bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative effectiveness of vitamin D supplementation via buccal spray versus oral supplements on 25(OH)D concentrations: a systematic review
Authors: Pritchard Lucy , Hickson Mary , Lewis Stephen
Published: June 2020

Vitamin D (vitD) deficiency is the most common nutritional deficiency worldwide. Most patients are treated with oral vitD capsules (either vitD2 or vitD3). A few studies have reported equal efficacy of buccal spray vitD. This is a new formulation that is absorbed via the oral mucosa into the systemic circulation, bypassing the gastrointestinal route. The main objective of this systematic review was to identify RCT evidence for the comparative effectiveness of buccal spray versus oral vitD on serum 25-hydroxyvitaminD [25-OHD] concentrations and any adverse effects of buccal spray vitD. We have published an a priori protocol using Joanna Briggs Institute (JBI) methodology (PROSPERO CRD42018118580). A three-step search strategy to identify RCTs was conducted, which reported serum 25-OHD concentrations from five databases from 2008–2018. Retrieved abstracts were screened; included papers imported into JBI SUMARI and assessed for study quality (GRADE) by two authors. Meta-analysis was planned. Three RCTs met our inclusion criteria. Due to heterogeneity of studies, meta-analysis was not possible. In a RCT crossover study, mean serum 25-OHD concentrations were significantly higher in patients with malabsorption syndrome (n = 20) on 1000IU buccal spray + 117.8%(10.46, 95%CI6.89,14.03ng/ml) vs.1000IU oral vitD3 + 36.02%(3.96, 95%CI2.37, 5.56ng/ml) at 30days (p < 0.0001). Mean serum 25-OHD were also significantly higher in healthy adults (n = 20) on buccal spray + 42.99%(7.995, 95%CI6.86,9.13ng/ml)vs.oral vitD3 + 21.72%(4.06, 95%CI3.41,4.71ng/ml) at 30days (p < 0.0001). In another RCT crossover study, ANCOVA revealed no significant difference in the mean and SD change from baseline total 25-OHD concentrations in adults (n = 22) on 3000IU buccal spray vs. 3000IU oral vitD3 + 44%,26.15 (SD17.85) vs. + 51%,30.38 (SD17.91)nmol/l, respectively;F = 1.044, adjusted r20.493,p = 0.313 at 4 weeks. In a RCT, 800IU buccal spray was equally effective as 750IU oral vitD3 in children with neurodisabilities(n = 24) at 3 months. Both groups had a significant increase in 25-OHD; 11.5 ng/ml(median8–19) to 26.5(13.6–39)ng/ml and 15.5ng/ml(8–20) to 34.5(22–49)ng/ml, respectively (z = 150;p < 0.0001). The overall certainty of evidence was very low to moderate. No adverse effects were reported. The evidence from these studies suggests that 800IU-3000IU doses of buccal spray vitD3 given daily may be an effective alternative as oral vitD3 in obtaining short-term haematological responses in serum 25-OHD concentrations. Buccal spray vitD3 may be a useful alternative for patients with intestinal malabsorption or dysphagia. Future research should compare buccal spray VD3 to intramuscular injections and confirm these findings in well-designed trials.
In-patient nutrition counseling and therapy – Exploration of structures for process driven work in a German clinical centre
Authors: Peuker Maren , Wiegand Talitha , Radziwill Roland , Kohlenberg-Müller Kathrin
Published: June 2020

Introduction

An implementation of process driven work in dietetics requires detailed analysis and specific planning. Therefore, gathering information on structures of the institution is an essential step and prerequisite for the development of an implementation concept. Process driven work in nutrition counseling and therapy, especially the implementation of the new developments into practice becomes more and more important.

The aim of the present qualitative study was to assess and analyse structures of the in-patient setting of nutrition counseling and therapy in a German clinical centre. Subsequently, strengths and challenges for the implementation of process driven work were identified.

Materials and Methods

Based on a structured literature search, guidelines for interviews with dietitians of a clinical centre were developed. The five interviews were recorded, transcribed with f4® and analysed by using the qualitative content analysis by Mayring. Finally, strengths and challenges for process driven work were identified out of this qualitative research.

Results

The following strengths and challenges were identified:

Strengths: concrete responsibility for indications, flexible duration of patient-consultations, use of standardized patient information, use of a digital documentation system, continuous intra- and interprofessional exchange, participation in education and training

Challenges: variety of different activities, barriers in the access to the dietitian, often only one-time dietitian-patient-consultation, time dependent problems because of the limited in-patient therapy, deficiency of rooms for a private patient consultation, non-existing data exchange from the in-patient into the outpatient setting, knowledge deficits of dietitians regarding process-driven work

Discussion

For the new developments for process driven work adequate structures of nutrition counseling and therapy in the in-patient setting are very important for patient care. Based on the gathered information on structures and processes, a concept for the implementation of a process model with a target and milestone planning will be helpful. Especially the appropriate access to patients as well as the fact that the dietitian-patient-consultation is mainly one-time have to be considered for the implementation concept. The integration of every process step in the in-patient setting is difficult to realize. Therefore, the prioritization of the considered process steps is necessary. Consequently, an exchange with the outpatient setting is advisable for the implementation of the complete process model.
Free dietary advice via the Internet as a tool for prevention and treatment of chronic non-communicable diseases - preliminary reports
Authors: Siuba-Strzelińska Magdalena , Wiśniewska Klaudia , Jarosz Mirosław
Published: June 2020

Introduction

Currently, there are no dietary consultations in the health service in Poland, that is why free access to the dietician is often difficult. The use of modern teleinformation technologies in medicine, creates unprecedented possibilities of providing medical services. Therefore, as part of the National Health Program financed by the Ministry of Health, the first digital platform was established in Poland - the Online Diet Center, where everyone with access to the Internet can use the advice of a professional dietitian free of charge.

