Probiotics in the prevention of clinical manifestations of common infectious diseases in children and in the elderly

Infectious diseases put an enormous burden on both children and the elderly in the forms of respiratory, gastrointestinal and oral infections. There is evidence suggesting that specific probiotics may be antagonistic to pathogens and may enhance the immune system, but the clinical evidence is still too sparce to make general conclusions on the disease-preventive effects of probiotics. This thesis, consisting of four independent, double-blind, placebo-controlled clinical trials, investigated whether Lactobacillus GG (LGG) or a specific probiotic combination containing LGG would reduce the risk of common infections or the prevalence of pathogens in healthy and infection-prone children and in independent and institutionalised elderly people. In healthy day-care children, the 7-month consumption of probiotic milk containing Lactobacillus GG appeared to postpone the first acute respiratory infection (ARI) by one week (p=0.03, adjusted p=0.16), and to reduce complicated infections (39% vs. 47%, p<0.05, adjusted p=0.13), as well as the need for antibiotic treatment (44% vs. 54%, p=0.03, adjusted p=0.08) and day-care absences (4.9 vs. 5.8 days, p=0.03, adjusted p=0.09) compared to the placebo milk. In infection-prone children, the 6-month consumption of a combination of four probiotic bacteria (LGG, L. rhamnosus LC705, Propionibacterium freudenreichii JS, Bifidobacterium breve 99) taken in capsules appeared to reduce recurrent ARIs (72% vs. 82%, p<0.05; adjusted p=0.06), and the effect was particularly noticeable in a subgroup of children with allergic diseases (12% vs. 33%, p=0.03), although no effect on the presence of nasopharyngeal rhinovirus or enterovirus was seen. The 5-month consumption of the same probiotic combination did not show any beneficial effects on the respiratory infections in frail, institutionalised elderly subjects. In healthy children receiving Lactobacillus GG, the reduction in complications resulted in a marginal reduction in the occurrence of acute otitis media (AOM) (31% vs. 39%, p=0.08; adjusted p=0.19), and the postponement of the first AOM episode by 12 days (p=0.04; adjusted p=0.09). However, in otitis-prone children, a probiotic combination did not reduce the occurrence of AOM or the total prevalence of common AOM pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis), except in the case of children with allergic diseases, in whom probiotics reduced recurrent AOM episodes (0% vs. 14%, p=0.03). In addition, interaction between probiotics and bacterial carriage was seen: probiot-ics reduced AOM in children who did not carry any bacterial pathogens (63% vs. 83%), but the effect was the reverse in children carrying bacteria in the nasopharynx (74% vs 62%) (p<0.05). Long-term probiotic treatment, either LGG given in milk to healthy children for 7 months or a combination of probiotics given in capsules to institutionalised elderly subjects for 5 months, did not reduce the occurrence of acute diarrhoea. However, when the probiotic combination (LGG, L. rhamnosus LC705, Propionibacterium JS) was given in cheese to independent elderly subjects for 4 months, the oral carriage of high Candida counts was reduced in the probiotic group vs. the placebo group (21% vs. 34%, p=0.01, adjusted p=0.004). The risk of hyposalivation was also reduced in the probiotic group (p=0.05). In conclusion, probiotics appear to slightly alleviate the severity of infections by postponing their appearance, by reducing complications and the need for antimicrobial treatments. In addition, they appear to prevent recurrent infections in certain subgroups of children, such as in infection-prone children with allergic diseases. Alleviating ARI by probiotics may lead to a marginal reduction in the occurrence of AOM in healthy children but not in infection-prone children with disturbed nasopharyngeal microbiota. On the basis of these results it could be supposed that Lactobacillus GG or a specific combination containing LGG are effective against viral but not against bacterial otitis, and the mechanism is probably mediated through the stimulation of the immune system. A specific probiotic combination does not reduce respiratory infections in frail elderly subjects. Acute diarrhoea, either in children or in the elderly, is not prevented by the continuous, long-term consumption of probiotics, but the consumption of a specific probiotic combination in a food matrix is beneficial to the oral health of the elderly, through the reduction of the carriage of Candida.

