Breath : allegory, knowledge practices, youth at-risk

Youth and risk are artefacts of expertise, constructed at the intersection of a wide range of knowledges about Youth and so-called Youth issues: an intersection marked by institutionalised, scientific representations of education, family, the life course, risk, and so on. In this paper I suggest that the messiness of human experiences and existence requires knowledge practices in the social sciences that can rethink what counts as truth. These interests – which are grounded in the knowledge practices that frame the work being undertaken in a large scale, qualitative investigation of the cultural drivers shaping the alcohol practices of 14 to 24 year old Australian’s - will be addressed through a discussion of the ways in which Tim Winton’s (2008) new novel Breath can be read as an allegorical tale about the terror of being ordinary: and of the teenage years as being a time in a life in which the fear of being ordinary compels Winton’s key characters to seek out, sometimes stumble upon, and embrace that which promises to make their’s a life less ordinary. In these recollections risk is something that breathes energy and purpose into lifeworlds that are dominated by the institutionalised ordinariness of family, school, and work.

Incidence of cardiovascular risk factors by education level 2000-2005 : the Australian diabetes, obesity and lifestyle (AusDiab) cohort study

Lower socioeconomic status (SES) is associated with a higher prevalence of major risk factors for cardiovascular disease (CVD). However, few longitudinal studies have examined the association between SES and CVD risk factors over time. We aimed to determine whether SES, using education as a proxy, is associated with the onset of CVD risk factors over 5 years in an Australian adult cohort study.

Participants in the Australian Diabetes, Obesity and Lifestyle study (AusDiab) study aged 25 years and over who attended both baseline and 5-year follow-up examinations (n=5 967) were categorised according to educational attainment. Cardiovascular risk factor data at both time points were ascertained through questionnaire and physical measurement.

Women with lower education had a greater risk of progressing from normal weight to overweight or obesity than those with higher education (age-adjusted OR 1.57, 95% CI 1.06-2.31). Both men and women with lower education were more likely to develop diabetes (age-adjusted OR from higher education 1.75, 95% CI 1.14-2.71 and 3.01, 95% CI 1.26-7.20, respectively). A lower level of education was associated with a greater number of risk factors accumulated over time in women (OR of progressing from having two or less risk factors at baseline to three or more at follow up, 2.04, 95% 1.32-3.14).

In this Australian population-based study, lower educational attainment was associated with an increased risk of developing both individual and total CVD risk factors over a 5-year period. These findings suggest that SES inequalities in CVD will persist into the future.

Promoting social inclusion of frail older people living in the community

The increasingly diverse needs and wants of Australia's ageing population, like those in many other societies, are drawing attention to aged care as an increasingly important area of broader health and social policy. Active qgeing and a focus on enabling people to remain living in their own homes in the community are two of the key components of this policy shift.

The policy shift towards active ageing recognises and aims to support the desires of older people to remain active members of their communities as they age. Active ageing is 'the process of optimising opportunities for physical, social and mental wellbeing throughout the life-course, in order to extend healthy life expectancy, productivity and quality oflife in older age' (AIPC 2008: 26).

According to the World Health Organization (WHO), the rights, needs, preferences and capacities of older people should be central to active ageing policies, and these should be framed by a life-course approach to ageing (WHO 2002). The development of age-friendly communities, social inclusion and engagement are emerging as key policy issues in the context of an ageing population.

Recent research demonstrates the importance of a sense of belonging in maintaining a sense of identity and increasing the wellbeing of an individual. The sense of belonging that comes about through community engagement also plays a role in successful adjustment to ageing, including prolonging good health and reduced risk of entry into residential aged care.

Book review: Understanding human development:a multi-dimensional approach (2nd ed.)

Book review: This book has much to offer social work and human services students. It covers many key theories, ideas, and debates relevant to a wide range of practice fields in a comprehensive, clearly organised, and engaging fashion. The author proposes, as on overarching premise, a “multidimensional” approach to understanding lifespan development and experiences of trauma, stress, and grief, as well as responses of adaptation and resilience across the life course. Consistent with social work values, the multidimensional approach “places an emphasis on the constant interaction of the biological, psychological, and spiritual dimensions of our inner worlds with the relational, social, structural, and cultural dimensions of our outer worlds” (p. 394).

Client self-assessment in community aged care: A comparative study involving older Australians and their case managers

Self-assessment of support needs is a relatively new and under-researched phenomenon in domiciliary aged care. This article outlines the results of a comparative study focusing on whether a self-assessment approach assists clients to identify support needs and the degree to which self-assessed needs differ from an assessment conducted by community care professionals. A total of 48 older people and their case managers completed a needs assessment tool. Twenty-two semi-structured interviews were used to ascertain older people’s views and preferences regarding the self-assessment process. The study suggests that while a co-assessment approach as outlined in this article has the potential to assist older people to gain a better understanding of their care needs as well as the assessment process and its ramifications, client self-assessment should be seen as part of a co-assessment process involving care professionals. Such a co-assessment process allows older people to gain a better understanding of their support needs and the wider community aged care context. The article suggests that a co-assessment process involving both clients and care professionals contains features that have the capacity to enhance domiciliary aged care.

