Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping : a multilevel study in Melbourne, Victoria

Objective: To describe associations between demographic and individual and arealevel socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping.Design: Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables.Setting: Random selection of households from fifty small areas in Melbourne, Australia, in 2003.Subjects: The main food shoppers in each household (n 2564).Results: A lack of money was significantly more likely among the young and in households with single adults. Difficultly lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower individual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficultly lifting and reduced car access.Conclusions: In Melbourne, households with lower individual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.<br /

Using Geographic Information Systems (GIS) to assess the role of the built environment in influencing obesity: a glossary

Features of the built environment are increasingly being recognised as potentially important determinants of obesity. This has come about, in part, because of advances in methodological tools such as Geographic Information Systems (GIS). GIS has made the procurement of data related to the built environment easier and given researchers the flexibility to create a new generation of environmental exposure measures such as the travel time to the nearest supermarket or calculations of the amount of neighbourhood greenspace. Given the rapid advances in the availability of GIS data and the relative ease of use of GIS software, a glossary on the use of GIS to assess the built environment is timely. As a case study, we draw on aspects the food and physical activity environments as they might apply to obesity, to define key GIS terms related to data collection, concepts, and the measurement of environmental features

Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

Background : While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) &ndash; a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003.Methods : The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics.Results : Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 &ndash; 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors.Conclusion : Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.<br /

The Impacts of Transitional Employment for Mentally Retarded Young Adults: Results of the STETS Demonstration

The Structured Training and Employment Transitional Services (STETS) demonstration was designed to provide the first rigorous test of the effectiveness of transitional-employment programs in integrating mentally retarded young adults into the economic and social mainstream. Under the demonstration, which was funded by the Employment and Training Administration of the U.S. Department of Labor and directed by MDRC, programs were operated from the fall of 1981 through December 1983 in five cities throughout the country. This demonstration has greatly expanded our knowledge about the implementation and operation of transitional-employment programs for this target population and has documented the effectiveness of such programs in enhancing the economic and social independence of mentally retarded young adults. This report on the impact evaluation and the benefit-cost analysis of the demonstration program consists of the following components: (1) a brief description of the rationale for the demonstration and overviews of the STETS demonstration and the evaluation design, (2) a discussion of the success of the program in achieving its impact goals, (3) a comparison of the benefits and costs of the program, and (4) a review of the policy implications of the demonstration findings

Does parkland influence walking? The relationship between area of parkland and walking trips in Melbourne, Australia

Background : Using two different measures of park area, at three buffer distances, we sought to investigate the ways in which park area and proximity to parks, are related to the frequency of walking (for all purposes) in Australian adults. Little previous research has been conducted in this area, and results of existing research have been mixed. Methods : Residents of 50 urban areas in metropolitan Melbourne, Australia completed a physical activity survey (n = 2305). Respondents reported how often they walked for &gt;=10 minutes in the previous month. Walking frequency was dichotomised to \u27less than weekly\u27 (less than 1/week) and \u27at least weekly\u27 (1/week or more). Using Geographic Information Systems, Euclidean buffers were created around each respondent\u27s home at three distances: 400metres (m), 800 m and 1200 m. Total area of parkland in each person\u27s buffer was calculated for the three buffers. Additionally, total area of \u27larger parks\u27, (park space &gt;= park with Australian Rules Football oval (17,862 m2)), was calculated for each set of buffers. Area of park was categorised into tertiles for area of all parks, and area of larger parks (the lowest tertile was used as the reference category). Multilevel logistic regression, with individuals nested within areas, was used to estimate the effect of area of parkland on walking frequency. Results : No statistically significant associations were found between walking frequency and park area (total and large parks) within 400 m of respondent\u27s homes. For total park area within 800 m, the odds of walking at least weekly were lower for those in the mid (OR 0.65, 95% CI 0.46-0.91) and highest (OR 0.65, 95% CI 0.44-0.95) tertile of park area compared to those living in areas with the least amount of park area. Similar results were observed for total park area in the 1200 m buffers. When only larger parks were investigated, again more frequent walking was less likely when respondents had access to a greater amount of park area. Conclusions : In this study we found that more park area in residential environments reduced the odds of walking more frequently. Other area characteristics such as street connectivity and destinations may underlay these associations by negatively correlating with park area. <br /

Does the choice of neighbourhood supermarket access measure influence associations with individual-level fruit and vegetable consumption? A case study from Glasgow

BackgroundPrevious studies have provided mixed evidence with regards to associations between food store access and dietary outcomes. This study examines the most commonly applied measures of locational access to assess whether associations between supermarket access and fruit and vegetable consumption are affected by the choice of access measure and scale.MethodSupermarket location data from Glasgow, UK (n = 119), and fruit and vegetable intake data from the \u27Health and Well-Being\u27 Survey (n = 1041) were used to compare various measures of locational access. These exposure variables included proximity estimates (with different points-of-origin used to vary levels of aggregation) and density measures using three approaches (Euclidean and road network buffers and Kernel density estimation) at distances ranging from 0.4 km to 5 km. Further analysis was conducted to assess the impact of using smaller buffer sizes for individuals who did not own a car. Associations between these multiple access measures and fruit and vegetable consumption were estimated using linear regression models.ResultsLevels of spatial aggregation did not impact on the proximity estimates. Counts of supermarkets within Euclidean buffers were associated with fruit and vegetable consumption at 1 km, 2 km and 3 km, and for our road network buffers at 2 km, 3 km, and 4 km. Kernel density estimates provided the strongest associations and were significant at a distance of 2 km, 3 km, 4 km and 5 km. Presence of a supermarket within 0.4 km of road network distance from where people lived was positively associated with fruit consumption amongst those without a car (coef. 0.657; s.e. 0.247; p0.008).ConclusionsThe associations between locational access to supermarkets and individual-level dietary behaviour are sensitive to the method by which the food environment variable is captured. Care needs to be taken to ensure robust and conceptually appropriate measures of access are used and these should be grounded in a clear a priori reasoning