The aim of the study was to obtain information on the characteristics of patients reporting online consultations and identifying their needs.

Materials and methods

The study was conducted among the patients of the Online Diet Center during the 12 months of running a diet counseling (December 2017-December 2018) using the authorial questionnaire that each patient completed after creating an account on the online counseling platform before and after the advice (satisfaction survey). Each advice lasted 30 minutes and was conducted by a trained dietitian.

Results

The number of patients who created an account on the Dietetic Online Center platform was 10,850, of which 23% were men and 77% women. Most often it was used by residents of large cities (including Warsaw, Krakow, Katowice, Wrocław, Poznań, Gdańsk, Łódz´). Almost 2% of patients were also Poles living abroad (Denmark, Australia, Great Britain, Ireland, Germany, Norway, Belgium, Italy, Spain, Brazil). Almost 1/3 of all registered patients after one consultation had another consultation with a dietitian. The most common disease was obesity (17%). Patients also declare hypothyroidism (15%), hypertension (13%), food allergy or intolerance (6.8%), eating disorders (5.6%) and depression (5%). Only 10% of patients were people who did not report any diseases. Only less than 1% of patients were not satisfied with such a consultation system, explaining that the information provided by the dietician was not useful. The duration of the advice was sufficient for patients.

Discussion

A large group of patients who apply to the Online Diet Center were women, which is consistent with the general trend in the area of dietary services. Due to the low frequency of using online dietary advice in small towns, in year 2019 a promotional campaign will be addressed to these places. The low percentage of dissatisfied patients and the willingness to make further advices, testifies to the success of platform of online dietary counseling and the legitimacy of its further development.
“Breakfast like a king, lunch like a prince, and dinner like a pauper”: how do European children and adolescents eat?
Authors: Bogl Leonie Helen , Intemann Timm , Hunsberger Monica , Siani Alfonso , De Henauw Stefaan , Molnár Dénes , Moreno Luis , Tornaritis Michael , Veidebaum Toomas , Ahrens Wolfgang , Hebestreit Antje
Published: June 2020

Chrono-nutrition is an emerging field of research that focuses on the interplay between nutrition, circadian rhythms and metabolism. Most nutritional guidelines recommend regular and frequent meals for children and adolescents throughout the day. However, preliminary research, mostly in animals suggests that eating at the “wrong” time of the day and longer eating windows (and concomitant shorter fasting periods) may relate to metabolic health. This study aimed to identify meal-timing patterns of European children and adolescents in eight European countries.

We examined 1225 children and adolescents (mean age: 11.8 years, 50% boys, and 26% overweight/obese) from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden enrolled in the European I.Family study (2013/2014). Information on energy intake and meal-timing patterns was derived from multiple web-based 24-hour dietary recalls (proxy-assisted for children < 12 years). We used the National Cancer Institute (NCI) method to estimate individual usual intakes. Subsequently, we applied the k-means algorithm to identify clusters for meal-timing patterns. Five variables were selected for the cluster analysis: 1) Duration between first and last meal of the day (eating window in hours), 2) Proportion of daily energy intake before 11am, 3) Proportion of daily energy intake after 5pm, 4) Number of meals per day, and 5) Pre-sleep fasting time.

Three clusters, labelled “late and time-restricted”, “late and long” and “early and frequent” meal-timing patterns were identified. Similar clusters were derived when excluding energy misreporters according to Goldberg cut-offs. Children in the “early and frequent” pattern were younger, had a lower body mass index (BMI) z-score, and a longer sleep duration than children in the other two meal-timing patterns. A higher proportion of plausible energy reporters were classified into the “early and frequent” pattern than into the other two patterns. The proportion of children from Italy, Cyprus and Spain was highest in the “late and long” pattern, while the proportion of children from Belgium, Sweden, Germany and Hungary was highest in the “early and frequent” patterns, and the proportion of children from Estonia was highest in the “late and time-restricted” pattern.

