Cohort profile : The resilience for eating and activity despite inequality (READI) study

The Resilience for Eating and Activity Despite Inequality (READI) cohort was established to address the following two key aims: to investigate the pathways (personal, social and structural) by which socio-economic disadvantage influences lifestyle choices associated with obesity risk (physical inactivity, poor dietary choices) and to explore mechanisms underlying ‘resilience’ to obesity risk in socio-economically disadvantaged women and children. A total of 4349 women aged 18–46 years and 685 children aged 5–12 years were recruited from 80 socio-economically disadvantaged urban and rural neighbourhoods of Victoria, Australia, and provided baseline (T1: 2007–08) measures of adiposity, physical activity, sedentary and dietary behaviours; socio-economic and demographic factors; and psychological, social and perceived environmental factors that might impact on obesity risk. Audits of the 80 neighbourhoods were undertaken at baseline to provide objective neighbourhood environmental data. Three-year follow-up data (2010–11) have recently been collected from 1912 women and 382 children. Investigators welcome enquiries regarding data access and collaboration.

Educational inequalities in women's depressive symptoms : the mediating role of perceived neighbourhood characteristics

Socio-economically disadvantaged (e.g., less educated) women are at a greater risk of depression compared to less disadvantaged women. However, little is known regarding the factors that may explain socioeconomic inequalities in risk of depression. This study aimed to investigate the contribution of perceived neighbourhood factors in mediating the relationship between education and women’s risk of depression. Cross-sectional data were provided by 4,065 women (aged 18–45). Women self-reported their education level, depressive symptoms (CES-D 10), as well as four neighbourhood factors (i.e., interpersonal trust, social cohesion, neighbourhood safety, and aesthetics). Single and multiple mediating analyses were conducted. Clustering by neighbourhood of residence was adjusted by using a robust estimator of variance. Multiple mediating analyses revealed that interpersonal trust was the only neighbourhood characteristic found to partly explain the educational inequalities in women’s depressive symptoms. Social cohesion, neighbourhood aesthetics and safety were not found to mediate this relationship. Acknowledging the cross-sectional nature of this study, findings suggest that strategies to promote interpersonal trust within socioeconomically disadvantaged neighbourhoods may help to reduce the educational inequalities in risk of depression amongst women. Further longitudinal and intervention studies are needed to confirm these findings.

Classroom teacher effectiveness research and inquiry, and its relevance to the development of public education policy: an Australian context

This paper has as its focus an analysis of the question and problem of classroom teacher effectiveness research and inquiry. It presents an examination of what counts as valid and worthwhile research in classroom teacher effectiveness studies for the development of education policy within an Australian context, the State of Victoria. The Government’s Blueprint, the major education policy document of the Victorian State Labour Government, outlines its educational approach. Important and core features of government direction for education policy include a focus on social and economic disadvantage. A priority for the Victorian State Labour Government is tangible and measurable improvement in the performance of the public education system. A particular concern is the problem of academic underperformance within public schools, particularly those designated as low-performing and situated in socially and economically disadvantaged communities. Building the capacity of the State’s teacher workforce forms a key component of the Blueprint, and State Government direction in public education. The paper utilises a qualitative theoretical framework. Eight education policy actor/participants were interviewed and their responses analysed using a critical discourse approach. The main findings indicate that education policy actors advocate a strong belief in particular forms of evidence-based research for the development of education policy in the area of classroom teacher effectiveness.

Stores healthy options project in remote indigenous communities (SHOP@RIC): a protocol of a randomised trial promoting healthy food and beverage purchases through price discounts and in-store nutrition education

Background
Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related. Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease. There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.

This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities.

Methods/Design
We will utilise a randomised multiple baseline (stepped wedge) design involving 20 communities in remote Indigenous Australia. The study will be conducted in partnership with two store associations and twenty Indigenous store boards. Communities will be randomised to either i) a 20% price discount on fruit, vegetables, water and diet soft-drinks; or ii) a combined price discount and in-store nutrition education strategy. These interventions will be initiated, at one of five possible time-points, spaced two-months apart. Weekly point-of-sale data will be collected from each community store before, during, and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks. Data on physical, social and economic factors influencing weekly store sales will be collected in order to identify important covariates. Intervention fidelity and mediators of behaviour change will also be assessed.

