Self-reported racism and experience of toothache among pregnant Aboriginal Australians: the role of perceived stress, sense of control, and social support

Objectives We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship. Methods Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator. Results Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (β coefficient-=-0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator. Conclusions The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache.

Who cooks from scratch and how do they prepare food

Purpose – There is increasing interest in the domestic preparation of food and with the postulated health benefits of “cooking from scratch”. The purpose of this paper is to examine the demographic and food preparation associations of this term in order to examine its operational value. Design/methodology/approach – A national online survey was conducted during 2012 in Australia among 1,023 domestic food providers, half of whom were men. Questions were asked about cooking from scratch, demographic characteristics, food preparation practices and interest in learning about cooking. Findings – Three quarters of the sample reported they often or always “cooked from scratch” (CFS). More women than men always CFS; fewer 18-29 year olds did so often or always but more of the over 50s always did so; fewer single people CFS than cohabiting people. No statistically significant ethnic, educational background or household income differences were found. High levels of cooking from scratch were associated with interest in learning more about cooking, greater use of most cooking techniques (except microwaves), meat and legume preparation techniques, and the use of broader ranges of herbs, spice, liquids/ sauces, other ingredients and cooking utensils. Research limitations/implications – In future work a numerical description of the frequency of cooking from scratch should be considered along with a wider range of response options. The data were derived from an online panel from which men were oversampled. Caution is required in comparisons between men and women respondents. The cross-sectional nature of the sample prevents any causal attributions from being drawn from the observed relationships. Further replication of the findings, especially the lack of association with educational background should be conducted. Originality/value – This is the first study to examine the associations of demographic characteristics and cooking practices with cooking from scratch. The findings suggest that cooking from scratch is common among Australian family food providers and signifies interest in learning about cooking and involvement in a wide range of cooking techniques.

How Australian and New Zealand schools of optometry prepare students for culturally competent practice

Background: This study is an investigation of how Australian and New Zealand schools of optometry prepare students for culturally competent practice. The aims are: (1) to review how optometric courses and educators teach and prepare their students to work with culturally diverse patients; and (2) to determine the demographic characteristics of current optometric students and obtain their views on cultural diversity. Methods: All Australian and New Zealand schools of optometry were invited to participate in the study. Data were collected with two surveys: a curriculum survey about the content of the optometric courses in relation to cultural competency issues and a survey for second year optometry students containing questions in relation to cultural awareness, cultural sensitivity and attitudes to cultural diversity. Results: Four schools of optometry participated in the curriculum survey (Deakin University, Flinders University, University of Melbourne and University of New South Wales). Sixty-three students (22.3 per cent) from these four schools as well as the University of Auckland participated in the student survey. Cultural competency training was reported to be included in the curriculum of some schools, to varying degrees in terms of structure, content, teaching method and hours of teaching. Among second year optometry students across Australia and New Zealand, training in cultural diversity issues was the strongest predictor of cultural awareness and sensitivity after adjusting for school, age, gender, country of birth and language other than English. Conclusion: This study provides some evidence that previous cultural competency-related training is associated with better cultural awareness and sensitivity among optometric students. The variable approaches to cultural competency training reported by the schools of optometry participating in the study suggest that there may be opportunity for further development in all schools to consider best practice training in cultural competency. © 2014 Optometrists Association Australia.

Subjective wellbeing among adults with diabetes : results from Diabetes MILES—Australia

This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which depression and socio-demographic factors account for subjective wellbeing is investigated. People with type 1 or type 2 diabetes have significantly lower subjective wellbeing compared to the general population, even after controlling for covariates (demographic and socio-economic status, diabetes duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health. These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.

Intradialytic hypotension prevention and management knowledge and practices: Results from a survey of Australian and New Zealand nephrology nurses

Intradialytic hypotension (IDH) remains the most frequent serious side effect of hemodialysis, increasing morbidity in patients on hemodialysis. Nephrology nurses have a critical role in the prevention and management of IDH. The aim of this study was to investigate nephrology nurse knowledge and practice habits in the prevention and management of IDH. This was an explorative cross-sectional design, web-based survey of Australian and New Zealand nephrology nurses (n = 173). IDH definitions, blood pressureinterpretation, and IDH interventions were inconsistent and not always evidencebased.Demographic characteristics had little impact on the variation in responses. A universal definition for IDH may improve early recognition of the problem. Formal guidelines in considering individualized interventional strategies for asymptomaticepisodes prior symptomatic IDH occurrence may improve outcomes for patients on hemodialysis

