Adolescent Healthcare Brokering: Prevalence, Experience, Impact, and Opportunities

BACKGROUND: Limited health literacy disproportionately affects those with limited English proficiency (LEP). Parents with LEP might rely on their adolescent children to interpret health information. We call this adolescent health care brokering. This study uncovers the prevalence of brokering, kinds of tasks, emotional and academic impact, and desired support. METHODS: We invited 165 students from health classes (in a community in which 29.8% are foreign-born and 53.4% speak another language at home) to complete a survey. We used IBM SPSS to calculate descriptive statistics. RESULTS: Of the 159 who received parental consent and assented, 54.1% (n=86) assist with healthcare tasks. When brokering, 80.2% (n=69) translate. Most common tasks were talking to a doctor, reading prescriptions, and searching on the Internet. Participants were most confident reading prescriptions and talking to a doctor and least confident finding healthcare services. Among brokers, 29.1% (n=24) missed school; 33.7% did not complete homework. They most wanted to learn about filling out insurance forms and talking to doctors. CONCLUSIONS: Despite assurances that children are not permitted to interpret, adolescents are acting as healthcare brokers. The impact can be academic and emotional. Findings indicate a need for further research and support for adolescents who want to learn about healthcare tasks

The Adolescent Health Care Broker – Adolescents Interpreting for Family Members and Themselves in Health Care

Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) “What is happening? What are people doing?” and (b) “What do these stories indicate? What might they suggest about social justice?” High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n=137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n=112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n=11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent

Is healthy behavior contagious: associations of social norms with physical activity and healthy eating

BackgroundSocial norms are theoretically hypothesized to influence health-related behaviors such as physical activity and eating behaviors. However, empirical evidence relating social norms to these behaviors, independently of other more commonly-investigated social constructs such as social support, is scarce and findings equivocal, perhaps due to limitations in the ways in which social norms have been conceptualized and assessed. This study investigated associations between clearly-defined social norms and a range of physical activity and eating behaviors amongst women, adjusting for the effects of social support. MethodsSelf-report survey data about particular physical activity (leisure-time moderate-vigorous activity; volitional walking; cycling for transport) and eating behaviors (fast food, soft drink and fruit and vegetable consumption), and social norms and support for these, were provided by 3,610 women aged 18-46 years living in socioeconomically disadvantaged neighborhoods in Victoria, Australia. ResultsResults of regression analyses showed that social norms for physical activity and eating behaviors predicted these respective behaviors relatively consistently; these associations generally remained significant after adjustment for social support. ConclusionsAcknowledging the cross-sectional study design, these data confirm theoretical accounts of the importance of social norms for physical activity and eating behaviors, and suggest that this is independent from social support. Intervention strategies aimed at promoting physical activity and healthy eating could incorporate strategies aimed at modifying social norms relating to these behaviors.<br /

Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults : cross-sectional data from the WELL study

BackgroundLifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F&amp;V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults.MethodsThis cross-sectional study comprised 3,644 older adults (48% men) aged 55-65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life (&quot;WELL&quot;) study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman\u27s coefficient (rho) was used to evaluate the relationship between F&amp;V intake, LTPA and ST. Their individual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics).ResultsThe correlations between F&amp;V intake, LTPA and ST were low. F&amp;V intake and LTPA were positively associated with self-rated health. Each additional serving of F&amp;V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F&amp;V intake). The effect of F&amp;V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men.ConclusionThis study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F&amp;V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group

'It's a film' : medium specificity as textual gesture in Red road and The unloved

British cinema has long been intertwined with television. The buzzwords of the transition to digital media, 'convergence' and 'multi-platform delivery', have particular histories in the British context which can be grasped only through an understanding of the cultural, historical and institutional peculiarities of the British film and television industries. Central to this understanding must be two comparisons: first, the relative stability of television in the duopoly period (at its core, the licence-funded BBC) in contrast to the repeated boom and bust of the many different financial/industrial combinations which have comprised the film industry; and second, the cultural and historical connotations of 'film' and 'television'. All readers of this journal will be familiar – possibly over-familiar – with the notion that 'British cinema is alive and well and living on television'. At the end of the first decade of the twenty-first century, when 'the end of medium specificity' is much trumpeted, it might be useful to return to the historical imbrication of British film and television, to explore both the possibility that medium specificity may be more nationally specific than much contemporary theorisation suggests, and to consider some of the relationships between film and television manifest at a textual level in two recent films, Red Road (2006) and The Unloved (2009)

Navigating to new frontiers in behavioral neuroscience: traditional neuropsychological tests predict human performance on a rodent-inspired radial-arm maze

