Measuring physical inactivity:do current measures provide an accurate view of "sedentary" video game time?

BACKGROUND: Measures of screen time are often used to assess sedentary behaviour. Participation in activity-based video games (exergames) can contribute to estimates of screen time, as current practices of measuring it do not consider the growing evidence that playing exergames can provide light to moderate levels of physical activity. This study aimed to determine what proportion of time spent playing video games was actually spent playing exergames. METHODS: Data were collected via a cross-sectional telephone survey in South Australia. Participants aged 18 years and above (n = 2026) were asked about their video game habits, as well as demographic and socioeconomic factors. In cases where children were in the household, the video game habits of a randomly selected child were also questioned. RESULTS: Overall, 31.3% of adults and 79.9% of children spend at least some time playing video games. Of these, 24.1% of adults and 42.1% of children play exergames, with these types of games accounting for a third of all time that adults spend playing video games and nearly 20% of children's video game time. CONCLUSIONS: A substantial proportion of time that would usually be classified as "sedentary" may actually be spent participating in light to moderate physical activity

Neighbourhood Environmental Attributes Associated with Walking in South Australian Adults: Differences between Urban and Rural Areas

Although the health benefits of walking are well established, participation is lower in rural areas compared to urban areas. Most studies on walkability and walking have been conducted in urban areas, thus little is known about the relevance of walkability to rural areas. A computer-assisted telephone survey of 2402 adults (aged ≥18 years) was conducted to determine walking behaviour and perceptions of neighbourhood walkability. Data were stratified by urban (n = 1738) and rural (n = 664). A greater proportion of respondents reported no walking in rural (25.8%) compared to urban areas (18.5%). Compared to urban areas, rural areas had lower walkability scores and urban residents reported higher frequency of walking. The association of perceived walkability with walking was significant only in urban areas. These results suggest that environmental factors associated with walking in urban areas may not be relevant in rural areas. Appropriate walkability measures specific to rural areas should be further researched

Characteristics of patients with haematological and breast cancer (1996–2009) who died of heart failure-related causes after cancer therapy

Aims: To describe the characteristics and time to death of patients with breast or haematological cancer who died of heart failure (HF) after cancer therapy. Patients with an index admission for HF who died of HF-related causes (IAHF) and those with no index admission for HF who died of HF-related causes (NIAHF) were compared. Methods and results: We performed a linked data analysis of cancer registry, death registry, and hospital administration records (n = 15 987). Index HF admission must have occurred after cancer diagnosis. Of the 4894 patients who were deceased (30.6% of cohort), 734 died of HF-related causes (50.1% female) of which 279 (38.0%) had at least one IAHF (41.9% female) post-cancer diagnosis. Median age was 71 years [interquartile range (IQR) 62–78] for IAHF and 66 years (IQR 56–74) for NIAHF. There were fewer chemotherapy separations for IAHF patients (median = 4, IQR 2–9) compared with NIAHF patients (median = 6, IQR 2–12). Of the IAHF patients, 71% had died within 1 year of the index HF admission. There was no significant difference in HF-related mortality in IAHF patients compared with NIAHF (HR, 1.10, 95% CI, 0.94–1.29, P = 0.225). Conclusions: The profile of IAHF patients who died of HF-related causes after cancer treatment matched the current profile of HF in the general population (over half were aged ≥70 years). However, NIAHF were younger (62% were aged ≤69 years), female patients with breast cancer that died of HF-related causes before hospital admission for HF-related causes—a group that may have been undiagnosed or undertreated until death

Negative workplace behaviour: temporal associations with cardiovascular outcomes and psychological health problems in Australian police

Negative workplace behaviour, such as workplace bullying, is emerging as an important work-related psychosocial hazard with the potential to contribute to employee ill health. We examined the risk of two major health issues (poor mental and cardiovascular health) associated with current and past exposure to negative behaviour in the workplace. Data from 251 police officers, who completed an anonymous mail survey at two time-points spaced 12 months apart, support the potential role of exposure to negative workplace behaviour in the development of physical disease and psychological illness. Specifically, we saw significant effects associated with past exposure to such behaviour on indicators of poor cardiovascular health, and a significant effect of current exposure on the indicator of mental health problems. Our findings reinforce the need to continue to study links between employee health and both negative workplace behaviour and more severe cases of bullying, particularly the mechanisms involved to strengthen theory in this area, and to protect against employee ill health (specifically cardiovascular outcomes and psychological problems) by preventing negative behaviour at work. Copyright (C) 2010 John Wiley & Sons, Ltd

Public attitudes to government intervention to regulate food advertising, especially to children

The World Health Organization has called on governments to implement recommendations on the marketing of foods and beverages to children. This study describes high public support for government intervention in marketing of unhealthy food to children and suggests more effort is needed to harness public opinion to influence policy development

Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

INTRODUCTION: There is a 70% higher age-adjusted incidence of heart failure (HF) among Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths as among non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community health care to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing.  METHODS: This study was conducted in two phases and utilised a mixed-methods approach (qualitative and quantitative). Phase 1 used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. An HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources, and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made.  RESULTS: Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this, and members of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. Phase 2: Five Aboriginal participants, mean age 61.6±10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0±6.7% to 58.0±9.7%, a 20.8% increase, and results of the self-care index indicated that the biggest change was in patient confidence for self-care, with a 95% increase in confidence score (46.7±16.0 to 91.1±11.5). Changes in management and maintenance scores varied between patients.  CONCLUSIONS: By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence

Differences in the health, mental health and health-promoting behaviours of rural versus urban cancer survivors in Australia

Purpose People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer. Methods Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer (n = 4295) were analysed with adjustment for survey year, gender, age group, education, income, family structure, work status, country of birth and area-level relative socioeconomic disadvantage (SEIFA). Results Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other co-morbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA. Conclusions There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors’ specific needs and risk factors

Differences in chronic conditions and lifestyle behaviour between people with a history of cancer and matched controls

OBJECTIVE: To determine whether people with a history of cancer have a higher prevalence of chronic conditions or different lifestyle behaviour compared with controls.  DESIGN, SETTING AND PARTICIPANTS: Cross-sectional, self-reported data from a telephone survey conducted between 1 January 2010 and 31 March 2012 of adult residents of South Australia who self-reported a previous cancer diagnosis (cases) and randomly selected age- and sex-matched residents with no cancer diagnosis (controls).  MAIN OUTCOME MEASURES: Self-reported medically diagnosed cardiovascular disease, hypertension, hyperlipidaemia, diabetes and osteoporosis; lifestyle behaviour (smoking, physical activity and diet); body mass index (BMI); psychological distress and self-reported health.  RESULTS: A total of 2103 cases and 4185 controls were included in the analyses. For men, after adjusting for age, cancer survivors were more likely than controls to have ever had cardiovascular disease (P<0.001), high blood pressure (P=0.001), high cholesterol (P<0.001) and diabetes (P=0.04). These associations remained significant after controlling for socioeconomic status (SES), with the exception of high blood pressure (P=0.09). For women, there was an increased prevalence of high cholesterol (P=0.005), diabetes (P=0.02) and osteoporosis (P=0.005) in cancer cases, but after adjusting for SES, these associations were no longer significant. Women with a previous cancer diagnosis were more likely than controls to have ever smoked, after adjusting for SES (P=0.001). There were no other differences in lifestyle behaviour or BMI between cases and controls for men or women.  CONCLUSION: Despite similar lifestyle habits and BMI, the prevalence of chronic conditions was significantly higher among people with a history of cancer than among controls without cancer. This supports the importance of chronic disease management as part of health care after a diagnosis of cancer

Acute effects of an Avena sativa herb extract on responses to the Stroop Color-Word test

Background and aims: Extracts from oat (Avena sativa) herb may benefit cognitive performance. This study investigated whether Neuravena®, an oat herb extract, could acutely improve responses to the Stroop Color–Word test, a measure of attention and concentration and the ability to maintain task focus.  Subjects and methods: Elderly volunteers with below-average cognitive performance consumed single doses (0, 1600, and 2400 mg) of oat herb extract at weekly intervals in a double-blind, randomized, crossover comparison. Resting blood pressure (BP) was assessed before and after supplementation, and a Stroop test was performed.  Results: Significantly fewer errors were made during the color-naming component of the Stroop test after consuming the 1600-mg dose than after the 0-mg or 2400-mg doses (F (1,36)=18.85, p<0.001). In 7 subjects with suspected cognitive impairment, Stroop interference score was also improved by the 1600-mg dose compared to 0- and 2400-mg doses (F (1, 34)=2.40, p<0.01). Resting BP was unaffected by supplementation.  Conclusions: Taking 1600 mg of oat herb extract may acutely improve attention and concentration and the ability to maintain task focus in older adults with differing levels of cognitive status

There is no association between the omega-3 index and depressive symptoms in patients with heart disease who are low fish consumers

Background: Long chain Omega-3 polyunsaturated fatty acids (LCn3PUFAs) may improve cardiovascular health and depression. This study investigated the relationships between erythrocyte membrane LCn3PUFA status, depression and angina symptoms in patients with heart disease.  Methods: We recruited 91 patients (65 males and 26 females, mean age 59.2 ± 10.3 years) with heart disease and depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D ≥ 16) and low fish/fish oil intakes. The Omega-3 Index (EPA+DHA) of erythrocyte membranes (as a percentage of total fatty acids) was assessed by gas chromatography. Depression status was measured by both self-report and clinician-report scales; CES-D and the Hamilton depression scale (HAM-D). Angina symptoms were measured using the Seattle Angina Questionnaire and the Canadian Cardiovascular Society Classification for Angina Pectoris.  Results: The mean Omega-3 Index was 4.8 ± 1.0% (±SD). Depression scores measured by CES-D and HAM-D were 29.2 ± 8.8 (moderate to severe) and 11.0 ± 5.7 (mild) (arbitrary units) respectively reflecting a different perception of depressive symptoms between patients and clinicians. Angina status was inversely associated with depression scores (r > -0.26, P < 0.03). There were no significant relationships between individual LCn3PUFA or the Omega-3 Index and either the depression scores or the angina symptoms.  Conclusion: Worse angina status was associated with worse depression, but the Omega-3 Index was not associated with symptoms of depression or angina in patients with heart disease