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Reminiscence therapy and music are often used to improve the wellbeing of older people; however, we do not know how these interventions are used in practice. This study explored how those working with older people view and use verbal Reminiscence Therapy (VRT) and Music-assisted Reminiscence Therapy (MRT). A total of 110 participants who worked or volunteered with older people in Australia were surveyed in this descriptive, mixed-method study. VRT and MRT were frequently and spontaneously used to respond to the varied needs of older adults. VRT and MRT lead to reported positive outcomes including better care practices, positive affect and mood, and improved social connections. MRT was used as a compensatory strategy when traditional VRT was not possible. This study describes the current practices of VRT and MRT, and an overview of how reminiscence-based approaches are used in Australia to address the health and wellbeing of older people., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Chronic exposure of the macula to blue light from electronic devices has been identified as a potential macular health concern. The impacts remain poorly investigated as no validated methods to capture usual device use behaviours exist., Purpose: The aim of this study was to develop and validate the Electronic Device Use Questionnaire (EDUQ) against multiple 24-h electronic device use diaries in healthy Australian and United Kingdom adults., Methods: The EDUQ and diaries were developed to capture device use across categories (television, computer and handheld devices). Over eight weeks 56 Australian and 24 United Kingdom participants completed three questionnaires and eight diaries via online platforms. Tool validity was determined through Bland-Altman plot analysis of mean daily hours of device use between the tools., Results: The EDUQ demonstrated poor validity in both cohorts with poor agreement when compared with the diaries. When the device categories were combined, a mean difference between the tools of 1.54 h/day, and 95% limits of agreement between -2.72 h/day and 5.80 h/day was observed in the Australian cohort. Across both cohorts and all device categories the mean differences indicated individuals were more likely to report higher device use through the questionnaire rather than diaries., Conclusions: The EDUQ is a novel tool and demonstrated the difficulty for participants of accurately recalling usual behaviour of device use. Poor agreement in reported device use occurred across all device categories. The poor agreement may be related to factors such as memory recall bias, and the number of diaries captured not being reflective of usual use. Future studies should look to address these factors to improve validity of device use capture., (© 2024. The Author(s).)

Background: Dietary nitrates may play a role in mediating several key physiological processes impacting health and/or exercise performance. However, current methods for assessing dietary nitrate (NO 3 - ) consumption are inadequate. The present study aimed to examine the dietary nitrate intake in a sample of 50 healthy adults, as well as test the validity of a purposefully developed food frequency questionnaire (FFQ)., Methods: Dietary nitrate intake was estimated over a week using (i) three 24-h dietary recalls; (ii) a short-term (7-day) FFQ; and (iii) a biomarker (urinary nitrate), in conjunction with a nitrate reference database., Results: Daily dietary nitrate intake estimates were 130.94 mg (average of three 24-h recalls) and 180.62 mg (FFQ). The mean urinary NO 3 - excretion was 1974.79 µmol day -1 (or 917.9 µmol L -1 ). Despite the difference between the two dietary assessment methods, there was a moderate positive correlation (r = 0.736, ρ < 0.001) between the two tools. There was also a positive correlation between urinary NO 3 - and 24-h recall data (r = 0.632, ρ < 0.001), as well as between urinary NO 3 - and FFQ (r = 0.579, ρ < 0.001)., Conclusions: The ability to accurately estimate nitrate intakes depends on having suitable reference methods to estimate the concentrations of nitrate in the food supply, coupled with valid and reliable dietary assessment tools. Based on the findings from the present study, at an individual level, dietary recalls or records may be more accurate in estimating intakes of NO 3 - . However, given the lower cost and time needed for administration relative to recalls, the FFQ has merit for estimating NO 3 - intakes in health interventions, dietary surveys and surveillance programs., (© 2022 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Here, we examined retrospective reports of adults' earliest autobiographical memory, the age of this report and whether the reported age was associated with exposure to early life adversity, current anxiety and childhood attachment. Across four studies, we found that reporting a later 'earliest' memory was associated with higher self-reported anxiety in both American (Studies 1, 2 and 4) and Australian (Study 3) samples. Furthermore, in Studies 2-4, we found that reporting a later earliest memory uniquely predicted anxiety when controlling for number of adverse childhood events (a risk factor for the development of anxiety). In Study 4, we established that this relation is partially mediated by childhood anxious attachment. Although we consistently demonstrated that later earliest memories were associated with current anxiety, we found little evidence for a relation between reported age at the time of earliest memory and childhood adversity. We also found no evidence of gender differences in the associations of interest. These results suggest that poorer memory of early childhood is associated with greater childhood anxious attachment and anxiety in adulthood. The implications of this work are discussed in terms of the adaptive nature of autobiographical memory and the development of a coherent life narrative., (© 2021 The British Psychological Society.)

Health departments routinely investigate cases of gastroenteritis through interviews to determine the source of infection. However, validation studies of dietary questionnaires typically focus on quantities consumed and don't assess questions designed to identify sources of foodborne illness. We aimed to assess the accuracy and reliability of information collected by surveys of food history recall for gastroenteritis investigations. A questionnaire was developed to investigate the sources of foodborne gastroenteritis in Australia, with questions on food exposures selected for validation. Fifty-five participants photographed all foods consumed and food receipts obtained during a seven-day observation period. These photographs were uploaded to an online survey or emailed to the researcher. Participants were contacted 14 days later for a telephone interview about foods consumed in the seven-day period. Questionnaire responses were compared to uploaded photographs. Kappa statistics (κ) and 95% confidence intervals were calculated. Sixty-two questions were assessed, including those targeting foods considered high-risk for foodborne gastroenteritis. Potential risk factors covered by these questions included: meats (poultry, beef, pork, and deli meats), the state of poultry purchased (raw versus precooked), and the number of meals eaten outside of the home. Several questions targeting high-risk foods were found to have substantial-to-almost perfect agreement (κ ≥ 0.610) between what was eaten and what was reported by participants, with most questions showing at least a moderate level of agreement (κ = 0.410–0.600). Questions regarding exposure to different types of meat showed a high level of consistency. The only question with poor participant recall (κ < 0.000) was that relating to consumption of undercooked beef or veal. Several questions designed for investigation of gastroenteritis were found to provide at least a moderate level of accurate and reliable recall, even after a delay until interview. These questions are suitable for investigating sources of foodborne gastroenteritis. • Recall of exposure to high-risk foods was assessed. • Most questions showed at least a moderate level of agreement. • Dining locations were assessed as having consistently high recall. • Questions that quantified consumption in number of days had poorer validity. • Questions and results can inform surveys for investigation of gastroenteritis. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the relative validity and reproducibility of a six-item Australian Short Dietary Screener (Aus-SDS). The Aus-SDS assessed the daily intake of core food groups (vegetables, fruits, legumes and beans, cereals, protein sources and dairy sources) in 100 Australians (52 males and 48 females) aged ≥70 years. Relative validity was assessed by comparing intakes from the Aus-SDS1 with an average of three 24-hour recalls (24-HRs), and reproducibility using two administrations of the Aus-SDS (Aus-SDS1 and Aus-SDS2). Cohen's kappa statistic between the Aus-SDS1 and 24-HRs showed moderate to good agreement, ranging from 0.44 for fruits and dairy to 0.64 for protein. There was poor agreement for legume intake (0.12). Bland-Altman plots demonstrated acceptable limits of agreement between the Aus-SDS1 and 24-HRs for all food groups. Median intakes obtained from Aus-SDS1 and Aus-SDS2 did not differ. For all food groups, Cohen's kappa statistic ranged from 0.68 to 0.89, indicating acceptable agreement between the Aus-SDS1 and Aus-SDS2. Spearman's correlation coefficient between Aus-SDS1 and 24-HRs across all food groups ranged from 0.64 for fruit to 0.83 for protein. We found the Aus-SDS to be a useful tool in assessing daily intake of core food groups in this population., Competing Interests: Sophia Zoungas reports payment to institution (Monash University)—Eli Lilly Australia Ltd., Boehringer-Ingelheim, MSD Australia, AstraZeneca, Novo Nordisk, Sanofi, Servier, outside the submitted work. All other authors have no conflicts of interest to declare in relation to the present work.

