Discourses in Interaction: The intersection of literacy and health research internationally

Literacy and health are deeply influential in social participation, utilisation of social resources and quality of life. This paper discusses interacting discourses and common conceptual points shared by the adult literacy and public health fields and situates how the sub-field at the intersection of these two domains, known as ‘health literacy’, is constructed and enacted. Emerging approaches that recognise the convergence of education and health within international policy, research and in practice are articulated. The paper argues a case for re-thinking the literacy-health connection from a cross-sectoral perspective and for more effective approaches furthering the interests of both life-long learning and wellbeing.

Obesity and its risk factors among African migrant adolescents : assessing the role of intergenerational acculturation gap, family functioning and parenting

African migrants constitute a fast-growing, culturally and linguistically diverse subpopulation in Australia. The 2006 census data suggest that there are more than 210,000 African migrants living in Australia, 24% of whom live in Victoria. In Victoria, African migrants are concentrated in the Greater Dandenong, Western Region, and Northern Region, and small numbers in regional areas such as Shepparton and Swan Hill. On arrival in Australia, they are at increased risk of obesity and chronic diseases and this risk has strong cultural roots, accentuated by poor health literacy and intergenerational discrepancies in acculturation between parents and children. However, there are other factors related to the family functioning and parenting styles that predispose African migrants to obesity and chronic diseases, but these factors are poorly documented. This pilot study sought to develop and trial a framework for engaging with African communities, and to document and describe elements of family functioning, parenting style, acculturation that predispose African young people to obesity

Radiation-associated angiosarcoma after autologous breast reconstruction: report of two cases in a plastic surgery unit

Radiation-associated breast angiosarcoma is a rare diagnosis but is commonly reported. Angiosarcoma occurring in non-breast tissue in breasts that have been reconstructed with autologous tissue following mastectomy is extremely rare. In our unit, we have managed two patients with angiosarcoma arising in non-breast tissue autologous reconstructions. Our report emphasises that any tissue treated with radiotherapy—that is, the residual mastectomy skin flaps or non-breast tissue autologous reconstructions—are at a risk of secondary angiosarcoma. We also discuss recommended surgical management, surveillance and genetic testing. Level of Evidence is V, risk study

Meta-analysis of outcomes of patients with COVID-19 infection with versus without gastrointestinal symptoms.

This systematic review analyzed whether the presence or absence of gastrointestinal symptoms in patients with SARS-COV-2 infection is associated with adverse outcomes. Searching the Cochrane Center Register of Controlled Trials, we included any studies looking at patients with COVID-19 with gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain) compared to those with COVID-19 but without gastrointestinal manifestations as a control group. The final search yielded 186 articles, all of which were individually screened. Seven studies were identified but three were excluded: one due to lack of a control group without gastrointestinal symptoms, one reported as viral RNA in the stool, and one with only non-critically ill patients. Results of the meta-analysis showed a pooled odds ratio for mortality among those with COVID-19 and gastrointestinal symptoms of 0.91 (confidence interval 0.49-1.68) with heterogeneity of 0% and a pooled odds ratio for acute respiratory distress syndrome of 2.94 (confidence interval 1.17-7.40) with heterogeneity of 0%. In conclusion, gastrointestinal symptoms with COVID-19 are associated with a higher risk of acute respiratory distress syndrome, but do not increase the risk for mortality

Parent-centred and culturally-competent literacies for health promotion with newly arrived African communities : a literature review

When considering culturally competent health literacy in newly arrived communities the following key concepts are important: Health literacy and literacy - People practice and use literacy in many ways. People use text or the written word, oral literacy (or the spoken word), visual literacy (or images) and technological literacy (through the use of information and communication technologies). They also draw on other people who mediate health-related information. People’s identities and their access to social networks shape their use of literacy practices and their engagement with health promoting activities. Literacy practices are not static. Initiatives to improve health literacy need to be responsive to the social context (e.g. migration experience; life history; gender; ethnicity; religion; life stage; education) and integrate expertise from both the health promotion and the adult literacy fields. Collectivism and authoritarianism - Most western cultures, such as Australia, support an environment that promotes individualism. With parenting, this translates to parenting styles that place high priority on children’s autonomy, individual achievement, self-expression and egalitarianism. However, African (and other) cultures place a high priority on collectivism and authoritarianism as the norm. Authoritarianism is characterized by the imposition of an absolute set of standards, the valuing of obedience and respect for authority. In this sense the collectivist cultures discourage self-assertion and autonomy, and the goal of parenting is the promotion of interdependence, cooperation, compliance without discussion, and inhibition of personal wishes. Acculturation - Acculturation of immigrants and refugees is a complex and dynamic interaction that takes place between groups settling in the host country and the people, culture, environment, politics and systems of the new country. The impact of acculturation on the health and wellbeing of new arrivals is significant and there are several models of acculturation described in the literature. A way to support health appears to be through a combination of maintenance of beneficial traditional elements of life as well as adopting useful host cultural skills. Cultural competence - The literature frames ‘cultural competence’ as the evolution of the terms cultural sensitivity and cultural awareness. The concept is important as it shifts focus from the individual to the organisation and systems. The ethos of cultural competence is a reflective practice and ongoing process of learning, valuing and interacting crossculturally at an individual, organisation and system level

Guidance for research on social isolation, loneliness, and participation among older people: Lessons from a mixed methods study