Violent offending, masculinity and age: exploring the role of developmental processes in adulthood

While the link between violent crime and masculinity is often implicitly assumed, to date, research has not specifically investigated beliefs about violence and masculinity at different stages of the adult life-course. This thesis explored the role of maturational processes in the way beliefs about masculinity and violence may differ in early and middle adulthood. Results of a quantitative study did not uncover statistically significant differences between younger and older adult violent offenders on a measure of criminal thinking. However, results of an interpretative phenomenological analysis indicated that beliefs about masculinity may differentially influence violent crime at different stages of adulthood. The results of these two studies provide a foundation for arguing that beliefs about violence and masculinity change throughout the life-course, and that masculinity in particular may be important treatment target in contemporary rehabilitation programs.

Food insecurity among university students in Victoria: A pilot study

Aims: Susceptibility to food insecurity can vary over a life course; however, a potential period of particular vulnerability is while studying at a tertiary institution. This pilot study aimed to assess the prevalence, severity and potential determinants of food insecurity among tertiary students attending a Victorian-based institution. Methods: The present study employed a cross-sectional design, involving use of a self-reported questionnaire. The survey, conducted in 2012, was administered to a sample of 124 Deakin University students and contains measures of food insecurity status, demographics and other potential explanatory factors. Descriptive and regression analysis was undertaken to investigate the prevalence of food insecurity and associations with factors that may support or hinder a student's ability to procure food, such as living arrangements, income and knowledge of support services. Results: Food insecurity without hunger was reported by 18% of Deakin University students, while an additional 30% reported experiencing the more severe form of food insecurity (with hunger). A lower odds of being food insecure was reported among students living with their family (without hunger OR 0.35; 95% CI 0.12-0.99; with hunger OR 0.29; 95% CI 0.12-0.70), while a higher odds was found among those receiving government support (with hunger OR 2.52; 95% CI 1.05-6.04). Conclusions: The reported prevalence of food insecurity among the tertiary student sample was greater than the general Australian population, suggesting they are a vulnerable group. This may be attributable to financial pressures faced when students are not living with their parents.

Testing the feasibility of a mobile technology intervention promoting healthy gestational weight gain in pregnant women (txt4two) - study protocol for a randomised controlled trial.

BACKGROUND: Overweight, obesity and excess gestational weight gain (GWG) are associated with negative health outcomes for mother and child in pregnancy and across the life course. Interventions promoting GWG within guidelines report mixed results. Most are time and cost intensive, which limits scalability. Mobile technologies (mHealth) offer low cost, ready access and individually-tailored support. We aim to test the feasibility of an mHealth intervention promoting healthy nutrition, physical activity and GWG in women who begin pregnancy overweight or obese. METHODS/DESIGN: txt4two is a parallel randomised control trial pilot recruiting women with a singleton, live gestation between 10(+0) and 17(+6) weeks at the first hospital antenatal clinic visit. Inclusion criteria are pre-pregnancy BMI > 25 kg/m(2) and mobile phone ownership. One hundred consenting women will be randomised to intervention or control groups at a 1:1 ratio. All participants will receive standard antenatal care. In addition, the txt4two intervention will be delivered from baseline to 36 weeks gestation and consists of a tailored suite of theoretically-grounded, evidence-based intervention strategies focusing on healthy nutrition, physical activity and GWG. This includes: mobile phone interactive text messages promoting positive health behaviours, goal setting and self-monitoring; video messages; an information website; and a private moderated Facebook® chat forum. The primary outcome is the feasibility of the intervention. Secondary outcomes include GWG and participants' knowledge and behaviour regarding diet and physical activity during pregnancy. DISCUSSION: Findings will inform the development of larger-scale mHealth programmes to improve the delivery of healthy pregnancy nutrition, physical activity and GWG, that could be widely translated and disseminated. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRNU111111544397 . Date of registration: 19 March 2014.

Longitudinal predictors of domestic violence perpetration and victimization: a systematic review

Domestic violence (DV) is a serious and complex social issue which is associated with significant costs to both those individuals who are directly affected and the wider community. Preventative approaches with vulnerable population groups represent an important component of any integrated response to DV and should be informed by an understanding of those factors that influence violence developmentally. This paper reports the findings of a systematic review of longitudinal studies that have prospectively investigated childhood and/or adolescent predictors of DV perpetration and/or victimization among adult men and women in intimate relationships. We identified 25 original studies that met the inclusion criteria, all of which investigated predictors of domestic physical abuse. Few studies prospectively examined psychological, sexual and verbal abuse. Child and adolescent abuse, family of origin risks, child and adolescent behavioral problems, adolescent peer risks, and sociodemographic risks were all identified as significant predictors of DV perpetration and victimization. It is concluded that early childhood and adolescent factors are consistent predictors in the development of DV perpetration and victimization and that prevention and early intervention approaches targeting these factors are likely to prove the most effective.