Unmet needs and depression among carers of people newly diagnosed with cancer

AIMS: The aims of this analysis were to examine levels of unmet needs and depression among carers of people newly diagnosed with cancer and to identify groups who may be at higher risk, by examining relationships with demographic characteristics. METHODS: One hundred and fifty dyads of people newly diagnosed with cancer and their carers, aged 18years and older, were recruited from four Australian hospitals. People with cancer receiving adjuvant cancer treatment with curative intent, were eligible to participate. Carers completed the Supportive Care Needs Survey-Partners & Caregivers (SCNS-P&C45), and both carers and patients completed the Centre of Epidemiologic-Depression Scale (CES-D). RESULTS: Overall, 57% of carers reported at least one, 37% at least three, 31% at least five, and 15% at least 10 unmet needs; the most commonly endorsed unmet needs were in the domains of information and health care service needs. Thirty percent of carers and 36% of patients were at risk of clinical depression. A weak to moderate positive relationship was observed between unmet needs and carer depression (r=0.30, p<0.001). Carer levels of unmet needs were significantly associated with carer age, hospital type, treatment type, cancer type, living situation, relationship status (in both uni- and multi-factor analysis); person with cancer age and carer level of education (in unifactor analysis only); but not with carer gender or patient gender (in both uni- and multi-factor analyses). CONCLUSION: Findings highlight the importance of developing tailored programmes to systematically assist carers who are supporting patients through the early stages of cancer treatment.

Migration, acculturation and environment: determinants of obesity among Iranian migrants in Australia

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants' perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors.

Normative data for the strengths and difficulties questionnaire for young children in Australia

AIM: The aim of this study was to report normative data for the parent-reported Strengths and Difficulties Questionnaire (SDQ) from a large population cohort of young children aged 4-6 years from Victoria, Australia, to establish age- and sex-specific cut-off values for future use, and to determine the scale reliability of the SDQ for children aged 4-6 years. METHODS: Parents of children (n = 53 372) entering their first year of school in Victoria in 2010 completed a survey via a 15-page School Entrant Health Questionnaire reporting on the physical and emotional well-being of their child (including the SDQ), use of child health and other support services, and a range of socio-demographic variables. Reliability was assessed and norms generated. Appropriate cut-off values for each SDQ scale and total difficulties scale were generated for each age group separately for each sex. RESULTS: The five scales of the SDQ and total difficulties scale generally had acceptable internal reliability. Mean SDQ scale scores differed for both sex and age, although only a narrow age range is examined in this study. Cut-off values were marginally higher for girls (lower for prosocial) and generally increased with age. CONCLUSIONS: This study has utilised a large Australian population sample of children to generate age- and sex-specific cut-off values that define SDQ scores as 'normal', 'borderline' or 'abnormal' for Australian children aged 4-6 years.

Do birdwatchers care about bird disturbance?

Little is known about how non-consumptive recreationists perceive their impacts on animals and how this relates to recreationist behavior. We surveyed attitudes and behaviors relating to bird disturbance of 179 birdwatchers who visited a world-renowned, restricted-access birdwatching destination (the Western Treatment Plant [WTP], Victoria, Australia). We distributed a 10-page, 49-question survey to birdwatchers at the WTP and posted it to a mailing list of those who held birdwatching access permits. The questionnaire explored socio-demographic profiles of respondents, and their bird- watching behaviors and attitudes to bird disturbance. Birdwatchers regarded vehicles as particularly disturbing and some bird groups, and breeding birds, as especially sensitive to disturbance. They generally disagreed with the contention that birdwatchers and plant workers disturb birds. All respondents reported using strategies to mitigate bird disturbance (e.g., keeping quiet and distant). Those who adopted more strategies to mitigate disturbance agreed more with the contention that birdwatchers and workers cause disturbance, and that breeding birds are especially sensitive to disturbance. Our results suggest that birdwatchers who perceive that their activity disturbs birds are more likely to modify their behaviors to minimize the disturbance. As such, wildlife managers and educators must clearly communicate possible impacts of birdwatching to birdwatchers to maximize the uptake of ethical birdwatching practices.

Objectively measured physical activity and sedentary time in youth: The International children's accelerometry database (ICAD)

Background: Physical activity and sedentary behaviour in youth have been reported to vary by sex, age, weight status and country. However, supporting data are often self-reported and/or do not encompass a wide range of ages or geographical locations. This study aimed to describe objectively-measured physical activity and sedentary time patterns in youth. Methods: The International Children's Accelerometry Database (ICAD) consists of ActiGraph accelerometer data from 20 studies in ten countries, processed using common data reduction procedures. Analyses were conducted on 27,637 participants (2.8-18.4 years) who provided at least three days of valid accelerometer data. Linear regression was used to examine associations between age, sex, weight status, country and physical activity outcomes. Results: Boys were less sedentary and more active than girls at all ages. After 5 years of age there was an average cross-sectional decrease of 4.2 % in total physical activity with each additional year of age, due mainly to lower levels of light-intensity physical activity and greater time spent sedentary. Physical activity did not differ by weight status in the youngest children, but from age seven onwards, overweight/obese participants were less active than their normal weight counterparts. Physical activity varied between samples from different countries, with a 15-20 % difference between the highest and lowest countries at age 9-10 and a 26-28 % difference at age 12-13. Conclusions: Physical activity differed between samples from different countries, but the associations between demographic characteristics and physical activity were consistently observed. Further research is needed to explore environmental and sociocultural explanations for these differences.