This article provides methodological guidance to researchers wishing to develop collaborative research projects with local governments and other agencies, by describing the process adopted in a mixed methods study conducted in the City of Wanneroo (the City), a local government area in Perth, Western Australia. The study explored factors related to older people’s (60+ years) participation in community-based activities and links between their participation and levels of social isolation, loneliness, and social connectedness. The research incorporated four interrelated stages: (1) an audit of existing programs in the City and program participant characteristics; (2) focus groups with program participants and interviews with nonparticipants; (3) a cross-sectional survey to assess factors associated with participation and links to social isolation, loneliness, and social connectedness; (4) face-to-face interviews with survey respondents screened at risk for loneliness. Methodological recommendations are provided to guide future collaborative research with local authorities, program developers, and administrators, aimed at minimizing social isolation and loneliness among older people. These include the need for clear communication and documentation of mutually agreed research objectives and responsibilities from project initiation to completion, identifying and working with local agencies to maximize recruitment among “hard to reach” groups, understanding the dimensions of loneliness addressed in the selected instrument used to screen for loneliness, and integrating innovative data collection techniques when working with vulnerable groups such as socially isolated older people

Validating the Food Behavior Questions from the Elementary School SPAN Questionnaire

Background The School Physical Activity and Nutrition (SPAN) questionnaire were developed as a surveillance instrument to measure physical activity, nutrition attitudes, and dietary and physical activity behaviors in children and adolescents. The SPAN questionnaire has 2 versions. Objective This study was conducted to evaluate the validity of food consumption items from the elementary school version of the SPAN questionnaire. Design Validity was assessed by comparing food items selected on the questionnaire with food items reported from a single 24-hour recall covering the same reference period. Setting 5 elementary schools in Indiana. Participants Fourth-grade student volunteers (N = 121) from 5 elementary schools. Main Outcome Measure Agreement between responses to SPAN questionnaire items and reference values obtained through 24-hour dietary recall. Analysis The agreement between the questionnaire and the 24-hour recall was measured using Spearman correlation, percentage agreement, and kappa statistic. Results Correlation between SPAN item responses and recall data ranged from .25 (bread and related products) to .67 (gravy). The percentage agreement ranged from 26% (bread and related products) to 90% (gravy). The kappa statistic varied from .06 (chocolate candy) to .60 (beans). Conclusions and implications Results from this study indicate that the SPAN questionnaire can be administered in the classroom quickly and easily to measure many previous day dietary behaviors of fourth graders. However, questions addressing the consumption of “vegetables,” “candy,” and “snacks” need further investigation

Connectional architecture of a mouse hypothalamic circuit node controlling social behavior

Type 1 estrogen receptor-expressing neurons in the ventrolateral subdivision of the ventromedial hypothalamus (VMHvl^(Esr1)) play a causal role in the control of social behaviors, including aggression. Here we use six different viral-genetic tracing methods to systematically map the connectional architecture of VMHvl^(Esr1) neurons. These data reveal a high level of input convergence and output divergence (“fan-in/fan-out”) from and to over 30 distinct brain regions, with a high degree (∼90%) of bidirectionality, including both direct as well as indirect feedback. Unbiased collateralization mapping experiments indicate that VMHvl^(Esr1) neurons project to multiple targets. However, we identify two anatomically distinct subpopulations with anterior vs. posterior biases in their collateralization targets. Nevertheless, these two subpopulations receive indistinguishable inputs. These studies suggest an overall system architecture in which an anatomically feed-forward sensory-to-motor processing stream is integrated with a dense, highly recurrent central processing circuit. This architecture differs from the “brain-inspired,” hierarchical feed-forward circuits used in certain types of artificial intelligence networks

To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security

© 2020 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association Issue addressed: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. Methods: An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six-item US Household Food Security Survey Module, 12 socio-demographic variables and 32 questions related to elements of food literacy. Results: Food insecure respondents were more likely to frequent fast food vs (P =.002), takeaway (P \u3c .001) and food courts (P \u3c .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P =.043) and fresh, pre-prepared produce (P =.002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre-packaged products (P \u3c .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. Conclusions: Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. So what?: This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in-home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food

A multiproxy study of past environmental changes in the Sea of Okhotsk during the last 1.5 Ma

Long-chain diols have been detected in a wide range of environments and have been used to reconstruct past environmental changes, however only a few long-term records exist to date. Here we reconstructed past environmental changes in the central Sea of Okhotsk over the last 1.5 million years, covering the Mid-Pleistocene Transition (MPT). Sea surface temperatures (SST) reconstructed using the Long-Chain Diol Index (LDI) reflects glacial/interglacial changes. However, when compared with other organic paleothermometers (Uk′37 and TEXL86) the LDI-SST is lower during interglacials and similar or higher during glacials, possibly suggesting a shift of diol production season during interglacials. The LDI-SST does not change in periodicity around the MPT as observed for the TEXL86, likely due to this seasonal shift. Diatom productivity, as recorded by 1,14-diols and biogenic opal content, increased during the main deglaciations with a succession from Proboscia diatoms to diatoms with a more heavily silicified shell, confirming that primary productivity in the central Sea of Okhotsk is driven by sea-ice progress and retreat. In contrast to the LDI-SST, the 1,14-diols record shows a change in periodicity around the MPT from 41- to 100-kyr cycle, suggesting an influence of orbital parameters on diatom productivity. In the central Sea of Okhotsk, the relative amount of C32 1,15-diol (FC32 1,15), a proxy for riverine input, correlates with sea-level change with more riverine-derived material reaching the core site when the Amur River mouth is closer at lower sea-levels. In agreement, FC32 1,15 shows a change in periodicity during the MPT, with the appearance of a 100-kyr cycle. Our results show that the long chain diols can provide important paleoceanographic information in subpolar environments over long time scales, but that temperature reconstructions can be severely impacted by changes in seasonality