Discussion
This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting.

Barriers to avoiding fast-food consumption in an environment supportive of unhealthy eating

Objective
To investigate factors (ability, motivation and the environment) that act as barriers to limiting fast-food consumption in women who live in an environment that is supportive of poor eating habits.

Design
Cross-sectional study using self-reports of individual-level data and objectively measured environmental data. Multilevel logistic regression was used to assess factors associated with frequency of fast-food consumption.

Setting
Socio-economically disadvantaged areas in metropolitan Melbourne, Australia.

Subjects
Women (n 932) from thirty-two socio-economically disadvantaged neighbourhoods living within 3 km of six or more fast-food restaurants. Women were randomly sampled in 2007–2008 as part of baseline data collection for the Resilience for Eating and Activity Despite Inequality (READI) study.

Results
Consuming low amounts of fast food was less likely in women with lower perceived ability to shop for and cook healthy foods, lower frequency of family dining, lower family support for healthy eating, more women acquaintances who eat fast food regularly and who lived further from the nearest supermarket. When modelled with the other significant factors, a lower perceived shopping ability, mid levels of family support and living further from the nearest supermarket remained significant. Among those who did not perceive fruits and vegetables to be of high quality, less frequent fast-food consumption was further reduced for those with the lowest confidence in their shopping ability.

Conclusions
Interventions designed to improve women's ability and opportunities to shop for healthy foods may be of value in making those who live in high-risk environments better able to eat healthily.

More yuppy stuff coming soon: gentrification, cultural policy, social inclusion and the arts

Responding to gentrification has become a key planning issue for many urban municipalities. Local governments need to balance the often-competing agendas of urban regeneration, social inclusion and arts access and participation. This paper argues that arts and cultural units within local government bear the impact of such tensions. More importantly, however, local government policies and their implementation represent a third position in the polarised discussion on the cultural impact of gentrification. The example discussed here is the rapidly gentrifying City of Maribyrnong in Melbourne’s western suburbs: a municipality where any potential realisation of the economic benefits of gentrification is balanced against the needs of a significant population of resident professional artists, and the social inclusion needs of socio-economically disadvantaged residents. Maribyrnong’s arts and cultural unit, like those within many municipalities in the developed world, has had to develop cultural policies and plans as tools for negotiating complex relationships and diverse needs of community members by considering the economic, social and cultural benefits of the arts for all residents.

Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working aged Australians

Background:People with disabilities are socio-economically disadvantaged and have poorer health than people without disabilities; however, little is known about the way in which disadvantage is patterned by gender and type of impairment.Objectives:1. To describe whether socio-economic circumstances vary according to type of impairment (sensory and speech, intellectual, physical, psychological and acquired brain injury) 2. To compare levels of socio-economic disadvantage for women and men with the same impairment typeMethods:We used a large population-based disability-focused survey of Australians, analysing data from 33,101 participants aged 25 to 64. Indicators of socio-economic disadvantage included education, income, employment, housing vulnerability, and multiple disadvantage. Stratified by impairment type, we estimated: the population weighted prevalence of socio-economic disadvantage; the relative odds of disadvantage compared to people without disabilities; and the relative odds of disadvantage between women and men.Results:With few exceptions, people with disabilities fared worse for every indicator compared to people without disability; those with intellectual and psychological impairments and acquired brain injuries were most disadvantaged. While overall women with disabilities were more disadvantaged than men, the magnitude of the relative differences was lower than the same comparisons between women and men without disabilities, and there were few differences between women and men with the same impairment types.Conclusions:Crude comparisons between people with and without disabilities obscure how disadvantage is patterned according to impairment type and gender. The results emphasise the need to unpack how gender and disability intersect to shape socio-economic disadvantage.

