Healthier Ones Research Articles

DESIGNING CLOTHING INSPIRED BY AVERSION THERAPY TO CREATE AWARENESS

To assist people in kicking cancer-causing habits, Fashion Fights Cancer presents a cutting-edge fashion collection that is modelled by aversion treatment methods. By combining psychology and fashion, this innovative method offers a special tool to encourage healthy lives and reduce the incidence of cancer. This collection offers an innovative and captivating approach to assist people in breaking bad habits by implementing the ideas of aversion therapy, which involves linking unpleasant stimuli with negative behaviours to prevent their recurrence. Every article of clothing in this collection is designed with attention to arouse feelings or visual signals that set up subconscious unpleasant reactions associated with particular actions that cause cancer. With thoughtfully chosen textures, colours, patterns, and design aspects, these pieces serve as concrete deterrents and reminders, encouraging wearers to reevaluate their decisions and make good transitions toward healthier ones. Fashion Fights Cancer allows people to address their habits in a novel and effective way by incorporating psychological concepts into fashion design. This compilation increases awareness of the link between lifestyle decisions and cancer risk while also promoting personal development. Fashion Fights Cancer promotes proactive health behaviours and emphasizes prevention in the fight against cancer by starting conversations and questioning social conventions through fashion. People are inspired to take control of their well-being and make wise decisions that prioritize long-term health and vitality thanks to this creative marriage of fashion and psychology. In this study, the clothes in the collection are designed to make people feel uncomfortable about habits that can cause cancer. They use colours, textures, and designs to remind people of these habits, encouraging them to think about making healthier choices instead. The goal is to use creativity to help people change their habits and improve their health. Combining fashion with psychology wants to help people understand how their lifestyle choices can affect their chances of getting cancer. They hope to inspire people to take better care of themselves and prevent cancer by starting conversations and encouraging healthy behaviours. This method also shows how using creative activities, like making clothes, can support people who are dealing with cancer.

Effect of pomegranate peel on physicochemical and antioxidant properties of tortilla chips prepared from germinated corn and mung bean flour

There is increasing demand of innovative functional foods in the market to cure widely prevalent deficiencies observed globally. In line with this issue, the study was aiming to replace existing snacking habits with the healthier ones by using corn and mung bean seeds to produce their respective germinated flours for production of tortilla chips with varied concentrations (5 %, 10 %, 15 %) of pomegranate peel powder (PPP) for enhancing the shelf life of the chips without use of synthetic preservatives. All these variations were then fried at three temperatures 170, 180, 190ºC for different times 75 s, 60 s, 45 s, respectively and were then evaluated for their proximate composition, antioxidant properties, sensory properties and shelf life for a period of 40 days. Ash content analysis showed increased content up to 7.6 % for T"1 (with 15 % PPP/170 °C). Total antioxidant activity and phenolic content increased with increased peel concentration and decreased with increased frying temperature. After control, the maximum overall acceptability among samples having peel powder was of T2 (with 5 % PPP and fried at 180 °C) with score 7.68. However, the peroxide value and free fatty acid value were found minimum for T"3 (with 15 % PPP and fried at 190 °C) indicating an extended shelf life.

Associations of polysocial risk score, lifestyle and genetic factors with incident psoriasis: a larger-scale prospective cohort study

