Personal, Social, and Environmental Mediators Associated With Increased Recreational Physical Activity in Women and Girls in the Kingdom of Tonga.

BACKGROUND: The purpose of this paper was to identify personal, social, and environmental mediators of recreational physical activity (PA) in a 6-month netball-based intervention for women and girls in Tonga. METHODS: Tonga Netball's "low-engagement village program" was implemented in 10 villages and aimed to increase the recreational PA levels in women and girls through a comprehensive, structured community-level netball program addressing key barriers to participation. In a mixed-methods approach, these mediating barriers were identified through qualitative interviews based on the socioecological model. Quantitative measures for mediators and recreational PA were then developed, and data from 301 women and girls were collected. Standard mediation analyses methods were then applied. RESULTS: Program participation appeared to significantly increase PA levels. Statistically significant personal mediators were body issues, preferring competitions, and clothing. Social mediators were support from sports council, community leaders, friends, and church. Environmental mediators were travel time and access to balls, bibs, and umpires. CONCLUSION: A comprehensive community-level program addressing key participation barriers can increase recreational PA among women and girls in Tonga. Triangulating these results with mediation analyses of variables on the causal pathway can strengthen our understanding of causation and inform funding prioritization for critical program components in similar contexts

Universal reporting of maternal mortality : an achievable goal?

Abstract This paper aims to highlight the importance of aspiring to achieve universal reporting of maternal deaths as a part of taking responsibility for these avoidable tragedies. The paper first discusses the reasons for reporting maternal deaths, distinguishing between individual case notification and aggregate statistics. This is followed by a summary of the status of reporting at national and international levels, as well as major barriers and facilitators to this process. A new framework is then proposed — the REPORT framework, designed to highlight six factors essential to universal reporting. Malaysia is used to illustrate the relevance of these factors. Finally, the paper makes a Call to Action by FIGO to promote REPORT and to encourage health professionals to play their part in improving the quality of reporting on all maternal deaths — not just those directly in their care.This invited paper was prepared under the auspices of the international research program IMMPACT (Initiative for Maternal Mortality Programme Assessment. See http://www/abdn.ac.uk/immpact), funded by the Bill and Melinda Gates Foundation, the Department for International Development, the European Commission, and USAID. The funders have no responsibility for the information provided or views expressed in this paper. The views expressed herein are solely those of the authors’. WG is funded by the University of Aberdeen and IMMPACT, and JH is funded by IMMPACT

Meta-analysis of shared genetic architecture across ten pediatric autoimmune diseases

Genome-wide association studies (GWASs) have identified hundreds of susceptibility genes, including shared associations across clinically distinct autoimmune diseases. We performed an inverse χ(2) meta-analysis across ten pediatric-age-of-onset autoimmune diseases (pAIDs) in a case-control study including more than 6,035 cases and 10,718 shared population-based controls. We identified 27 genome-wide significant loci associated with one or more pAIDs, mapping to in silico-replicated autoimmune-associated genes (including IL2RA) and new candidate loci with established immunoregulatory functions such as ADGRL2, TENM3, ANKRD30A, ADCY7 and CD40LG. The pAID-associated single-nucleotide polymorphisms (SNPs) were functionally enriched for deoxyribonuclease (DNase)-hypersensitivity sites, expression quantitative trait loci (eQTLs), microRNA (miRNA)-binding sites and coding variants. We also identified biologically correlated, pAID-associated candidate gene sets on the basis of immune cell expression profiling and found evidence of genetic sharing. Network and protein-interaction analyses demonstrated converging roles for the signaling pathways of type 1, 2 and 17 helper T cells (TH1, TH2 and TH17), JAK-STAT, interferon and interleukin in multiple autoimmune diseases

Malaysian grocery shoppers' behavioural response to stock-outs

Purpose – A better understanding of the response of shoppers in developing countries to inevitable product stock-outs would help logisticians to put structures in place to reduce the disruption. The purpose of this paper is to examine the differences in orientations that characterize shoppers’ responses to stock-outs in retailing environments by comparing an emerging economy, Malaysia, with a developed economy, Australia. Design/methodology/approach – Randomly selected adult grocery shoppers across Kuala Lumpur, Malaysia were surveyed to examine shoppers’ behavioural response to a most recent stockout of their preferred dairy item. This study followed the methodology and reporting framework adopted in an Australian study. Findings – When responding to stock-outs of their preferred grocery items, shopping lists serve as instruments that give archetypical Malaysian shoppers, unlike their Australian counterparts, a framework to adjust their budgets and seek alternatives within the store itself rather than venture to another store. Most Malaysian shoppers’ reactions to an out-of-stock situation, just as their Australian counterparts, appear to be underpinned by their household size. If their preferred item is not available, the frugal and observant among Malaysian shoppers, however, are not inclined as much as their Australian counterparts, to buy more of their alternative choice, even if these substitute items are discounted. Research limitations/implications – Insight into Malaysian shoppers’ behavioural response to inadequate shelf life of perishable products, considering that they might feel impelled to act as per their shopping lists, would give members of the supply chain confidence to adopt inventory management policies that make a judicious balance between avoiding stock-outs and ensuring stock availability with acceptable shelf life. Practical implications – Malaysian frugal and observant shoppers when responding to stock-outs of their preferred items might allow the opportunity to let a bargain pass on alternative brands or variants, because these shoppers, guided by their shopping lists, are possibly hamstrung, by budgetary constraints in not being able to make heavier purchase outlays and by likely storage constraints in their living accommodation. Retailers in Malaysia have a greater challenge than Australian retailers to dispose of stocks of grocery products that are fast approaching their expiry dates through discounting, because Malaysian shoppers may resist buying more than their immediate need. Originality/value – Malaysian shoppers, inclined to carry memory scripts to assist them in their shopping efforts, are conditioned to stay within their planned budgets and when confronted with a stock-out of their preferred item, are likely to resist buying anymore than what they had planned to buy