In conclusion, this study identified three different meal-timing patterns in children that varied by age, BMI z-score, country, misreporting status, and sleep duration. Investigations on the associations between meal timing patterns and metabolic health in this study sample are currently ongoing.
Monitoring intake of free sugars: benefits of assessing the usual intake distribution of population groups
Authors: Kaartinen Niina , Tapanainen Heli , Valsta Liisa , Männistö Satu
Published: June 2020

Free sugars, especially in the form of sugar-sweetened beverages, easily provide excess energy leading to increased risk of obesity and various NCDs. Free sugar intake below 10 E% is a public health nutrition target established in international (WHO) and many national nutrition recommendations across Europe. However, representative population-based data on free sugar intakes from the overall diet (i.e. free sugars from both liquid and solid foods) remain sparse. Besides mean intakes, the usual intake distributions of free sugar intake overall and in sociodemographic groups are infrequently reported. We aimed to study the intake of free sugars in the Finnish adults, and evaluate the proportion of the population reaching the recommendation. We used the data of the nationally representative FinDiet 2017 Survey consisting of two non-consecutive 24-hour dietary recalls obtained from 1655 subjects aged 18–74 years (53% participation rate). Weighing factors were used to correct non-participation bias. Assessment of daily free sugar intake was based on a food disaggregation procedure utilizing the national food composition database Fineli® (including standard recipes and ingredient level values for all different monosaccharides and disaccharides). Usual intake distribution modelling was performed using the SPADE program (RIVM, the Netherlands). We used SAS version 9.3 and R statistical software version 3.4.1 for the analyses. P-values < 0.05 were considered statistically significant.The mean intake of free sugars was 9.2 E% in men (n = 780) (P25: 6.4 E%, P50: 8.7 E%, P75: 11.5 E%), and 9.3 E% in women (n = 875) (P25: 6.6 E%, P50: 8.8 E%, P75: 11.4 E%). However, the recommendation (free sugars < 10 E%) was not reached by 37% of the population. Across the age groups (18–24, 25–44, 45–64, 65–74 years, respectively), the proportion of not reaching the recommendation varied between 28%−40% (men) and 44%−32% (women). Regarding educational groups (categories: low, middle, high), mean free sugar intake in men was higher in the lowest educational group (9.9 E%) compared with the highest educational group (8.8 E%) (P-value: 0.01). In women, free sugar intake did not differ between the educational groups. Overall, despite mean free sugar intakes below 10 E%, at least one third of Finnish adults did not reach the recommendation. Population groups with high free sugar intakes and the determinants of intake deserve further studying. Such information is needed in targeting interventions and policy actions to improve and sustain an optimal free sugar intake in all population groups.
Food intake, Healthy Eating Index and Dietary inflammatory index in patients with Psoriatic Arthritis
Authors: Leite Beatriz , Morimoto Melissa , Genaro Patricia , Shivappa Nitin , Hèbert James , Pinheiro Marcelo
Published: June 2020

Psoriatic Arthritis (PsA) is a chronic inflammatory disease that are associated with multiple comorbidities, particularly metabolic syndrome (MetS), obesity, hypertension and diabetes. These findings brought up a potential link between adiposity and psoriasis/ PsA. Though a healthy diet could improve some aspects related to MetS, as well as painful joints and skin lesions in patients with PsA, the aim of this study is to describe the main particularities related to food intake and nutrient consumption, including the dietary inflammatory index (DII) and the healthy eating index (HEI), in patients with PsA. A total of 97 patients with PsA were included in this cross-sectional study. Food intake was evaluated by using a 3-day food-record, HEI and the DII. Energy was adjusted using the residual method in order to control the effects of energy intake when evaluating micronutrient intake. Weight, waist of circumference, Body Mass Index (BMI) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were also evaluated. The inferential analysis included t-student test, Pearson's correlation and Tukey's test. Kolmogorov-Smirnov test was used to define normality. Level of significance was set as p < 0.05. Patients with PsA had hypercaloric diet and inadequate consumption of sodium, vitamin A, vitamin E, magnesium, zinc and copper when compared to Dietary Reference Intake. The HEI had low score (63.2 ± 10.2), suggesting that more than 90% of the patients had inappropriate diet and need nutritional intervention. Moreover, the DII score was high (+ 2.48 ± 0.9), highlighting a pro-inflammatory pattern. It was also observed an increase of BMI (mean 30.5 ± 5.7 kg/m2), waist circumference (103.13 ± 13.26 cm) and a high prevalence of MetS (54.6%). Our data showed patients with PsA had high prevalence of MetS, low quality of food intake, diet inadequacy and a pro-inflammatory pattern, especially regarding antioxidants intake.
The food frequency intake and eating behaviours of metabolically obese and non obese polycystic ovary syndrome women
Authors: Czlapka-Matyasik Magdalena , Bykowska-Derda Aleksadra , Stelcer Boguslaw , Kaluzna Malgorzata , Ziemnicka Katarzyna , Ruchała Marek
Published: June 2020

Introduction: Normal weight obesity is characterized as regular BMI and excessive body fatness. This type of metabolic obesity may be observed and overlooked in polycystic ovary syndrome women (PCOS), in whom obesity and increased cardiometabolic risk are observed. There are limited data concerning eating habits and lifestyle behaviours of/in normal weight obesity PCOS women. The purpose of this study is to distinguish the food frequency intake and eating habits behaviours of PCOS women characterized by regular weight and body fatness, regular weight and excess fatness and overweight and excess body fatness.