ObjectivesThe impact of polysocial risk score (PsRS), a composite measure of multiple social risk factors, on the development of psoriasis remains unclear. Moreover, the potential modifying effects of lifestyle and genetic susceptibility on the relationship between PsRS and psoriasis risk require further exploration. Study designThis was a prospective cohort study conducted among UK Biobank. MethodsIn this study, we analyzed 331,631 participants enrolled in the UK Biobank cohort. To derive the PsRS, we utilized a summative strategy, amalgamating six social determinants of health derived from three domains: socio-economic status, psychosocial factors, and neighborhood and living environment consistently linked to incident psoriasis. Cox proportional hazard models were used to assess the associations between PsRS and psoriasis incidence. Furthermore, we constructed a lifestyle score and a genetic risk score to explore the potential modifying effects of these factors on the relationship between PsRS and psoriasis risk. ResultsCompared with individuals with a low PsRS (≤1), those with intermediate PsRS (2–4) and high PsRS (≥5) had 1.20 (95% confidence interval [CI], 1.06–1.36) and 1.53 (95% CI, 1.31–1.78) times higher risks of developing psoriasis, respectively. Our findings revealed an additive interaction between PsRS and genetic susceptibility. Moreover, it was found that individuals with high PsRS and unhealthier lifestyles had a 2.60 times higher risk of developing psoriasis than those with lower PsRS and healthier ones. ConclusionsOur study results imply that an elevated PsRS is linked to a heightened risk of psoriasis, which is further influenced by genetic factors. Our results also indicate that greater social vulnerability and unhealthier lifestyle may synergistically contribute to the additional risk of psoriasis.

Compensatory health motivations and behaviors scale: Development, evaluation, psychometric properties and a preliminary validation

The “Compensatory Health Beliefs” scale assesses the degree to which one believes that unhealthy behaviours can be compensated through healthier ones. However, no validated scale to assess compensatory weight-related behaviors exists. The study's objective was to develop (Study 1) and validate (Study 2) a questionnaire measuring compensatory health motivations and behaviors (CHMB) and to assess their associations with body mass index (BMI) and psychological weight-related measures. An initial 34-item measure was constructed based on a target sample's (Study 1, n = 158) suggestions and refined based on expert feedback. The measure was then tested in a representative Canadian adult sample (N = 1400, 48.7% male). The sample was stratified by sex and age and then randomly split into two (N = 701 for exploratory factor analysis; N = 699 for confirmatory factor analysis (CFA) cross-validation). Fit indices, standardized Cronbach's alphas and the associations between the CHMB model with cognitive restraint, weight concerns, and BMI were assessed in multiple linear regression models controlling for age and sex. The final CHMB model (n = 17 items) consisted of four subscales: (1) motivation, (2) use on special occasions, (3) general use, (4) compensatory health beliefs. Fit indices (Goodness of Fit Index = 0.922) and Cronbach's alphas were good (α = 0.88). In multiple linear regression models, all CHMB subscales were associated with greater cognitive restraint in eating. Compensatory behavior use on special occasions was associated with greater weight concern (B = 0.12, p < .0001), while general compensatory behavior use was associated with lower weight concern (B = −0.07, p < .05). None of the subscales were associated with BMI. The validated CHMB scale allows for the assessment of compensatory health motivations and behaviors in a Canadian population. Research on whether this scale can predict weight changes and general health is needed.

Systems of Reference for Personality Structure: Peseschkian &amp; Zubiri on Systems of Reference

The Spanish philosopher, Xavier Zubiri, wrote a major work titled Sentient Intelligence wherein he analyzes the human act of intellective knowing. In this work he delineates the importance of a system of reference (SoR) which serves two important functions: providing a direction for intellectual inquiry and providing an experience. The Iranian born psychiatrist, Nossrat Peseschkian, creator of Positive Psychotherapy, which originated in Germany in 1968, also mentions the importance of systems of reference (SsoR) for psychological knowing and personality structure. In this article, I expound upon and develop this construct, showing how humans have many SsoR which we use in interpreting psychological experience which form our unique personalities, based upon what we learn in our environments-of-origin. These SsoR become foundations for individual personality characteristics and provide insights into personality structure. I apply Zubiri’s construct to Peseschkian’s psychological system of reference, drawing out elements of Peseschkian’s contribution to personality theory. SsoR which we learn as infants can be modified and differentiated to create healthier ones and knowing them are important for psychological understanding. Furthermore, all approaches to psychotherapy and theories of personality can benefit from knowing of these SsoR.

