The ethical beliefs and behaviours of Victorian fitness professionals

A survey based on those employed by Petitpas, Brewer, Rivera, and Van Raalte (1994), Pope, Tabachnick, and Keith-Spiegel (1987), Tabachnick, Keith-Spiegel, and Pope (1991), and Pope and Vetter (1992) was used to investigate the ethical beliefs and behaviours of Victorian fitness professionals. Although there is evidence that Victorian fitness professionals are knowledgeable about some general ethical principles, the results of this study suggest that there is some lack of consensus among Victorian fitness professionals about the ethical appropriateness of a number of complex issues relating to business practices, confidentiality, dual relationships, and personal and professional boundaries. The findings suggest there is a need to improve the professional and ethical education of fitness professionals and to develop comprehensive ethical principles and a code of conduct that is relevant to the individuals working in the Australian fitness profession

Prevalence of Oral Pain and Barriers to use of Emergency Oral Care Facilities Among Adult Tanzanians.

Oral pain has been the major cause of the attendances in the dental clinics in Tanzania. Some patients postpone seeing the dentist for as long as two to five days. This study determines the prevalence of oral pain and barriers to use of emergency oral care in Tanzania. Questionnaire data were collected from 1,759 adult respondents aged 18 years and above. The study area covered six urban and eight rural study clusters, which had been selected using the WHO Pathfinder methodology. Chi-square tests and logistic regression analyses were performed to identify associations.\ud Forty two percent of the respondents had utilized the oral health care facilities sometimes in their lifetime. About 59% of the respondents revealed that they had suffered from oral pain and/or discomfort within the twelve months that preceded the study, but only 26.5% of these had sought treatment from oral health care facilities. The reasons for not seeking emergency care were: lack of money to pay for treatment (27.9%); self medication (17.6%); respondents thinking that pain would disappear with time (15.7%); and lack of money to pay for transport to the dental clinic (15.0%). Older adults were more likely to report that they had experienced oral pain during the last 12 months than the younger adults (OR = 1.57, CI 1.07-1.57, P < 0.001). Respondents from rural areas were more likely report dental clinics far from home (OR = 5.31, CI = 2.09-13.54, P < 0.001); self medication at home (OR = 3.65, CI = 2.25-5.94, P < 0.001); and being treated by traditional healer (OR = 5.31, CI = 2.25-12.49, P < 0.001) as reasons for not seeking emergency care from the oral health care facilities than their counterparts from urban areas. Oral pain and discomfort were prevalent among adult Tanzanians. Only a quarter of those who experienced oral pain or discomfort sought emergency oral care from oral health care facilities. Self medication was used as an alternative to using oral care facilities mainly by rural residents. Establishing oral care facilities in rural areas is recommended

Establishing What Constitutes a Healthy Human Gut Microbiome: State of the Science, Regulatory Considerations, and Future Directions.

On December 17, 2018, the North American branch of the International Life Sciences Institute (ILSI North America) convened a workshop "Can We Begin to Define a Healthy Gut Microbiome Through Quantifiable Characteristics?" with &gt;40 invited academic, government, and industry experts in Washington, DC. The workshop objectives were to 1) develop a collective expert assessment of the state of the evidence on the human gut microbiome and associated human health benefits, 2) see if there was sufficient evidence to establish measurable gut microbiome characteristics that could serve as indicators of "health," 3) identify short- and long-term research needs to fully characterize healthy gut microbiome-host relationships, and 4) publish the findings. Conclusions were as follows: 1) mechanistic links of specific changes in gut microbiome structure with function or markers of human health are not yet established; 2) it is not established if dysbiosis is a cause, consequence, or both of changes in human gut epithelial function and disease; 3) microbiome communities are highly individualized, show a high degree of interindividual variation to perturbation, and tend to be stable over years; 4) the complexity of microbiome-host interactions requires a comprehensive, multidisciplinary research agenda to elucidate relationships between gut microbiome and host health; 5) biomarkers and/or surrogate indicators of host function and pathogenic processes based on the microbiome need to be determined and validated, along with normal ranges, using approaches similar to those used to establish biomarkers and/or surrogate indicators based on host metabolic phenotypes; 6) future studies measuring responses to an exposure or intervention need to combine validated microbiome-related biomarkers and/or surrogate indicators with multiomics characterization of the microbiome; and 7) because static genetic sampling misses important short- and long-term microbiome-related dynamic changes to host health, future studies must be powered to account for inter- and intraindividual variation and should use repeated measures within individuals

Examining the feasibility of mixture risk assessment: A case study using a tiered approach with data of 67 pesticides from the Joint FAO/WHO Meeting on Pesticide Residues (JMPR)