Methods: Women with PCOS (n = 149, BMI: 26 ± 6 kg/m2, aged 17–44 years) were divided into three groups according to the BMI and body fatness percentage (FM%): Regular weight and FM% (RW, n = 64), regular weight and high FM% (RWHF, n = 24) and high weight and high FM% (HWHF, n = 61). FM% was measured by air displacement plethysmography (BodPod, Life Measurement Inc, Concord, CA). Anthropometrics included weight, height and waist-to-hip-ratio (WHR) were measured. Food frequency intake and lifestyle behaviours were assessed by Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN, The Committee of Human Nutrition, Polish Academy of Science). To assess psychological factors influencing nutrition, My Eating Habits (MEH) Questionnaire was used. To detect the differences between the groups Kruskall-Wallis ANOVA and Mann Whitney-U tests were used.

Results: The results showed that the groups with higher body fatness (HWHF and RWHF) had significantly higher scores of dietary restrictions than the RW group. The RWHF group had significantly lower frequency intake of grains and lower physical activity in relation to other groups. In the group HWHF we indicated the higher risk of eating disorders since scored there higher in emotional overeating section of Eating Habits questionnaire.

Conclusion:The differences in body fatness in PCOS women might by driven by eating behaviours and frequency of intake selected food groups. Individual approach emphasized on dietary coaching of eating and lifestyle habits, might be beneficial to body composition management and cardiometabolic risk reduction in PCOS women.
Using nudges to promote healthy food choices at Greater Boston food pantries
Authors: Brown Lisa , Townsend Alice , Bates Sydney , Worthington Adriene
Published: June 2020

Nudging is a strategy used in behavioral economics to influence consumer decision-making through subtle changes in the choice environment. Recently, behavioral economists have been testing the use of nudge techniques to encourage healthier foods for high risk individuals. Food insecure individuals have an elevated risk of obesity and non-communicable diseases and would benefit from eating more nutrients dense foods for prevention and treatment. To promote more nutrient dense foods for food insecure individuals, Feeding America created a list of Foods to Encourage (F2E). This study evaluated the efficacy of nudge interventions in promoting two selected F2E at client-choice food pantries in Massachusetts. The objective of this study was to determine if the nudge interventions increased the take-rate of the targeted F2E: carrots and brown rice. Nudge interventions were implemented at three client-choice food pantries. Carrots were subjected to a “recipe nudge” in which recipe cards were placed next to the product. Brown rice underwent a placement nudge, which entailed moving the product to the proximal end of the display at waist height within easy reach and line of sight. Data was collected three times pre-intervention and three times post-intervention at each site to determine if the nudge had an impact on take rate. This study took place at three suburban food pantries in the Greater Boston area. The total number of shoppers observed before intervention was 402 and after intervention was 417. The main outcome was the take-rate of the products determined by the number of shoppers who selected the foods before and after intervention. Analyses were performed using IBM SPSS Version 24 (Armonk, NY). Odds ratios were calculated to determine the effect of the intervention with a logistic regression controlling for the site. The take-rate of brown rice increased significantly post-placement intervention. The odds ratio for brown rice was 1.940 (95% CI = 1.318 to 2.857). The take rate of other types of rice did not change post-intervention. The take rate for fresh carrots also increased significantly post recipe card intervention. The odds ratio for carrots was 1.519 (95% CI = 1.129 to 2.044). The results of this study indicate a favorable effect of nudges on the take rate of nutrient dense products and could support the use of nudges as a strategy to promote the distribution of healthy food in client-choice food pantries.
The accuracy of nutrition labels as a means of monitoring the reformulation of food in Ireland - The case of yoghurts
Authors: O'Mahony S. , O'Donovan C. B. , McDonald K. , Lyons O. C. , Quinn S. F. , Creane R. J. , Flynn M. A. T. , Anderson W. , Gibney E. R. , Collins N. A.
Published: June 2020

Over half of the Irish population is overweight or obese. The Obesity Policy and Action Plan 2016–2025 will set reformulation targets for fat, saturated fat and sugar in Ireland and review progress. In 2016, the Food Safety Authority of Ireland undertook a cross-sectional market scan of yoghurts to evaluate the energy, fat, saturated fat and sugar content based solely on declared nutrition labels. The aims of this 2018 study were to verify the accuracy of declared nutrition information on yoghurts and to confirm the suitability of declared nutrition labels for energy, fat, saturated fat and sugar reformulation monitoring.

Yoghurts identified in the 2016 market scan (n578) were weighted based on categorisation of manufacturer type (branded, own brand), product category (natural, flavoured and luxury) and declared nutrition content. Samples (n200) were randomly selected from these weighted groups and tested by a laboratory accredited for energy, fat, saturated fat, and sugar analysis. Data was analysed using IBM SPSS (version25). As data was not normally distributed, median values were investigated for declared and tested energy, fat, saturated fat and sugar content using Wilcoxon Signed-Rank Test and Spearman Rank-Order Correlation.