The Three-Year Effect of Medicaid Expansion on Emergency Department Visits and Admissions

We examine the effect of the Medicaid expansion in 2014 under in the Patient Protection and Affordable Care Act on emergency department (ED) utilization and ED admission rates (fraction of ED visits that lead to hospital admission) during the first 3 postexpansion years (2014 to 2016). We compared ED utilization and ED admission rates in 151 EDs in 14 expansion states with those in 376 EDs in 14 nonexpansion states, using difference-in-differences methods with data from 3 national emergency medicine groups from 2013 to2016. In expansion states, the volume of Medicaid-paid ED visits increased 49% (95% confidence interval 34% to 65%), and the volume of uninsured visits decreased 44% (95% confidence interval -52% to -34%) relative to that of nonexpansion states. Both effects on payer mix leveled off during 2015. There was no significant relative change in overall ED utilization or overall ED admission rates in expansion versus nonexpansion states during the study. However, relative ED admission rates for uninsured patients declined 8% (95% confidence interval -18% to -2%) in expansion states. Large changes in payer mix in expansion versus nonexpansion states were observed but leveled off during 2015, with more Medicaid-paid visits and fewer uninsured visits in expansion states. Despite these large changes, during this 3-year period, there was no evidence that expansion affected either overall ED visit volume or ED admission rates. The relative decline in ED admission rates in expansion states among the uninsured may reflect a selection effect in which, among newly Medicaid-eligible persons, sicker persons were more likely to enroll than healthier ones.

Nutritional quality, child-oriented marketing and health/nutrition claims on sweet biscuit, breakfast cereal and dairy-based dessert packs in Argentina.

As children are particularly vulnerable to marketing, this study analyzes marketing techniques and health/nutrition claims in food packaging and evaluates the nutritional quality in three food categories: sweet biscuits, breakfast cereals and dairy-based desserts. This descriptive study analyzed marketing techniques and claims included in food packaging (n = 301) in one of the largest retailers in Argentina. Trained researchers coded data following an adapted version of the INFORMAS protocol to account for local food packaging regulations. Nutritional quality was assessed using both Pan American Health Organization Nutrient Profile (PAHO NPM) and the WHO Regional Office for Europe Nutrient Profile (WHO Euro NPM) models. Under the PAHO model, 87% (n 262) of the product sample presented excess content of at least one nutrient ("less healthy" products), and 91% (n = 273) should not be marketed to children according to the WHO Euro model. Almost 40% of less healthy food products displayed nutrition claims on their package. Characters or celebrity endorsements, which are particularly attractive to children, featured in 32% of less healthy products, being more frequent in less healthy food products than in healthier ones. Results indicate that packaging for food products with low nutritional value often includes powerful marketing elements in Argentina, which renders young children very vulnerable to obesogenic influence. Moreover, the real nutritional value of the products analyzed were often at odds with the health claims shown on its package. Food labeling policies must be improved in Argentina to guarantee people's health protection against deceptive advertising.

Chemical, microbial and sensory properties of a chestnut and milk ice cream with improved healthy characteristics

ABSTRACT With the aim of revalorization of two productions of economic relevance (milk and chestnuts), a novel ice cream was formulated incorporating milk, chestnut flour and chestnut bits. Using the best sensory valued formula as a basis, eight ice cream formulations were elaborated replacing the ingredients normally used (milk fat, sucrose and carboxymethylcellulose) by healthier ones (olive oil, erythritol + steviol glycosides, and tara (Caesalpinia spinosa) gum, respectively). The formulations were analyzed for composition, physicochemical parameters, fatty acid profile, volatile profile, microbiological characteristics and sensory attributes. A general preference of the tasters was observed for the formulations containing sucrose over those made with the hypocaloric sweetener.

Adolescents' Weight Management Goals: Healthy and Unhealthy Associations with Eating Habits and Physical Activity

