"I tell ya who needs educatin’”: non-Indigenous cultural self-awareness and prisoner education.

Glen says, “current education is colonial; it ain’t ours. I tell ya who needs educatin’, wadjellas”. Glen is a Noongar man who, along with several other Aboriginal adults living in Western Australia, teaches me in a PhD research project about prisoner education from their perspective. His words pose a question for wadjellas like myself who are raised, taught and work in a white neo-colonial society. We have been raised in, taught in and work in a colonial system. As non-Aboriginal people we have unearned privileges which are often invisible and unacknowledged. How then to address the outcomes of this in a way that might lead to working co-operatively alongside Aboriginal people? What kind of ‘educatin’ could teach us about our own unacknowledged privilege and the disadvantage this can lead to for others? Is the standard cross-cultural awareness training enough?This paper shares some of the teachings of Glen and other participants in this research. It expresses the view that, ultimately, the usually unacknowledged legacy of colonisation and associated issue of denied Aboriginal sovereignty lies at the heart of much of the disadvantage experienced by Aboriginal people today when considering education and the prison system. Addressing gaps in non-Indigenous cultural self-awareness by learning from Aboriginal people is an important factor in improving their experiences of education.

Characterizing problematic hypoglycaemia: iterative design and preliminary psychometric validation of the Hypoglycaemia Awareness Questionnaire (HypoA-Q)

AIMS: To design and conduct preliminary validation of a measure of hypoglycaemia awareness and problematic hypoglycaemia, the Hypoglycaemia Awareness Questionnaire.

METHODS: Exploratory and cognitive debriefing interviews were conducted with 17 adults (nine of whom were women) with Type 1 diabetes (mean ± sd age 48±10 years). Questionnaire items were modified in consultation with diabetologists/psychologists. Psychometric validation was undertaken using data from 120 adults (53 women) with Type 1 diabetes (mean ± sd age 44±16 years; 50% with clinically diagnosed impaired awareness of hypoglycaemia), who completed the following questionnaires: the Hypoglycaemia Awareness Questionnaire, the Gold score, the Clarke questionnaire and the Problem Areas in Diabetes questionnaire.

RESULTS: Iterative design resulted in 33 items eliciting answers on awareness of hypoglycaemia when awake/asleep and hypoglycaemia frequency, severity and impact (healthcare utilization). Psychometric analysis identified three subscales reflecting 'impaired awareness', 'symptom level' and 'symptom frequency'. Convergent validity was indicated by strong correlations between the impaired awareness subscale and existing measures of awareness: (Gold: rs =0.75, P<0.01; Clarke: rs =0.76, P<0.01). Divergent validity was indicated by weaker correlations with diabetes-related distress (Problem Areas in Diabetes: rs =0.25, P<0.01) and HbA1c (rs =-0.05, non-significant). The impaired awareness subscale and other items discriminated between those with impaired and intact awareness (Gold score). The impaired awareness subscale and other items contributed significantly to models explaining the occurrence of severe hypoglycaemia and hypoglycaemia when asleep.

CONCLUSIONS: This preliminary validation shows the Hypoglycaemia Awareness Questionnaire has robust face and content validity; satisfactory structure; internal reliability; convergent, divergent and known groups validity. The impaired awareness subscale and other items contribute significantly to models explaining recall of severe and nocturnal hypoglycaemia. Prospective validation, including determination of a threshold to identify impaired awareness, is now warranted.

Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial.

OBJECTIVE: Impaired awareness of hypoglycemia (IAH) and defective counterregulation significantly increase severe hypoglycemia risk in type 1 diabetes (T1D). We evaluated restoration of IAH/defective counterregulation by a treatment strategy targeted at hypoglycemia avoidance in adults with T1D with IAH (Gold score ≥4) participating in the U.K.-based multicenter HypoCOMPaSS randomized controlled trial. RESEARCH DESIGN AND METHODS: Eighteen subjects with T1D and IAH (mean ± SD age 50 ± 9 years, T1D duration 35 ± 10 years, HbA1c 8.1 ± 1.0% [65 ± 10.9 mmol/mol]) underwent stepped hyperinsulinemic-hypoglycemic clamp studies before and after a 6-month intervention. The intervention comprised the HypoCOMPaSS education tool in all and randomized allocation, in a 2 × 2 factorial study design, to multiple daily insulin analog injections or continuous subcutaneous insulin infusion therapy and conventional glucose monitoring or real-time continuous glucose monitoring. Symptoms, cognitive function, and counterregulatory hormones were measured at each glucose plateau (5.0, 3.8, 3.4, 2.8, and 2.4 mmol/L), with each step lasting 40 min with subjects kept blinded to their actual glucose value throughout clamp studies. RESULTS: After intervention, glucose concentrations at which subjects first felt hypoglycemic increased (mean ± SE from 2.6 ± 0.1 to 3.1 ± 0.2 mmol/L, P = 0.02), and symptom and plasma metanephrine responses to hypoglycemia were higher (median area under curve for symptoms, 580 [interquartile range {IQR} 420-780] vs. 710 [460-1,260], P = 0.02; metanephrine, 2,412 [-3,026 to 7,279] vs. 5,180 [-771 to 11,513], P = 0.01). Glycemic threshold for deterioration of cognitive function measured by four-choice reaction time was unchanged, while the color-word Stroop test showed a degree of adaptation. CONCLUSIONS: Even in long-standing T1D, IAH and defective counterregulation may be improved by a clinical strategy aimed at hypoglycemia avoidance.

