Between the sea and the sky: A social practice investigation into health behaviours during cruise travel.

ISSUE ADDRESSED: The COVID-19 pandemic has highlighted organised cruise holidays as perfect incubators for microbiological infections due to the constant socialising within closed spaces. Little is known about people's health behaviours and perceptions during cruise holidays. METHODS: Narrative group interviews and respondent photo diary exercises were conducted with families (n = 25) residing in different areas across metropolitan NSW, Australia. Guided by a social practice theoretical approach we undertook a thematic analysis that identifies reasons for choosing a cruise, health considerations and behaviours in relation to cruise travel and awareness of official cruise health information. RESULTS: Cruise travel included a licence to abandon cautious behaviours, reinforced by confidence in the cruise organiser's risk management ability. Health concerns were not a high priority for participants and were mainly understood in terms of eating healthy, modest exercise, managing seasickness and having adequate supplies of medications. Awareness of official cruise health and risk information was largely non-existent. CONCLUSION: Understanding how travel health practices emerge and are likely to be modifiable produces health-promoting awareness and intervention efforts that recognise and link with people's ideas about cruise holidays as times of fun, leisure, relaxation, without interfering with or imposing on them. SO WHAT?: This study highlights the importance of developing health communication and promotion strategies that are responsive to the interconnected meanings, competencies and materials that have a bearing on how cruise travellers understand and enact health-related behaviours in preparation for and during a cruise holiday.

A spatial causal network approach for multi-stressor risk analysis and mapping for environmental impact assessments.

Environmental impact assessment (EIA) relies on rigorous scientific assessment of all potential causal pathways by which large-scale developments may impact on valued assets in a region. Despite their importance to informed decision-making, many EIAs are flawed by incomplete analysis of causal pathways, limited spatial assessment and a lack of transparency about how risks have been evaluated across the region. To address these, we describe an EIA methodology based on network analysis of potential causal pathways in a given region. This network approach is coupled with a systematic evaluation of the likelihood, consequence and mitigation options for each causal pathway from one or more human activities to multiple valued assets. The method includes analysis of the confidence in these evaluations, recognizing where knowledge gaps constrain assessments of risks to particular assets. The causal network approach is complemented by a spatially explicit analysis of the region that allows residual risk (i.e. risk remaining after all feasible mitigations) to be mapped for all valued assets. This identifies which activities could lead to potential impacts of varying concern (rated from 'very low' to 'very high'), their likely pathways, which valued assets are at risk and where these residual risks are greatest. The output maps reveal 'risk hotspots' where more detailed local-scale assessments and monitoring should focus. The method is demonstrated by application to potential impacts on 8 valued assets (aquifers, ecosystems and protected species) due to unconventional gas resource development in the Cooper Basin, central Australia. Results show which activities and causal pathways are of potential concern to different valued assets and where residual risk is greatest for particular species and ecosystems. This spatial causal network provides a systematic, consistent and transparent assessment of potential impacts, improving the quality of decision-making about planned developments and their environmental risks.

Communication's role in overcoming challenges for obesity prevention partnerships.

With obesity rates growing worldwide calls have increased to coordinate efforts in nationwide partnership models. Yet, the necessity for professional partnerships has brought into sharper focus a problem in jointly communicating obesity and its prevention. Following a social representation framework and using episodic interviewing of members from different professions directly or indirectly involved in obesity prevention, this report critically analysed concepts and communicative approaches held by those professional areas. Key findings included different perspectives about communication orientations, namely distribution of responsibility, control and communication goals. This suggests that the profession-specific world-views prevented respondents from communicating with members from other professions. We conclude that health communication experts bring unique skills to bring together professional teams to not only develop a common language and conceptual framework but also facilitate a sense of inclusion and personal accomplishment.

Mediated representations of violence against women in the mainstream news in Australia.