This study aims to quantify associations between one's weight management goal and eating behaviors and physical activity among teenagers. Weighted logistic regressions were performed predicting healthy behaviors from weight goal separately for boys and girls while controlling for age, body mass index, socioeconomic indicators, school type, and region using data from the 2010 to 2011 Enquête québécoise sur la santé des jeunes du secondaire, a survey of a representative sample of Quebec adolescents (N=32,040). About 18%, 31%, 19%, and 34% of boys and 32%, 34%, 5%, and 25% of girls were respectively trying to lose weight, maintain their weight, gain weight, and not trying to do anything about their weight. Trying to lose weight was associated with lower likelihood of eating breakfast daily (boys: odds ratio [OR]=0.72; 95% confidence interval [CI]=0.61, 0.84 girls: OR=0.61; 95% CI=0.54, 0.70). Among girls, trying to lose weight was also associated with higher likelihood of consuming at least 5 portions of fruits and vegetables (OR=1.20; 95% CI=1.04, 1.37), lower likelihood of drinking sugar-sweetened beverages daily (OR=0.77; 95% CI=0.66, 0.90). Each weight-related goal was associated with unhealthy behaviors but most of them were also associated with adoption of healthier ones. Having a weight related goal cannot inherently be thought of as health promoting goal.

Cooling The Hot Spots Where Child Hospitalization Rates Are High: A Neighborhood Approach To Population Health.

Improving population health requires a focus on neighborhoods with high rates of illness. We aimed to reduce hospital days for children from two high-morbidity, high-poverty neighborhoods in Cincinnati, Ohio, to narrow the gap between their neighborhoods and healthier ones. We also sought to use this population health improvement initiative to develop and refine a theory for how to narrow equity gaps across broader geographic areas. We relied upon quality improvement methods and a learning health system approach. Interventions included the optimization of chronic disease management; transitions in care; mitigation of social risk; and use of actionable, real-time data. The inpatient bed-day rate for the two target neighborhoods decreased by 18percent from baseline (July 2012-June 2015) to the improvement phase (July 2015-June 2018). Hospitalizations decreased by 20percent. There was no similar decrease in demographically comparable neighborhoods. We see the neighborhood as a relevant frame for achieving equity and building a multisector culture of health.

Disease avoidance, and breeding group age and size condition the dispersal patterns of western lowland gorilla females.

Social dispersal is an important feature of population dynamics. When female mammals occur in polygynous groups, their dispersal decisions are conditioned by various female-, male-, and group-related factors. Among them, the influence of disease often remains difficult to assess. To address this challenge, we used long-term monitoring data from two gorilla populations (Gorilla gorilla gorilla) affected by infectious skin disease lesions. After controlling for other potentially influential factors, we investigated to which extent disease avoidance drives the dispersal decisions of gorilla females. We showed that the infection of a silverback of a breeding group by the skin disease increased the probability of adult females to emigrate. Moreover, adult females avoided breeding groups with a high prevalence of skin disease by emigrating from them and immigrating into healthier ones. Age of the breeding group was also an important factor. Adult females left older groups, near the end of a male tenure, to join younger ones led by younger fully grown silverbacks that could be of high reproductive and protective value. Our study highlights that, although females select for high-quality males, disease avoidance is a critical driver of their dispersion decision.

Using Internet Surveys to Estimate Visitors’ Willingness to Pay for Coral Reef Conservation in the Kenting National Park, Taiwan

Without appropriate conservation action, coral reefs globally continue to degrade, causing declines in economic value. Therefore, their local conservation and quantifying its benefits become increasingly important. However, accurately measuring these values remains expensive or complicated. Leveraging digital survey tools, an interdisciplinary on-line survey was created to estimate willingness to pay (WTP) for coral reef conservation using pictures and ecological data. Using the contingent valuation method we estimate current values as well as changes in value due to restoration or degradation for coral ecosystems in the Kenting National Park (KNP) in Taiwan. Results suggest that conserving degraded coral reef ecosystems leads to larger gains in value than healthier ones. Average WTP estimates a non-market economic value of 680 million US$ per year for the whole KNP marine area. Despite potential self-reporting bias and limits on sample size, these values appear consistent with similar studies and suggest future economic sampling strategies for KNP.