Of the tested yoghurts, 3% (n6), 5% (n9) and 19% (n31) were outside the recommended European Commission (EC) labelling tolerance for fat, saturated fat and sugar, respectively. Tested nutrient content was consistently lower than declared. There was a statistically significant difference in declared vs. tested energy (87kcal vs. 84kcal p = 0.03), fat (2.7 g vs. 2.5 g p < 0.001), and sugar (9.9 g vs. 8.7 g p < 0.001) content per 100 g yoghurt. Declared vs. tested sugar content per 100 g yoghurt was statistically significant across all yoghurt types, including natural (4.8 g vs. 3.4 g p < 0.001), flavoured (9.7 g vs. 8.6 g p < 0.001) and luxury (15 g vs. 13.6 g p = 0.002). There was a statistically significant difference between declared vs. tested fat (2.8 g vs. 2.5 g p < 0.001) and saturated fat (1.9 g vs.1.6 g p = 0.017) content of own brand yoghurts per 100 g. There was a positive correlation between energy content and portion size (r = .2,p < 0.01).

There was a high level of agreement between declared vs. tested fat and saturated fat content of yoghurts, but a lower level of agreement between declared vs. tested sugar content of yoghurts. This indicates that declared nutrition labels are suitable for reformulation monitoring of fat and saturated fat, but may not be suitable for sugar. This finding will be further investigated and tested in future work planned for nutrition label verification of other food categories.
Selection of theories, models and frameworks (TMFs) in the implementation of Healthy Eating Interventions in Centre-Based Childcare
Authors: do Vale Marjorie Lima , Farmer Anna , Ball Geoff , Gokiert Rebecca , Maximova Katerina , Thorlakson Jessica
Published: June 2020

Childcare settings are ideal for health promotion; however, they may not provide food environments that support children's healthy eating behaviours. To address this problem, researchers and practitioners have designed interventions with the aid of Theories, Models and Frameworks (TMFs) with the aim to improve centre-based childcare food environments. Considering the many TMFs that exist, the question of which TMF to select remains a challenge. As such, one of the objectives of our scoping review was to explore the selection criteria used in studies that aimed to promote healthy eating in centre-based childcare.

We utilized the scoping review steps outlined by Arksey & O'Malley (2005), and Levac, Colquhoun, & O'Brien (2012). We searched Medline, Embase, CINAHL, ERIC, PsycINFO, Scopus, CAB Abstracts, Agricola, ProQuest Dissertations and Theses, Prospero, and Cochrane library of SR for studies published from January 1990 to October 2018. We also consulted subject matter experts and hand searched reference lists. First level screening was completed by two reviewers (Kappa > 0.8). Second level was completed by one reviewer and questions were addressed through discussion with a second reviewer. TMF categorisation (i.e., individual, community, process and evaluation-focused) was informed by Nilsen (2015) and Rimer (2005). We used direct content analysis to organize the reported criteria used by authors to select TMFs. The rationales presented by authors were coded using Birken et al. (2017) criteria and definitions, which were based on seminal articles and an iterative consensus process. The categorization was completed by one reviewer (MV) and verified by a second reviewer (AF).

We retained 38 studies and identified 28 TMFs. TMFs were used to design implementation strategies, steps and outcomes, identify implementation factors and stakeholders, explain findings, and provide recommendations. Of the total of 14 criteria for selecting TMFs identified, the most frequently used were for describing a change process (n = 12; 23%), providing process guidance (n = 8; 15%), and TMFs use in empirical studies (n = 7; 13%).

TMF selection was most often based on descriptive rather than predictive or explanatory characteristics. Increasing childcare researchers’ and practitioners’ awareness of existing TMFs and tools to guide TMF selection might reduce selection based on convenience or where limited evidence for TMF effectiveness exist.
The impact of proposed nutrient criteria for the display of mandatory front-of-package ‘high-in’ symbols in the Canadian prepackaged foods supply
Authors: L'Abbe Mary , Christoforou Anthea , Mulligan Christine , Vergeer Laura , Bernstein Jodi
Published: June 2020

Background: Front-of-package (FOP) nutrition labelling has become a core component of policy recommendations to address the growing burden of diet-related non-communicable disease globally. The CODEX Committee on Food Labelling is in the process of establishing standardized criteria for the definition of “high-in” for use with FOP labels highlighting excessive amounts of fats, sugars and sodium in foods. Recently, as part of Health Canada's Healthy Eating Strategy, regulations requiring the mandatory display of high-in FOP symbols have been published. The aim of this study was to investigate the extent to which these symbols would appear on foods and beverages in the Canadian prepackaged food supply, both overall and by food category.

Methods: Foods and beverages in the University of Toronto's Food Label Information Program database 2013 (n = 15,277) were assessed for the prevalence of products that would have to display a symbol based on criteria published in the draft Canadian regulations. The criteria include thresholds based on the % Daily Value (DV) for each nutrient, above which, products would be required to display a FOP symbol for that nutrient. Exemptions are provided for fruits and vegetables without added sodium, sugars, or saturated fats, non-flavoured whole or partly skimmed milk, eggs, sweetening agents (i.e. sugar, honey, syrups and molasses) and table salt.

Results: 61.7% (n = 10,251) of products would be required to display at least one symbol. Of these, 52.3% (n = 5,358) would have a sodium symbol, 41.9% (n = 4,295) a saturated fats symbol and 41.0% (n = 4,207) a sugars symbol. Overall, 37% of products would display a symbol for more than one nutrient. The highest concentration of symbols were found on processed meats (93.8%), soups (93.0%), desserts (87.2%), sugars and sweets (82.3%), dairy (76.9%) and bakery products (71.0%).

