Robyn Dixon

Nutrition labels: a survey of use, understanding and preferences among ethnically diverse shoppers in New Zealand.

OBJECTIVE Effective nutrition labels are part of a supportive environment that encourages healthier food choices. The present study examined the use, understanding and preferences regarding nutrition labels among ethnically diverse shoppers in New Zealand. DESIGN AND SETTING A survey was carried out at twenty-five supermarkets in Auckland, New Zealand, between February and April 2007. Recruitment was stratified by ethnicity. Questions assessed nutrition label use, understanding of the mandatory Nutrition Information Panel (NIP), and preference for and understanding of four nutrition label formats: multiple traffic light (MTL), simple traffic light (STL), NIP and percentage of daily intake (%DI). SUBJECTS In total 1525 shoppers completed the survey: 401 Maori, 347 Pacific, 372 Asian and 395 New Zealand European and Other ethnicities (ten did not state ethnicity). RESULTS Reported use of nutrition labels (always, regularly, sometimes) ranged from 66% to 87% by ethnicity. There was little difference in ability to obtain information from the NIP according to ethnicity or income. However, there were marked ethnic differences in ability to use the NIP to determine if a food was healthy, with lesser differences by income. Of the four label formats tested, STL and MTL labels were best understood across all ethnic and income groups, and MTL labels were most frequently preferred. CONCLUSIONS There are clear ethnic and income disparities in ability to use the current mandatory food labels in New Zealand (NIP) to determine if foods are healthy. Conversely, MTL and STL label formats demonstrated high levels of understanding and acceptance across ethnic and income groups.

Development of a New Measurement Tool for Individualism and Collectivism

A new measurement tool for individualism and collectivism has been developed to address critical methodological issues in this field of social psychology. This new measure, the Auckland Individualism and Collectivism Scale (AICS), defines three dimensions of individualism: (a) responsibility (acknowledging ones responsibility for ones actions), (b) uniqueness (distinction of the self from the other), and (c) competitiveness (striving for personal goals is ones prime interest). The scale also defines two dimensions of collectivism: (a) advice (seeking advice from people close to one, before taking decisions) and (b) harmony (seeking to avoid conflict). The AICS avoids the need for measuring horizontal and vertical dimensions of collectivism and individualism and the confounding effect of familialism on the collectivism—individualism constructs.

A Pragmatic Randomized Controlled Trial of Computerized CBT (SPARX) for Symptoms of Depression among Adolescents Excluded from Mainstream Education

BACKGROUND Adolescents excluded from mainstream education have high mental health needs. The use of computerized Cognitive Behavioural Therapy (cCBT) has not been investigated with this group. AIMS To test the efficacy of the SPARX cCBT programme for symptoms of depression among adolescents in programmes for students excluded or alienated from mainstream education. METHOD Adolescents (32; 34% Maori, 38% Pacific Island, 56% male) aged 13-16 with Child Depression Rating Scale Revised (CDRS-R) scores indicating possible through to almost certain depressive disorder were randomized to SPARX to be completed over the following 5 weeks (n = 20) or to waitlist control (n = 12). Assessments were at baseline, 5 weeks and 10 weeks. Those in the wait condition were invited to complete SPARX after the 5 week assessment. RESULTS Most participants (n = 26, 81%) completed at least 4 levels of SPARX and 22 (69%) completed all 7 levels. Among the 30 (94%) participants who began treatment as randomized and provided 5-week data, significant differences were found between cCBT and wait groups on the CDRS-R (baseline to 5-week mean change -14.7 versus -1.1, p<.001), remission (78% vs. 36%, p = .047) and on the Reynolds Adolescent Depression Scale (-4.6 vs. +3.2 p = .05) but not on other self-rating psychological functioning scales. In intent-to-treat analyses CDRS-R changes and remission remained significant. Gains were maintained at 10-week follow-up. CONCLUSIONS SPARX appears to be a promising treatment for students with symptoms of depression who are in alternative schooling programmes for those excluded from mainstream education.

Open-label, phase II study of routine high-flow nasal oxygen therapy in cardiac surgical patients

BACKGROUND Respiratory complications after cardiac surgery increase morbidity, mortality, and length of stay. Studies suggest that routine delivery of positive airway pressure after extubation may be beneficial. We sought to determine whether the routine administration of nasal high-flow oxygen therapy (NHF) improves pulmonary function after cardiac surgery. METHODS A pragmatic randomized controlled trial; participants received either NHF (45 litre min(-1)) or usual care from extubation to Day 2 after surgery. The primary outcome was number of patients with / ratio ≥445 on Day 3 after surgery. The secondary outcomes included atelectasis score on chest X-ray; spirometry; intensive care and hospital length of stay; mortality on Day 28; oxygenation indices; escalation of respiratory support; and patient comfort. RESULTS We randomized 340 patients over 14 months. The number of patients with a / ratio of ≥445 on Day 3 was 78 (46.4%) in the NHF group vs 72 (42.4%) standard care [odds ratio (OR) 1.18, 95% confidence interval (CI) 0.77-1.81, P=0.45]. was reduced at both 4 h post-extubation and at 9 a.m. on Day 1 in the NHF group (5.3 vs 5.4 kPa, P=0.03 and 5.1 vs 5.3 kPa, P=0.03, respectively). Escalation in respiratory support at any time in the study occurred in 47 patients (27.8%) allocated to NHF compared with 77 (45%) standard care (OR 0.47, 95% CI 0.29-0.7, P=0.001). CONCLUSIONS Routine use of NHF did not increase / ratio on Day 3 but did reduce the requirement for escalation of respiratory support. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry www.anzctr.org.au (ACTRN12610000973011).