Availability of healthier vs. less healthy food and food choice: an online experiment

BackgroundOur environments shape our behaviour, but little research has addressed whether healthier cues have a similar impact to less healthy ones. This online study examined the impact on food choices of the number of (i) healthier and (ii) less healthy snack foods available, and possible moderation by cognitive load and socioeconomic status.MethodsUK adults (n = 1509) were randomly allocated to one of six groups (two cognitive load x three availability conditions). Participants memorised a 7-digit number (7777777: low cognitive load; 8529713: high cognitive load). While remembering this number, participants chose the food they would most like to eat from: (a) two healthier and two less healthy foods, (b) six healthier and two less healthy foods, or (c) two healthier and six less healthy foods.ResultsCompared to being offered two healthier and two less healthy options, the odds of choosing a healthier option were twice as high (Odds Ratio (OR): 2.0, 95%CI: 1.6, 2.6) with four additional healthier options, while the odds of choosing a less healthy option were four times higher (OR: 4.3, 95%CI: 3.1, 6.0) with four additional less healthy options. There were no significant main effects or interactions with cognitive load or socioeconomic status.ConclusionsThis study provides a novel test of the impact of healthier vs. less healthy food cues on food choice, suggesting that less healthy food cues have a larger effect than healthier ones. Consequently, removing less healthy as opposed to adding healthier food options could have greater impact on healthier choices. Studies are now needed in which choices are made between physically-present foods.

Microalgae based innovative animal fat and proteins replacers for application in functional baked products

Abstract Animal fat and proteins, such as milk butter and eggs, are the main ingredients of baked products, and are frequently blamed for food allergies, obesity, cancer and type II diabetes. Therefore, there is an urgent need to replace these ingredients with healthier ones without degrading the organoleptic characteristics of the final product. Microalgae are a great source of protein, minerals and lipids such as omega-3 and omega-6 fatty acids, which are beneficial for human health, offering multiple health benefits such as antioxidant and anti-aging activity. In this study, Chlorella vulgaris microalgae were the selected raw material for the innovative replacers because of their high content in proteins and polyunsaturated fatty acids. The obtained microalgal oil was colour corrected and used to produce brioche-type baked products with 100% animal fat substitution. For protein recovery, the aquatic extract was freeze-dried, producing a dry protein powder that fully substituted the animal protein in the baked products. Finally, the development of bakery products with 100% replacement of both animal fat and protein was achieved. These innovative bakery products showed equal performance to the commercial ones, and even improved organoleptic characteristics according to the sensorial analysis that occurred.

Food marketing with movie character toys: Effects on young children's preferences for unhealthy and healthier fast food meals

This study aimed to test whether movie tie-in premiums (MTIPs) accompanying unhealthy and healthier fast food meals influenced children's meal preferences and their perceptions of these meals. Nine hundred and four Grade 1 and 2 students (aged 5–9 years) from Melbourne, Australia participated in a between-subjects online experiment comprising the following conditions: (A) unhealthy and healthier meals with no MTIP (control); (B) unhealthy and healthier meals with MTIP (current situation in Australia); (C) unhealthy meals with MTIP and healthier meals without MTIP; (D) unhealthy meals without MTIP and healthier meals with MTIP. The latter condition tested a potential regulatory model restricting premiums to healthier meals. Participants were shown a trailer for a current children's movie followed by an advertisement for an associated McDonald's Happy Meal® (conditions B-D) or an advertisement for a children's leisure activity (condition A). They were then shown four McDonald's Happy Meal® options on screen and asked to select their preferred meal before completing detailed meal ratings. Overall, children showed a preference for unhealthy meals over healthier ones. Children were significantly more likely to select a healthier meal over an unhealthy meal when only the healthier meals were accompanied by a MTIP (condition D) compared to the other three conditions. When healthier meals were accompanied by a MTIP, children reported the meal looked better, would taste better, they would be more likely to ask their parents for this meal, and they would feel happier if their parents bought them this meal, compared to when the healthier meal was not accompanied by a MTIP. Results suggest that modifying the food marketing environment to restrict MTIPs to healthier meals should encourage healthier fast food meal choices by children.