Gardens play a vital role in homemaking for many older people living in aged-care facilities. A garden is where residents can assert ownership, agency, and recall significant memories, especially after relocation in later life. This research addresses a gap in literature about aged-care gardens by expanding notions of therapeutic benefits. It adopts a phenomenological framework and applies unstructured interviews, Go-Along videorecording and digital storytelling for data collection. Findings suggest residents are not merely passive users of gardens, they are active creators, shaping their outdoor environment through gardening and creating meanings in their local landscape that contribute to their experience of being 'home'., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Wearable camera photographs have been shown to be an effective memory aid in people with and without memory impairment. Most studies using wearable cameras as a memory aid have presented photographs on a computer monitor and used a written diary or no review as a comparison. In this pioneering study, we took a new and innovative approach to wearable camera photograph review that embeds the photographs within a virtual landscape. This approach may enhance these benefits by reinstating the original environmental context to increase participants' sense of re-experiencing the event., Objective: We compare the traditional computer monitor presentation of wearable camera photographs and actively taken digital photographs with the presentation of wearable camera photographs in a new immersive interface that reinstates the spatiotemporal context., Methods: Healthy older adults wore wearable or took digital photographs during a staged event. The next day and 2 weeks later, they viewed wearable camera photographs on a computer monitor or in context on an immersive interface, or digital photographs., Results: Participants who viewed wearable camera photographs in either format recalled more details during photo viewing and subsequent free recall than participants who viewed digital photographs they had taken themselves., Conclusion: Wearable camera photographs are an effective support for event memory, regardless of whether they are presented in context in an experience-near format., (© 2020 S. Karger AG, Basel.)

Objectives: Child witnesses often describe their experiences across multiple interviews. It is unknown whether talking with a familiar interviewer increases disclosures, however, or whether any benefits of a familiar interviewer could be achieved by ensuring that interviewers (regardless of familiarity) behave in socially supportive ways. This study tested the effects of interviewer familiarity and social support on children's reports of an adult's transgressions., Hypotheses: We predicted that familiarity and supportiveness would increase transgression reports at a second interview and that children who spoke with familiar, supportive interviewers would disclose the most transgressions., Method: Children (N = 160, 5 to 9 years) participated in a science event involving 6 transgressions. Across 2 interviews, they spoke with the same trained university student interviewer or different interviewers, and these interviewers engaged in supportive or neutral behaviors. Interviews were coded for overall information reported, number of transgressions, and confabulations., Results: There were no effects of support in the first interview or on total details reported in either interview. Children reported more transgressions to supportive than neutral interviewers in the second interview (IRR = 1.19), even during open-ended prompting (IRR = 1.26), and they omitted fewer transgressions that had been reported in the first interview (IRR = 0.69). Confabulations were infrequent. There were no condition differences in the total number of confabulations reported across interviews, but these errors occurred more often in the second interview in the supportive condition., Conclusions: Interviewer support may play a greater role than familiarity in facilitating children's testimony. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background: The last few years have seen renewed interest in use-of-time recalls in epidemiological studies, driven by a focus on the 24-h day [including sleep, sitting, and light physical activity (LPA)] rather than just moderate-vigorous physical activity (MVPA). This paper describes four different computerised use-of-time instruments (ACT24, PAR, MARCA and cpar24) and presents population time-use data from a collective sample of 8286 adults from different population studies conducted in Australia/New Zealand, Germany and the United States., Methods: The instruments were developed independently but showed a number of similarities: they were self-administered through the web or used computer-assisted telephone interviews; all captured energy expenditure using variants of the Ainsworth Compendium; each had been validated against criterion measures; and they used a domain structure whereby activities were aggregated under categories such as Personal Care and Work., Results: Estimates of physical activity level (average daily rate of energy expenditure in METs) ranged from 1.53 to 1.78 in the four studies, strikingly similar to population estimates derived from doubly labelled water. There was broad agreement in the amount of time spent in sleep (7.2-8.6 h), MVPA (1.6-3.1 h), personal care (1.6-2.4 h), and transportation (1.1-1.8 h). There were consistent sex differences, with women spending 28-81% more time on chores, 8-40% more time in LPA, and 3-39% less time in MVPA than men., Conclusions: Although there were many similarities between instruments, differences in operationalizing definitions of sedentary behaviour and LPA resulted in substantive differences in the amounts of time reported in sedentary and physically active behaviours. Future research should focus on deriving a core set of basic activities and associated energy expenditure estimates, an agreed classificatory hierarchy for the major behavioural and activity domains, and systems to capture relevant social and environmental contexts.

In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, so compliance with recommendations is not known. This analysis describes free sugars intakes, food sources and determinants of high consumption among Australian children at 2 years of age. Free sugars intakes were estimated using a customized Food Frequency Questionnaire, and median usual free sugars intake at 2 years was 22.5 (Interquartile Range (IQR) 12.8⁻37.7) g/day, contributing a median 8% of the estimated energy requirement (EER). Based on the EER, most children (71.1%) exceeded the World Health Organization recommendation that <5% of energy should come from free sugars, with 38% of participants exceeding the <10% recommendation. Children from households with the greatest socioeconomic disadvantage were more likely to exceed the 10% recommendation (Prevalence Ratio (PR) 1.44, 95% Confidence Interval (95% CI) 1.13⁻1.84), and be in the top tertile for free sugars intake (PR 1.58, 95% CI 1.19⁻2.10) than the least disadvantaged. Main sources of free sugars were non-core foods, such as fruit juice, biscuits, cakes, desserts and confectionery; with yogurt and non-dairy milk alternatives the two notable exceptions. Improved efforts to reduce free sugars are needed from the introduction of solid food, with a particular focus on fruit juice and non-core foods.

Dietary fibre is important for regular laxation and reduces chronic disease risk. The National Health and Medical Research Council outlines daily fibre intake targets, yet the proportion of the population that meets these targets is unknown. Using the 2011⁻2012 National Nutrition and Physical Activity Survey, we profiled fibre intake among Australian children and adults. Data from one-day dietary recalls were analysed ( n = 12,153, ≥2 years) as well as demographic and anthropometric factors. The median fibre intake was 18.2 g (interquartile range [IQR] 13.2⁻25.0) in children and 20.7 g (IQR 14.3⁻28.7) in adults. We found that 42.3% (95% CI 40.5⁻44.1%) of children and 28.2% (95% CI 27.3⁻29.1%) of adults met the Adequate Intake (AI), and less than 20% of adults met the Suggested Dietary Target (SDT) to reduce the risk of chronic disease. Older children (aged 14⁻18 years), girls, young adults (19⁻30 years), males, and those of lower socio-economic status were less likely to meet the AI ( p < 0.001). Those with a higher energy intake were more likely to meet the AI. Anthropometric measures were not associated with fibre intake or the likelihood of meeting the AI. Fibre is a nutrient of concern in Australian diets, with most children and adults falling short of recommendations. Adolescents, girls, young adults, men, and those of lower socio-economic status were less likely to meet the recommendations and may benefit most from public health interventions., Competing Interests: The authors declare no conflict of interest. Kellogg Australia had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Recent decades have seen an explosion of research into children's eyewitness capabilities and resulted in legal reform to render the adversarial trial process more child friendly. Many, however, have been left with the feeling that the most intimidating legal process for child complainants-cross-examination-has not changed meaningfully despite its potential to distort children's evidence. To test this possibility, we compared the cross-examination questioning of Australian child sexual abuse complainants in the 1950s to that used in contemporary cases. We found that the format of cross-examination questions has remained largely consistent over time, with leading questions still making up the bulk of the questions asked. The changes that we did observe, however, are concerning. Cross-examination questions posed to contemporary child complainants were less likely to be open-ended and more likely to be complex, relative to those asked in the 1950s. Crucially, contemporary complainants were asked 3 times as many cross-examination questions as they were 60 years ago. These changes are likely to have detrimental effects on child complainants and their evidence and could reduce the ability of jurors to reach just outcomes in these cases.