Epidemiological studies of Streptococcus pneumoniae carriage in the post-vaccination era among two risk groups: children and the elderly

Dissertation presented to obtain the Ph.D. degree in Biology/ Molecular Biology

Obsessive Compulsive Inventory-Child Version (OCI-CV) in a Spanish community sample of children and adolescents

Resumen tomado de la publicaci??n

Migrant youth, cultural identity and media representation

The current social climate of heightened intercultural tensions in culturally pluralist societies such as Australia highlights the need to develop a more nuanced understanding of the complex cultural adjustment processes  encountered by migrant youth in developing and articulating a sense of  national belonging, To this end, this chapter examines migrant settlement experiences as a 'process by which individuals and groups ... maintain their cultural identity while actively participating in the larger societal framework' (Karac 2001). Research into these critical aspects of integration and  acculturation examines identity formation as a cultural process of  renegotiating individual and group identity, and focuses on concepts of belonging, recognition and self-respect (Berry '997). While cultural factors are considered critical indicators of successful integration into the host community, insufficient research has been conducted into the particular processes of group and individual identity formation that take place amongst migrant youth. In the case of Australia, this process has been made  particularly difficult for some cultural groups due to the contemporary resurgence of populist and exclusionary discourses of national identity. In such a context, the construction of identity amongst migrant youth is all the more challenging, especially when this process exhibits notions of dual attachment, hybridity and difference. For migrant youth, the engagement with different social institutions such as family, school and wider societal networks often affects the processes of identity 'formation that are inherently  dynamic and 'necessarily multiple and fluid' (Noble & Tabar 2002, pp.I28). Negotiating life in-between cultures, youths from migrant backgrounds experience identity construction as a highly contested territory.

Cultural identity is a central issue for immigrants, regardless of how much time has elapsed since leaving their country of origin. This issue is particularly salient for first- and second-generation1 migrant youth, who negotiate identity space comfortably alongside, in opposition to, or more commonly, somewhere in between, their immigrant parents' conceptions of culture and the receiving culture in which they live. Unlike their native peers,  the children of immigrants arc exposed to intra-ethnic and inter- ethnic   dynamics and experiences in their journey towards cultural identity formation. These experiences are complex and diverse, and are navigated within multi- layered ethnic, racial, familial, gendered, socioeconomic and educational  contexts.

The chapter begins by providing theoretical frameworks for conceptualising  cultural diversity and cultural identity. It then examines how migrant youth  negotiate cultural identity in the public realms of family networks and school  environments and how these translate into key educational and behavioural  outcomes. It will draw on some qualitative snapshots as a way of illustrating  shifting migrant youth attitudes towards society, school and culture.

Digital natives? : new and old media and children’s language acquisition

The current generation of young children has been described as “digital natives”, having been born into a ubiquitous digital media environment. They are envisaged as educationally independent of the guided interaction provided by “digital immigrants”: parents and teachers. This paper uses data from the multiples waves of the Longitudinal Study of Australian Children (LSAC) to study the effect of various media on children’s development of vocabulary and traditional literacy. Previous research has suggested that time spent watching television is associated with less time spent reading, and ultimately, with inferior educational outcomes. The early studies of the “new” digital media (computers, games consoles, mobile phones, the Internet, etc.) assumed these devices would have similar effects on literacy outcomes to those associated with television. Moreover, these earlier studies relied on poorer measures of time spent in media use and usually did not control for the context of the child’s media use. Fortunately, LSAC contains measures of access to digital devices; parental mediation practices; the child’s use of digital devices as recorded in time use diaries; direct measures of the child’s passive vocabulary; and teachers’ ratings of the child’s literacy. The analysis presented shows the importance of the parental context framing the child’s media use in promoting the acquisition of vocabulary, and suggests that computer (but not games) use is associated with more developed language skills. Independently of these factors, raw exposure to television is not harmful to learning, as previously thought.

Children's media use : perspectives from social research

The paper explains the impacts of digital media on previously observed developmental patterns of time choices for the current generation of young children, age 5-11. It shows that work and family routines still influence patterns of media use, rather than just broadcast media schedules and access to digital and mobile devices. Contrary to previous research on digital natives that predicted that interactive media would eventually displace traditional linear media, these findings from a nationally-representative study show that time-use of 'lean back media' and 'lean forward media' run in parallel for Australian children 5-11.

A good place to raise a family? Comparing parents, service-providers', and media perspectives of the inner and outer suburban areas of Melbourne

In Australia, the suburbs have historically been the favoured place to raise children. However this is being challenged both by social change and government policy encouraging innerurban renewal. We examined how inner-urban areas compare with more traditional suburban locations as places to raise a family. Recognising that there are many influences on perceptions of place, we included the opinions of parents, service-providers and the media in the two locations.