Discussion: This is the first study to evaluate the impact of proposed regulations for the mandatory display of FOP symbols on Canadian prepackaged foods. Findings identify a high concentration of symbols in categories contributing meaningfully to dietary sodium, sugars, and saturated fats intakes, but also in categories for which consumption is discouraged in national dietary guidelines (e.g. processed meats, desserts). The findings presented here will inform ongoing discussions on how best to optimize criteria underpinning the display of FOP “high-in” labels.
Perspectives of dietitians on the taxation of sugar sweetened beverages in South Africa
Authors: Ebrahim Zarina , Koen Nelene , Smit Yolandi
Published: June 2020

The taxation on sugar sweetened beverages (SSB), known as the health promotion levy (HPL) was implemented in South Africa in April 2018. The aim of the taxation was to reduce the excessive intake of sugar in the SA population. Many studies have linked a high intake of sugar, particularly SSB to an increased energy intake, increasing the risk of overweight and obesity. The aim of this study was to investigate the perspectives of dietitians on the HPL.

Methods: In this cross-sectional descriptive study, dietitians were recruited through the weekly Association of Dietetics in South Africa newsletter and social media platforms. Dietitians (n = 138) completed an electronic survey using Survey Monkey. The survey consisted of five sections; consent, demographics, awareness of the sugar taxation, opinions and SSB purchasing/consumption of patients. Descriptive statistics was performed using Statistica version 13.2.

Results: Nearly all of the dietitians were female (95%, n = 131), with a mean age of 33 years (± 9.73). Two thirds were qualified with a four year professional Honors degree (67%, n = 92) and 25% (n = 34) had a Master's degree. A majority of dietitians were employed full time (80%, n = 111), working mainly in the area of clinical nutrition (26%, n = 33) and private practice (21%, n = 27). Most dietitians (98%, n = 127) were aware of the sugar tax, although 75% (n = 98) did not know the sugar content where tax was applicable and 78% (n = 101) did not know the tax amount levied. Dietitians opinion towards the HPL was positive (75%, n = 94), although 56% (n = 68) disagreed it would reduce obesity. A majority of dietitians (86%, n = 108) indicated other factors contribute to obesity. Most dietitians consult with patients (73%, n = 90). Patients were mainly from a lower socio-economic status (43%, n = 60). Dietitians disagreed it would reduce their patient's beverage consumption (61%, n = 55), with most agreeing the tax was too little to make a difference (71%, n = 89) and that it is mainly due to patient's liking the taste for not changing (46%, n = 36). Dietitians (34%, n = 31) use the SBL as a motivational tool, while 83% (n = 75) teach their patients to look for sugar on food labels.

Conclusion: From the dietitian's perspective, the sugar taxation has not influenced their patient's consumption behaviour. Dietitians have a positive attitude toward the HPL although they don't think it will reduce the prevalence of obesity. Other strategies should be employed to reduce sugar consumption in the SA population.
The Durability of Client Regimes
Authors: Casey Adam E.
Published: June 2020

Conventional wisdom holds that great power patrons prop up client dictatorships. But this is generally assumed rather than systematically analyzed. This article provides the first comprehensive analysis of the relationship between foreign sponsorship and authoritarian regime survival, using an original data set of all autocratic client regimes in the postwar period. The results demonstrate that patronage from Western powers—the United States, France, and the United Kingdom—is not associated with client regime survival. Rather, it’s only Soviet sponsorship that reduced the risk of regime collapse. The author explains this variation by considering the effects of foreign sponsorship on the likelihood of military coups d’état. He argues that the Soviet Union directly aided its clients by imposing a series of highly effective coup prevention strategies. By contrast, the US and its allies didn’t provide such aid, leaving regimes vulnerable to military overthrow.
Cobbler, Stick to Your Last? Social Democrats’ Electoral Returns from Labour Market Policy
Authors: FOSSATI FLAVIA , TREIN PHILIPP
Published: June 2020

In this article, we examine how labour market policy interventions, notably short-time work (STW), affect voting behaviour in times of electoral downturn. We use the 2009 German general elections as an example. This is a particularly interesting case because the grand coalition of Christian democrats (CDU/CSU) and social democrats (SPD) was up for re-election against the backdrop of a major recession following the 2007/08 financial crisis and extensively used STW policies to counteract rising unemployment. Interestingly, STW policy and unemployment vary considerably between regions. We exploit this variance to create a unique dataset that combines regional information on STW policy and unemployment in 299 German electoral constituencies with individual data from the post-election survey. Our results show that especially the SPD profited from high STW rates at constituency level on election day, but this policy was insufficient to preclude the major losses social democrats suffered during the election. More generally, our results indicate that classic labour market policy can generate electoral support for social democratic parties, even as a “junior partner” in a grand coalition. Nevertheless, it remains unclear whether such support is sufficient for electoral victories.
Two-level multi-methodological evaluation of a new complex primary support programme for stroke care-givers in Germany
Authors: Krieger Theresia , Feron Frans , Dorant Elisabeth
Published: June 2020

