collected as part of a policy compliance randomised trial. For each ...menu item, dietitians classified its nutritional value; ‘green’ (‘good sources of nutrients’), ‘amber’ (‘some nutritional value’), ‘red’ (‘lack adequate nutritional value’) and assigned a food category (e.g. ‘Drinks’, ‘Snacks’). Pricing information was extracted. Within each food category, ANOVAs assessed differences between the mean price of ‘green’, ‘amber’ and ‘red’ items, and post‐hoc tests were conducted.
Seventy of the 124 invited schools participated. There were significant differences in the mean price of ‘green’, ‘amber’ and ‘red foods’ across categories, with ‘green’ items more expensive than ‘amber’ items in main‐meal categories (‘Sandwiches’ +$0.43, ‘Hot Foods’ +$0.71), and the reverse true for non‐meal categories (‘Drinks’ −$0.13, ‘Snacks’ −$0.18, ‘Frozen Snacks’ −$0.25^).
Current pricing may not encourage the purchasing of healthy main‐meal items by and for students. Further investigation of pricing strategies that enhance the public health benefit of existing school canteen policies and practices are warranted.
Providing support to canteen managers regarding healthy canteen policies may have a positive impact on public health nutrition.
Depression is highly prevalent and associated with increased hospitalisations and mortality among patients with heart failure (HF). This study will evaluate the effectiveness and cost-effectiveness ...of an online wellbeing program for patients discharged from hospital with acute decompensated heart failure (ADHF) in (i) improving emotional and physical wellbeing, and (ii) decreasing healthcare utilisation.
Two-arm randomised controlled trial. Eligible patients with ADHF will be recruited pre-discharge from two hospitals. Five hundred and seventy participants will be randomised to receive the intervention (online enhanced care program for HF: 'Enhanced HF Care') or usual care. Enhanced HF Care includes health education (11 micro-learning modules) and monitoring of depression and clinical outcomes via fortnightly/monthly surveys for 6 months, with participants offered tailored advice via video email and SMS. Cardiac nurses track real-time patient data from a dashboard and receive automated email alerts when patients report medium- or high-risk levels of depression or clinical symptoms, to action where needed. General practitioners also receive automated alerts if patients report medium- or high-risk survey responses and are encouraged to schedule a patient consultation.
Sixty-five participants enrolled to-date. Co-primary outcomes ('Minnesota Living with Heart Failure Questionnaire' Emotional and Physical subscales) and healthcare utilisation (secondary outcome) at 1- and 6-month post-recruitment will be compared between treatment arms using linear mixed effects regression models.
This study has the potential to reduce the burden of depression for patients with HF by prioritising urgent mental health needs and clinical symptoms while simultaneously empowering patients with self-care knowledge.
The trial was prospectively registered via the Australian New Zealand Clinical Trials Registry: ACTRN12622001289707. Issue date: 4 October 2022.
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