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.

Supporting healthy communities through arts programs

There are some evaluations, critical descriptions of programs and systematic reviews on the benefits to Aboriginal and Torres Strait Islander communities from participation in arts programs. These include: improved physical and mental health and wellbeing; increased social inclusion and cohesion; some improvements in school retention and attitudes towards learning; increased validation of, and connection to, culture; improved social and cognitive skills; and some evidence of crime reduction.The effects of arts programs can be powerful and transformative. However, these effects tend to be indirect.For example, using these programs to reduce juvenile anti-social behaviour largely work through diversion: providing alternative safe opportunities to risk taking, maintenance of social status, as well as opportunities to build healthy relationships with Elders and links with culture.Art forms such as song, dance and painting, coupled with ceremony, are integral to cultural continuity and cultural maintenance in Indigenous Australian communities.

Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

Development and evaluation of a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence

Abstract Aims: To develop and evaluate a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence. Methods: A retrospective audit of attendances at a diabetes outpatient clinic at a public, teaching hospital over a 16-month period was conducted. Logistic regression was undertaken to examine risk factors associated with medication problems relating to hypoglycaemia and medication non-adherence and the most predictive set of factors comprise the Diabetes Medication Risk Screening Tool. Evaluating the tool involved assessing sensitivity and specificity, positive and negative predictive values, cut-off scores, inter-rater reliability, and content validity. Results: The Diabetes Medication Risk Screening Tool comprises seven predictive factors: age, living alone, English language, mental and behavioural problems, comorbidity index score, number of medications prescribed, and number of high-risk medications prescribed. The tool has 76.5% sensitivity, 59.5% specificity, and has a 65.1% positive predictive value, and a 71.8% negative predictive value. A score of 27 or more out of 62 was associated with high-risk of a medication problem. The inter-rater reliability of the tool was high (κ = 0.79, 95% CI 0.75 - 0.84) and the content validity index was 99.4%. Conclusion: The Diabetes Medication Risk Screening Tool has good psychometric properties and can proactively identify people with diabetes at greatest risk of medication problems relating to hypoglycaemia and medication non-adherence.

Comparing the strength of auditing and reporting standards and investigating their predictors in Europe and Asia

The World Economic Forum conducted an opinion survey to determine the strength of auditing and reporting standards (SARS) in 133 countries. It then assigned a score for SARS to each country as one of its global competitive indices. This is a unique dataset on SARS at country level. Using this dataset, this paper compares SARS scores for 72 countries (41 European and 31 Asian). A multi-phase regression analysis is employed to empirically investigate the predictors of SARS using five sub-models. Findings from the study support existing theory and add new findings to the auditing and reporting literature at a regional level. It suggests that there are nine predictors of SARS which are similar for both Europe and Asia but with different magnitude. In Asia the efficiency of the legal framework and the size of the foreign export market are also significant predictors of SARS compared to Europe.

Toward a standard approach to measurement and reporting of perioperative mortality rate as a global indicator for surgery

INTRODUCTION: The proportion of patients who die during or after surgery, otherwise known as the perioperative mortality rate (POMR), is a credible indicator of the safety and quality of operative care. Its accuracy and usefulness as a metric, however, particularly one that enables valid comparisons over time or between jurisdictions, has been limited by lack of a standardized approach to measurement and calculation, poor understanding of when in relation to surgery it is best measured, and whether risk-adjustment is needed. Our aim was to evaluate the value of POMR as a global surgery metric by addressing these issues using 4, large, mixed, surgical datasets that represent high-, middle-, and low-income countries. METHODS: We obtained data from the New Zealand National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa, and Port Moresby, Papua New Guinea. For each site, we calculated the POMR overall as well as for nonemergency and emergency admissions. We assessed the effect of admission episodes and procedures as the denominator and the difference between in-hospital POMR and POMR, including postdischarge deaths up to 30 days. To determine the need for risk-adjustment for age and admission urgency, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site. RESULTS: A total of 1,362,635 patient admissions involving 1,514,242 procedures were included. More than 60% of admissions in Pietermaritzburg and Port Moresby were emergencies, compared with less than 30% in New Zealand and Geelong. Also, Pietermaritzburg and Port Moresby had much younger patient populations (P < .001). A total of 8,655 deaths were recorded within 30 days, and 8-20% of in-hospital deaths occurred on the same day as the first operation. In-hospital POMR ranged approximately 9-fold, from 0.38 per 100 admissions in New Zealand to 3.44 per 100 admissions in Pietermaritzburg. In New Zealand, in-hospital 30-day POMR underestimated total 30-day POMR by approximately one third. The difference in POMR if procedures were used instead of admission episodes ranged from 7 to 70%, although this difference was less when central line and pacemaker insertions were excluded. Age older than 65 years and emergency admission had large, independent effects on POMR but relatively little effect in multivariate analysis on the relative odds of in-hospital death at each site. CONCLUSION: It is possible to collect POMR in countries at all level of development. Although age and admission urgency are strong, independent associations with POMR, a substantial amount of its variance is site-specific and may reflect the safety of operative and anesthetic facilities and processes. Risk-adjustment is desirable but not essential for monitoring system performance. POMR varies depending on the choice of denominator, and in-hospital deaths appear to underestimate 30-day mortality by up to one third. Standardized approaches to reporting and analysis will strengthen the validity of POMR as the principal indicator of the safety of surgery and anesthesia care.