Family care-givers are the backbone of the long-term support system for care receivers at home. Care for stroke survivors after rehabilitation primarily rests on the shoulders of family members, often of older age themselves. We report the outcomes of a new complex support programme, the Care-givers’ Guide, on both individual and system levels. Psycho-social support and personalised information were the main ingredients of this intervention. A two-level multi-methodological approach was needed, with two concurrent interconnected studies. Family care-givers reflected on outcomes at an individual level in a quant-QUAL study with a pre–post quantitative questionnaire and a post-intervention qualitative semi-structured interview. Practitioners participated in a QUAL-QUAL studyex postinterview, reflecting on the outcomes on the care-givers and on their own stroke care system. Individual family care-givers showed an increase in health literacy and level of psycho-social health. Qualitative analysis revealed improvement in knowledge, capability to act and individual empowerment; and stabilisation of sense of certainty, life balance and emotional wellbeing. Practitioners observed an optimisation of the stroke support system by improving professionals’ daily routine, augmenting the institutional support offer, securing the quality of patient care and increasing inter-institutional co-operation attempts. Positive outcomes of the support programme were observed on both evaluation levels: family care-givers showed improved health literacy and psycho-social health, whereas the professionals noticed an optimisation of the support system.
The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran
Authors: Khosravi A. , Chaman R. , Rohani-Rasaf M. , Zare F. , Mehravaran S. , Emamian M. H.
Published: June 2020

The aim of this study was to estimate the basic reproduction number (R0) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. TheR0of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using ‘earlyR’ and ‘projections’ packages in R software. The maximum-likelihood value ofR0was 2.7 (95% confidence interval (CI): 2.1−3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03–1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178–383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (Rt), which had a descending trend and was around 1, reduced to 0.70. Based on theRtfor the last 21 days (days 46–67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48–136) new cases. In order to maintainRbelow 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population.
Exposure to maternal depressive symptoms and growth in adolescent substance use: The mediating role of delay discounting
Authors: Felton Julia W. , Collado Anahí , Cinader Morgan , Lejuez Carl W. , Chronis-Tuscano Andrea , Yi Richard
Published: June 2020

Maternal depression is associated with instability within the family environment and increases in offspring substance use across adolescence. Rates of delay discounting, or the tendency to select smaller rewards that are immediately available relative to larger, but delayed rewards, are also associated with steeper increases in substance use among youth. Moreover, recent research suggests that early unstable environments may reinforce youths’ propensity towards opportunistic decision making and delay discounting specifically. The current prospective, longitudinal study examined links between maternal depressive symptoms, adolescent delay discounting, and subsequent substance use. Participants included 247 adolescents and their mothers who were assessed annually over a 6-year period (from ages 13 to 19 years). Results supported a small but significant mediation effect. Specifically, maternal depressive symptoms predicted increases in adolescent delay discounting, which, in turn, predicted steeper increases in adolescent substance use over time. Thus, youth decision making may represent a mechanism linking maternal depression and adolescent risk behaviors. Findings indicate the potential for interventions targeting parental psychopathology to prevent subsequent adolescent substance use.
Cofree coalgebras and differential linear logic
Authors: Clift James , Murfet Daniel
Published: June 2020

We prove that the semantics of intuitionistic linear logic in vector spaces which uses cofree coalgebras is also a model of differential linear logic, and that the Cartesian closed category of cofree coalgebras is a model of the simply typed differential λ-calculus.
From Literary Illusions to Media Simulacra: Toward a Semiotic Imagology in the Era of Global Communication
Authors: Hu Yirong , Mei Lin
Published: June 2020

In the pre-globalization era, when communication between nations was difficult and infrequent, and direct (experiential) or indirect (textual-descriptive) knowledge was scant, images of ‘foreign countries’ were frequently constructions based on inadequate information. As a result, fictional descriptions and images were the primary source for people to gain some knowledge of other nations. However, beginning with the great voyages of discovery of the fifteenth and sixteenth centuries, we began to step into an age of globalization, which generated the diversification of ‘source texts’ in this regard. Today, the emergence of new media has accelerated and proliferated such diversity. These new media texts now play a dominant role in forming the image of other countries, to some degree replacing traditional fictional texts. The basic presuppositions of comparative literature imagology have changed accordingly. Starting from the core concept of ‘images’, this paper discusses why it is necessary to integrate imagology, with ‘semiotic images’ as core concept, and ‘communications research’.
Efficacy and acceptability of a pilot dietary intervention focusing on self-compassion, goal-setting and self-monitoring
Authors: Rahimi-Ardabili Hania , Vartanian Lenny R , Zwar Nicholas , Sharpe Albie , Reynolds Rebecca Charlotte
Published: June 2020

Objective:

Overweight and obesity are universal health challenges. Recent evidence emphasises the potential benefits of addressing psychological factors associated with obesity in dietary programmes. This pilot study investigated the efficacy and acceptability of a combined online and face-to-face dietary intervention that used self-compassion, goal-setting and self-monitoring to improve dietary behaviour, as well as psychological factors associated with dietary behaviour.