Background: Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients' memory of medical information., Objectives: This study aimed to develop a method for eliciting and coding recall of medical information in non-English-speaking patients., Design: This method, called Patient-Interpreter-Clinician coding (PICcode), was developed in the context of a phase II trial conducted in two outpatient oncology clinics in Melbourne, Australia, and was refined iteratively through consultation with an expert panel and piloting. Between-coder differences in early versions of the coding system were resolved through discussion and consensus resulting in refinements to PICcode., Results: The final version of PICcode involved transcribing, translating and coding of audio-recorded consultations and semi-structured interviews (SSI). The SSIs were designed to elicit patients' free-recall of medical information. Every unit of medical information in the consultation was identified and categorized in a coding tree. SSIs were coded to identify the extent to which information was recalled from the consultation., Discussion: The iterative changes involved in developing PICcode assisted in clarifying precise details of the process and produced a widely applicable coding system. PICcode is the most comprehensively described method of determining the amount of information that patients who use an interpreter recall from their medical consultations. PICcode can be adapted for English-speaking patients and other healthcare populations., (© 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.)

Objective: The Australian Dietary Guidelines recommend Australians choose mostly whole-grain and/or high-fibre varieties within the grains (cereal) foods category, with other groups specifying a whole grain Daily Target Intake of 48 g for Australians aged 9 years or above. The USA and UK report estimates of whole grain intake that are low and declining, and no comprehensive studies on whole grain intake in the Australian population are available. The present study aimed to determine national estimates of whole grain intake, compared with current recommendations., Design: A recently updated whole grain database was applied to the most current population dietary intake data. Single 24 h dietary recall intake data were reviewed against age group, sex, relative to energy intake and whole grain recommendations., Setting: Australia., Subjects: Australians (2-85 years) participating in the 2011-13 Australian Health Survey (n 12 153)., Results: The median daily whole grain intake was 21 g for adults (19-85 years) and 17 g for children/adolescents (2-18 years), or 28 and 23 g/10 MJ per d, respectively. Approximately 30 % of children/adolescents consumed no whole grains on the day of the survey. Whole grain intake was lowest for the age group 14-18 years (8·7 g/d). Of all participants aged ≥9 years, 73 % did not reach the recommended Daily Target Intake of 48 g., Conclusions: Whole grain intake in Australia is below recommendations in all age groups. Adolescents may be a key target for campaigns to increase whole grain consumption. This study provides the first quantification of absolute whole grain intake from all food sources in a national sample of Australians.

Objective: To consider the plausible nutritional impacts of fluctuations in money availability within an income cycle for remote Indigenous Australians., Design: Community-level dietary intake (energy, micro/macronutrients) and expenditure on foods and beverages (F&B) were estimated over one year for three remote Indigenous Australian communities (Northern Territory, Australia) using monthly F&B transaction data. F&B that were likely to be consumed during a period within an income cycle when money was relatively limited (low money period (LMP) foods) were identified by panel consensus and scenario modelling was conducted to simulate the nutritional outcomes of a range of F&B selection responses to having an LMP., Results: All scenarios resulted in reduced diet quality during the LMP relative to overall average diet values. Protein and fat energy percentages were reduced and carbohydrate energy percentage increased. Despite reduced expenditure, declines in energy intake were typically buffered due to the reduced energy cost ($AU/MJ) of the LMP diet. The micronutrient profile of the LMP diet was substantially poorer, such that additional key micronutrients dropped below population-weighted Estimated Average Requirements/Adequate Intakes., Conclusions: The modelling undertaken herein suggests that even a short period of low money within an income cycle may noticeably contribute to the reduced diet quality of remote Indigenous Australians and exacerbate lifestyle disease risk. Dietary strategies that are designed to respond to diets and expenditure during different income cycle periods, rather than the overall average diet and expenditure, should be considered for improving diet quality and reducing cardiometabolic disease risk in remote Indigenous Australians.

Image-based dietary records could lower participant burden associated with traditional prospective methods of dietary assessment. They have been used in children, adolescents and adults, but have not been evaluated in pregnant women. The current study evaluated relative validity of the DietBytes image-based dietary assessment method for assessing energy and nutrient intakes. Pregnant women collected image-based dietary records (via a smartphone application) of all food, drinks and supplements consumed over three non-consecutive days. Intakes from the image-based method were compared to intakes collected from three 24-h recalls, taken on random days; once per week, in the weeks following the image-based record. Data were analyzed using nutrient analysis software. Agreement between methods was ascertained using Pearson correlations and Bland-Altman plots. Twenty-five women (27 recruited, one withdrew, one incomplete), median age 29 years, 15 primiparas, eight Aboriginal Australians, completed image-based records for analysis. Significant correlations between the two methods were observed for energy, macronutrients and fiber ( r = 0.58-0.84, all p < 0.05), and for micronutrients both including ( r = 0.47-0.94, all p < 0.05) and excluding ( r = 0.40-0.85, all p < 0.05) supplements in the analysis. Bland-Altman plots confirmed acceptable agreement with no systematic bias. The DietBytes method demonstrated acceptable relative validity for assessment of nutrient intakes of pregnant women., Competing Interests: The authors declare no conflict of interest.