Research focused on two municipalities in Melbourne, one located >25km and the other <10km from the CBD. Themes were obtained and compared from in-depth interviews with parents, serviceproviders and analysis of municipality-specific and state-wide newspaper articles.

Service provision was the only theme common at all levels of analysis. For all other themes, differences occurred between perspectives of service-providers, media and parents, as well as between the two residential locations. These in-depth snapshots on the challenges and rewards of raising children in different urban locations can help inform government in planning healthy neighbourhoods that better serve the needs of contemporary Australian families.

Comparison of food industry policies and commitments on marketing to children and product (re)formulation in Australia, New Zealand and Fiji

Unhealthy food environments are known to be major drivers of diet-related non-communicable diseases globally, and there is an imperative for major food companies to be publicly accountable for their actions to improve the healthiness of food environments. This paper examines the prevalence of publicly available policies and commitments of major packaged food and soft drink manufacturers, and fast-food restaurants in Australia, New Zealand and Fiji with respect to reducing food marketing to children and product (re)formulation. In each country, the most prominent companies in each sector were selected. Company policies, commitments and relevant industry initiatives were gleaned from company and industry association websites. In Australia and New Zealand, there are a higher proportion of companies with publicly available marketing and formulation policies than in Fiji. However, even in Australia, a large proportion of the most prominent food companies do not have publicly available policies. Where they exist, policies on food marketing to children generally focus on those aged less than 12, do not apply to all types of media, marketing channels and techniques, and do not provide transparency with respect to the products to which the policies apply. Product formulation policies, where they exist, focus mostly on salt reduction and changes to the make-up of overall product portfolios, and do not generally address saturated fat, added sugar and energy reduction. In the absence of strong policies and corresponding actions by the private sector, it is likely that government action (e.g. through co-regulation or legislation) will be needed to drive improved company performance.

Digital marketing of unhealthy foods to Australian children and adolescents

The emergence of new media—including branded websites, social media and mobile applications—has created additional touch points for unhealthy food and beverage companies to target children and adolescents. The aim of this study was to perform an audit of new media for three top selling food and beverage brands in Australia. The top selling brand in three of the most advertised food and beverage categories was identified. Facebook, websites and mobile phone applications from these three brands were assessed using a combination of descriptive analyses and structured data collection during June and July 2013. Information on target audience, main focus of the activity, marketing strategies employed and connectivity were collected. Promotional activities were assessed against industry self-regulatory codes. McDonald's, Coca-Cola and Cadbury Dairy Milk were audited, with 21 promotional activities identified. These promotional activities appeared to use a number of marketing strategies, with frequent use of indirect product association, engagement techniques and branding. We identified strategic targeting of both children and adolescents. We found that while all promotional activities technically met self-regulatory codes (usually due to media-specific age restrictions) a number appeared to employ unhealthy food or beverage marketing directed to children. Brands are using engaging content via new media aimed at children and adolescents to promote unhealthy food and beverages. Given the limitations of self-regulatory codes in the context of new media, strategies need to be developed to reduce exposure of children and adolescents to marketing of unhealthy food and beverage products via these avenues.

Chasing reporters : Infotainment, intertextuality and media satire

The Chaser’s War on Everything is a night time entertainment program which screened on Australia’s public broadcaster, the ABC in 2006 and 2007. This enormously successful comedy show managed to generate a lot of controversy in its short lifespan (see, for example, Dennehy, 2007; Dubecki, 2007; McLean, 2007; Wright, 2007), but also drew much praise for its satirising of, and commentary on, topical issues. Through interviews with the program’s producers, qualitative audience research and textual analysis, this paper will focus on this show’s media satire, and the segment ‘What Have We Learned From Current Affairs This Week?’ in particular. Viewed as a form of ‘Critical Intertextuality’ (Gray, 2006), this segment (which offered a humorous critique of the ways in which news and current affairs are presented elsewhere on television) may equip citizens with a better understanding of the new genre’s production methods, thus producing a higher level of public media literacy. This paper argues that through its media satire, The Chaser acts not as a traditional news program would in informing the public with new information, but as a text which can inform and shape our understanding of news that already exists within the public sphere. Humorous analyses and critiques of the media (like those analysed in this paper), are in fact very important forms of infotainment, because they can provide “other, ‘improper,’ and yet more media literate and savvy interpretations” (Gray, 2006, p. 4) of the news.