Insufficient evidence on health literacy amongst Indigenous people with cancer: a systematic literature review.

BACKGROUND: Indigenous people experience poorer cancer survival outcomes compared with non-Indigenous people. Currently, there is growing awareness of poor health literacy as a determinant of cancer outcomes. However, little attention has been given to researching cancer-related health literacy amongst Indigenous people. OBJECTIVES: To systematically review empirical studies of cancer health literacy amongst Indigenous people worldwide. METHODS: Articles were identified in Medline (1946-2013); Pre-Medline; CINAHL; PsycINFO (1967-2013); PubMed; Current Contents/All Editions (1993-2013); Allied Health and Complimentary Medicine (1985-2013), and in the reference lists of retrieved articles and by expert consultation. 64 abstracts were screened for inclusion and 16 articles were retained. RESULTS: There is a paucity of high-quality research concerning of health literacy amongst Indigenous cancer patients. No articles used formal measures of health literacy and data on the prevalence of health literacy was not reported. Of the 7 articles describing interventions only one included a control group and the remainder employed quasi-experimental methods. CONCLUSIONS: Research is needed to explore the cultural relevance of existing measures of health literacy and to document the prevalence of health literacy amongst Indigenous people with cancer. A better understanding of Indigenous cancer patients' health literacy is required before health literacy interventions can be designed to improve Indigenous cancer outcomes.

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review.

BACKGROUND: Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. OBJECTIVE: The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. METHODS: Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. RESULTS: Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. CONCLUSIONS: A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes.

THE COGNITIVE COMPETENCES OF IMMIGRANT AND NATIVE STUDENTS ACROSS THE WORLD: AN ANALYSIS OF GAPS, POSSIBLE CAUSES AND IMPACT.

Immigration, immigration policies and education of immigrants alter competence levels. This study analysed their effects using PISA, TIMSS and PIRLS data (1995 to 2012, N=93 nations) for natives' and immigrants' competences, competence gaps and their population proportions. The mean gap is equivalent to 4.71 IQ points. There are large differences across countries in these gaps ranging from around +12 to -10 IQ points. Migrants' proportions grow roughly 4% per decade. The largest immigrant-based 'brain gains' are observed for Arabian oil-based economies, and the largest 'brain losses' for Central Europe. Regarding causes of native-immigrant gaps, language problems do not seem to explain them. However, English-speaking countries show an advantage. Acculturation within one generation and intermarriage usually reduce native-immigrant gaps (≅1 IQ point). National educational quality reduces gaps, especially school enrolment at a young age, the use of tests and school autonomy. A one standard deviation increase in school quality represents a closing of around 1 IQ point in the native-immigrant gap. A new Greenwich IQ estimation based on UK natives' cognitive ability mean is recommended. An analysis of the first adult OECD study PIAAC revealed that larger proportions of immigrants among adults reduce average competence levels and positive Flynn effects. The effects on economic development and suggestions for immigration and educational policy are discussed.

A tertiary approach to improving equity in health: quantitative analysis of the Maori and Pacific Admission Scheme (MAPAS) process, 2008-2012.

INTRODUCTION: Achieving health equity for indigenous and ethnic minority populations requires the development of an ethnically diverse health workforce. This study explores a tertiary admission programme targeting Maori and Pacific applicants to nursing, pharmacy and health sciences (a precursor to medicine) at the University of Auckland (UoA), Aotearoa New Zealand (NZ). Application of cognitive and non-cognitive selection tools, including a Multiple Mini Interview (MMI), are examined. METHODS: Indigenous Kaupapa Maori methodology guided analysis of the Maori and Pacific Admission Scheme (MAPAS) for the years 2008-2012. Multiple logistic regression models were used to identify the predicted effect of admission variables on the final MAPAS recommendation of best starting point for success in health professional study i.e. 'CertHSc' (Certificate in Health Sciences, bridging/foundation), 'Bachelor' (degree-level) or 'Not FMHS' (Faculty of Medical and Health Sciences). Regression analyses controlled for interview year, gender and ancestry. RESULTS: Of the 918 MAPAS interviewees: 35% (319) were Maori, 58% (530) Pacific, 7% (68) Maori/Pacific; 71% (653) school leavers; 72% (662) females. The average rank score was 167/320, 40-80 credits below guaranteed FMHS degree offers. Just under half of all interviewees were recommended 'CertHSc' 47% (428), 13% (117) 'Bachelor' and 38% (332) 'Not FMHS' as the best starting point. Strong associations were identified between Bachelor recommendation and exposure to Any 2 Sciences (OR:7.897, CI:3.855-16.175; p < 0.0001), higher rank score (OR:1.043, CI:1.034-1.052; p < 0.0001) and higher scores on MAPAS mathematics test (OR:1.043, CI:1.028-1.059; p < 0.0001). MMI stations had mixed associations, with academic preparation and career aspirations more consistently associated with recommendations. CONCLUSIONS: Our findings raise concerns about the ability of the secondary education sector to prepare Maori and Pacific students adequately for health professional study. A comprehensive tertiary admissions process using multiple tools for selection (cognitive and non-cognitive) and the provision of alternative entry pathways are recommended for indigenous and ethnic minority health workforce development. The application of the MMI within an equity and indigenous cultural context can support a holistic assessment of an applicant's potential to succeed within tertiary study. The new MAPAS admissions process may provide an exemplar for other tertiary institutions looking to widen participation via equity-targeted admission processes.