Awareness of energy drink intake guidelines and associated consumption practices: a cross-sectional study

BACKGROUND: Despite concern regarding harms of energy drink (ED) consumption, no research has been conducted to determine awareness and compliance with ED intake guidelines displayed on product packaging in Australia (a novel approach internationally).

METHODS: A convenience sample of 1922 people completed an online survey. Participants reported their knowledge of maximum recommended daily ED intake according to Australian guidelines.

RESULTS: Guideline awareness was reported by 38, 23 and 19 % of past year consumers, lifetime, and non-consumers, respectively. Amongst past year consumers, 'accurate estimators' reported greater ED intake and were more likely to exceed intake guidelines and consume alcohol mixed with ED (AmED). After controlling for demographics and frequency of use, guideline awareness predicted increased likelihood of exceeding guidelines in ED sessions, but was not associated with exceeding ED guidelines in AmED sessions.

CONCLUSIONS: Australia is considered to have the most stringent regulatory approach to EDs internationally. However, advisory statements are not associated with greater awareness and compliance with intake guidelines. Failure to comply with standards for efficacious product labelling, and absence of broader education regarding guidelines, needs to be addressed.

Enhancing English language learners’ text understanding through metaphor awareness

 The study examined awareness of metaphor as a tool to enhance English language learners’ understanding of texts with embedded metaphors. Findings revealed that an enhanced awareness of metaphor, as indicated by greater use of the metalanguage of metaphor, longer turns conversation and reflective journals, helped them get deeper text meaning.

Prescription and over-the-counter pain medication in arthritis: awareness of active ingredients and attitudes to medication borrowing and sharing

Background:
Many Australians with arthritis self-manage their pain with prescription and/or over-the-counter pain medications, containing paracetamol. If taken appropriately, these medications are relatively safe; however, if mismanaged through patients' iinability to understand medication labels and instructions, these medications may cause adverse drug events and/or toxicities.
Aim:
This study explored the prescription and over-the-counter pain medications most commonly used by people with arthritis and the ability of these patients to correctly identify paracetamol as an active ingredient in commonly available preparations. The study also investigated the functional health literacy of these patients and their inclination to borrow and/or share pain medications.
Method:
Adult participants diagnosed with arthritis were invited to complete an anonymous survey which included questions about their prescription and over-the-counter pain medications; their medication borrowing and sharing behaviours; their functional health literacy; and their knowledge about preparations containing paracetamol as an active ingredient.
Results:
Most of the 254 participants used analgesic agents containing paracetamol, as combination tablets (paracetamol 500 mg and codeine 30 mg) or paracetamol-only tablets (paracetamol 665 mg) to self-manage their pain. Respondents with low functional health literacy scores were significantly less likely to identify paracetamol as an active ingredient in both combination and paracetamol-only pharmaceutical products, and were more likely to guess or did not know how to identify that paracetamol was an active ingredient in these products. Almost 30% of the respondents indicated that they had and/or intended to borrow/share their over-the-counter
pain medications whereas less than 10% suggested that they had and/or intended to borrow/share their prescription pain medication.
Conclusion:
Australians with arthritis, especially those with low functional health literacy scores, self-managing their pain with paracetamol-containing products, do not always recognise paracetamol as an active ingredient in combination products, and may risk potential paracetamol-related adverse effects and/or toxicities.

Development and validation of the awareness of narrative identity questionnaire (ANIQ)

The utility of a narrative approach to identity and its role in psychological functioning are becoming increasingly recognized across various fields of inquiry. The current study aimed to develop a quantitative, self-report measure of the awareness of narrative identity and how globally coherent one's autobiographical memories are perceived to be, specifically, in terms of temporal ordering, causal associations, and the perception of unifying themes. The construct validity and reliability of the Awareness of Narrative Identity Questionnaire (ANIQ) were assessed across three studies. In the first study, exploratory factor analysis of the responses of a large sample (N = 441, M [age in years] = 33.1, SD = 15.2) to an initial item pool resulted in a 20-item four-factor structure congruent with the proposed subscales, and convergent and divergent validity were established. In the second study, and with a different sample (N = 320, M [age in years] = 26.2, SD = 4.0), further evidence for the factor structure was provided through confirmatory factor analysis. Validity findings from Study 1 were replicated and extended on, and test-retest reliabilities were found to be high (r = .72-.79). Importantly, in the third study (N = 71, M [age in years] = 24.9, SD = 6.9), criterion validity was established, whereby the ANIQ subscales were demonstrated to be associated with dimensions of narrative coherence coded from written turning-point narratives. Across all studies, the internal reliabilities for the subscales were high (α = .86-.96). The ANIQ represents a valid, psychometrically sound, and novel method of assessing the awareness of narrative identity and autobiographical memory coherence.