BACKGROUND: How the mainstream news media report violence against women is significant if levels of violence are to be reduced and ultimately eliminated. Media reporting is an important indicator through which to measure progress towards shifting social and cultural norms that reinforce or challenge the place of violence against women in our society. The current study, therefore, aimed to establish a baseline picture of the extent and nature of reporting of violence against women by the mainstream Australian news media. METHODS: Descriptive and content analysis of media reports on violence against women that were collected over four months in three states of Australia. Reports were from newspapers, broadcast (television and radio) and online news sites. RESULTS: Coverage of violence against women in the mainstream news media was extensive. Explicitly situating violent experiences for women within a broader social context was infrequent. Few news reports included information for women on where to seek help. Additionally, news reports rarely elevated the voices of survivors, advocates and other experts, with a disproportionate emphasis on law enforcement, political and criminal justice perspectives. CONCLUSIONS: Despite readiness among journalists and readers to engage in news about violence against women, reporting that promotes public understanding of the issue is not always the norm.

Australian Media Messages: Critical Discourse Analysis of Two Intimate Homicides Involving Domestic Violence.

This study uses critical discourse analysis to examine news reporting of two cases of intimate partner violence in Australia. The fine-grained analysis of newswriting and news-editing practices focuses particularly on the lexical features and referential strategies used to represent the perpetrator and the victim, the crime, and the location of the crime. Findings show that reporting often omits social context, sensationalizes, and acts to shift blame in ways that do not increase public understanding of the nature of domestic violence. These results build on international findings and add to the evidence base about media reporting of violence against women.

Achieving the tobacco endgame: evidence on the hardening hypothesis from repeated cross-sectional studies in New Zealand 2008-2014.

INTRODUCTION: The hardening hypothesis proposes that as smoking prevalence declines the proportion of 'hardcore' or 'hardened' smokers will increase. The possible constructs of hardening include reduced motivation to quit, increased levels of addiction, increased levels of disadvantage and reduced quit rates among continuing smokers. Most previous studies have investigated only a single facet of the hypothesis. We used data from a national population monitor to test the hypothesis using measures across all four hardening constructs. METHODS: We analysed data from a biennial population-based survey of New Zealand adults (aged 15 years+) from 2008 to 2014. Data were collected through face-to-face computer-assisted personal interviews. RESULTS: During a period of reducing smoking prevalence, there were no statistically significant changes in indicators of hardening including the proportion of smokers who were unmotivated to quit, unable to quit despite repeated attempts or receiving state benefits or on a low income. Quit rates did not change significantly over the study period. For 2014 versus 2008, the OR for recent (within last 1-12 months) quitting was 1.14 (95% CI 0.53 to 2.46) and for sustained (within previous 13-24 months) quitting was 1.88 (95% CI 0.78 to 4.54). CONCLUSIONS: This study provides evidence that robust tobacco control strategies that result in substantial declines in smoking prevalence are not accompanied by the hypothesised increase in 'hardcore' or 'hardened' smokers who are more addicted and less motivated and able to quit. The findings suggest that there is no need for substantial change in approach to achieve New Zealand's Smokefree 2025 goal on the grounds that the smoker population is becoming increasingly hardened.

The role of nurses and dietitians in managing paediatric coeliac disease.

Coeliac disease (CD) is an immune-mediated genetic condition elicited by the ingestion of gluten, leading to proximal small bowel enteropathy. It affects around 1% of the population, although only a small proportion of cases are actually diagnosed. It is a multisystem disorder presenting with both gastrointestinal and extra-intestinal manifestations such as diarrhoea, abdominal pain, constipation, vomiting, iron deficiency anaemia, faltering growth, dental enamel defects, short stature, liver disease, arthropathy and recurrent aphthous ulcers. Nurses, working in different clinical settings, are best placed for early recognition and diagnosis of CD in children. Suspicion of CD should lead to immunoglobulin A (IgA)-based anti-tissue transglutaminase antibody screening tests and a diagnosis confirmed by an intestinal biopsy. Modification of European (ESPGHAN) guidelines now enables CD to be diagnosed without a small-bowel biopsy in a select group of symptomatic children. A gluten-free diet should preferably be started by paediatric dietitians. Strict adherence to a gluten-free diet is essential to maintain good health and to prevent long-term complications. A case study demonstrating some of the challenges that may be faced in children with CD in clinical practice is described. Specialist nurse-led CD clinics are gaining popularity and have been found to be equally effective in providing continuity of quality care.

Obese people's perceptions of the thin ideal.

