Cross-cultural comparisons of health-related quality of life in Australian and Japanese midlife women

Objective: The purpose of this study was to address (1) the existence of an association between menopausal status and the health-related quality of life (HRQOL) in Australian and Japanese women and (2) the relative contributions of menopausal status, modifiable lifestyle risk factors, health, and sociodemographic factors on HRQOL. Design: The Australian and Japanese Midlife Women's Health Study (AJMWHS) was a multisite, population-based study conducted in 2001 to 2002. Measures were conducted on data collected from a survey questionnaire used for a sample of women from Australia and Japan. HRQOL was assessed with seven subscales from the Short Form-36. Results: The differences seen in physical functioning, general health, and vitality are significant. The results support an effect of country of residence on physical functioning and general health. The impact of menopausal status on HRQOL was significantly associated with bodily pain and role-emotional. The country of residence did have a modifying effect on the relationship between menopausal status and physical functioning. After control for confounders, there was a significant difference between Australian and Japanese women for HRQOL. Menopausal status was not associated with HRQOL in the areas of general health and physical functioning. Modifiable lifestyle risk factors contributed more highly to HRQOL for the Australian women than for the Japanese women. If the women had a lowered body mass index, undertook physical activity, consumed dietary phytoestrogens, and used alcohol, their physical functioning seemed to be better. Differences were seen in the contributions to HRQOL in these areas, with lower body mass index in the Australian women and physical activity in the Japanese women being the highest predictors. Somatic and psychological symptoms seem to negatively affect both Japanese and Australian women's physical functioning, contributing more than sociodemographic factors, menopausal status, and behavioral determinants combined to general health and physical functioning. Conclusions: It is important that that consideration be given to incorporating the same tool within the cross-cultural design of studies so that comparisons between cultures and patterns of healthy aging can be made. The research suggests that there seems to be variations across Australian and Japanese midlife women in some areas of HRQOL and some factors that contribute to these areas.

Methods used in cross-cultural comparisons of psychological symptoms and their determinants

This paper is the second in a series of reviews of cross-cultural studies of menopausal symptoms. The goal of this review is to compare and contrast methods which have been previously utilized in Cross-Cultural Midlife Women's Health Studies with a view to (1) identifying the challenges in measurement across cultures in psychological symptoms and (2) suggesting a set of unified questions and tools that can be used in future research in this area. This review also aims to examine the determinants of psychological symptoms and how those determinants were measured. The review included eight studies that explicitly compared symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and the Women's International Study of Health and Sexuality (WISHeS). This review concludes that mental morbidity does affect vasomotor symptom prevalence across cultures and therefore should be measured. Based on the review of these eight studies it is recommended that the following items be included when measuring psychological symptoms across cultures, feeling tense or nervous, sleeping difficulty, difficulty in concentrating, depressed and irritability along with the CES-D Scale, and the Perceived Stress Scale. The measurement of these symptoms will provide an evidence based approach when forming any future menopause symptom list and allow for comparisons across studies.

Methods used in cross-cultural comparisons of sexual symptoms and their determinants

This is the fourth in a series of reviews of cross-cultural studies of menopausal symptoms. The purpose of this review is to examine methods used in cross-cultural comparisons of sexual symptoms among women at midlife, and to examine the determinants of sexual symptoms and how those determinants were measured. The goal of this review is to make recommendations that will improve cross-cultural comparisons in the future. The review included nine studies that explicitly examined symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). Although methods used for assessing sexual symptoms across cultures differed between studies, statistically significant differences were reported. Cross-cultural differences in sexual symptoms exist, and should be measured by including the following symptoms: loss of interest in sex, vaginal dryness, and the Females Sexual Function Index which covers desire, arousal, lubrication, orgasm, satisfaction, and pain on intercourse. The measurement of these symptoms will provide an evidence-based approach when forming any future menopause symptom list and allow for comparisons across studies.