Socio-economic differences in predictors of frequent dairy food consumption among Australian adolescents: a longitudinal study

Sufficient dairy food consumption during adolescence is necessary for preventing disease. While socio-economically disadvantaged adolescents tend to consume few dairy foods, some eat quantities more in line with dietary recommendations despite socio-economic challenges. Socio-economic variations in factors supportive of adolescents' frequent dairy consumption remain unexplored. The present study aimed to identify cross-sectional and longitudinal associations between intrapersonal, social and environmental factors and adolescents' frequent dairy consumption at baseline and two years later across socio-economic strata, and to examine whether socio-economic position moderated observed effects.

Maternal efficacy and sedentary behavior rules predict child obesity resilience

Abstract
Background:
To identify longitudinal individual, social and environmental predictors of adiposity (BMI z-score),
and of resilience to unhealthy weight gain, in healthy weight children and adolescents.
Methods:
Two hundred healthy weight children aged 5–12 years at baseline and their parents living in socio-economically disadvantaged neighborhoods were surveyed at baseline and three years later. Children’s height and weight were objectively measured, parents completed a detailed questionnaire that examined the home, social and neighborhood environments, and objective measures of the neighborhood environment were assessed using geographic information system data. Ch
ildren classified as healthy weight at baseline who had
small or medium increases in their BMI z-score between baseline and three year follow up (those in the bottom
and middle tertiles) were categorized as‘ resilient to unhealthy weight gain’. Where applicable, fully adjusted
multivariable regression models were employed to determine baseline intrapersonal, social and environmental predictors of child BMI z-scores at follow-up, and resilience to unhealthy weight gain at
follow-up.
Results:
Maternal efficacy for preventing their child from engaging in sedentary behaviors (B = − 0.03, 95 % CI: 0.06, 0.00) was associated with lower child BMI z-score at follow up. Rules to limit sedentary behaviors (OR = 1.14, 95 % CI: 1.03, 1.25) was a predictor of being resilient to unhealthy weight gain.
Conclusion:
The findings suggest that strategies to support parents to limit their children ’s sedentary behavior may be important in preventing unhealthy weight gain in socioeconomically disadvantaged communities.

Demographic risk factors for alcohol-related aggression in and around licensed venues

AIMS: Few studies have examined the role of gender and both area-level and individual socio-economic status (SES) as independent predictors of alcohol-related aggression (ARA) in and around licensed venues. METHODS: The aim of the present study was to investigate the relationship between gender, area-level SES and individual SES (operationalised as occupational category) and ARA in and around licensed venues. The sample comprised 697 men and 649 women aged 16-47, who completed a patron intercept survey as part of a larger study assessing trends in harm and stakeholders' views surrounding local community level interventions in dealing with alcohol-related problems in the night-time economy. RESULTS: Binary logistic regression analyses showed that age, gender, occupational category, area-level SES and level of intoxication at time of interview were all significant predictors of involvement in ARA. Being male doubled the odds of involvement in ARA, while age was a protective factor. Blue collar workers had more than double the odds of ARA involvement of professionals, while those living in the most socio-economically disadvantaged areas were over twice as likely to report experiencing ARA compared to those living in the most advantaged areas. However, assessment of the predictive model by gender revealed that effects of age, occupational category and area-level SES were restricted to male participants, with greater intoxication no longer predictive. CONCLUSIONS: ARA among patrons was significantly more likely to occur among men, those in blue collar occupations, and individuals living in low SES areas, suggesting both individual and area-level disadvantage may play a role in ARA.

Cancer diagnosed in the emergency department of a regional health service

OBJECTIVE: Patients diagnosed with cancer in the Emergency Department (ED) have more advanced disease at diagnosis and poorer outcomes. High rates of initial presentation to ED suggest potential problems with access to care. The aim of this project was to interpret findings in regional/rural Victoria and explore implications for practice.

DESIGN: Cross-sectional study linking two independent data sets.

SETTING: Regional city of Geelong and surrounding rural areas in south-west Victoria.

PARTICIPANTS: All newly diagnosed cancer patients in 2009.

MAIN OUTCOME MEASURES: Number of cancer patients diagnosed in the ED.

