Factors affecting adherence to statins in hypercholesterolemic Kuwaiti patients: A cross-sectional study

Objective: This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD). Subjects and Methods: Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to 50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01). Conclusion: In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile

Associations between parenting styles and children's fruit and vegetable intake

This study investigated associations between children’s fruit and vegetable intake and their parents’ parenting style (i.e., authoritative: high warmth-high control; authoritarian: low warmth-high control; permissive: high warmth-low control; and disengaged: low warmth-low control). Data from the Longitudinal Study of Australian Children K cohort, comprising approximately 5,000 children, were used for analyses in wave 1 (4–5 years), wave 2 (6–7 years), and wave 3 (8–9 years). Fruit and vegetable intake patterns were extracted through exploratory factor analysis. Boys with authoritarian mothers were found less likely to consume fruits and vegetables at 6–9 years. Children of both genders with authoritative and permissive fathers, and girls with authoritative mothers at 4–5 years were found most likely to consume fruits and vegetables two and four years later. Exploring possible mechanisms underlying such associations may lead to interventions aimed at increasing children’s consumption of fruits and vegetables

Impact of a school-based food garden on attitudes and identification skills regarding vegetables and fruit: A 12-month intervention trial

Objective To determine changes in ability to identify specific vegetables and fruits, and attitudes towards vegetables and fruit, associated with the introduction of a school-based food garden. Design A 12-month intervention trial using a historical control (control n 132, intervention n 120), class-based, self-administered questionnaires requiring one-word answers and 3-point Likert scale responses. Setting A state primary school (grades 4 to 7) in a low socio-economic area of Brisbane, Australia. Intervention The introduction of a school-based food garden, including the funding of a teacher coordinator for 11 h/week to facilitate integration of garden activities into the curriculum. Main outcome measures Ability to identify a series of vegetables and fruits, attitudes towards vegetables and fruit. Analysis Frequency distributions for each item were generated and χ2 analyses were used to determine statistical significance. Exploratory factor analysis was employed to detect major trends in data. Results The intervention led to enhanced ability to identify individual vegetables and fruits, greater attention to origins of produce (garden-grown and fresh), changes to perceived consumption of vegetables and fruits, and enhanced confidence in preparing fruit and vegetable snacks, but decreased interest in trying new fruits. Conclusions The introduction of this school-based food garden was associated with skill and attitudinal changes conducive to enhancing vegetable and fruit consumption. The ways in which such changes might impact on dietary behaviours and intake require further analysis

Using a household food inventory to assess the availability of traditional vegetables among resettled African refugees

A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age, having a vegetable garden, employment status, and having a supermarket in the local neighborhood. Food preparers from homes with low vegetable availability were less likely to consume the recommended number of vegetable servings. Barriers faced in the food environment included language, lack of availability of traditional vegetables and lack of transport. All of these aspects contributed to the study findings that both individual and food environment characteristics may play a role in access to and availability of food and vegetable consumption of resettled refugees. Consumption of traditional foods among the resettled refugees continues post resettlemen

Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review

Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources. Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods; purchase, or selection of meat/plant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review. The results were narratively synthesised. Included studies were categorised into individual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of individual level interventions (52%) aimed to reduce red/processed meat intake among people with current/past chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population

Evaluation of a virtual, simulated international public health peer-to-peer exchange learning experience

IntroductionPublic Health’s (PH) global rise is accompanied by an increasing focus on training the new generation of PH graduates in interdisciplinary skills for multisectoral and cross-cultural engagement to develop an understanding of commonalities in health system issues and challenges in multi-cultural settings. Online teaching modalities provide an opportunity to enhance global health skill development through virtual engagement and peer exchange. However, current teaching pedagogy is limited in providing innovative modes of learning global health issues outside of traditional classroom settings with limited modalities of evidence-informed implementation models.MethodsThis study designed, implemented, and evaluated a novel global health online synchronous module as proof of concept that incorporated elements of virtual Practice-based learning (PBL) using a case study approach offered to currently enrolled public health students at the University of Canberra (UC) and a partnering public health university from India, the Indian Institute of Public Health Gandhinagar (IIPH-G). Using constructive learning theory and the Social Determinants of Health framework, four online sessions were designed and implemented in August–September 2022. Formal process and outcome evaluation using a quantitative adapted survey of the validated International Student Experience survey (IES) at session end and findings provided.ResultsOver 100 participating public health students from Australia and India provided narrative feedback and quantitative responses from the adapted IES instrument across four key dimensions, namely “motivation,” “personal development,” intellectual development, and “international perspectives” reporting an overall high mean impact of 4.29 (out of 5) across all four themes seen together. In essence, the sessions supported students to explore global health issues from a different cultural perspective while developing intercultural communication skills and enhancing their global exposure in real-time.DiscussionsThis innovation, implemented as a proof of concept, provided evidence, and demonstrated the implementation feasibility of a flexible virtual integrated practice-based module that can supplement classroom teaching. It provides participating students with the opportunity to develop intercultural understanding and communication competence as well as support global mindedness by engaging with international peers around focused global health case studies

Reporting of dietary control frameworks in studies on simvastatin efficacy

Background & aims: HMG-Co reductase inhibitors (e.g. simvastatin) are important coronary heart disease (CHD) risk-reduction agents. Prescription protocols recommend low-fat diets in conjunction with simvastatin prescription. Simvastatin efficacy studies were reviewed to define dietary contexts within which simvastatin is most efficacious. Methods: Randomised controlled trials of simvastatin were identified by a literature search of Medline Databases (1992-2006), English-language journals, and reference lists of original articles, reviews and metanalyses. Studies involving both genders, sample size >30, were assessed for published details on dietary advice, dietary intervention duration, dietary adherence measures, and dietary data analysis. Results: Review of 18 selected studies revealed an absence of transparency of dietary control frameworks and analysis. Even where a specific diet was integral to study design, information was scant on dietrelated outcomes or methods applied to assure dietary adherence. Conclusions: The absence of published details on dietary methodology reveals substantial gaps in understanding the context within which simvastatin is most efficacious. Further, these studies provide little scope for post hoc analysis for effects of specific dietary factors on simvastatin efficacy. Since dietary advice is often given in conjunction with prescription of many drugs, more rigorous attention to reporting dietary methodology is warranted.No Full Tex