Ngati and healthy: translating diabetes prevention evidence into community action.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a major health issue in New Zealand Maori. Clinical trials have demonstrated potential for the prevention of T2DM, but whether community public health programmes aiming to prevent diabetes are effective is untested. OBJECTIVE: To describe the planning and design of an intervention aiming to translate T2DM prevention clinical trial evidence into a community-wide population health intervention in a high risk predominantly Maori community. APPROACH: Community concerns about the diabetes burden were heard by the local diabetes nurse, herself a tribal member, and discussed with a locally raised academic. Project planning ensued. The intervention and its evaluation were designed using a participatory community development model. The planned intervention had three components: community-wide health promotion initiatives conveying healthy lifestyle messages, community education and monitoring for identified high-risk individuals and their extended families, and a structural strategy aimed at adapting local environments to support lifestyle changes. The evaluation plan involved interrupted time series surveys coupled with formative and process evaluations rather than a randomised control trial design. DISCUSSION: Consulting communities, validating community concerns and prioritising cultural and ethical issues were key steps. Time spent developing good relationships amongst the health provider and academic research team members at the outset proved invaluable, as the team were united in addressing the project planning and implementation challenges, such as funding obstacles that arose because of our ethically and culturally appropriate non-randomised control trial evaluation design. The pre-intervention survey demonstrated high rates of diabetes (13%), insulin resistance (33%) and risk factors, and provided evidence for positive, as opposed to negative, lifestyle intervention messages. CONCLUSION: Community-wide lifestyle interventions have the potential to reduce rates of type 2 diabetes and other chronic diseases in high-risk communities, but require a high level of commitment from the health sector and buy-in from the community. Adequate commitment, leadership, planning and resources are essential.

Introducing embedded indigenous psychological support teams: a suggested addition to psychological first aid in an international context.

The current article introduces Embedded Indigenous Psychological Support Teams (IPST) as a possible addition to current disaster relief efforts. This article highlights psychological first aid in an international context by drawing on mainstream disaster relief models such as The American Red Cross, Critical Incident Stress Management, and Flexible Psychological First Aid. IPST are explained as teams utilizing techniques from both CISM and FPFA with a focus on resiliency. It is currently theorized that in utilizing IPST existing disaster relief models may be more effective in mitigating negative physical or mental health consequences post-disaster.

Pathways to El Norte: origins, destinations, and characteristics of Mexican migrants to the United States.

The geography Mexican migration to the U.S. has experienced deep transformations in both its origin composition and the destinations chosen by migrants. To date, however, we know little about how shifting migrant origins and destinations may be linked to each another geographically and, ultimately, structurally as relatively similar brands of economic restructuring have been posited to drive the shifts in origins and destinations. In this paper, we describe how old and new migrant networks have combined to fuel the well-documented geographic expansion of Mexican migration. We use data from the 2006 Mexican National Survey of Population Dynamics, a nationally representative survey that for the first time collected information on U.S. state of destination for all household members who had been to the U.S. during the 5 years prior to the survey. We find that the growth in immigration to southern and eastern states is disproportionately fueled by undocumented migration from non-traditional origin regions located in Central and Southeastern Mexico and from rural areas in particular. We argue that economic restructuring in the U.S. and Mexico had profound consequences not only for the magnitude but also for the geography of Mexican migration, opening up new region-to-region flows.

We really are all multiculturalists now.