RESULTS: One in five newly diagnosed cancer patients present to ED 6 months prior to cancer diagnosis. One in 10 is diagnosed as a result of their ED visit. Patients presenting to ED were older, more often men and from disadvantaged areas. Symptoms on presentation included chest complaints, bowel obstruction, abdominal pain, anaemia and generalised weakness. Cancer diagnosed in the ED is associated with advanced stage and shorter survival.

CONCLUSION: Reasons for presentation to ED would be multifactorial and include complex cases with coexisting symptoms making diagnosis difficult. The general public appear to have a low level of awareness of alternative primary care services or difficulty accessing such information. Some of the changes towards reducing the number of patients presenting to ED will include patient education.

Escola para os filhos dos outros: trajetória histórica da escola industrial de Natal (1942-1968)

This paper presents a reconstruction of the historical trajectory of the Escola Industrial de Natal (Industrial School of Natal), in the period 1942 to 1968, based on the analysis of its cultural, social and pedagogical characteristics in a process in which its educational practices and the individuals who constructed them were getting involved in their actions. In this sense, the concepts of memory and school culture occupied a central place to understand the elements that characterized its administrative and pedagogical organization such as, for example, its curriculum, aims, disciplinary rules, clientele, teachers, leaders and the configuration of the institutional power. Designed to meet the demands of an industrial process that has strengthened in the country, throughout its history, the Escola Industrial de Natal was becoming a space predominantly occupied by individuals, from economically disadvantaged social groups in society, in search of a professional training that would guarantee them the exercise of a profession. The time frame from 1942 to 1968 allowed us to verify the changes caused by the Organic Law of Industrial Education of 1942, and the Law number 3.552, from 1959, in the organizational structure of this school. In this context, a characteristic that was evident was the purpose of making it flow between the students the love for the country, the respect for civic values and the belief that industrial education would be able to boost the country's development, an aspect that reached a bigger dimension from the 1950 s. Marked the disciplinary character of this institution the control over the actions of individuals, developed through its multiple educational practices in specific areas and in the predetermined time, under the constant gaze of those who participated, in some from, in driving this process. On the other hand, the vocational and human training, provided to students, allowed new opportunities for social integration, not only in the state of Rio Grande do Norte, but also in other regions of Brazil. Conversely, during his career, the Escola Industrial de Natal has remained being seen as an organized institution, with good teachers, but intended for the children of others

Lazer na terceira idade: desenvolvimento humano e qualidade de vida

The article aimed to understand the concept of leisure and understanding that older people have about their benefits to the quality of life as part of the idleness of the population. We used a sample of subjects living in the city of Bauru, SP, aged less than fifty years, of both sexes and economically disadvantaged class. It was used in literature, documentary and field. We developed an intervention project that aimed to education for leisure. It was the conclusion that public policies are necessary and qualified professionals for construction projects and equipment to expand the Recreation, spreading it and reaching the people of old age since previous stages of life. Materials with simple and low cost, the project of intervention, it reached the recreation-education and education for leisure satisfactorily.

Tarifa social e subsídio cruzado: o mito da universalidade do transporte público brasileiro

Pós-graduação em Direito - FCHS

The Young Mother and the Labor Market

Introduction - The Centro de Orientacao ao Adolescente of Campinas (Southeastern Brazil) maintains a program to qualify economically disadvantaged adolescent students aged 15 to 18 years to enter the labor market. Objective - To understand life projects of teenagers who became mothers while participating in the program, in the period from 2003 to 2008, aiming to find the place of professional life in their life trajectory before and after motherhood. Method - Eight young mothers were interviewed, and a qualitative methodology was applied to the analysis of the interviews. Results - The trajectories of study and work were discontinued or adapted due to motherhood. Four young mothers completed high school and none had entered university. Three did not return to work and the rest had diverse work experiences. The reported difficulties to enter the labor market were: inadequate instruments to support the children's care, low income, lack of work experience, presence of small children and little educational background. Final Considerations - Teenage motherhood did not indicate the exclusion of educational or work projects but indicated adjustments and the need for a family and social support network. It was noted the need for public policies targeted at the inclusion of youths in the labor market and at support services such as nurseries. Also, the need for a change in gender relations was demonstrated, with greater equality of rights as a precondition for the inclusion of women, especially those who are mothers, in the labor market.