Methods used in cross-cultural comparisons of vasomotor symptoms and their determinants

Methodological differences among studies of vasomotor symptoms limit rigorous comparison or systematic review. Vasomotor symptoms generally include hot flushes and night sweats although other associated symptoms exist. Prevalence rates vary between and within populations, but different studies collect data on frequency, bothersomeness, and/or severity using different outcome measures and scales, making comparisons difficult. We reviewed only cross-cultural studies of menopausal symptoms that explicitly examined symptoms in general populations of women in different countries or different ethnic groups in the same country. This resulted in the inclusion of nine studies: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). These studies highlight the methodological challenges involved in conducting multi-population studies, particularly when languages differ, but also highlight the importance of performing multivariate and factor analyses. Significant cultural differences in one or more vasomotor symptoms were observed in 8 of 9 studies, and symptoms were influenced by the following determinants: menopausal status, hormones (and variance), age (or actually, the square of age, age2), BMI, depression, anxiety, poor physical health, perceived stress, lifestyle factors (hormone therapy use, smoking and exposure to passive smoke), and acculturation (in immigrant populations). Recommendations are made to improve methodological rigor and facilitate comparisons in future cross-cultural menopause studies.

Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants : Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies

This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms “cross cultural comparison” and “menopause.” Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction.

Methods used in cross-cultural comparisons of somatic symptoms and their determinants

This paper is the third in a series of reviews of cross-cultural studies of symptoms at midlife. The goal of this review is to examine methods used previously in cross-cultural studies of menopause and women's health at midlife to (1) identify challenges in the measurement of somatic symptoms across cultures and (2) recommend questions and tools that can be used in future research. This review also aims to examine the determinants of somatic symptoms. The review concludes that methods used for assessing somatic symptoms differ across studies. Somatic symptoms, particularly, aches, pain, and fatigue have a high prevalence. Statistically significant differences were seen in the prevalence of somatic symptoms across cultures. Based on the number of studies that demonstrated cross-cultural differences in symptom prevalence, we recommend that the following symptoms be included in future studies of symptoms at midlife: headaches, aches/pain, palpitations, dizziness, fatigue, breathing difficulties, numbness or tingling, and gastrointestinal difficulties. We also recommend that objective measures of physical function be administered when possible to supplement subjective self-evaluation.

Social Procurement: Promoting the sustainability of NPOs through the transformation of economic, social and cultural capital

Social procurement provides a key source of income for the Third Sector, and is vital for the sustainability of many nonprofit organisations. Social procurement involves the exchange of economic capital from one organisation, typically government (although for-profit and non-profit organisations can also purchase), with a nonprofit organisations in order to deliver other forms of. It is this transformation of economic capital into other forms of capital (cultural, human, social) in the social procurement process, which is the focus of this paper. Four case studies, which are representative of the four main types of social procurement, will be examined in order to trace how economic capital is transformed into other types of capital in each of these cases. In so doing, the paper will advance our understanding of social procurement theoretically, and lead to a wider discussion about the role of social procurement in ensuring the sustainability of nonprofit organisations, and the civil societies in which they operate.

Parsing the Australian curriculum English : grammar, multimodality and cross-cultural texts

The release of the Australian Curriculum English (ACE) by the Australian Curriculum, Assessment and Reporting Authority (ACARA) has revived debates about the role of grammar as English content knowledge. We consider some of the discussion circulating in the mainstream media vis-à-vis the intent of the ACE. We conclude that this curriculum draws upon the complementary tenets of traditional Latin-based grammar and systemic functional linguistics across the three strands of Language, Literature and Literacy in innovative ways. We argue that such an approach is necessary for working with contemporary multimodal and cross-cultural texts. To demonstrate the utility of this new approach, we draw out a set of learning outcomes from Year 6 and then map out a framework for relating the outcomes to the form and function of multimodal language. As a case in point, our analysis is of two online Coca-Cola advertising texts, one each from South Korea and Australia.