Background: It is critical to promote healthy eating early in life., Objective: The aim of this study was to examine diet quality and its predictors among Australian preschool-aged children., Design: Diet was assessed at age 3.5 years using multiple 24-hour recalls. Diet quality was assessed using an adapted version of the Revised Children's Diet Quality Index (RC-DQI). Potential predictors of diet quality were from questionnaires at age 3, 9, and 18 months and informed by the ecologic model of childhood overweight. Potential predictors included child's sex, age of introduction to solid foods, breastfeeding status, food acceptance, maternal nutrition knowledge, modeling of healthy eating, self-efficacy, education, and home food availability., Participants: Data from 244 children participating in the Melbourne Infant Feeding, Activity, and Nutrition Trial in 2008-2010 and follow-up data collection in 2011-2013 were examined., Main Outcome Measures: Diet quality at age 3.5 years., Statistical Analyses Performed: Bivariate logistic regression was performed to assess the relationship between diet quality and each predictor. A multivariable logistic regression model accounting for influences of covariates, treatment arm, and clustering by group tested associations between diet quality and significant predictors from bivariate analyses., Results: RC-DQI scores had a mean±standard deviation score of 62.8±8.3 points out of a maximum of 85 points. Breastfeeding status (odds ratio [OR] 2.34, 95% CI 1.33 to 4.10) and maternal modeling of healthy eating (OR 1.75, 95% CI 1.01 to 3.03) were positively associated with RC-DQI scores. Both breastfeeding status (OR 3.09, 95% CI 1.63 to 5.85) and modeling (OR 2.01, 95% CI 1.04 to 3.88) remained positively associated with diet quality after adjustment for child age, body mass index z score, energy intake, treatment arm, and clustering., Conclusions: Breastfeeding status and modeling of healthy eating were independently associated with children's diet quality. Early intervention could assist mothers to practice these behaviors to provide support for improving child diet quality., (Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Previous studies in Australian children/adolescents and adults examining added sugar (AS) intake were based on now out-of-date national surveys. We aimed to examine the AS and free sugar (FS) intakes and the main food sources of AS among Australians, using plausible dietary data collected by a multiple-pass, 24-h recall, from the 2011-12 Australian Health Survey respondents (n 8202). AS and FS intakes were estimated using a previously published method, and as defined by the WHO, respectively. Food groups contributing to the AS intake were described and compared by age group and sex by one-way ANOVA. Linear regression was used to test for trends across age groups. Usual intake of FS (as percentage energy (%EFS)) was computed using a published method and compared with the WHO cut-off of <10%EFS. The mean AS intake of the participants was 60·3 (SD 52·6) g/d. Sugar-sweetened beverages accounted for the greatest proportion of the AS intake of the Australian population (21·4 (sd 30·1)%), followed by sugar and sweet spreads (16·3 (SD 24·5)%) and cakes, biscuits, pastries and batter-based products (15·7 (sd 24·4)%). More than half of the study population exceeded the WHO's cut-off for FS, especially children and adolescents. Overall, 80-90% of the daily AS intake came from high-sugar energy-dense and/or nutrient-poor foods. To conclude, the majority of Australian adults and children exceed the WHO recommendation for FS intake. Efforts to reduce AS intake should focus on energy-dense and/or nutrient-poor foods.

Background: In Australia, sport is saturated by the promotion of junk food, alcohol and gambling products. This is particularly evident on player jerseys. The effect of this advertising on children, who are exposed to these messages while watching sport, has not been thoroughly investigated. The aim of this research study was to investigate: (1) the extent to which children implicitly recalled shirt sponsors with the correct sporting team; (2) whether children associated some types of sponsors with certain sporting codes more than others; and (3) whether age of the children influenced the correct recall of sponsoring brands and teams., Method: This experimental study conducted in New South Wales, Australia used projective techniques to measure the implicit recall of team sponsorship relationships of 85 children aged 5-12 years. Participants were asked to arrange two sets of magnets - one which contained sporting teams and one which contained brand logos - in the manner deemed most appropriate by them. Children were not given any prompts relating to sporting sponsorship relationships., Results: Three quarters (77 %) of the children were able to identify at least one correct shirt sponsor. Children associated alcohol and gambling brands more highly with the more popular sporting code, the National Rugby League compared to the Australian Football League sporting code. Results showed that age had an effect on number of shirt sponsors correctly recalled with 9-12 year olds being significantly more likely than 5-8 year olds to correctly identify team sponsors., Conclusions: Given children's ability to implicitly recall shirt sponsors in a sporting context, Australian sporting codes should examine their current sponsorship relationships to reduce the number of unhealthy commodity shirt sponsors. While there is some regulation that protects children from the marketing of unhealthy commodity products, these findings suggest that children are still exposed to and recall these sponsorship relationships. Results suggest that the promotion of unhealthy commodity products during sporting matches is contributing to increased awareness amongst children of unhealthy commodity brands. Further investigation is required to examine the extent and impact of marketing initiatives during televised sporting matches on children.

Background: Population-level interventions can possibly enhance each other's effects when they are implemented simultaneously. When the plain packaging policy was implemented in Australia, pictorial health warning labels (HWLs) on cigarette packages were also updated and a national mass media campaign was aired. This study examined whether smokers who recalled the media campaign reported more attention to and talking about HWLs., Methods: Longitudinal survey data was obtained among Australian adult smokers, aged 18 years and older, from an online consumer panel. One survey wave was conducted before (September 2012) and two waves were conducted after (January 2013 and May 2013) the interventions. The sample was replenished to maintain a sample size of 1000 participants at each wave. Generalized Estimating Equations analyses were performed., Results: Compared to wave 1, attention to HWLs increased at wave 2 (b=0.32, SE=0.06, p<0.001), but not at wave 3 (b=0.10, SE=0.08, p=0.198). Talking about HWLs increased over time (IRR=1.82, 95% CI=1.58-2.09 and IRR=1.25, 95% CI=1.05-1.47, at wave 2 and wave 3 respectively). Campaign recall was significantly associated with more attention to HWLs (b=0.29, SE=0.05, p<0.001) and with more talking about HWLs (IRR=1.17, 95% CI=1.06-1.29) with similar effects across waves 2 and 3., Conclusions: Recall of the campaign was associated with more attention to and talking about HWLs. When adjusting for campaign recall, there was still an increasing trend in attention and talking. This suggests that the media campaign and the new packaging and labeling policies had independent and positive effects on attention to and talking about HWLs., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objectives: To describe recall of anti-tobacco advertising (mainstream and targeted), pack warning labels, and news stories among a national sample of Aboriginal and Torres Strait Islander smokers, and to assess the association of these messages with attitudes that support quitting, including wanting to quit., Design, Setting and Participants: A quota sampling design was used to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. We surveyed 1643 Aboriginal and Torres Strait Islander smokers from April 2012 to October 2013., Main Outcome Measures: Frequency of recall of advertising and information, warning labels and news stories; recall of targeted and local advertising; attitudes about smoking and wanting to quit., Results: More smokers recalled often noticing warning labels in the past month (65%) than recalled advertising and information (45%) or news stories (24%) in the past 6 months. When prompted, most (82%) recalled seeing a television advertisement. Just under half (48%) recalled advertising that featured an Aboriginal or Torres Strait Islander person or artwork (targeted advertising), and 16% recalled targeted advertising from their community (local advertising). Frequent recall of warning labels, news stories and advertising was associated with worry about health and wanting to quit, but only frequent advertising recall was associated with believing that society disapproves of smoking. The magnitude of association with relevant attitudes and wanting to quit increased for targeted and local advertising., Conclusions: Strategies to tackle Aboriginal and Torres Strait Islander smoking should sustain high levels of exposure to anti-tobacco advertising, news stories and warning labels. More targeted and local information may be particularly effective to influence relevant beliefs and subsequently increase quitting.

Background: An important role of pre-travel consultations is to improve travelers' understanding of travel-related diseases, but the efficacy of education provided is unknown. This study sought to assess recall and knowledge immediately following a pre-travel consultation., Methods: The study was conducted at a hospital-based pre-travel clinic in Melbourne, Australia. Travelers aged ≥16 years seen between September 2010 and March 2012 were invited to complete an anonymous self-administered questionnaire immediately following their consultation to assess knowledge of appropriate preventive measures and presumptive self-treatment strategies for common travel risks. The doctor of each participating traveler also completed a survey regarding issues discussed., Results: A total of 300 participants were recruited (34% male, median age 31 years). Most were traveling for vacation (77%) and reported previous travel (95%). Main travel destinations were Asia (43%), Americas (21%), and Africa (17%). Doctors' and travelers' surveys showed variable levels of concordance: 94% of patients recalled discussion of malaria, 84% rabies, and 76% dengue. For malaria, 95% remembered discussions regarding insect repellents, and 92% recalled that medical advice should be sought if fever developed. For travelers with whom rabies was discussed, 94% recalled that medical advice must be urgently sought following a bite/scratch. For travelers' diarrhea (TD), 99% knew to drink only boiled/bottled water, but 13% did not recall avoiding unpeeled fruit/vegetables as a prevention strategy. There was 20% discordance between doctors and travelers regarding antibiotics for TD self-treatment, but only 4% discordance regarding prescription of malaria prophylaxis. Factors associated with improved recall were doctor discussion, previous travel, and a university education., Conclusions: Key travel health messages are well assimilated after pre-travel consultation. However, large amounts of information are discussed and immediate recollection of all information is not possible. This study reinforces the importance of providing supplementary information (eg, written and/or electronic resources) to accompany pre-travel consultations., (© 2015 International Society of Travel Medicine.)