Predictors of awareness of standard drink labelling and drinking guidelines to reduce negative health effects among Australian drinkers

INTRODUCTION AND AIMS: This study examined rates of awareness of standard drink labelling and drinking guidelines among Australian adult drinkers. Demographic predictors of these two outcomes were also explored.

DESIGN AND METHODS: Online survey panel participants aged 18-45 years(n = 1061; mean age = 33.2 years) completed an online survey assessing demographics, alcohol consumption patterns, awareness of standard drink labels and the National Health and Medical Research Council (NHMRC) guidelines, and support for more detailed labels.

RESULTS: The majority (80%) of participants had seen standard drink labels on alcohol products; with younger drinkers, those from a regional/rural location and high-risk drinkers significantly more likely to have seen such labelling. Most respondents estimated at or below the maximum number of drinks stipulated in the NHMRC guidelines. However, their estimates of the levels for male drinkers were significantly higher than for female drinkers. High-risk drinkers were significantly less likely to provide accurate estimates, while those who had seen the standard drink logo were significantly more likely to provide accurate estimates of drinking levels to reduce the risk of long-term harms only. Just under three-quarters of respondents supported the inclusion of more information on labels regarding guidelines to reduce negative health effects.

DISCUSSION AND CONCLUSIONS: The current standard drink labelling approach fails to address high-risk drinkers. The inclusion of information about NHMRC guidelines on alcohol labels, and placing standard drink labelling on the front of products could improve awareness of what constitutes a standard drink and safe levels of consumption among Australian drinkers.

Feasibility of conducting a randomized trial to promote healthy eating, active play and sustainability awareness in early childhood curricula

We sought to evaluate the feasibility of conducting a randomized trial to evaluate the efficacy of a preschool/kindergarten curriculum intervention designed to increase 4-year-old children's knowledge of healthy eating, active play and the sustainability consequences of their food and toy choices. Ninety intervention and 65 control parent/child dyads were recruited. We assessed the study feasibility by examining recruitment and participation, completion of data collection, realization of the intervention and early childhood educators’ experiences of implementing the study protocol; our findings suggest the intervention was feasible to deliver. In addition, children's sustainability awareness of non-compostable and recyclable items increased. Children in the intervention group significantly reduced their sugary drink consumption and increased their vegetable intake at follow-up compared to control. We conclude with recommendations for revisions to the child interview and parent questionnaire delivery to ensure the roll out of the randomized trial is conducted efficiently and rigorously.

Awareness of nutrition problems among Vietnamese health and education professionals.

Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals.

Developing a measure to understand young children’s internet cognition and cyber-safety awareness: a pilot test

Advancements in technology have increased preschool children’s access to the Internet. Very little research has been conducted to identify pre-school-aged children’s understandings of the Internet and ramifications of being ‘online’. Without an understanding of children’s thinking about the Internet, it is difficult to provide age and pedagogically appropriate cyber-safety education. This study developed and pilot-tested an interview schedule that focuses on the Internet thinking and cyber-safety awareness of Australian children aged 4–5 years. The schedule is informed by sociocultural theory, cyber-safety education research and approaches for researching with young children. The schedule shows potential to elicit children’s understandings of the Internet and cyber-safety awareness. Adjustments are required to allow more contextualised responses from children.

Neural correlates of impaired self-awareness of apathy, disinhibition and dysexecutive deficits in cocaine-dependent individuals

Cocaine addiction is characterized by impaired self-awareness about cognitive and motivational deficits, leading to poor treatment outcomes. However, there is still limited understanding of the neurophysiological underpinnings of this impairment. We aimed to establish if impaired self-awareness is underpinned by brain structural phenotypes among cocaine-dependent individuals (CDI). Sixty-five CDI and 65 designated informants completed the Frontal Systems Behavior Scale, and a subsample of 40 CDI were scanned via magnetic resonance imaging. We applied multiple regression models to establish the association between levels of self-awareness indexed by Frontal Systems Behavior Scale's discrepancy scores (i.e. informant ratings minus self-reports of apathy, disinhibition and dysexecutive deficits) and gray matter volumes indexed by magnetic resonance imaging voxel-based measures within five brain regions of interest: anterior cingulate cortex, orbitofrontal cortex (OFC), striatum, insula and dorsolateral prefrontal cortex (DLPFC). We also examined the neural underpinnings of underestimation versus overestimation of deficits, by splitting the CDI group according to the positive or negative value of their discrepancy scores. We found that poorer self-awareness of apathy deficits was associated with greater gray matter volume in the dorsal striatum, and poorer self-awareness of disinhibition deficits was associated with greater gray matter volume in the OFC in the whole sample. More underestimation and more overestimation of executive deficits were linked to lower DLPFC volume. We show that impaired self-awareness of cognitive and motivational deficits in cocaine addiction has a neural underpinning, implicating striatum, OFC and DLPFC structural phenotypes.