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The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a ‘validity-driven’ approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach’s Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations. Trial Registration: German Clinical Trial Registration (DRKS): . Registered 23 March 2011. [ABSTRACT FROM AUTHOR]

Background: Immigration often results in changes in family dynamics, and within this process of dynamic relational adjustment youth can be conceptualised as contested sites of culture and associated intergenerational conflicts. This paper considers the experiences of migrant youth in Greater Western Sydney, New South Wales, Australia using conflict as a useful lens through which to view issues of migrant youth identity and their sense of social connectedness, belonging, and agency. The aim of this study was twofold: 1) to explore how migrant youth cope with acculturative stress and intergenerational conflicts, and 2) to better understand the systemic and family-related factors that facilitate positive settlement experiences for migrant youth. Methods: A total of 14 focus group discussions, comprising 164 people, were carried out in Greater Western Sydney, New South Wales, Australia. These focus groups targeted newly arrived migrant parents and young adults (aged 18–24) of African, Burmese, Nepalese, Indian, Afghani, Bangladeshi and Iraqi backgrounds. Each focus group was 1.5 hours in duration and was conducted by a team of three people (an experienced facilitator, an accredited interpreter/bilingual worker, and a note taker). Data were collected using a standard interview schedule, and an accredited interpreter/bilingual worker asked the questions in the appropriate language and translated participant responses into English. Results: The findings highlight how youth in new migrant families become contested sites of culture as they try to balance integration into the new culture while maintaining their originating country’s cultural values. Two themes and four subthemes emerged from the analysis: Intergenerational acculturation gap (loss of family capital and intergenerational conflicts); and factors that successfully protected positive family values while still allowing young people to integrate (the legal system that disarm authoritarian parenting practices and family rules; and parental use of children’s increased knowledge of the new environment to navigate their new environment). Migrant families conceptualised family capital as the social solidarity, influence, and control governing obligations and expectations, intergenerational knowledge transmission and information flow, social norms, and cultural identity. The loss of family capital was characterised by children’s refusal to associate with or meet family members, preferring to be alone in their rooms and private space. Migrant youth find themselves caught between and negotiating two cultures, with unwanted negative consequences at the family level in the form of intergenerational conflicts. The new found freedom among children and their rapid transition into the Australian society gives children an increased sense of agency, which in turn threatens parental authority, allowing children to exercise three forms of power: increased assertiveness due to legal protection of children against any corporal punishment; and English language fluency and greater understanding of the functioning of Australian social institutions. Conclusion: Our findings suggest the need for an inter-generational approach to healthy family dynamics within migrant communities when dealing with youth negotiating the complexity and sensitivity of forging their cultural identity. [ABSTRACT FROM AUTHOR]

Background: Building or maintaining institutional trust is of central importance in democratic societies since negative experiences (potentially leading to mistrust) with government or other institutions may have a much more profound effect than positive experiences (potentially maintaining trust). Healthy democracy relies on more than simply trusting the national government of the time, and is mediated through other symbols of institutional power, such as the legal system, banks, the media and religious organisations. This paper focuses on institutional trust–the level and predictors of trust in some of the major institutions in society, namely politics, the media, banks, the legal system and religious organisations. We present analyses from a consolidated dataset containing data from six countries in the Asia Pacific region–Australia, Hong Kong, Japan, South Korea, Taiwan and Thailand. Methods: Cross-sectional surveys were undertaken in each country in 2009–10, with an overall sample of 6331. Analyses of differences in overall levels of institutional trust between countries were undertaken using Chi square analyses. Multivariate binomial logistic regression analysis was undertaken to identify socio-demographic predictors of trust in each country. Results: Religious institutions, banks and the judicial system had the highest overall trust across all countries (70%, 70% and 67% respectively), followed by newspapers and TV (59% and 58%) and then political leaders (43%). The range of levels of higher trust between countries differed from 43% for banks (range 49% in Australia to 92% in Thailand) to 59% for newspapers (28% in Australia to 87% in Japan). Across all countries, except for Australia, trust in political leaders had the lowest scores, particularly in Japan and South Korea (25% in both countries). In Thailand, people expressed the most trust in religious organisations (94%), banks (92%) and in their judicial/legal system (89%). In Hong Kong, people expressed the highest level of trust in their judicial/legal system (89%), followed by religious organisations (75%) and banks (77%). Australian respondents reported the least amount of trust in TV/media (24%) and press/newspapers (28%). South Korea put the least trust in their political leaders (25%), their legal system (43%) and religious organisations (45%). The key predictors of lower trust in institutions across all countries were males, people under 44 years and people unsatisfied with the health and standard of living. Conclusion: We interpreted our data using Fukuyama’s theory of ‘high/low trust’ societies. The levels of institutional trust in each society did not conform to our hypothesis, with Thailand exhibiting the highest trust (predicted to be medium level), Hong Kong and Japan exhibiting medium trust (predicted to be low and high respectively) and Australia and South Korea exhibiting low trust (predicted to be high and medium respectively). Taiwan was the only country where the actual and predicted trust was the same, namely low trust. Given the fact that these predictors crossed national boundaries and institutional types, further research and policy should focus specifically on improving trust within these groups in order that they can be empowered to play a more central role in democratic vitality. [ABSTRACT FROM AUTHOR]