The Short Form of the Five-Factor Narcissism Inventory: Psychometric Equivalence of the Turkish Version

Narcissism is named after Narcissus, a famous character from Greek mythology who was fated to fall in love with himself. Narcissism is an important and complex phenomenon studied in many subfields of psychology that include, but are not limited to, clinical (therapeutic), organizational, developmental, and social psychology (Sherman et al., 2015). Narcissism is characterized by grandiosity, arrogance, and a callous defense of one's self-image as perfect; interest in others is only a means for regulating self-esteem (Kubarych, Deary, & Austin, 2004).The narcissistic personality was first introduced as a psychological concept by Walder (as cited in Campbell & Miller, 2011). Freud saw narcissism as an unhealthy relationship between one's ego and libido, and he advanced the concept of narcissism by introducing the ego-libido personality type characterized by independence, extraversion, and an inability to commit to long-term relationships; yet narcissists usually attract attention and admiration, taking leadership roles (1991; 1950). Psychodynamic theoreticians such as Kernberg and Kohut are credited for making elaborate efforts at understanding and treating narcissistic personalities and establishing foundations for the Diagnostic and Statistical Manual of Mental Disorder's (DSM) criteria of narcissistic personality disorder (Campbell & Miller, 2011). Kernberg (2004) envisioned narcissism as originating from a maladaptive pattern that originates in early childhood. On the other hand, Kohut (1971; 1977) defined childhood narcissism and exhibitionism as normal. However, a failure in transforming narcissistic patterns into healthier ones creates a narcissistic personality disorder in the later stages of development. Within terms of the psychoanalytical structural model, Kernberg defined narcissism as a libidinal investment in the self (Kernberg, 2004).Based on the predominantly psychodynamic literature, Narcissistic Personality Disorder (NPD) was first included in the 3rd Edition of the DSM (American Psychiatric Association [APA], 1980) and assessment instruments were subsequently developed. In a text revision of DSM-IV (DSM-IV-TR; APA, 2000) and earlier versions, NPD was mainly defined by categorical criteria. The DSM-IV-TR stressed narcissism of the grandiose type over the vulnerability type (Miller et al., 2013). In DSM-V (APA, 2013), narcissistic traits were introduced and incorporated into the NPD criteria (Few et al., 2013; Miller, Gentile, Wilson, & Campbell, 2013).SubtypesNarcissism is usually conceptualized within a continuum that ranges from normal to maladaptive or pathological forms. The pathological form of narcissism is usually studied within the context of psychodynamic theories, while the normal form is studied more through empirical methods (Blais & Little, 2010). Pathological narcissism has been insufficiently studied due to different reasons, the lack of psychometrically sound measures being foremost (Schoenleber, Roche, Wetzel, Pincus, & Roberts, 2015). Scientific study of narcissism is seen as fragmented and under-pursued (Blais & Little, 2010). Miller and Campbell (2010) asserted that the scientific understanding of pathological narcissism is predominantly speculative and lacks empirical support.The normal, sub-clinical form (trait narcissism) is also a crucial construct in the study of personalities (Paulhus, 2001). Subclinical narcissism, subclinical psychopathy, and Machiavellianism have been defined as the dark triad. All of these traits are linked to emotional coldness, aggressiveness, deception, and self-promotion (Paulhus & Williams, 2002). On the other hand, it has also been suggested that most people can exhibit narcissistic behaviors, with the claim that a moderate level of narcissism may in fact even contribute to success and better functioning (Kets de Vries & Miller, 1985). Trait narcissism has been shown to predict a wide range of psychological phenomena in many studies from recent decades (Ames, Rose, & Anderson, 2006). …

Patterns of Emphysema Heterogeneity

Background: Although lobar patterns of emphysema heterogeneity are indicative of optimal target sites for lung volume reduction (LVR) strategies, the presence of segmental, or sublobar, heterogeneity is often underappreciated. Objective: The aim of this study was to understand lobar and segmental patterns of emphysema heterogeneity, which may more precisely indicate optimal target sites for LVR procedures. Methods: Patterns of emphysema heterogeneity were evaluated in a representative cohort of 150 severe (GOLD stage III/IV) chronic obstructive pulmonary disease (COPD) patients from the COPDGene study. High-resolution computerized tomography analysis software was used to measure tissue destruction throughout the lungs to compute heterogeneity (≥15% difference in tissue destruction) between (inter-) and within (intra-) lobes for each patient. Emphysema tissue destruction was characterized segmentally to define patterns of heterogeneity. Results: Segmental tissue destruction revealed interlobar heterogeneity in the left lung (57%) and right lung (52%). Intralobar heterogeneity was observed in at least one lobe of all patients. No patient presented true homogeneity at a segmental level. There was true homogeneity across both lungs in 3% of the cohort when defining heterogeneity as ≥30% difference in tissue destruction. Conclusion: Many LVR technologies for treatment of emphysema have focused on interlobar heterogeneity and target an entire lobe per procedure. Our observations suggest that a high proportion of patients with emphysema are affected by interlobar as well as intralobar heterogeneity. These findings prompt the need for a segmental approach to LVR in the majority of patients to treat only the most diseased segments and preserve healthier ones.