Attachment Security and Alexithymia in a Heavy Drinking Population

Attachment difficulties have been proposed as a key risk factor for the development of alexithymia, a multifaceted personality trait characterised by difficulties identifying and describing feelings, a lack of imagination and an externally oriented thinking style. The present study investigated the relationship between attachment and alexithymia in an alcohol dependent population. Participants were 210 outpatients in a Cognitive Behavioural Treatment Program assessed on the Toronto Alexithymia Scale (TAS-20) and the Revised Adult Attachment Scale (RAAS). Significant relationships between anxious attachment and alexithymia factors were confirmed. Furthermore, alexithymic alcoholics reported significantly higher levels of anxious attachment and significantly lower levels of closeness (secure attachment) compared to non-alexithymic alcoholics. These findings highlight the importance of assessing and targeting anxious attachment among alexithymic alcoholics in order to improve alcohol treatment outcomes. Keywords: Attachment, alexithymia, alcohol dependence.

Cultural chaos : Journalism, News and Power in a Globalised World

With examples drawn from media coverage of the War on Terror, the 2003 invasion of Iraq, Hurricane Katrina and the London underground bombings, Cultural Chaos explores the changing relationship between journalism and power in an increasingly globalised news culture. In this new text, Brian McNair examines the processes of cultural, geographic and political dissolution in the post-Cold War era and the rapid evolution of information and communication technologies. He investigates the impact of these trends on domestic and international journalism and on political processes in democratic and authoritarian societies across the world. Written in a lively and accessible style, Cultural Chaos provides students with an overview of the evolution of the sociology of journalism, a critical review of current thinking within media studies and an argument for a revision and renewal of the paradigms that have dominated the field since the early twentieth century. Separate chapters are devoted to new developments such as the rise of the blogosphere and satellite television news and their impact on journalism more generally. Cultural Chaos will be essential reading for all those interested in the emerging globalised news culture of the twenty-first century.

Creative suburbia : rethinking urban cultural policy – the Australian case

This article considers the question of whether creative workers demonstrate a preference for inner cities or suburbs, drawing upon research findings from the ‘Creative Suburbia’ project undertaken by a team of Australian researchers over 2008–2010 in selected suburban areas of Brisbane and Melbourne. Locating this question in wider debates about the relationship of the suburbs to the city, as well as the development of new suburban forms such as master-planned communities, the article finds that the number of creative industries workers located in the suburbs is significant, and those creative workforce members living and working in suburban areas are generally happy with this experience, locating in the suburbs out of personal choice rather than economic necessity. This runs counter to the received wisdom on creative cities, which emphasize cultural amenity in inner city areas as a primary driver of location decisions for the ‘creative class’. The article draws out some implications of the findings for urban cultural policy, arguing that the focus on developing inner urban cultural amenity has been overplayed, and that more attention should be given to how to better enable distributed knowledge systems through high-speed broadband infrastructure.

Evolving a relationship for cross-cultural participatory innovation

Participatory design prioritises the agency of those who will be most affected by design outcomes. However in cross cultural innovation involving indigenous and non-indigenous communities there is much work to do to develop the cross cultural innovation practices that can best bring together different skills, perspectives and ways of knowing in order to realise the aspirations of indigenous peoples. In this short paper we outline a work-inprogress method based upon relationship development and reciprocity over practical, tangible and culturally appropriate activities. We argue that in a cross-cultural setting the participatory innovation process must be part of a larger relationship building process. The paper centres around a proposed design project with a remote indigenous community on the Groote Eylandt archipelago. A project proposal has evolved from a relationship built through ecological work between scientists and the local community to study native populations of animal species. We describe the context and history and our proposed approach to engaging indigenous knowledge in design.

The uses of satire : unorthodox news, cultural chaos and the interrogation of power

This article focuses on the satirical Australian show The Chaser’s War on Everything, and uses it to critically assess the potential political and social ramifications of what McNair (2006) has called ‘cultural chaos’. Drawing upon and analysing several examples from this particular program, alongside interviews with its production team and qualitative audience research, this article argues that this TV show’s engagement with politicians and political issues, in a way that departs from the conventions of traditional journalism, offers a significant opportunity for the interrogation of power. The program’s use of often bizarre and unexpected comedic confrontation allows it to present a perhaps more authentic image of political agents than is often cultivated in mainstream journalism. This suggests therefore that the shift from homogeneity to heterogeneity in the news media – which McNair (2006) sees as a key feature of cultural chaos – presents a significant challenge to those who wish to retain control over what the public sees and understands about the political world, and is a development which should be viewed in positive terms.