Does consumers' future buying behavior regarding products that are returned influence the way consumers want returned goods to be disposed?

Shoppers exiting malls were questioned about what they would consider as appropriate disposal methods of four categories of products that are returned most often. This measure was used as the dependent variable in a two-step process, first using multinomial logit regression followed by a binomial logit regression, with the independent variables being reasons for returning different products, satisfaction with the return process, inclination to repurchase the returned brands, beliefs of shopping at the store, and selected demographics such as age and household size. Consumers who are inclined to repurchase the brands of food items and toiletries that they return expect the complete destruction of the faulty items. There is evidence in this study that consumers are not prepared to continue patronizing brands of appliances and apparel known to be reconstituted and available in alternative stores or charity shops. Notwithstanding manufacturers' attempts to rebuild brand equity, it may be prudent for them not to publicize the availability of reconstituted brands in alternative/charity stores, because prime consumers might be inhibited to patronize these brands

Family size underpins grocery shoppers' behavioural response to stock-outs

Grocery shoppers were questioned about their response to the stock-out of their preferred item of milk and milk products. This measure was used as the dependent variable in a multinomial logit model with the independent variables being shopper dispositions, the contextual shopping situations, age, and household size. This study identified distinctive customer orientations that foreshadowed shoppers' buying a brand variant, buying another brand, and forgoing or postponing their purchase. A binary logit model then estimated the shoppers'orientations that motivated them to seek their preferred item from another store. It emerged that for most shoppers, their household size appeared to be a pressing variable that influenced the way they tackled the non-availability of their normal choice. Marketing literature postulates that large families invariably gravitate to larger pack sizes. Previous research also observes that brand loyalty is negatively correlated to household size. If their regular choice is not available, shoppers could, therefore, easily be driven to seek alternative brands. This study has identified that it would be useful for brand variants to offer shoppers sufficient consumption time till the products' use-by dates to encourage their purchase and prevent shoppers from crossing over to another brand or store. Central to the ample availability of consumption time is the capacity of channel members to support frequent deliveries of larger pack sizes in small lot quantities to the retail store

Disposal of items returned could be influenced by the future buying behaviour of consumers

Conference held in Oslo, Norway 22-25 July, 200

Non-surgical management of ankle contracture following acquired brain injury.

BACKGROUND AND PURPOSE: The purpose of this study was to document the outcome of non-surgical management of equinovarus ankle contracture in a cohort of patients with acquired brain injury admitted to a specialist Neurosurgical Rehabilitation Unit. METHODS: This prospective descriptive study examined all patients with a new diagnosis of moderate to severe acquired brain injury (Glasgow Coma Scale score <12) admitted for rehabilitation over a 1 year period. Ankle dorsiflexion range and plantarflexor/invertor muscle activity were evaluated weekly during the period of hospitalization. Contracture was defined as maximal passive range of motion <0 degrees dorsiflexion, with the knee extended, on a minimum of two measurement occasions. Patients were retrospectively allocated to one of four treatment outcome categories according to ankle dorsiflexion range, type of intervention required and response to treatment. RESULTS: Ankle contracture was identified in 40 of the 105 patients studied. Contracture resolved with a standard physiotherapy treatment programme, including prolonged weight-bearing stretches and motor re-education, in 23 patients. Contracture persisted or worsened in 17 of 40 cases, all of whom exhibited dystonic muscle overactivity producing sustained equinovarus posturing. Ten of 17 cases required serial plaster casting (+/- injection of botulinum toxin type A) in order to achieve a functional range of ankle motion. Remediation of ankle contracture was not considered a priority in the remaining seven patients due to the severity of their overall disability.CONCLUSION: The incidence of ankle contracture identified in this population was considerably less than previously reported. Reduced dorsiflexion range was remediated with standard physiotherapy treatment in over half of the cases. Additional treatment with serial casting +/- botulinum toxin type-A injection was required to correct persistent or worsening contracture in one quarter of cases. Dystonic extensor muscle overactivity was a major contributor to persistent or progressive ankle contracture