In 2009, the Australian Government's National Sexually Transmitted Infection Prevention Program launched a multi-million dollar sexual health campaign targeting young people. We assessed campaign recognition among a community sample of young people. Individuals aged 16-29 years self-completed a questionnaire at a music festival. Participants were asked whether they recognised the campaign image and attempted to match the correct campaign message. Recognition of two concurrent campaigns, GlaxoSmithKline's The Facts genital herpes campaign (targeting young women) and the Drama Downunder campaign (targeting gay men) were assessed simultaneously. Among 471 participants, just 29% recognised the National Sexually Transmitted Infection Prevention Program campaign. This compared to 52% recognising The Facts and 27% recognising Drama Downunder. Of 134 who recognised the National Sexually Transmitted Infection Prevention Program campaign, 27% correctly recalled the campaign messages compared to 61% of those recognising the Facts campaign, and 25% of those recognising the Drama Downunder campaign. There was no difference in National Sexually Transmitted Infection Prevention Program campaign recognition by gender or age. Campaign recognition and message recall of the National Sexually Transmitted Infection Prevention Program campaign was comparatively low. Future mass media sexual health campaigns targeting young people can aim for higher recognition and recall rates than that achieved by the National Sexually Transmitted Infection Prevention Program campaign. Alternative distribution channels and message styles should be considered to increase these rates., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

This study explored why and how Indigenous and non-Indigenous Australians remember the past. Indigenous Australians traditionally share a strong oral tradition in which customs, personal and cultural histories, and other narratives are passed across groups and between generations by word of mouth. Drawing on this tradition, in which inherent value is placed on sharing knowledge and maintaining connectedness with others, we hypothesised that Indigenous Australians would be more likely than non-Indigenous Australians to report reminiscing to fulfil social functions (but not self or directive functions). Furthermore, we hypothesised that Indigenous Australians would recall personal past experiences more elaborately than would non-Indigenous Australians. In Study 1, 33 Indigenous Australians and 76 non-Indigenous Australians completed Webster's Reminiscence Functions Scale. As predicted, Indigenous participants reported higher scores on subscales related to social functions than did non-Indigenous Australians: particularly "Teach/Inform" and "Intimacy Maintenance". They also scored higher on the "Identity" subscale. In Study 2, 15 Indigenous and 14 non-Indigenous Australians shared three memories from the distant and recent past. While Indigenous and non-Indigenous narratives did not differ in either emotion or elaboration, Indigenous Australians provided more memory context and detail by including a greater proportion of semantic memory content. Taken together, these findings suggest differences in both why and how Australians remember.

Background: Young children's diets are currently suboptimal. Given that mothers have a critical influence on children' diets, they are typically a target of interventions to improve early childhood nutrition. Understanding the maternal factors which mediate an intervention's effect on young children's diets is important, but has not been well investigated. This research aimed to test whether maternal feeding knowledge, maternal feeding practices, maternal self-efficacy, and maternal dietary intakes acted as mediators of the effect of an intervention to improve child diet quality., Methods: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster-randomized controlled trial, conducted from 2008-2010. This novel, low-dose, health promotion intervention was delivered quarterly over 15 months and involved educational activities, promotion of peer discussion, a DVD and written materials. Post-intervention, when children were approximately 18 months of age, child diets were assessed using multiple 24-hour recalls and a purpose-developed index of diet quality, the Obesity Protective Dietary Index. Maternal mediators were assessed using a combination of previously validated and purpose-deigned tools. Mediation analysis was conducted using the test of joint significance and difference of coefficients methods., Results: Across 62 parents' groups in Melbourne, Australia, 542 parents were recruited. Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality. While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality., Conclusions: Mediation analysis of this novel health promotion intervention showed the importance of maternal feeding knowledge and use of foods as rewards in impacting child diet quality. The other maternal factors assessed were appropriate targets but further research on how to impact these in an intervention is important. This evidence of intervention efficacy and mediation provides important insights for planning future interventions., Trial Registration: Current Controlled Trials ISRCTN81847050, registered 23 November 2007.

Background: Late diagnosis is considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to presentation needs to be reliably and accurately measured. This qualitative study explored the use of calendar landmarking instruments in cancer symptom research., Methods: We performed a secondary analysis of transcripts of interviews using the calendar landmarking instrument, undertaken with patients who had either been diagnosed with cancer (n = 40, IRCO study, Western Australia), or who had symptoms suggestive of cancer (n = 38, SYMPTOM study, North East and Eastern England). We used constant comparison methods to identify use of the calendar landmarking instruments and the impact of their application., Results: The calendar landmarking instrument appeared to help many patients, either by acting as a prompt or helping to refine recall of events. A combination of personal (e.g. birthday) and national (e.g. Christmas) landmarks seemed to be the most effective. Calendar landmarking instruments appeared more useful where the time period between onset of symptoms and date of first consultation was less than three months. The interviewee's age, gender and cancer type did not appear to influence whether or not the instrument facilitated recall, and there were no instances where the use of the instrument resulted in the disclosure of a new first symptom. Symptoms of similar chronic conditions could create difficulties when applying the instrument; it was difficult for these participants to characterise and disentangle their symptoms which prompted their decisions to seek help. Some participants tended to prefer to use their own, already personalised, diaries to assist in their recall of events., Conclusions: This study is the first to describe the potential role of calendar landmarking instruments to support research interviews which explore symptoms and events along the cancer diagnostic pathway. The major challenge remains as to whether they actually improve accuracy of recall.

Background: The literature available on the format of the feedback session following assessment of memory impairment is minimal. This study explored how this information should be presented from the perspective of patients and their families., Methods: Thirty-two semi-structured interviews were conducted with memory clinic patients and their carer at the clinic visit that followed the feedback session, to ask: what they recalled, what they found helpful, and what they thought was the best way to disclose a diagnosis of dementia. A second interview was conducted with 14 patient/carer dyads at their next appointment., Results: Recall of information from the feedback session was variable. Most respondents (76% of patients; 66% of carers) thought that a direct approach was best when informing the patient of a dementia diagnosis, and that both written information and compassion demonstrated by the doctor were helpful. Opinions on whether all the information should be given at once or in stages were divided., Conclusions: The current format of the feedback session needs revision to improve recall. Patients and their families want a direct approach to be used by a supportive and professional doctor with an opportunity to ask questions. They want the support of a family member or friend when they are told of their diagnosis and they would like a written summary to refer to afterwards.

Objective: The objective was to describe parent-reported child eating behavior and maternal parenting impact outcomes of an infant feeding intervention to reduce child obesity risk., Methods: An assessor masked Randomized Controlled Trial (RCT) with concealed allocation of individual mother-infant dyads. The NOURISH RCT enrolled 698 first-time mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female) aged 4.3 months (SD = 1.0) at baseline. Outcomes were assessed 6 months post-intervention when the children were 2 years old. Mothers reported on child eating behaviors using the Children's Eating Behavior Questionnaire (CEBQ), food preferences, and dietary intake using a 24-hour telephone recall. Parenting was assessed using five scales validated for use in Australia., Results: Intervention effects were evident on the CEBQ overall (MANOVA P = 0.002) and 4/8 subscales: child satiety responsiveness (P = 0.03), fussiness (P = 0.01), emotional overeating (P < 0.01), and food responsiveness (P = 0.06). Intervention children "liked" more fruits (P < 0.01) and fewer non-core foods and beverages (P = 0.06, 0.03). The intervention mothers reported greater "autonomy encouragement" (P = 0.002)., Conclusions: Anticipatory guidance on protective feeding practices appears to have modest positive impacts on child eating behaviors that are postulated to reduce future obesity risk., (Copyright © 2014 The Obesity Society.)

