Food acculturation experiences of new Iranian skilled migrant mothers in South Australia.

AIM: This research aimed to investigate the food acculturation experiences of Iranian mothers who have migrated to Australia. METHODS: The study used qualitative methodology to interview seven mothers with children aged 5 to 15 years, who: carried primary responsibility for family food provisioning; arrived in Australia within the last 5 years; and spoke reasonably fluent English. RESULTS: Seven mothers were interviewed, and the findings revealed three broad themes: (a) adjusting to foods/foodways in Australia (b) sociocultural identity and (c) children and intergenerational conflict. The study highlighted psychosocial and economic stresses associated with food acculturation for this immigrant group. The impact of food acculturation on immigrant health is intricately linked to the complex balance between maintaining traditional cultural identity and practices, while at the same time adapting to the food culture and practices of the new home. CONCLUSIONS: Dietitians and healthcare professionals working with such immigrant groups need to consider food acculturation stress as a factor contributing to the health risks of new immigrants.

Characterizing screening strategies for type 2 diabetes in high-risk ethnic communities: a scoping review protocol.

OBJECTIVE: This review aims to identify the characteristics of screening strategies for type 2 diabetes to determine the most pragmatic approach to improve relevance to high-risk community groups from ethnically diverse backgrounds. INTRODUCTION: Type 2 diabetes is increasingly contributing to the global burden of disease and is more common in some community groups. Although screening underpins the success of primary prevention programs for type 2 diabetes, screening of high-risk community groups from ethnically diverse backgrounds require different screening protocols and can be challenging. These strategies have never been systematically scoped. INCLUSION CRITERIA: This scoping review will consider screening strategies for type 2 diabetes that target high-risk ethnic community groups. Studies with adults older than 18 years will be considered for inclusion. Screening strategies may include, but are not limited to, risk-assessment questionnaires, blood tests, or both, using an opportunistic approach involving general practices or a targeted approach toward high-risk community groups from ethnically diverse backgrounds. Experimental and observational quantitative studies and mixed methods studies will be included. METHODS: MEDLINE, CINAHL, PsycINFO, Informit, ProQuest, Web of Science, and Scopus will be searched. Studies will be screened for inclusion by two independent reviewers, and data will be extracted using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Results will be summarized in tables accompanied by narrative text.

Migration, Stress and the Challenges of Accessing Food: An Exploratory Study of the Experience of Recent Afghan Women Refugees in Adelaide, Australia.

This study explored the migration and food experiences of Afghani women refugees residing in Adelaide, South Australia for 2 years or less. In-depth semi-structured qualitative interviews were conducted with 10 women between May and September 2017. The data were thematically analysed, and the Social Determinants of Health Framework was used to discuss the findings. Five key themes emerged from the data. In the transition country (Iran/Pakistan), respondents experienced (i) trauma, discrimination and exclusion and (ii) familiar food culture, but food stress. In the destination country (Adelaide, Australia) respondents experienced (iii) a sense of precariousness, (iv) unfamiliar food culture and (v) challenges in accessing halal food. Afghani refugees experienced considerable stressors both in the transition and the final destination country but for different reasons. In the transition country, stresses related to the lack of social services and support, discrimination, racism and poverty seemed to have affected their ability to afford food. In Australia stressors pertaining to socioeconomic, housing and employment precariousness, as well as difficulties in accessing halal foods were identified as challenges. Furthermore, food stress in Australia was associated with the cultural appropriateness of food, the complexity of the food system, and the women's lack of skills and experiences in navigating the food system. With increasing refugee and immigration flows globally, it is necessary to acknowledge how food and social determinants intersect for refugee immigrants to ensure positive health outcomes.

Feeding Mode of Australian Infants in the First 12 Months of Life.

BACKGROUND: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. OBJECTIVES: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. METHODS: Mother-infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. RESULTS: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. CONCLUSION: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation.

Validity and reliability of a nutrition screening tool in hospitalized patients.

OBJECTIVE: The British nutrition screening tool is a questionnaire designed to assess the nutrition status of hospitalized patients by nurses. The aim of this study was to evaluate the validity and reliability of this questionnaire in patients on admission to the hospital in Tehran. METHODS: For 6 mo, 446 patients aged over 18 y admitted to different wards of a general hospital were studied within the first 24 h of admission. A nutritionist undertook nutritional assessment in all patients to determine their nutritional status as an objective standard. Then a nurse completed the screening tool for patients. Results obtained using the screening tool were compared with those of the nutritional assessment to calculate the sensitivity, specificity, and predictive values. The interrater reliability of the tool was assessed by two nurses who completed the screening tool separately during the first 24 h following admission of each patient. It was also completed by a nurse within 2-d period of admission to test the intrarater reliability. RESULTS: Study participants included 229 women and 217 men with mean age of 49.5 ± 16.0 y. Sensitivity and specificity of the questionnaire were 86.7% (95% CI: 83.9-90.3%) and 61.7% (95% CI: 57.5-66.5%), respectively. Positive and negative predictive values were 79.1% (95% CI: 68.9-77.1%) and 73.1% (95% CI: 75.1-82.9), respectively. The sensitivity of the tool was over 80% for both genders, for all body mass index grades, and for data obtained from gastroenterology, transplant, oncology, and hematology wards. The interrater reliability of screening tool was interpreted as substantial, being k = 0.68 and k = 0.74 on both the first and second days, respectively. The intrarater reliability of the screening tool was also interpreted as substantial, being k = 0.77. CONCLUSION: The nutrition screening tool is a simple, valid, and reliable tool that can be used by nurses to facilitate identification of patients requiring nutritional interventions.