Viewing The Biggest Loser : modes of reception and reflexivity among obese people

This article builds on previous reception research and scholarship on makeover TV through an analysis of obese people's views of The Biggest Loser (TBL). TBL involves obese people competing to lose weight as personal trainers push them through dietary and physical activity regimes. We articulate four themes characterizing responses to TBL: “That's not reality,” “Public ownership and judgment of the fat body,” “The lure of the transformation,” and “A guilty pleasure.” We consider how these themes are reflected in participants' movement between mediated, discursive, transparent, and referential modes of reception. While some were adamant in their rejection of the program, others were ambivalent in accepting and identifying with the desire for weight loss but questioning TBL's aesthetic dimensions and moralizing undertones. We argue that the reflexivity of viewers complicates appraisals of TBL as governing at a distance and offer some alternative readings of the impact and appeal of the program.

Indelible shame? News reporting of non-convictions in digital space

This paper examines the role of media in publicising the names of people who receive a non-conviction for a minor crime. It positions the news media’s ability to “name and shame” people who appear before the courts as a powerful cultural practice, rather than adopt a widely celebrated Fourth Estate view of the press as a watchdog on the judicial process. The research draws on interviews conducted in two regional centres of Victoria, Australia, with those involved in news coverage of very minor crimes where non-convictions were imposed. Their spoken words reveal a range of tensions linked to reporting non-convictions in the digital age. In the eyes of the law, a non-conviction means that an offender has an opportunity to rehabilitate away from the public gaze. However, the news media ‘s ability to name such offenders online has the potential to impose a lasting “mark of shame” in digital space that can prevent them gaining employment or housing, and damage their social standing and relationships. We live in a media-saturated culture in which the vast majority of people rely on news media for information about judicial proceedings and in turn, the news media constructs public understanding of the law through the way it represents crime and court processes. This paper argues that traditional understanding of the nexus between the judicial system and the Fourth Estate fails to acknowledge the news media’s considerable power outside the officially recognised operation of the open justice relationship, and that this deserves attention in the digital age

Effect of nativity and duration of residence on chronic health conditions among Asian immigrants in Australia: a longitudinal investigation

This study examined the effect of Asian nativity and duration of residence in Australia on the odds of reporting a chronic health condition (cancer, respiratory problems, cardiovascular disease (CVD) and diabetes mellitus). Data were from waves 3, 7 and 9 of the Household Income and Labour Dynamics in Australia (HILDA) longitudinal survey, and multi-level group-mean-centred logistic regression models were used for the analysis. After covariate adjustment, Asian immigrants were less likely to report cancer and respiratory problem compared with native-born Australians. While there was no significant difference in reporting CVD, they were more likely to report diabetes than native-born people. Asian immigrants maintained their health advantage with respect to cancer regardless of duration of residence. However, after 20 years of stay, Asian immigrants lost their earlier advantage and were not significantly different from native-born people in terms of reporting a respiratory problem. In contrast, Asian immigrants were not measurably different from native-born Australians in reporting diabetes if their length of stay in Australia was less than 20 years, but became disadvantaged after staying for 20 years or longer. There was no measurable difference in the odds of reporting CVD between Asian immigrants and native-born Australians for any duration of residence. On the whole this study found that health advantage, existence of healthy immigrant effect and subsequent erosion of it with increasing duration of residence among Asian immigrants depends upon the chronic health condition.

Economic and social opportunity: the changing lives of Aboriginal Victorians

 This study examined Aboriginal advantage in Victoria, demonstrating that relatively rapid change is occurring on a number of socio-economic indicators. This research, including interviews with Aboriginal participants, highlighted the interdependence of Aboriginal agency and responsive societal structures as significant enablers of Indigenous progress and advancement.

Marketing performance measurement : overview of approaches and practices for high technology firms

Um levantamento de 320 executivos de marketing feito pelo Conselho CMO e divulgado em junho de 2004 indicou que poucas companhias de alta tecnologia (menos de 20% das empresas entrevistadas) têm desenvolvido medidas e métricas úteis e expressivas para as suas organizações de marketing. Porém a pesquisa também revelou que companhias que estabeleceram medidas formais e compreensivas atingiram resultados financeiros superiores e tiveram mais confiança do CEO na função de marketing. Esta dissertação provê uma visão geral da informação precisa para executivos de marketing entenderem e implementarem processos para medição de performance de marketing (MPM) em suas organizações. Ela levanta questões para gerentes de marketing na industria de alta tecnologia com respeito às demandas para maior responsabilidade final, valor de medição para o melhoramento dos processos de marketing, iniciativas para determinar a lucratividade dos investimentos em marketing, e a importância das atividades de marketing nos relatórios corporativos. Esta dissertação defende a implementação de MPM, mapeando seus benefícios de medição para ambos gerentes de marketing e as suas empresas. o trabalho logo explora alguns conceitos gerais de medição de marketing e investiga algumas abordagens a MPM propostas pela industria, pela comunidade acadêmica, e pelos analistas. Finalmente, a dissertação descreve algumas práticas que todo gerente de marketing na industria de alta tecnologia deve considerar quando adotando MPM. As sugestões são gerais, mas devem familiarizar o leitor com as informações precisas para habilitar processos e rigor na sua organização com respeito a MPM.