Design:

Embedded mixed methods including a 4-week before-after trial and a one-on-one interview. Quantitative outcomes of the study were the levels of self-compassion; eating pathology; depression, anxiety and stress; and dietary intake. Qualitative outcomes were participants’ perceptions about the acceptability of the intervention.

Setting:

UNSW Kensington campus.

Participants:

Fourteen participants with overweight and obesity aged between 18 and 55 years old.

Results:

Results showed that the intervention significantly improved self-compassion and some aspects of dietary intake (e.g. decrease in energy intake) at Week Four compared with Week Zero. Some aspects of eating pathology also significantly decreased (e.g. Eating Concern). However, changes in self-compassion over the 4 weeks did not significantly predict Week Four study outcomes, except for level of stress. Most participants found self-compassion, goal-setting and self-monitoring to be essential for dietary behaviour change. However, participants also indicated that an online programme needed to be efficient, simple and interactive.

Conclusions:

In conclusion, the current study provides preliminary but promising findings of an effective and acceptable combined online and face-to-face intervention that used self-compassion, goal-setting and self-monitoring to improve dietary habits. However, the results need to be examined in future long-term randomised controlled trials.
The new fundamental plane dictating galaxy cluster evolution
Authors: Fujita Yutaka , Umetsu Keiichi , Rasia Elena , Meneghetti Massimo , Donahue Megan , Medezinski Elinor , Okabe Nobuhiro , Postman Marc , Ettori Stefano
Published: June 2020

In this study, we show that the characteristic radius rs, mass Ms, and the X-ray temperature, TX, of galaxy clusters form a thin plane in the space of (log rs, log Ms, log TX). This tight correlation indicates that the cluster structure including the temperature is affected by the formation time of individual clusters. Numerical simulations show that clusters move along the fundamental plane as they evolve. The plane and the cluster evolution within the plane can be explained by a similarity solution of structure formation. The angle of the plane shows that clusters have not achieved “virial equilibrium”. The details of this study are written in Fujita et al. (2018a,b).
Active and dust obscured star-forming galaxies at z ∼ 4 probed with UV spectral slope beta
Authors: Yamanaka Satoshi , Yamada Toru
Published: June 2020

We investigate the stellar population of star-forming galaxies at z ∼ 4 by focusing on their slope of rest-frame ultraviolet continuum called UV spectral slope β. We analyze the sample of bright Lyman Break Galaxies (LBGs) with Subaru/i′≤26.0in the Subaru/XMM-Newton Deep Survey field. Our detailed SED fitting analysis indicates that the LBGs with observed UV slope > −1.7, , Av > 1.0, and intrinsic UV slope < −2.5 are the intrinsically active star-forming galaxies with star formation rates larger than a few × 102 M⊙yr−1. A significant fraction of the UV-selected LBGs at z ∼ 4 is on-going active and dust obscured star-forming galaxies.
A comparison of star formation history between NGC 300 and M33
Authors: Kang Xiaoyu , Zhang Fenghui , Chang Ruixiang
Published: June 2020

NGC 300 is a near-optical twin of the Local Group galaxy M33, which are benchmarks for understanding late-type spiral galaxies. They are two bulgeless and low-mass spiral galaxies in different environments. In order to explore the common properties and differences between the two nearby low-mass systems, we first use the simple chemical evolution model to explore the star formation history (SFH) of NGC300 and M33, and then compare the feasible model predicted SFH of NGC 300 with that of M33. Through comparing the SFHs between them, it can be found that the mean stellar age of NGC 300 is older than that of M33, there is a recent lack of primordial gas infall onto the disk of NGC 300, recent star formation along the disk of NGC 300 is less active than that of M33, and the local environment may play a key role in the secular evolution of a galaxy.
Deep learning for galaxy mergers in the galaxy main sequence
Authors: Pearson William J. , Wang Lingyu , Trayford James , Petrillo Carlo E. , van der Tak Floris F. S.
Published: June 2020

Starburst galaxies are often found to be the result of galaxy mergers. As a result, galaxy mergers are often believed to lie above the galaxy main sequence: the tight correlation between stellar mass and star formation rate. Here, we aim to test this claim.

Deep learning techniques are applied to images from the Sloan Digital Sky Survey to provide visual-like classifications for over 340 000 objects between redshifts of 0.005 and 0.1. The aim of this classification is to split the galaxy population into merger and non-merger systems and we are currently achieving an accuracy of 92.5%. Stellar masses and star formation rates are also estimated using panchromatic data for the entire galaxy population. With these preliminary data, the mergers are placed onto the full galaxy main sequence, where we find that merging systems lie across the entire star formation rate - stellar mass plane.
Radial resolved galaxy disks models based on semi-analytic models of galaxy formation
Authors: Fu Jian
Published: June 2020

We show our work on the L-Galaxies semi-analytic models of galaxy formation, which includes the radial resolved distribution of star, gas, SFR and metallicity on each galaxy disk. The newest version of the codes include the H22-to-HI gas transition prescriptions and the chemical enrichment of various elements. Our revised model can give results on cold gas components, radial metallicity gradients and scaling relations, which can fit the recent observations.