The way in which mixture risk assessment (MRA) should be included in chemical risk assessment is a current topic of debate. We used data from 67 recent pesticide evaluations to build a case study using Hazard Index calculations to form risk estimates in a tiered MRA approach in line with a Framework proposed by WHO/IPCS. The case study is used to illustrate the approach and to add detail to the existing Framework, and includes many more chemicals than previous case studies.A low-tier MRA identified risk as being greater than acceptable, but refining risk estimates in higher tiers was not possible due to data requirements not being readily met. Our analysis identifies data requirements, which typically expand dramatically in higher tiers, as being the likely cause for an MRA to fail in many realistic cases. This forms a major obstacle to routine implementation of MRA and shows the need for systematic generation and collection of toxicological data. In low tiers, hazard quotient inspection identifies chemicals that contribute most to the HI value and thus require attention if further refinement is needed. Implementing MRA requires consensus on issues such as scope setting, criteria for performing refinement, and decision criteria for actions.Oak Foundation (Grant number OCAY-13-391), which is gratefully acknowledged, and partly in the context of an European Food Safety Authority contract (CFT/EFSA/PPR/2010/04

The Role of Ideas in Policy Transfer: The Case of UK Smoking Bans since Devolution

This article explores the relationship between ideas and interests in policy change by examining tobacco control in each country of the United Kingdom (UK). In all four, the moves towards further prohibition reflected international trends, with evidence of policy transfer and the virus-like spread of ideas which has shifted the way that tobacco is framed. However, there are notable differences in the development of policy in each territory. This reinforces conceptions of transfer in which the importation of policy is mediated by political systems. Differences in policy conditions, institutions and &lsquo;windows of opportunity' mean that our conclusions on the role and influence of interest groups, institutions and agenda-setting vary by territory, even within a member state. This suggests that a focus on an &lsquo;idea whose time has come' should be supplemented by careful analysis of the political context in which the idea was articulated and accepted

Towards a comprehensive estimate of national spending on prevention

Background Comprehensive information about national spending on prevention is crucial for health policy development and evaluation. This study provides a comprehensive overview of prevention spending in the Netherlands, including those activities beyond the national health accounts. Methods National spending on health-related primary and secondary preventive activities was examined by funding source with the use of national statistics, government reports, sector reports, and data from individual health associations and corporations, public services, occupational health services, and personal prevention. Costs were broken down by diseases, age groups and gender using population-attributable risks and other key variables. Results Total expenditures on prevention were €12.5 billion or €769 per capita in the Netherlands in 2003, of which 20% was included in the national health accounts. 82% was spent on health protection, 16% on disease prevention, and 2% on health promotion activities. Most of the spending was aimed at the prevention of infectious diseases (34%) and acute physical injuries (29%). Per capita spending on prevention increased steeply by age. Conclusion Total expenditure on health-related prevention is much higher than normally reported due to the inclusion of health protection activities beyond the national health accounts. The allocative efficiency of prevention spending, particularly the high costs of health protection and the low costs of health promotion activities, should be addressed with information on their relative cost effectiveness

Inter-rater reliability of welfare outcomeassessment by an expert and farmers of SouthTyrolean dairy farming

The implementation of an animal welfare assurance programme for dairy cattle in South Tyrol (Eastern Italian Alps) faces particular feasibility constraints due to the outstanding volume of travel associated with routine on-farm audits of remote mountain farms. Therefore, this study aims to estimate the inter-rater reliability of the expert’s and farmers’ welfare outcome assessment regarding recommendations to involve milk producers in animal welfare assurance within South Tyrolean dairy farming. A formal training programme containing a classroom session and an on-farm observation became mandatory for all 188 participating farmers, which was offered by the expert, applied as reference standard. On-farm data collected on the farmers’ cows (dataset of 1719 dairy cows) were compared at animal level. Cohen’s kappa, respectively, weighted kappa, examined for several welfare indicators, range from slight to moderate agreement(k=0.018-0.416;Kw=0.163-0.310). These findings are further confirmed by results at farmlevel (ICC=0.018-0.577). Continuous repeatability checks as part of routine audits are therefore proposed to substantially reduce the variability between the raters and to avoid significant bias in the welfare outcome assessment. In this way, the competence for regular and standardised monitoring could be increasingly transferred to dairy farmers in order to reduce the need for costly and time-consuming inspections by external auditors, which are in long-term perspective also harmful to the alpine environment. Additionally, the promotion of welfare assessment as an instructive management tool would intensify farmers’ commitment to the assessment process

Objective methods for reliable detection of concealed depression

Recent research has shown that it is possible to automatically detect clinical depression from audio-visual recordings. Before considering integration in a clinical pathway, a key question that must be asked is whether such systems can be easily fooled. This work explores the potential of acoustic features to detect clinical depression in adults both when acting normally and when asked to conceal their depression. Nine adults diagnosed with mild to moderate depression as per the Beck Depression Inventory (BDI-II) and Patient Health Questionnaire (PHQ-9) were asked a series of questions and to read a excerpt from a novel aloud under two different experimental conditions. In one, participants were asked to act naturally and in the other, to suppress anything that they felt would be indicative of their depression. Acoustic features were then extracted from this data and analysed using paired t-tests to determine any statistically significant differences between healthy and depressed participants. Most features that were found to be significantly different during normal behaviour remained so during concealed behaviour. In leave-one-subject-out automatic classification studies of the 9 depressed subjects and 8 matched healthy controls, an 88% classification accuracy and 89% sensitivity was achieved. Results remained relatively robust during concealed behaviour, with classifiers trained on only non-concealed data achieving 81% detection accuracy and 75% sensitivity when tested on concealed data. These results indicate there is good potential to build deception-proof automatic depression monitoring systems