Objective: The research examined whether verbal learning and memory impairment previously observed 1 year after left hemisphere stroke endures over a longer period and whether stroke sufferers compensate for their impairments using working memory., Methodology: Twenty-one persons with left hemisphere lesions; 20 with right hemisphere lesions only and 41 matched controls completed the Hopkins Verbal Learning Test-Revised (HVLT-R), a working memory test (Letter-Number Sequencing, LNS) and the Boston Naming Test (BNT)., Results: Persons with left hemisphere damage performed more poorly on HVLT-R than controls. They showed poorer immediate recall, delayed recall, recognition and learning, but intact retention, suggesting an encoding impairment. BNT and LNS scores predicted recall in this group. HVLT-R performance of persons with right hemisphere lesions only was comparable to controls. BNT (not LNS) predicted recall in these groups., Conclusions: Persons with left hemisphere damage relied more on working memory and recruited diverse left hemisphere regions to compensate for their impaired encoding., Implications: Tasks requiring verbal encoding and memory are effortful following left hemisphere stroke. This should be recognized and accommodated.

Background: Cognitive-linguistic deficits often accompany traumatic brain injury (TBI) and can negatively impact communicative competency. The linguistic sequelae underpinning mild TBI (MTBI) remain largely unexplored in contemporary literature., Objectives: The present research methods aim to provide group evidence pertaining to the influence of MTBI on linguistic and higher-level language processing. Extrapolating on the findings of recent case reports, it is hypothesized that performance of the MTBI patients will be significantly reduced compared to normal controls performance on the employed high-level linguistic tasks., Methods: Sixteen patients with MTBI and 16 age- and education-matched normal control participants were assessed using a comprehensive battery of cognitive-linguistic assessments., Results: The results demonstrated statistically significant differences between MTBI and normal control group performance across a number of higher-level linguistic, general cognitive and general language tasks. MTBI group performance was significantly lower than the normal control group on tasks requiring complex lexical semantic operations and memory demands, including: Recall, organization, making inferences, naming and perception/discrimination., Conclusions: These outcomes confer that post-MTBI, cognitive, high-level language and isolated general language performance (e.g. naming) is significantly reduced in MTBI patients, compared to normal controls. Furthermore, the detailed cognitive-linguistic profile offered provides a necessary direction for the identification of areas of linguistic decline in MTBI and targets for therapeutic intervention of impaired cognitive-linguistic processes to ultimately improve communicative outcomes in MTBI.

Introduction: Neurocognitive deficits have been identified in eating disorders, including anorexia nervosa and bulimia nervosa. However, current data do not allow for firm conclusions regarding the nature or extent of these deficits. The current study aimed to evaluate neurocognitive functioning in a population-based sample of adolescents with and without eating disorders., Methods: Participants (N=669) were drawn from the Western Australian Pregnancy Cohort (Raine) Study. Cognitive testing was conducted using the computerised CogState assessment battery. Eating disorder symptoms were assessed using questions adapted from the Child Eating Disorder Examination and Eating Disorder Examination-Questionnaire. Adolescents who met full or partial criteria for a DSM-IV eating disorder (n=58) were compared to adolescents with no significant eating pathology (n=592)., Results: The eating disorder sample showed impaired performance on measures of executive functioning, including global processing and set shifting, but performed better than control participants on measures of visual attention and vigilance., Conclusions: This is the first study to evaluate neurocognitive functioning in a population-based sample of adolescents with eating disorders. Support is provided for weak central coherence and set-shifting difficulties early in the course of eating disorders. Research is needed to determine if these deficits precede and predict eating disorder onset.

Background: The evidence on the agreement between self-reported health resource use and administrative records is mixed and no gold standard exists. The objective of this study was to assess self-reported general practitioner (GP) and specialist doctor visits, as well as medication use via telephone interview against national insurance administrative data for colorectal cancer survivors., Methods: In a sample of 76 adults recently diagnosed with colorectal cancer, data was abstracted from telephone survey items on GP visits, specialist visits and medication use over the previous six months and compared with data on the same individuals from administrative data. Intraclass correlation coefficients (ICC) were used to assess the reliability of frequency of visits and kappa statistics were derived for four broad categories of medicines used for gastrointestinal conditions, cardiovascular disease, psychological conditions and chronic obstructive pulmonary disease. Logistic regression was undertaken to assess factors associated with agreement (yes/no) between the two data sources for doctors' visits., Results: Good agreement was found for GP visits (ICC 0.62, 95%CI: 0.38, 0.86) and specialist visits (ICC 0.73, 95%CI: 0.56, 0.91) across the two data sources. When costs were assigned to frequencies, mean costs for the two methods were not significantly different over six months. Over-reporting was more common among men and participants with frequent doctor encounters. Large discrepancies between self-reports and administration records were found for broad types of medications used (44% agreement, kappa 0.13)., Conclusion: Self-reported frequency of doctor's visits using telephone interviews may be a reasonable substitute for administratively recorded data however, medication use by self-report appears to be unreliable. Administrative records are preferable to self-report for health service use in colorectal cancer survivors with high and complex service needs.

Objective: To describe the pattern of dairy consumption in Australians aged 12 years and over, and assess the extent to which the population meets national recommendations., Methods: We developed a new method of combining quantitative data from a 24-hour dietary recall questionnaire with semiquantitative data from a food frequency questionnaire (FFQ), to investigate the usual patterns of dairy consumption. We applied this technique to data from the 9,096 Australians aged 12 and over who completed the FFQ part of the most recent nationally representative nutrition study - the 1995 National Nutrition Survey., Results: When weighted according to the characteristics of the Australian population, 58% of male and 73% of female FFQ respondents failed to regularly meet recommendations for consumption of dairy products. While mean dairy consumption was higher in adolescents, 62% of boys and 83% of girls failed to meet their higher recommendation of three serves per day. Breastfeeding women appeared to consume more dairy but 60% consumed less than two serves per day., Conclusions and Implications: Given accumulating evidence of protective effects of dairy foods for a range of metabolic and cardiovascular disorders, our observations warrant a focus on the development of cost-effective public health interventions to increase dairy consumption., (© 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.)

Objective: To assess Australian consumers' perception of portion size of fast-food items and their ability to estimate energy content., Design: Cross-sectional computer-based survey., Setting: Australia., Subjects: Fast-food consumers (168 male, 324 female) were asked to recall the items eaten at the most recent visit to a fast-food restaurant, rate the prospective satiety and estimate the energy content of seven fast-food or 'standard' meals relative to a 9000 kJ Guideline Daily Amount. Nine dietitians also completed the energy estimation task., Results: Ratings of prospective satiety generally aligned with the actual size of the meals and indicated that consumers perceived all meals to provide an adequate amount of food, although this differed by gender. The magnitude of the error in energy estimation by consumers was three to ten times that of the dietitians. In both males and females, the average error in energy estimation for the fast-food meals (females: mean 3911 (sd 1998) kJ; males: mean 3382 (sd 1957) kJ) was significantly (P < 0·001) larger than for the standard meals (females: mean 2607 (sd 1623) kJ; males: mean 2754 (sd 1652) kJ). In women, error in energy estimation for fast-food items predicted actual energy intake from fast-food items (β = 0·16, P < 0·01)., Conclusions: Knowledge of the energy content of standard and fast-food meals in fast-food consumers in Australia is poor. Awareness of dietary energy should be a focus of health promotion if nutrition information, in its current format, is going to alter behaviour.