The media play a key role in promoting the thin ideal. A qualitative study, in which we used in depth interviews and thematic analysis, was undertaken to explore the attitudes of 142 obese individuals toward media portrayals of the thin ideal. Participants discussed the thin ideal as a social norm that is also supported through the exclusion of positive media portrayals of obese people. They perceived the thin ideal as an 'unhealthy' mode of social control, reflecting on their personal experiences and their concerns for others. Participants' perceptions highlighted the intersections between the thin ideal and gender, grooming and consumerism. Participants' personal responses to the thin ideal were nuanced--some were in support of the thin ideal and some were able to critically reflect and reject the thin ideal. We consider how the thin ideal may act as a form of synoptical social control, working in tandem with wider public health panoptical surveillance of body weight.

Learning from journalists' experiences of the H1N1 pandemic.

Good working relationships with journalists are needed during public health crises

The role of the fatosphere in fat adults' responses to obesity stigma: a model of empowerment without a focus on weight loss.

Obese adults face pervasive and repeated weight-based stigma. Few researchers have explored how obese individuals proactively respond to stigma outside of a dominant weight-loss framework. Using a grounded theory approach, we explored the experiences of 44 bloggers within the Fatosphere--an online fat-acceptance community. We investigated participants' pathways into the Fatosphere, how they responded to and interacted with stigma, and how they described the impact of fat acceptance on their health and well-being. The concepts and support associated with the fat-acceptance movement helped participants shift from reactive strategies in responding to stigma (conforming to dominant discourses through weight loss) to proactive responses to resist stigma (reframing "fat" and self-acceptance). Participants perceived that blogging within the Fatosphere led them to feel more empowered. Participants also described the benefits of belonging to a supportive community, and improvements in their health and well-being. The Fatosphere provides an alternative pathway for obese individuals to counter and cope with weight-based stigma.

Communicating uncertainty--how Australian television reported H1N1 risk in 2009: a content analysis.

BACKGROUND: Health officials face particular challenges in communicating with the public about emerging infectious diseases of unknown severity such as the 2009 H1N1(swine 'flu) pandemic (pH1N1). Statements intended to create awareness and convey the seriousness of infectious disease threats can draw accusations of scare-mongering, while officials can be accused of complacency if such statements are not made. In these communication contexts, news journalists, often reliant on official sources to understand issues are pivotal in selecting and emphasising aspects of official discourse deemed sufficiently newsworthy to present to the public. This paper presents a case-study of news communication regarding the emergence of pH1N1. METHODS: We conducted a content analysis of all television news items about pH1N1. We examined news and current affairs items broadcast on 5 free-to-air Sydney television channels between April 25 2009 (the first report) and October 9 (prior to the vaccine release) for statements about [1] the seriousness of the disease [2] how the public could minimise contagion [3] government responses to emerging information. RESULTS: pH1N1 was the leading health story for eight of 24 weeks and was in the top 5 for 20 weeks. 353 news items were identified, yielding 3086 statements for analysis, with 63.4% related to the seriousness of the situation, 12.9% providing advice for viewers and 23.6% involving assurances from government. Coverage focused on infection/mortality rates, the spread of the virus, the need for public calm, the vulnerability of particular groups, direct and indirect advice for viewers, and government reassurances about effective management. CONCLUSIONS: Overall, the reporting of 2009 pH1N1 in Sydney, Australia was generally non-alarmist, while conveying that pH1N1 was potentially serious. Daily infection rate tallies and commentary on changes in the pandemic alert level were seldom contextualised to assist viewers in understanding personal relevance. Suggestions are made about how future reporting of emerging infectious diseases could be enhanced.

Media Reporting of Suicide Methods.

Internationally, media guidelines on the reporting of suicide suggest that the method of suicide should not be explicitly reported. This paper presents quantitative data on the reporting of suicide in Australia, which suggest that the media present a skewed image of reality with an over-reporting of suicide by violent and unusual methods. It also presents qualitative textual analyses of examples of newspaper reports of suicide in an attempt to examine differences in reporting practices across media and genres and to explore the limits of the notion of "explicitness." The paper concludes that journalistic decisions to maximize the newsworthiness of a story often conflict with the promotion of the accurate, ethical, and responsible reporting of suicide.