Endothelial-monocyte activating polypeptide II disrupts alveolar epithelial type II to type I cell transdifferentiation

<p>Abstract</p> <p>Background</p> <p>Distal alveolar morphogenesis is marked by differentiation of alveolar type (AT)-II to AT-I cells that give rise to the primary site of gas exchange, the alveolar/vascular interface. Endothelial-Monocyte Activating Polypeptide (EMAP) II, an endogenous protein with anti-angiogenic properties, profoundly disrupts distal lung neovascularization and alveolar formation during lung morphogenesis, and is robustly expressed in the dysplastic alveolar regions of infants with Bronchopulmonary dysplasia. Determination as to whether EMAP II has a direct or indirect affect on ATII→ATI trans-differentiation has not been explored.</p> <p>Method</p> <p>In a controlled nonvascular environment, an <it>in vitro </it>model of ATII→ATI cell trans-differentiation was utilized to demonstrate the contribution that one vascular mediator has on distal epithelial cell differentiation.</p> <p>Results</p> <p>Here, we show that EMAP II significantly blocked ATII→ATI cell transdifferentiation by increasing cellular apoptosis and inhibiting expression of ATI markers. Moreover, EMAP II-treated ATII cells displayed myofibroblast characteristics, including elevated cellular proliferation, increased actin cytoskeleton stress fibers and Rho-GTPase activity, and increased nuclear:cytoplasmic volume. However, EMAP II-treated cells did not express the myofibroblast markers desmin or αSMA.</p> <p>Conclusion</p> <p>Our findings demonstrate that EMAP II interferes with ATII → ATI transdifferentiation resulting in a proliferating non-myofibroblast cell. These data identify the transdifferentiating alveolar cell as a possible target for EMAP II's induction of alveolar dysplasia.</p

Impact of hormonal contraceptives on sex differences in fear conditioning and fear extinction in PTSD.

Sex differences in the neurobiological mechanisms involved in fear conditioning and extinction have been suggested to contribute to differential vulnerability for the development of posttraumatic stress disorder (PTSD) in women compared with men. Reproductive hormones, such as estradiol, have been shown to facilitate fear conditioning and extinction learning and may explain some of these differences. However, the effect of commonly used hormonal contraceptives on the neurobiological mechanisms of fear conditioning and extinction is poorly understood. A laboratory study was conducted in trauma-exposed men and women with and without full or partial PTSD to examine effects of sex and use of hormonal birth control on fear conditioning, fear extinction learning, and extinction retention. Participants underwent fear conditioning with stimuli that were paired (CS+) or unpaired (CS-) with shock. Extinction learning occurred 72 h later, and extinction retention was tested 1 wk after extinction. Women on hormonal contraceptives (HCs) demonstrated enhanced acquisition of fear conditioning and enhanced extinction of fear as compared with women off hormonal birth control and men. While clinical implications have yet to be determined, these results suggest that hormonal contraceptives may facilitate learning during both fear acquisition and extinction. Understanding the impact of sex and hormones on fear conditioning and extinction processes may lead to new insights into the pathophysiology of PTSD and result in advancements in treatment that may vary by sex

New deal for disabled people national extension: findings from the first wave of qualitative research with clients, job brokers and jobcentre plus staff

The New Deal for Disabled People (NDDP) was introduced in 1998 and 1999 as a series of pilots designed to evaluate services based on the use of personal advisers to help disabled people move into or stay in paid employment. The pilots were wound up in 2001 and superseded by what is known as the ‘national extension’ of NDDP, the aim of which is to ‘support and test innovative ways of helping people on Incapacity Benefits move from economic inactivity into sustained employment’ (DSS, ES, DfEE research specification, April, 2001). Services under the national extension are provided by a network of around 60 ‘Job Broker’ organisations including voluntary and other not-for-profit bodies, commercial companies, government agencies and other public sector organisations. This report presents findings from a first wave of qualitative research carried out in 2002 which forms part of a larger programme of work aimed at providing the Department for Work and Pensions with a comprehensive evaluation of the NDDP extension. The overall aim of the qualitative research is to explore the organisation, operation and impacts of the Job Broker service from the perspective of all key stakeholders, including users and providers of Job Broker services, and staff of Jobcentre Plus offices. Specifically, the research was designed to produce data on the following: • factors affecting participation in the Job Broker programme • clients’ understanding and experiences of NDDP • the role and operation of Job Brokers • the role and operation of the Jobcentre Plus staff who can provide people with information about Job Broker services. A research design was adopted that aimed to gather data using a range of qualitative research techniques from key actors associated with 18 Job Broker services operating in 15 specific geographical areas. The first wave of data collection was carried out in the Summer/Autumn of 2002; a second wave is planned for 2003. The report is organised into three main parts. Part I (Chapters 2 to 5) presents findings from the Job Broker and Jobcentre Plus staff research. In Part II (Chapters 6 to 9), the client perspective is presented. Part III (Chapter 10) provides an overall summary of the emerging issues