Images of child sexual abuse survivors have been strongly mediated by professional and self-help ideologies that espouse 'healthy' and 'unhealthy' responses to trauma. Drawing on interviews taken with five self-identified survivors of child sexual abuse, this paper maps the impact of psychological and popular discourses on victim/survivor identities and, in particular, the centrality of themes such as disclosure and 'healing' in accounts from survivors. Investment in these particular versions of recovery has operated to shift the focus of the survivor movement away from its political beginnings, such that private healing has replaced public discontent. As the excerpts from survivors in this paper suggest, the language commonly captured in both therapeutic and popular accounts of trauma may guide and delimit the subject positions available to survivors. Utilising the concept of 'wounded attachment', this paper identifies some of the outcomes associated with internalised notions of healing for survivors, as well as the dilemmas that might be impeding disclosure.

Background: Children's exposure to unhealthy food marketing influences their food knowledge, preferences and consumption. Sport sponsorship by food companies is widespread and industry investment in this marketing is increasing. This study aimed to assess children's awareness of sport sponsors and their brand-related attitudes and purchasing intentions in response to this marketing., Methods: Sports clubs known to have food sponsors and representing the most popular sports for Australian children across a range of demographic areas were recruited. Interview-based questionnaires were conducted at clubs with children aged 10-14 years (n = 103) to examine their recall of local sports club and elite sport sponsors, and their attitudes towards sponsors and sponsorship activities., Results: Most children (68%) could recall sponsors of their sports club, naming a median of two sponsors, including a median of one food company sponsor each. Almost half (47%) of children could recall any sponsors of their favourite elite sporting team. Children aged 10-11 years were more likely than older children to report that they thought about sponsors when buying something to eat or drink (P < 0.01); that they liked to return the favour to sponsors by buying their products (P < 0.01); and that sponsors were 'cool' (P = 0.02). Most children had received a voucher or certificate from a food or beverage company to reward sport performance (86% and 76%, respectively). Around one-third of children reported liking the company more after receiving these rewards., Conclusions: Children's high recall of food and beverage company sport sponsors and their positive attitudes towards these sponsors and their promotions is concerning as this is likely to be linked to children's food preferences and consumption. Limiting children's exposure to this marketing is an important initiative to improve children's nutrition.

Background: Questionnaires are widely used for data collection in travel medicine studies, but there are no validated instruments that are available to researchers in this field. Our objective was to develop and validate a questionnaire to be used in a prospective study designed to estimate the risk of three viral infections in Australian travelers to Asia., Methods: Qualitative nonexperimental cognitive methods, including cognitive review, task analysis, and cognitive interviews, were selected. A pilot study was performed to assess the instrument in the target population., Results: Recalling dates related to travel or health events was observed and reported to be the most difficult task for travelers. The use of cues embedded into items and provision of memory prompts such as calendars improves the recall of dates during travel. There is a wide spectrum of accommodation, activities, and travel experiences, and item responses that were constructed as lists were useful as memory triggers, particularly for travelers with long and complicated itineraries. Cognitive interviews provided a valuable insight into how travelers used inferential and direct memory to recall travel events and their confidence in the accuracy of these processes., Conclusions: The development and validation of questionnaires improve the accuracy of the data collected and should be considered an integral part of the methodology of travel-related studies., (© 2011 International Society of Travel Medicine.)

Differences in the time of onset and magnitude of terminal decline were examined in three cognitive domains: processing speed, episodic memory, and global function. In addition, cognitive reserve was investigated by testing whether education affected the onset or rate of decline across these domains. Eight hundred ninety-six community-dwelling Australian adults aged ≥ 70 years were assessed up to four times over 12 years, with vital status followed for 17 years. For each of the cognitive measures, a series of change point models were fitted across the 20 years before death to find the optimal point at which terminal decline was distinguished from preterminal decline. Change points were then assessed separately for high- and low-education groups. The change points were 8.5 years for processing speed (95% CI: 6.0-11.2 years), 7.1 years for global function (6.2-9.3), and 6.6 years for episodic memory (5.3-7.1). The rate of decline was two to four times greater in the terminal phase relative to the preterminal phase, depending on the domain. Increased education changed the terminal decline effect differently for each of the three tests, either by significantly hastening the onset of terminal decline and decreasing the rate of decline, or by increasing the rate of either preterminal or terminal decline. Analyses were repeated excluding participants diagnosed with dementia, with no substantive change to the outcomes. In conclusion, the rate and onset of terminal decline varied somewhat across cognitive domains. Education affected terminal decline differently across the domains, but this modification was not consistent with the predictions of cognitive reserve theory., ((c) 2011 APA, all rights reserved.)

Background: The principal goal of this study was to compare the diagnostic accuracy of three brief instruments in memory clinic attendees. Two of the instruments were based on face-to-face clinical assessment (Standardized Mini-mental State Examination and Rowland Universal Dementia Assessment Scale), whereas the third group used proxy information from an informant (Informant Questionnaire on Cognitive Decline in the Elderly). Dementia diagnosis as provided by a specialist physician (geriatrician, psychiatrist or neurologist) was used as the reference standard., Methods: This was a cross-sectional study. Data were collected from 204 consecutive memory clinic attendees (M = 76.90, 56% female) and their family caregivers. Comparative utility was assessed through receiver operating characteristic (ROC) analyses., Results: One hundred and fifty-two patients (75%) were diagnosed as having dementia. Diagnostic accuracy, as indicated by the area under the ROC curve (AUC), was similar for the three instruments as follows: SMMSE (AUC = 0.82, 95% CI = 0.76, 0.87, p < 0.0001) and RUDAS (AUC = 0.83, 95% CI = 0.77, 0.88, p < 0.0001), and slightly lower for IQCODE (AUC = 0.77, 95% CI = 0.71, 0.83, p < 0.0001). There was no significant difference between the areas under the curve (χ2 = 2.57, df = 2, p = 0.28)., Conclusions: Diagnostic accuracy was similar for the three instruments, which all proved to be moderately useful tools for initial screening for cognitive impairment in the memory clinic environment. Being a proxy measure, the IQCODE had specific practical use in this context, where the patient might not be able to provide information. The RUDAS exhibited high specificity and proved to be less dependent upon cultural factors than the SMMSE, making it particularly valuable in a multicultural setting.

Objective: To assess the recall of media reports about vitamin D and associated factors., Methods: Analysis of cross-sectional telephone interview data (2,001 Queensland adults, 18-70 years) on vitamin D and personal sun protection, recall of media reports and participant characteristics., Results: 83.7% of participants had heard of vitamin D, 47.5% through the media. Only 513 (25.6%) participants recalled the media content within four main themes: vitamin D is beneficial/comes from the sun (47.0%); some people aren't getting enough vitamin D, need more sun (27.9%); need to balance sun exposure and skin protection (11.5%); or other (13.6%). Only 65 of the 950 participants (6.8%) reported a change to their behaviour(s) due to the media report., Conclusion: Although the media were the main source of information about vitamin D for almost 50% of participants, recall of the content and direct effect on behaviour was low. Only a small minority recalled a balanced media report of beneficial and harmful aspects of sun exposure., Implications: Health professionals often supply media with background information. To achieve best public health practice for sun protection and vitamin D, information to foster balanced media reports should be provided., (© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.)