In recent years policy makers and social scientists have devoted considerable attention to wellbeing, a concept that refers to people’s capacity to live healthy, creative and fulfilling lives. Two conceptual approaches dominate wellbeing research. The objective approach examines the objective components of a good life. The subjective approach examines people’s subjective evaluations of their lives. In the objective approach how subjective wellbeing relates to objective wellbeing is not a relevant research question. The subjective approach does investigate how objective wellbeing relates to subjective wellbeing, but has focused primarily on one objective wellbeing indicator, income, rather than the comprehensive indicator set implied by the objective approach. This paper attempts to contribute by examining relationships between a comprehensive set of objective wellbeing measures and subjective wellbeing, and by linking wellbeing research to inequality research by also investigating how subjective and objective wellbeing relate to class, gender, age and ethnicity. We use three waves of a representative state-level household panel study from Queensland, Australia, undertaken from 2008 to 2010, to investigate how objective measures of wellbeing are socially distributed by gender, class, age, and ethnicity. We also examine relationships between objective wellbeing and overall life satisfaction, providing one of the first longitudinal analyses linking objective wellbeing with subjective evaluations. Objective aspects of wellbeing are unequally distributed by gender, age, class and ethnicity and are strongly associated with life satisfaction. Moreover, associations between gender, ethnicity, class and life satisfaction persist after controlling for objective wellbeing, suggesting that mechanisms in addition to objective wellbeing link structural dimensions of inequality to life satisfaction. [ABSTRACT FROM AUTHOR]

This paper presents findings of a recent study which explores rural women's use of an agricultural decision support system, CottonLOGIC, within the Australian cotton industry. Meta-analysis is applied through the theoretical framework of structuration theory while diffusion theory is used for lower level analysis. The concept of communication is applicable to both theories. The significance of CottonLOGIC as a communication medium for technology transfer of industry re-search to cotton farms is evaluated in this paper. The findings suggest that CottonLOGIC is a recognised means of information exchange but even more valuable is the cooperation of stake-holders to influence effective reconstruction of farm management practices and technology usage. [ABSTRACT FROM AUTHOR]

The production of sociological knowledge in Australian universities is explored through an empirical study of research papers published in a selection of academic outlets between 1960 and 2011. Drawing on theories concerning scholarly practices, institutional formation and the sociology of knowledge, questions are posed about the factors that shape and structure the production of sociological knowledge about health and medicine. The concept of intellectual schools is examined, with evidence sought for the presence of these 'knowledge networks' in the Australian context. The study suggests the formation and maintenance of schools are subject to structural factors within the university sector, specifically the relative wealth and prestige of the university and the dictates of the higher education market. [ABSTRACT FROM AUTHOR]

Abstract: Accompanying patients from active treatment towards specialist palliative care is a complex sphere of clinical practice that can be fraught with interpersonal and emotional challenges. While medical specialists are expected to break ‘bad news’ to their patients and ease their transitions to specialist palliative care if required, few have received formal training in such interpersonal complexities. Furthermore, there also often exists clinical ambiguity around whether to continue active treatment vis-à-vis refocusing on quality of life and palliation. In this paper we explore the experiences of twenty Australian medical specialists, focussing on issues such as: dilemmas around when and how to talk about dying and palliation; the art of referral and practices of representation; and, accounts of emotion and subjective influences on referral. The results illustrate how this transitional realm can be embedded in emotions, relationships and the allure of potentially life-prolonging intervention. We argue that the practice of referral should be understood as a relational and contextually-bound process. [Copyright &y& Elsevier]

Abstract: The increasing imperative to find what works in health services has meant a rise in research trialing interventions deemed ‘complex’. While the strength of these interventions comes from taking a ‘whole of problem’ approach using multiple and inter-linking strategies, ways of examining implementation are under-explored. Building sustainability is an important part of implementing complex intervention research, but this too has received little exploration in the implementation literature. This paper explores issues of implementation and sustainability by examining the case of PRISM (Program of Resources, Information and Support for Mothers), a community randomised trial in Victoria, Australia aimed at improving maternal health and wellbeing. It examines documents placed on the project website. Three groups of documents relating to implementation of the intervention were examined – implementation reports, media reports and community newsletters. Analysing these documents allowed a focus on the ‘work’ of the intervention – who does the work and what activities comprise the work – in order to examine implementation as it relates to sustainability. Document analysis provides a useful way of considering implementation and sustainability of complex intervention research. It can ‘value add’ to findings from process evaluation and extend our understanding of an intervention beyond outcome measures. Analysis of the documents in this case provides insights into why sustainability of an intervention may be difficult to achieve during implementation. [Copyright &y& Elsevier]

This paper presents the findings of a qualitative study of the impact of casualised and independent contractor work place arrangements on the psycho-social health of 72 workers in regional Victoria. It contributes to our understanding of the crisis in rural Australia in its use of qualitative methods focusing on the impact of work on health and well-being. There is some evidence in the literature that casualised work arrangement enhance the health and well-being of workers by giving them a sense of autonomy and freedom to negotiate their conditions of work. On the other hand, these arrangements may make an already vulnerable group even more vulnerable to uncertain work conditions, poor pay and uncertainty for their future with a significantly negative impact on their health and wellbeing. The results of these interviews support this latter perspective and show that these workers do not experience freedom and autonomy, but rather lowered social status, insecurity and serious limitations to their ability to manage their health, psychological wellbeing and social relations. [ABSTRACT FROM AUTHOR]

In Australia, fluoridation was first endorsed as an effective, safe and equitable means of improving population oral health over fifty years ago. However, recent opposition to attempts to introduce the measure in several regional Victorian towns has demonstrated that it remains a highly controversial health policy. This paper investigates the history of the Victorian fluoridation debate within a national and international context. It finds that although the evidence concerning fluoridation has advanced considerably, the essential arguments put forward by proponents and opponents have remained largely unchanged over that time. Protagonists incorporate the same scientific evidence yet come to polarised and unshakeable conclusions. I argue that the concept of deep structure ideation is a useful means to understand how this occurs. Furthermore, analysis of the ideas and social processes that determine a partisan position in the fluoridation debate makes this an important case study for approaching other durable scientific controversies. [ABSTRACT FROM AUTHOR]