The distribution of quality of life in Australia

 Australians enjoy a relatively high degree of life quality as judged by comparative international statistics. This chapter reviews the distribution of Quality of Life in Australia by considering both the objective and subjective wellbeing (SWB) of the Australian population. The review begins with an overview of objective circumstances, including income, social support, and life expectancy. It also considers the distribution of trust. Two extant measures of the subjective wellbeing of Australians are then reviewed, and it is revealed that SWB has demonstrated remarkably stable properties over the last 12 years. This chapter provides some insight into the properties of the measures and the theoretical construct of Subjective Wellbeing to explain fluctuations that occur for different components of SWB. Further, this chapter considers the demographic characteristics that are common to Australians with higher and lower SWB and offers a basis of research upon which future measures of population wellbeing can be founded

Rebound or resignation: developing a predictive model of return to subjective wellbeing set-point

Though subjective wellbeing (SWB) is generally stable and consistent over time, it can fall below its set-point in response to adverse life events. However, deviations from set-point levels are usually only temporary, as homeostatic processes operate to return SWB to its normal state. Given that income and close interpersonal relationships have been proposed as powerful external resources that are coincident with higher SWB, access to these resources may be an important predictor of whether or not a person is likely to recover their SWB following a departure from their set-point. Under the guiding framework of SWB Homeostasis Theory, this study considers whether access to a higher income and a committed partner can predict whether people who score lower than normal for SWB at baseline will return to normal set-point levels of SWB (rebound) or remain below the normal range (resigned) at follow-up. Participants were 733 people (53.3 % female) from the Australian Unity Longitudinal Wellbeing Study who ranged in age from 20 to 92 years (M = 59.65 years; SD = 13.15). Logistic regression analyses revealed that participants’ demographic characteristics were poor predictors of whether they rebounded or resigned. Consistent with homeostasis theory, the extent of departure from the proposed normal SWB set-point at baseline was significantly associated with rebound or resignation at time 2. These findings have implications for the way that SWB measures can be used in professional practice to identify people who are particularly vulnerable to depression and to guide the provision of appropriate and effective therapeutic interventions.

Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program

Fe deficiency remains the most common nutritional deficiency worldwide and young children are at particular risk. Preventative food-based strategies require knowledge of current intakes, sources of Fe, and factors associated with low Fe intakes; yet few data are available for Australian children under 2 years. This study’s objectives were to determine intakes and food sources of Fe for Australian infants and toddlers and identify non-dietary factors associated with Fe intake. Dietary, anthropometric and socio-demographic data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were analysed for 485 infants (mean age: 9·1 (sd 1·2) months) and 423 toddlers (mean age: 19·6 (sd 2·6) months) and their mothers. Dietary intakes were assessed via 24-h recalls over 3 non-consecutive days. Prevalence of inadequate Fe intake was estimated using the full probability approach. Associations between potential non-dietary predictors (sex, breast-feeding status, age when introduced to solid foods, maternal age, maternal education, maternal employment status and mother’s country of birth) and Fe intakes were assessed using linear regression. Mean Fe intakes were 9·1 (sd 4·3) mg/d for infants and 6·6 (sd 2·4) mg/d for toddlers. Our results showed that 32·6 % of infants and 18·6 % of toddlers had inadequate Fe intake. Main food sources of Fe were Fe-fortified infant formula and cereals for infants and toddlers, respectively. Female sex and current breast-feeding were negatively associated with infant Fe intakes. Introduction to solid foods at or later than 6 months was negatively associated with Fe intake in toddlers. These data may facilitate food-based interventions to improve Australian children’s Fe intake levels.

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.

Violence risk assessment in psychiatric patients in China: a systematic review

Objectives: The aim of this study was to undertake a systematic review on violence risk assessment instruments used for psychiatric patients in China.

Methods: A systematic search was conducted from 1980 until 2014 to identify studies that used psychometric tools or structured instruments to assess aggression and violence risk. Information from primary studies was extracted, including demographic characteristics of the samples used, study design characteristics, and reliability and validity estimates.

Results: A total of 30 primary studies were identified that investigated aggression or violence; 6 reported on tools assessing aggression while an additional 24 studies reported on structured instruments designed to predict violence. Although measures of reliability were typically good, estimates of predictive validity were mostly in the range of poor to moderate, with only 1 study finding good validity. These estimates were typically lower than that found in previous work for Western samples.

Conclusion: There is currently little evidence to support the use of current violence risk assessment instruments in psychiatric patients in China. Developing more accurate and scalable approaches are research priorities.