Carla Patterson

Measuring socio-economic position in dietary research: is choice of socio-economic indicator important?

OBJECTIVES To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour. DESIGN The sample was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a households choice of grocery items (including meat and chicken), fruit and vegetables. SETTING Brisbane City, Australia, 2000. PARTICIPANTS : Non-institutionalised residents of private dwellings located in 50 small areas (Census Collectors Districts). RESULTS When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices; however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant; income, however, showed a strong, graded association with food choice. CONCLUSIONS The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another.

Development and Validation of a Questionnaire Designed to Measure Foot-Health Status

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.

A comparison of self-reported and measured height, weight and BMI in Australian adolescents

Objective: To explore the relationship between self‐reported weight and height to actual weight and height in older Australian adolescents

Promoting and building resilience in primary school communities: Evidence from a comprehensive ‘health promoting school’ approach

This paper reports on the first phase of a multi-strategy health promotion project which uses a whole-school approach to promote resilience in children of primary school age in school, family and community settings in urban and rural/remote locations in Queensland, Australia. The study population comprised students from Years 3, 5, and 7 (ages 8, 10, 12 years), their parents/care-givers and staff in 20 primary schools. Evidence emerging from this phase of the project confirms that the school environment makes a major contribution to the development of psychological resilience in children. Schools in which students reported more positive adult and peer social networks and feelings of connectedness to adults and peers, and a strong sense of autonomy, were associated with higher self-ratings of resilience in the students. There was also high concurrence by parents and caregivers regarding perceptions of the school environment. These schools rated more highly on ‘health promoting school’ (HPS) attributes and principles. Characteristics of such schools included features like shared decision-making and planning, community participation, a supportive physical and social environment, good school-community relations, clearly articulated health policies and access to appropriate health services.

The socio-economic patterning of survey participation and non-response error in a multilevel study of food purchasing behaviour: area- and individual-level characteristics

OBJECTIVE To undertake an assessment of survey participation and non-response error in a population-based study that examined the relationship between socio-economic position and food purchasing behaviour. DESIGN AND SETTING The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Respondents were recruited using a range of strategies that attempted to maximise the involvement of persons from disadvantaged backgrounds: respondents were contacted by personal visit and data were collected using home-based face-to-face interviews; multiple call-backs on different days and at different times were used; and a financial gratuity was provided. PARTICIPANTS Non-institutionalised residents of private dwellings located in 50 small areas that differed in their socio-economic characteristics. RESULTS Rates of survey participation - measured by non-contacts, exclusions, dropped cases, response rates and completions - were similar across areas, suggesting that residents of socio-economically advantaged and disadvantaged areas were equally likely to be recruited. Individual-level analysis, however, showed that respondents and non-respondents differed significantly in their sociodemographic and food purchasing characteristics: non-respondents were older, less educated and exhibited different purchasing behaviours. Misclassification bias probably accounted for the inconsistent pattern of association between the area- and individual-level results. Estimates of bias due to non-response indicated that although respondents and non-respondents were qualitatively different, the magnitude of error associated with this differential was minimal. CONCLUSIONS Socio-economic position measured at the individual level is a strong and consistent predictor of survey non-participation. Future studies that set out to examine the relationship between socio-economic position and diet need to adopt sampling strategies and data collection methods that maximise the likelihood of recruiting participants from all points on the socio-economic spectrum, and particularly persons from disadvantaged backgrounds. Study designs that are not sensitive to the difficulties associated with recruiting a socio-economically representative sample are likely to produce biased estimates (underestimates) of socio-economic differences in the dietary outcome being investigated.

Promoting school connectedness through whole school approaches

Purpose – The purpose of this paper is to develop a framework to demonstrate the contribution of whole school approaches embodied by the health‐promoting school approach, to the promotion of school connectedness, defined as the cohesiveness between diverse groups in the school community, including students, families, school staff and the wider community.Design/methodology/approach – A cross‐disciplinary review of literature was conducted to identify strategies consistent with the health‐promoting school approach and the values and principles that promote school connectedness. The review included peer‐reviewed articles and published books and reports identified from the databases spanning the education, health, social science and science disciplines and used search terms encompassing health and mental health promotion, schools, social connectedness, belonging and attachment. The paper is also a framework of the contribution of the health‐promoting school approach to promoting school connectedness and was d...

A Qualitative Analysis of Reproductive Issues Raised by Young Australian Women with Breast Cancer

Available literature concentrates on infertility concerns of young women with breast cancer, while attention to psychosocial issues related to maintained or regained fertility is scarce. As part of a longitudinal, qualitative study of experiences of young women with breast cancer (diagnosed at 40 years or younger); (n = 13), concerns about fertility, contraception, pregnancy, and breastfeeding after breast cancer were expressed. Using semistructured, one-to-one interviews over three time phases, we explored these womens experiences. Perceptions of fertility changed over time. Contraception issues were raised together with recurrence fears related to pregnancy and breastfeeding after breast cancer. Decisions related to unplanned pregnancies and breastfeeding were described as particularly onerous.

Determination of manganese and chromium in foods by atomic absorption spectrometry after wet digestion

Abstract Wet digestion procedures using acid mixtures of HNO 3 /H 2 SO 4 /HClO 4 and HNO 3 /H 2 SO 4 were investigated for their effectiveness for decomposition of food samples prior to determination of manganese (Mn) and chromium (Cr) by flame and Zeeman graphite furnace atomic absorption spectrophotometry. The addition of hydrofluoric acid (HF) to the mixture of HNO 3 /H 2 SO 4 was also investigated for determination of Cr. All the acid mixtures tested were found to be satisfactory, but, for reasons of safety, HNO 3 /H 2 SO 4 was the method of choice. No apparent matrix interferences or losses of analytes were encountered with the method used. Analysis of selected food samples found relatively high levels of Mn and Cr in most cereal products. Meats, dairy products (except for Cr in cheese), vegetables and fruits contained relatively low levels of both elements.

Health-related quality of life following podiatric surgery.

This 6-month prospective study investigated the outcomes of foot surgery performed by Fellows of the Australian College of Podiatric Surgeons. The study recruited 140 patients who were treated for orthopedic, neurological, or integumentary diseases of the foot. The majority of subjects who underwent podiatric surgery experienced significant postoperative improvements in a range of health-related quality-of-life dimensions as measured by the disease-specific Foot Health Status Questionnaire (FHSQ) and the generic Short Form 36 (SF-36) questionnaire. Subjects reported a reduction in foot pain, increased levels of physical function, improved general foot health perception, and improved footwear-related quality of life. No significant adverse outcomes or unplanned re-admissions to the hospital were reported. This study demonstrates the advantage of assessing health-related quality of life as opposed to patient satisfaction.

Determination of selenium in foodstuffs using spectrofluorometry and hydride generation atomic absorption spectrometry

Abstract Two analytical methods, namely, spectrolluorometry and hydride generation atomic absorption spectrometry (HG-AAS), were used for determining the levels of selenium in food materials. The results of the two methods were compared. The efficiencies of acid mixtures used for decomposition of biological materials were also investigated. Nitric-perchloric acid mixture was found to be the most efficient method for spectrolluorometry. Nitric-perchloric acid mixture or nitric-perchloric-sulfuric acid mixture was found to be the most efficient method for HG-AAS. No apparent matrix interferences were encountered for either method of analysis. A wide range of levels of selenium was found in selected foods analyzed. High levels of selenium were found in cereals, meat, fish, and wheat products and relatively low levels in milk and milk products. Fruits and vegetables contained very little selenium and negligible amounts were found inmost drinks.