Background: There is conflicting evidence regarding the relationship between socio-economic position (SEP) and physical activity in adolescents. The aim of this study was to investigate associations between SEP and characteristics of physical activity in Australian adolescents using a high-resolution use-of-time tool., Method: Use-of-time and pedometer data were collected on a random sample of 2071 9-16-year-old Australian children. Use-of-time was recorded using a computerised 24-h use-of-time recall, the Multimedia Activity Recall for Children and Adults. Reported household income was used as a marker of SEP., Results: There were no differences in self-reported minutes of moderate to vigorous physical activity (MVPA) across the income bands and only very small differences in the number of daily steps. However, the mix of MVPA components varied across income bands, with adolescents from low-SEP families experiencing less sport but more active transport. Because the mean rate of energy expenditure was greater in sport than in other forms of MVPA (play, active transport or chores), there were significant differences in MVPA-related and total daily energy expenditure across income bands, with the lower bands having significantly lower values. Differences in total daily energy expenditure were almost entirely explained by differences in energy expenditure associated with sport., Conclusion: Physical activity patterns vary across SEP bands in Australian adolescents, with sport being the major locus of differences. Instruments which do not account for the energy costs of various activities may fail to detect important relationships.

The field of bereavement and grief has been expanding to recognise the potential for growth following the loss of a loved one. This study sought to examine the effect of the relationship to the deceased and perceptions of the severity of the trauma on dimensions of posttraumatic growth. Participants were 146 people who had lost either: a) a first degree relative, b) a second degree relative, or c) a non-related friend. Results demonstrated that both severity and the relationship to the bereaved differentiate posttraumatic growth outcomes. For example, participants who had lost a first degree relative reported higher levels of growth than those who had lost a second degree relative. Consistent with previous research in general trauma populations, the more severe the loss was rated, the higher the levels of growth. Implications for practice are discussed.

Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the "theory-practice gap". This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses--given their novice, rule governed status--who find themselves in the midst of the theory-practice void. This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.

Conversations about the past can involve voicing and silencing; processes of validation and invalidation that shape recall. In this experiment we examined the products and processes of remembering a significant autobiographical event in conversation with others. Following the death of Australian celebrity Steve Irwin, in an adapted version of the collaborative recall paradigm, 69 participants described and rated their memories for hearing of his death. Participants then completed a free recall phase where they either discussed the event in groups of three or wrote about the event on their own. Finally, participants completed the original questionnaire again, both 1 week and 1 month after the free recall phase. Discussion influenced later memories for hearing of Irwin's death, particularly memories for emotion and shock. Qualitative analysis of the free recall phase suggested that during conversation a shared understanding of the event developed, but that emotional reactions to the event were silenced in ways that minimised the event's impact. These findings are discussed in terms of the processes and consequences of sharing public and personal memories in conversation.

Background: Overweight, obesity and hypertension can be prevented through improvements in lifestyle including nutrition and physical activity. General practitioners (GPs) in Australia have access to over 90% of the population in the course of a year and therefore, the general practice setting may be ideal to assist patients with lifestyle change for weight management and hypertension. The present study aimed to determine the proportion of overweight/obese patients that recalled receiving advice by their GP to make lifestyle changes for weight loss. Recall of advice received by hypertensive patients to reduce salt intake was also measured., Methods: A face to face survey was conducted on a representative sample (urban, suburban and rural) of South Australian residents. Respondents provided information on height and weight (self-report), whether they had received lifestyle advice from their GP for weight loss, and for those with self reported hypertension if they had received advice to reduce dietary salt., Results: The sample included 2947 South Australian adult residents (58% female; BMI (mean (SD)), 26.6 (5.3) kg/m2; age, 50.7 (18.0) years). Ninety-six percent had visited their GP in the past 12 months. Forty-one percent of males and 25% of females were overweight and 19% of males and 20% of females were obese. Twenty-seven percent of overweight/obese respondents reported receiving lifestyle advice for weight loss purposes. Of the 33% who reported they had hypertension, 34% reported receiving advice to reduce salt intake., Conclusions: Less than 1/3 of overweight/obese patients reported that they had received lifestyle advice that could assist with weight loss from their GP. About a third of respondents with hypertension reported that they received advice to reduce salt intake. There are potentially missed opportunities in which GPs could provide re-enforcement of benefits of lifestyle changes with respect to weight and blood pressure control.

Objective: To conduct preliminary examination of the rater and test-reliability of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological measure designed to assess task-embedded information processing capacity during occupational therapy assessment of confused and agitated adults following traumatic brain injury., Methods: Occupational therapists observed and scored client performance using the PRPP System of Task Analysis. Correlational analysis and measures of agreement were performed to determine interrater and intrarater reliability. Test procedures were examined for reliability and internal consistency., Results: Interrater and test reliability considered three factors: therapists, clients and tasks. A moderate level of interrater reliability was achieved between trained therapists (intraclass correlation coefficient (ICC) = 0.60). Test procedures were highly reliable (ICC = 0.88). Across two measurement occasions, therapists showed a tendency towards harder rating on the second test occasion (-4.5%; 95% confidence interval for: -10.67% → 3.17%)., Conclusion: The findings of this study support the use of criterion-referenced tests in the area of occupational performance measurement. Occupational therapists achieved moderate interrater reliability when measuring the performance of adults with brain injury on various activities of daily living. Test procedures were found to be highly reliable in measuring the occupational performance of adults demonstrating confusion and agitation typical to the stage of post-traumatic amnesia following head injury.

Objective: The aim of the present study was to investigate what news stories about mental illness are recalled by Australian youth and whether these are associated with stigma and help-seeking beliefs., Method: A random sample of 3746 Australian youth aged 12-25 years were interviewed about mental health literacy in 2006. As part of the interview, they were asked whether they could recall any news stories about mental health problems during the past 12 months. Stigma was assessed, as well as willingness to seek help for a mental illness described in a vignette. Common news story themes were entered as predictors of stigma components and willingness to seek help in a series of logistic regressions., Results: Only a minority of youth could recall a news story about mental illness. The most common stories recalled were those involving crime or violence; mental health system failures; or disclosures of mental illness by prominent individuals. Recall of a disclosure by a prominent individual was associated with beliefs that people with mental illness are sick rather than weak, while recall of a story involving crime or violence was associated with greater reluctance to tell anyone about a mental health problem. There were no types of stories that predicted willingness to seek help., Conclusions: There is some evidence that recall of positive or negative news stories is associated with specific components of stigma. Overall, however, recall of news stories about mental illness added little explanatory power to differences in stigma or help-seeking intentions.

Purpose: Cross-sectional surveys depend on retrospective health transition questions (HTQ) to estimate recent changes in health status. This paper assesses the validity of the SF-36 HTQ and calibrates its categories against change assessed prospectively on the SF-36 domain scales in a sub-group known to have experienced clinically important changes in health status., Methods: Adults (n = 9,649) from a longitudinal population survey completed the SF-36 in 2001 and 2002. Prospective measures were calculated as mean changes in SF-36 scale scores adjusted for age and gender, and also expressed as standardised response means. Comparison groups were those who had developed a long-term health condition since the last interview and the HTQ response categories for those who had not developed any new conditions., Results: Those with a new condition and those without a new condition but who described their health as "somewhat worse" than a year ago had comparable declines in health status on all domain scales except role physical, where those with a new condition experienced a greater decline., Conclusions: This analysis demonstrates the validity and limitations of the HTQ as a measure of change in population studies. The calibration is useful for interpreting the meaning of the HTQ categories at the group level but not at the individual level.