Treating multiculturalism as a social fact, this article develops the argument that it ought to be construed as a form of political claims-making advanced by spokespersons on behalf of what can be described as communities of fate. After brief examinations of the claims-makers and those groups that claims are made on behalf of, five types of claims are analyzed: (1) exemption, (2) accommodation, (3) preservation, (4) redress, and (5) inclusion. This leads to a concluding section devoted to analyzing the politics of identity as constituting an effort to ovecome the burdens of stigmatization, with a focus on the respective contributions of Goffman, Taylor, and Alexander.

Race and imprisonments: vigilante violence, minority threat, and racial politics.

The effects of lynchings on criminal justice outcomes have seldom been examined. Recent findings also are inconsistent about the effects of race on imprisonments. This study uses a pooled time-series design to assess lynching and racial threat effects on state imprisonments from 1972 to 2000. After controlling for Republican strength, conservatism, and other factors, lynch rates explain the growth in admission rates. The findings also show that increases in black residents produce subsequent expansions in imprisonments that likely are attributable to white reactions to this purported menace. But after the percentage of blacks reaches a substantial threshold­and the potential black vote becomes large enough to begin to reduce these harsh punishments­reductions in prison admissions occur. These results also confirm a political version of racial threat theory by indicating that increased Republican political strength produces additional imprisonments.

The new "new racism" thesis: limited government values and race-conscious policy attitudes.

Some contend that Whites' application of values to form opinions about race-conscious policy may constitute a subtle form of racism. Others challenge the new racism thesis, suggesting that racism and values are exclusive in their influence. Proponents of the thesis assert that many Whites' attitudes about such policy are structured by a mix of racism and American individualism. The author suggests that an even more subtle form of racism may exist. Racism may actually be expressed in opposition to big government. The test results presented here indicate that the effects of limited-government values on attitudes about race-conscious policy are conditional on levels of racial prejudice for many Whites, whereas the effects on racially ambiguous social welfare policy attitudes are not. The author contends that these results provide support to the argument that racism still exists and has found a new subtle expression.

"I have seen the future": selling the unsustainable city.

Seventy years ago, General Motors' Highways and Horizons exhibit at the World's Fair, designed by Norman Bel Geddes and Eero Saarinen, promoted demand for cars and federal highways without any concern for environmental sustainability, the theme of our 2010 conference. The main exhibit included a sequence of four parts (entrance ramps, map lobby, Futurama ride, and "intersection of 1960") where the viewer's perception of spatial scale was manipulated. Setha M. Low's theory of "embodied space" helps decode why movement through these diverse spaces influenced millions of Americans' views of transportation and urban form, a promotional success yet to be equaled by advocates of environmental sustainability.

Evangelical Church polity and the nuances of white flight: a case study from the Roseland and Englewood neighborhoods in Chicago.

Present patterns of residential segregation have been proven to have antecedents in the so-called white flight of the 1950s, 1960s, and 1970s. Close scrutiny of this social phenomenon has yielded results that indicate complicated impetuses and call into question sweeping assumptions about white flight. A case study of seven congregations from a denomination called the Christian Reformed Church in North America (CRC) who left the Englewood and Roseland neighborhoods of Chicago during the juncture in question further reveals the dubious role of religious practices and arrangements in the out-migration of white evangelical Christians. By utilizing church histories, council minutes, and field interviews, it became readily apparent that the departure of the members of these congregations found sanction within the hierarchical apparatus (or lack thereof) of the church. The response of these CRC congregations exemplified how the political structures (congregational polity) and social networks of a particular denomination could allow for an almost seamless process of white flight.

Providing local color?: "cape coloreds," "cockneys," and Cape Town's identity from the late nineteenth century to the 1970s.

Jim Dyos, founding-father of British urban history, argued that cities have commonly acknowledged "individual characteristics" that distinguish them. Such distinctive characteristics, though usually based on material realities, are promoted through literary and visual representations. This article argues that those who seek to convey a city's distinctiveness will do so not only through describing its particular topography, architecture, history or functions but also by describing its "local colour": the supposedly unique customs, manner of speech, dress, or other special features of its inhabitants. In colonial cities this process involved white racial stereotyping of "others". In Cape Town, depictions of "Coloured" inhabitants as unique "city types" became part of the city's "destination branding". The article analyses change and continuity in such representations. To this end it draws on the insights of Gareth Stedman Jones into changing depictions of London's "Cockneys" and the insights of Stephen Ward into historical "place-selling".

Feeding the family during times of stress: experience and determinants of food insecurity in an Inuit community.