Preventing obesity in infants: the growing healthy feasibility trial protocol

INTRODUCTION: Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course. Early feeding choices, including breast and/or formula, timing of introduction of solids, physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity. Parents play a primary role in shaping these behaviours through parental modelling, feeding styles, and the food and physical activity environments provided. Children from low socio-economic backgrounds have higher rates of obesity, making early intervention particularly important. However, such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours. Parents across all socio-demographic groups frequently access primary health care (PHC) services, including nurses in community health services and general medical practices, providing unparalleled opportunity for engagement to influence family behaviours. One emerging and promising area that might maximise engagement at a low cost is the provision of support for healthy parenting through electronic media such as the Internet or smart phones. The Growing healthy study explores the feasibility of delivering such support via primary health care services.

METHODS: This paper describes the Growing healthy study, a non-randomised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app (or website) for parents living in socioeconomically disadvantaged areas, for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain. Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old. Data will be collected via web-based questionnaires and the data collected inherently by the app itself.

ETHICS AND DISSEMINATION: This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer-reviewed publications and conference presentations.

DNA methylation and the social gradient of osteoporotic fracture: a conceptual model

INTRODUCTION: Although there is a documented social gradient for osteoporosis, the underlying mechanism(s) for that gradient remain unknown. We propose a conceptual model based upon the allostatic load theory, to suggest how DNA methylation (DNAm) might underpin the social gradient in osteoporosis and fracture. We hypothesise that social disadvantage is associated with priming of inflammatory pathways mediated by epigenetic modification that leads to an enhanced state of inflammatory reactivity and oxidative stress, and thus places socially disadvantaged individuals at greater risk of osteoporotic fracture. METHODS/RESULTS: Based on a review of the literature, we present a conceptual model in which social disadvantage increases stress throughout the lifespan, and engenders a proinflammatory epigenetic signature, leading to a heightened inflammatory state that increases risk for osteoporotic fracture in disadvantaged groups that are chronically stressed. CONCLUSIONS: Our model proposes that, in addition to the direct biological effects exerted on bone by factors such as physical activity and nutrition, the recognised socially patterned risk factors for osteoporosis also act via epigenetic-mediated dysregulation of inflammation. DNAm is a dynamic modulator of gene expression with considerable relevance to the field of osteoporosis. Elucidating the extent to which this epigenetic mechanism transduces the psycho-social environment to increase the risk of osteoporotic fracture may yield novel entry points for intervention that can be used to reduce individual and population-wide risks for osteoporotic fracture. Specifically, an epigenetic evidence-base may strengthen the importance of lifestyle modification and stress reduction programs, and help to reduce health inequities across social groups. MINI ABSTRACT: Our conceptual model proposes how DNA methylation might underpin the social gradient in osteoporotic fracture. We suggest that social disadvantage is associated with priming of inflammatory signalling pathways, which is mediated by epigenetic modifications, leading to a chronically heightened inflammatory state that places disadvantaged individuals at greater risk of osteoporosis.

The extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) Program : a cluster-randomized controlled trial of an early intervention to prevent childhood obesity

BACKGROUND: Understanding how we can prevent childhood obesity in scalable and sustainable ways is imperative. Early RCT interventions focused on the first two years of life have shown promise however, differences in Body Mass Index between intervention and control groups diminish once the interventions cease. Innovative and cost-effective strategies seeking to continue to support parents to engender appropriate energy balance behaviours in young children need to be explored. METHODS/DESIGN: The Infant Feeding Activity and Nutrition Trial (InFANT) Extend Program builds on the early outcomes of the Melbourne InFANT Program. This cluster randomized controlled trial will test the efficacy of an extended (33 versus 15 month) and enhanced (use of web-based materials, and Facebook® engagement), version of the original Melbourne InFANT Program intervention in a new cohort. Outcomes at 36 months of age will be compared against the control group. DISCUSSION: This trial will provide important information regarding capacity and opportunities to maximize early childhood intervention effectiveness over the first three years of life. This study continues to build the evidence base regarding the design of cost-effective, scalable interventions to promote protective energy balance behaviors in early childhood, and in turn, promote improved child weight and health across the life course. TRIAL REGISTRATION: ACTRN12611000386932 . Registered 13 April 2011.

O trabalhador de saúde mental na atenção psicossocial: a questão do sofrimento psíquico

Pós-graduação em Psicologia - FCLAS

Práticas pedagógicas na educação infantil: a construção do sentido da escola para as crianças

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Rememorando vidas: lembranças de velhos trabalhadores

Pós-graduação em Serviço Social - FCHS