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Abstract: Background: Strong evidence links the consumption of a Mediterranean diet (MD) with a reduced cardiovascular disease (CVD) risk; however, there is uncertainty as to whether non‐Mediterranean regions will adopt this diet. The present qualitative research aimed to investigate attitudes towards a MD in individuals at high CVD risk in a Northern European population. This information is needed to inform development of MD interventions in non‐Mediterranean high‐risk populations. Methods: Focus groups (n = 12) were held with individuals at high CVD risk from Northern Europe (≥2 CVD risk factors, aged ≥50 years, no established CVD/type 2 diabetes). Attitudes to dietary change towards a MD were explored. Data were analysed using inductive thematic analysis. Results: Sixty‐seven adults participated (60% female, mean age 64 years). There was some awareness of the term MD but limited knowledge of its composition. Barriers to general dietary change were evident, including perception of expense, concern over availability, expectation of time commitment, limited knowledge, lack of cooking skills, amount and conflicting nature of media information on diets, changing established eating habits and resistance to dietary change. Barriers specific to MD adoption were also identified, including perceived difficulty living in a colder climate, perceived impact on body weight, acceptability of a MD and cultural differences. Conclusions: Knowledge of a MD was limited in this Northern European sample at high CVD risk. In addition to general barriers to dietary change, barriers specific to a MD were identified. These findings have implications for the development of interventions aiming to promote MD adoption in non‐Mediterranean populations. [ABSTRACT FROM AUTHOR]

Background Dementia is common among adults with Down's syndrome (DS); yet the diagnosis of dementia, particularly in its early stage, can be difficult in this population. One possible reason for this may be the different clinical manifestation of dementia among people with intellectual disabilities. Aims The aim of this study was to map out the carers' perspective of symptoms of dementia among adults with DS in order to inform the development of an informant-rated screening questionnaire. Method Unconstrained information from carers of people with DS and dementia regarding the symptoms, particularly the early symptoms of dementia, was gathered using a qualitative methodology. Carers of 24 adults with DS and dementia were interviewed. The interviews were recorded and fully transcribed. The transcripts were then analysed using qualitative software. Results There appeared to be many similarities in the clinical presentation of dementia in adults with DS and the non-intellectually disabled general population. Like in the non-intellectually disabled general population, forgetfulness especially, impairment of recent memory combined with a relatively intact distant memory and confusion were common, and presented early in dementia among adults with DS. However, many ‘frontal lobe’-related symptoms that are usually manifested later in the process of dementia among the general population were common at an early stage of dementia among adults with DS. A general slowness including slowness in activities and speech, other language problems, loss of interest in activities, social withdrawal, balance problems, sleep problems, loss of pre-existing skills along with the emergence of emotional and behaviour problems were common among adults with DS in our study. Conclusions This study highlights the similarities in the clinical presentation of dementia among the general population and people with DS with a particular emphasis on the earlier appearance of symptoms associated with the frontal lobe dysfunction among adults with DS. [ABSTRACT FROM AUTHOR]

Background Most adults in Europe lead sedentary lives; their physical inactivity is associated with a rising prevalence of obesity and is considered to contribute significantly to health inequalities. A recent NICE (2006) review concluded that, “there is an urgent need to conduct research into the effectiveness of environmental interventions, particularly within socially excluded sectors of the population who have the highest prevalence of physical inactivity”. Objective To investigate and utilise the community “knowledge” of individuals living in a socio-economically deprived community and of relevant stakeholders in statutory and voluntary organisations, regarding the design of community-based initiatives on increasing physical activity (PA) levels. Setting The Connswater Community Greenway is a £32 million investment in East Belfast. The aim of the Greenway is to provide a safe and accessible area which increases PA and improves the people's quality of life. Method Semi-structured interviews with leading community representatives were conducted regarding (i) the nature and extent to which there are specific groups of residents who would benefit from increased PA, (ii) the nature and provision of PA initiatives, and (iii) practical advice regarding the selection of focus group participants from “Physical Activity Need Groups”. Transcriptions were audio recorded and transcribed verbatim. Interim thematic analysis was conducted after each interview to inform the primary questions for subsequent interviews. Findings were validated by a second researcher. Results Preliminary analysis identified emerging themes relating to the design of successful initiatives. These include the perceived relationship between PA and health, financial and community support, access to facilities, programme content and current service provision. Participants acknowledged that promoting PA has associated health benefits but attributed higher priority to interventions focused on social issues. Short-term funding was a problem for sustaining initiatives and a need for volunteer support was identified. Participants reported local physical and social barriers to community engagement and emphasised the need to involve the local community in planning, to ensure relevance of possible components of interventions to the locality. Perceived needs of particular groups for PA promotion related both to their individual health needs and the geographical area in which they lived. The extent to which groups were perceived as being “hard to reach” influenced the provision of current services. Conclusion The promotion of PA in a socio-economically deprived area is a complex issue. Results will inform focus group discussions with community representatives and theory-based Intervention Mapping to guide the design of PA initiatives. [ABSTRACT FROM PUBLISHER]