This paper uses a mixed methods approach to characterise the experience of food insecurity among Inuit community members in Igloolik, Nunavut, and examine the conditions and processes that constrain access, availability, and quality of food. We conducted semi-structured interviews (n= 66) and focus groups (n= 10) with community members, and key informant interviews with local and territorial health professionals and policymakers (n= 19). The study indicates widespread experience of food insecurity. Even individuals and households who were food secure at the time of the research had experienced food insecurity in the recent past, with food insecurity largely transitory in nature. Multiple determinants of food insecurity operating over different spatial-temporal scales are identified, including food affordability and budgeting, food knowledge and preferences, food quality and availability, environmental stress, declining hunting activity, and the cost of harvesting. These determinants are operating in the context of changing livelihoods and climate change, which in many cases are exacerbating food insecurity, although high-order manifestations of food insecurity (that is, starvation) are no longer experienced.

Variations in the gender composition of immigrant populations: how they matter.

This paper estimates and interprets empirical shifts in the gender composition of immigrants to add to scholarship about the gendering of international migrations over time. We map shifts in gender ratios using micro-level data that permit us to create age-standardized estimates among adult foreign born stock living in the United States since 1850 and in 26 other nations worldwide since 1960. We examine regional and national variations in these shifts, and ask whether and how the gendered composition of foreigners from diverse origins in the United States ­ the nation that has received the largest populations of migrants for over a century ­ differs from other nations that receive large numbers of immigrants. We also examine recent variations in gender ratios among immigrants living in six regional destination countries. Results show substantial variation in the gender composition of foreign-born populations, and they offer a starting point for examining causes and consequences in future research.

Cultural dissimilarity and intermarriage. a longitudinal study of immigrants in Sweden, 1990­2005.

Intermarriage with natives is a key indicator of immigrant integration. This article studies intermarriage for 138 immigrant groups in Sweden, using longitudinal individual level data. It shows great variation in marriage patterns across immigrant populations, ranging from over 70 percent endogamy in some immigrants groups to below 5 percent in other groups. Although part of this variation is explained by human capital and the structure of the marriage market, cultural factors (values, religion, and language) play an important role as well. Immigrants from culturally more dissimilar countries are less likely to intermarry with natives, and instead more prone to endogamy.

Making time for the children: self-temporalization and the cultivation of the antisuicidal subject in south India.

This article examines suicide prevention among children in India's "suicide capital" of Kerala to interrogate the ways temporalization practices inform the cultivation of ethical, life-avowing subjects in late capitalism. As economic liberalization and migration expand consumer aspiration in Kerala, mental health experts link the quickening of material gratification in middle-class parenting to the production of insatiable, maladjusted, and impulsively suicidal children. Experiences of accelerated time through consumption in "modern" Kerala parenting practice reflect ideas about the threats of globalization that are informed both by national economic shifts and by nostalgia for the state's communist and developmentalist histories, suggesting that late capitalism's time­space compression is not a universalist phenomenon so much as one that is unevenly experienced through regionally specific renderings of the past. I demonstrate how experts position the Malayali child as uniquely vulnerable to the fatal dangers of immediate gratification, and thus exhort parents to retemporalize children through didactic games built around the deferral of desires for everyday consumer items. Teaching children how to wait as a pleasurable and explicitly antisuicidal way of being reveals anxieties, contestations, and contradictions concerning what ought to constitute "quality" investment in children as temporal subjects of late capitalism. The article concludes by bringing efforts to save elite lives into conversation with suicide prevention among migrants to draw out the ways distinct vulnerabilities and conditions of precarity situate waiting subjects in radically different ways against the prospect of self-destruction.

Pressure: the politechnics of water supply in Mumbai.

In Mumbai, most all residents are delivered their daily supply of water for a few hours every day, on a water supply schedule. Subject to a more precarious supply than the city's upper-class residents, the city's settlers have to consistently demand that their water come on "time" and with "pressure." Taking pressure seriously as both a social and natural force, in this article I focus on the ways in which settlers mobilize the pressures of politics, pumps, and pipes to get water. I show how these practices not only allow settlers to live in the city, but also produce what I call hydraulic citizenship­a form of belonging to the city made by effective political and technical connections to the city's infrastructure. Yet, not all settlers are able to get water from the city water department. The outcomes of settlers' efforts to access water depend on a complex matrix of socionatural relations that settlers make with city engineers and their hydraulic infrastructure. I show how these arrangements describe and produce the cultural politics of water in Mumbai. By focusing on the ways in which residents in a predominantly Muslim settlement draw water despite the state's neglect, I conclude by pointing to the indeterminacy of water, and the ways in which its seepage and leakage make different kinds of politics and publics possible in the city.