Towards a suitable ecological status assessment of highly stratified mediterranean estuaries: A comparison of benthic invertebrate fauna indices

Biotic indices developed to assess the ecological status of coastal waters according to the European Water Framework Directive (WFD) often show discrepancies when they are applied in transitional environments. Although several indices have been widely used in transitional waters throughout Europe, there is still a lack of knowledge about their suitability assessing ecological status. We evaluated the performance of most common used biotic indices and community parameters (e.g. Multivariate AZTI's Marine Biotic Index (M-AMBI), BENTIX, Benthic Opportunistic Polychaetes Amphipods index (BOPA), diversity indices, species richness, abundance) that have been proposed in the scope of WFD, using data of macroinvertebrate community coming from a special case of transitional water body, the highly stratified Ebro estuary. Additionally, we tested their ability to respond to the main pressures affecting the Ebro estuary, the hydrological alteration due to regulation and the pollution pressure due to nutrient enrichment. Estimation of hydrological alteration was based on flow historical data (period from 1913 to 1963), that we assumed as 'hydrological reference conditions' for Ebro estuary. Pollution pressure was estimated by means of PCA analysis including organic and nutrient enrichment related variables, expressed as a synthetic index by PCA factor scores extraction. All the community parameters were able to detect changes in macrofauna composition along the estuarine gradients and were able to differentiate between the impoverished stations and the healthier ones. Regarding indices, the ratings were contradictory and only M-AMBI classified the stations in the correct way. Strong significant correlations were found between indices and metrics and the calculated pressures; nevertheless, these correlations showed a paradoxical result, since increasing hydrological alteration benefited the macrofauna, achieving great complexity. Other identified limitations of biotic indices were the opposite classifications, overestimation of ecological status and low resolution ability. We conclude that for transitional water ecosystems, where each water body has particular characteristics, is difficult the use of 'common biological' assessment tools as the results of this study, among others (more details in discussion section), have demonstrated. Nevertheless, M-AMBI seemed to work in the correct way, so further investigation about its use for transitional waters is necessary. The development of new strategies such as the use of historical data, the use of metrics as a complement for the assessment could be a reliable alternative.

Influence of sensory and cultural perceptions of white rice, brown rice and beans by Costa Rican adults in their dietary choices

Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40–65 years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability.

Living Happily Ever After? The Effect of Taiwan’s National Health Insurance on the Happiness of the Elderly

The implementation of Taiwan’s National Health Insurance (NHI) in 1995 has created a quasi-experiment that permits us to draw causal inference for the effect of the NHI on the happiness and life satisfaction. The NHI is expected to have a positive effect on happiness because it not only improves the health and mitigates the uncertainty in financial losses due to health shocks, but also alleviates health inequality in the population through equal access to care. The results show that the NHI has a significant effect on happiness and life satisfaction. The effect ranges from 3 to 30 % depending on the measures of happiness. Nonetheless, the effect of the NHI in narrowing happiness inequality across socioeconomic status (SES) is significant for health and income groups only while its effect on education- and gender-happiness gradients are insignificant. The increase in the probability of being happy or satisfied with life among the least healthy group is 0.08 % points higher than that of the healthier ones. Earlier studies have shown that the effects of health insurance on health and disparity in health across SES groups are small. In contrast, our findings suggest that the welfare impact of the NHI is quite large.