Adolescents' perceptions of a health survey using multimedia computer-assisted self-administered interview

Objective: To ascertain young peoples perceptions of an adolescent health survey when administered by multimedia computer assisted self‐administered Interview (M‐CASI) through analysis of (1) questionnaire item responses and (2) focus group interviews.

Expectations of achievement: Student, teacher and parent perceptions

M (1948) proposed the self-fulfi lling prophecy over half a century ago and twenty years later this concept was applied to teachers (Rosenthal and Jacobson, 1968). The proposition was that when teachers expected their students to do well they interacted with them in ways that led to their expectations being fulfi lled. Since then the research has consistently explored teacher expectations; expectations of signifi cant others for student outcomes have been largely ignored. For example, while teachers clearly hold expectations for students, students will have self-expectations and parents will also have expectations for their children. Furthermore, parents, students and teachers will have expectations of each other. Yet these various perceptions have been little explored, and where they have, at most, expectations of two parties have been included (see Benner and Mistry, 2007, for a recent example). The primary aim of the current research was to explore expectations students, teachers and parents have for one another. An extensive literature search has not located any other studies that have explored these various perspectives in one study.

Parents' and children's perceptions of active video games: a focus group study

Energy expenditure studies have shown that playing Active Video Games (AVGs) is positively associated with increases in heart rate and oxygen consumption. It is proposed that playing AVGs may be a useful means of addressing inactivity and obesity in children. This study explored children’s and parents’ perceptions of AVGs and the likely facilitators and barriers to sustained use of AVGs. Data were gathered using focus group interviews: seven with children, four with adults. Both children and parents reported that AVGs offered a way to increase activity and improve fitness. Barriers to sustained engagement, according to parents, were the cost of AVGs and lack of space in the home to play the games. According to children, the likelihood of long-term engagement with AVGs depended on game content and child age, with AVGs being seen as more appropriate for younger children than teenagers. It would appear that there is potential for AVGs to reduce inactivity in young people. However, barriers to widespread, sustainable adoption would need to be addressed if this potential is to be realized.

Exploring Paternal Influences on the Dieting Behaviors of Adolescent Girls

In this article we investigate fathers influence on the dieting behavior of their adolescent daughters. Fifty father-daughter dyads (N = 100) participated. The girls completed a questionnaire concerning their beliefs and behaviors with respect to dieting, their body satisfaction, and their perception of the advantages of being thinner. Fathers were surveyed in order to ascertain their perceptions of the advantages of slimness for adolescent girls and their beliefs regarding the importance of physical appearance and weight control in females of all ages. Associations were found between fathers attitudes to physical attractiveness in females, their perceptions of the impact of being slimmer for adolescent girls, and their daughters dieting behavior. Fathers who believed strongly in the importance of attractiveness and careful control of food intake by females were significantly more likely to have daughters who induced vomiting to lose weight. Fathers play an influential role in determining the dieting behavior of their adolescent daughters.

Combining Noncontingent Escape and Functional Communication Training as a Treatment for Negatively Reinforced Disruptive Behavior.

Research has shown that noncontingent escape (NCE) and functional communication training (FCT) can be effective treatments for challenging behavior. One limitation of the NCE procedure is the failure to provide explicit contingencies for learning an alternative adaptive behavior. Additionally, problems can arise with a FCT procedure. In this study, FCT was superimposed on an existing NCE schedule in an attempt to maintain the advantages of each procedure while removing known limitations. The data showed that with NCE plus FCT, rates of disruptive behavior remained at near zero levels while compliance with task demands and appropriate verbal responses increased to levels significantly above baseline. The authors discuss the effectiveness of the procedure for addressing the limitations of each intervention.

‘It’s mean!’ The views of young people alienated from mainstream education on depression, help seeking and computerised therapy

Abstract Background: Adolescents alienated from mainstream education before they reach the minimum school leaving age have high rates of depression and seldom receive evidence-based mental health treatment. We set out to investigate their views on depression, help seeking and computerised therapy. Method: Focus groups with 39 young people (74% males, 49% Maori, 38% Pacific Island, all aged 13–16 years) in alternative schooling programmes for students excluded or alienated from mainstream education. Findings: Participants generally thought that depression was real and that people their age suffered from it. The main responses to feeling depressed were self-harm, fighting and substance use. Most were very reluctant to talk to health providers about depression. Some would be distressed or might hurt themselves if referred to mental health services. There was a high level of interest in computer programmes to assist with depression irrespective of the gender or ethnicity of the students or whether they felt down in the past. Barriers to using computerised therapies included lack of help seeking, potential embarrassment and access to computers. Conclusions: Approaches that allow young people to receive help, without having to actively seek assistance from health professionals may be needed to address depression among this vulnerable group. The use of computer programmes that are appealing and can be provided in non-stigmatising ways appears to be one promising approach.