We constructed an 11-arm, walk-through, human radial-arm maze (HRAM) as a translational instrument to compare existing methodology in the areas of rodent and human learning and memory research. The HRAM, utilized here, serves as an intermediary test between the classic rat radial-arm maze (RAM) and standard human neuropsychological and cognitive tests. We show that the HRAM is a useful instrument to examine working memory ability, explore the relationships between rodent and human memory and cognition models, and evaluate factors that contribute to human navigational ability. One-hundred-and-fifty-seven participants were tested on the HRAM, and scores were compared to performance on a standard cognitive battery focused on episodic memory, working memory capacity, and visuospatial ability. We found that errors on the HRAM increased as working memory demand became elevated, similar to the pattern typically seen in rodents, and that for this task, performance appears similar to Miller's classic description of a processing-inclusive human working memory capacity of 7 ± 2 items. Regression analysis revealed that measures of working memory capacity and visuospatial ability accounted for a large proportion of variance in HRAM scores, while measures of episodic memory and general intelligence did not serve as significant predictors of HRAM performance. We present the HRAM as a novel instrument for measuring navigational behavior in humans, as is traditionally done in basic science studies evaluating rodent learning and memory, thus providing a useful tool to help connect and translate between human and rodent models of cognitive functioning

Multiple introductions and human-aided dispersal of the UK’s most widespread non-native amphibian

The alpine newt Ichthyosaura alpestris has achieved a widespread distribution as a non-native (alien) species in Britain since its initial introduction over a century ago, but the patterns of its release and subsequent dispersal have never yet been collectively analysed. We employed a multi-disciplinary combination of methods, using geographic profiling to estimate the likely number and locations of introductions, and mitochondrial DNA polymorphisms to investigate the likely geographic source of primary introductions, including the potential role of the pet trade. In parallel we used population genetic analysis and coalescence-based modelling to infer the demographics and directionality of dispersal from founding populations. Our results show that alpine newts have been released at multiple sites. We found a close resemblance between patterns of mtDNA haplotypes in the pet trade and those of established alpine newt populations, suggesting a relationship between trade, releases, and dispersal. Results from demographic modelling using Approximate Bayesian Computation are also consistent with multiple independent introductions with limited local dispersal, and additionally suggest that releases may occur from intermediate sources, such as captive populations. Our results support the hypothesis that deliberate human activity is largely responsible for both introductions of alpine newts into the UK and their wider dispersal post-introduction. The likely involvement of the international pet trade highlights the risk that ongoing releases of I. alpestris may expose native species to pathogens, whether pre-existing or novel

The Ontology of Biological Attributes (OBA)-computational traits for the life sciences.

Existing phenotype ontologies were originally developed to represent phenotypes that manifest as a character state in relation to a wild-type or other reference. However, these do not include the phenotypic trait or attribute categories required for the annotation of genome-wide association studies (GWAS), Quantitative Trait Loci (QTL) mappings or any population-focussed measurable trait data. The integration of trait and biological attribute information with an ever increasing body of chemical, environmental and biological data greatly facilitates computational analyses and it is also highly relevant to biomedical and clinical applications. The Ontology of Biological Attributes (OBA) is a formalised, species-independent collection of interoperable phenotypic trait categories that is intended to fulfil a data integration role. OBA is a standardised representational framework for observable attributes that are characteristics of biological entities, organisms, or parts of organisms. OBA has a modular design which provides several benefits for users and data integrators, including an automated and meaningful classification of trait terms computed on the basis of logical inferences drawn from domain-specific ontologies for cells, anatomical and other relevant entities. The logical axioms in OBA also provide a previously missing bridge that can computationally link Mendelian phenotypes with GWAS and quantitative traits. The term components in OBA provide semantic links and enable knowledge and data integration across specialised research community boundaries, thereby breaking silos

CB1 Expression Is Attenuated in Fallopian Tube and Decidua of Women with Ectopic Pregnancy

BACKGROUND: Embryo retention in the Fallopian tube (FT) is thought to lead to ectopic pregnancy (EP), a considerable cause of morbidity. In mice, genetic/pharmacological silencing of cannabinoid receptor Cnr1, encoding CB1, causes retention of embryos in the oviduct. The role of the endocannabinoids in tubal implantation in humans is not known. METHODS AND FINDINGS: Timed FT biopsies (n = 18) were collected from women undergoing gynecological procedures for benign conditions. Endometrial biopsies and whole blood were collected from women undergoing surgery for EP (n = 11); management of miscarriage (n = 6), and termination of pregnancy (n = 8). Using RT-PCR and immunohistochemistry, CB1 mRNA and protein expression levels/patterns were examined in FT and endometrial biopsies. The distribution of two polymorphisms of CNR1 was examined by TaqMan analysis of genomic DNA from the whole blood samples. In normal FT, CB1 mRNA was higher in luteal compared to follicular-phase (p<0.05). CB1 protein was located in smooth muscle of the wall and of endothelial vessels, and luminal epithelium of FT. In FT from women with EP, CB1 mRNA expression was low. CB1 mRNA expression was also significantly lower (p<0.05) in endometrium of women with EP compared to intrauterine pregnancies (IUP). Although of 1359G/A (rs1049353) polymorphisms of CNR1 gene suggests differential distribution of genotypes between the small, available cohorts of women with EP and those with IUP, results were not statistically significant. CONCLUSIONS: CB1 mRNA shows temporal variation in expression in human FT, likely regulated by progesterone. CB1 mRNA is expressed in low levels in both the FT and endometrium of women with EP. We propose that aberrant endocannabinoid-signaling in human FT leads to EP. Furthermore, our finding of reduced mRNA expression along with a possible association between polymorphism genotypes of the CNR1 gene and EP, suggests a possible genetic predisposition to EP that warrants replication in a larger sample pool