Barriers and enablers influencing female athlete return-to-sport postpartum: a scoping review.

OBJECTIVE: Motherhood within sport has become more common with many female athletes seeking to return-to-sport (RTS) postpartum; yet few sport organisations possess policies that support female athletes to RTS postpartum. Our aim was to synthesise existing literature to identify the barriers and enablers that influence female athlete RTS postpartum to help guide the development of evidence-based policies to support postpartum athlete RTS. DESIGN: Scoping review. DATA SOURCES: Ovid-Medline, Embase, SportDiscus and Scopus were systematically searched. Reference lists of eligible studies were also searched to identify additional studies of relevance. ELIGIBILITY CRITERIA: Original, empirical, peer-reviewed, English-language studies reporting on female athletes and their RTS postpartum. Reviews, book chapters and grey literature were excluded. RESULTS: Twenty-two studies were included in this review. Identified barriers and enablers reflected 11 categories which occurred within and/or across three domains of the socioecological model. Five key factors were found to significantly influence female athlete RTS postpartum including (1) postpartum recovery time; (2) time to manage motherhood and sport demands; (3) sport organisation policies; (4) stereotypes; and (5) social support. CONCLUSION: Various barriers and enablers exist that influence successful RTS postpartum. These factors present opportunities for clinicians and sport organisations to improve their support of postpartum athletes. Paid maternity leave, offering job security, travel support for carer and child and affordable and accessible childcare are critical policy inclusions to appropriately support female athletes in their RTS postpartum.

A mixed-methods exploration of attitudes towards pregnant Facebook fitness influencers.

BACKGROUND: Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. METHODS: A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. RESULTS: The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being 'like' (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. CONCLUSIONS: User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information.

Experience and Satisfaction with a Family-Based Physical Activity Intervention Using Activity Trackers and Apps: A Qualitative Study.

Wearable activity trackers and smartphone apps have been shown to increase physical activity in children and adults. However, interventions using activity trackers and apps have rarely been tested in whole families. This study examined the experience and satisfaction with an activity tracker and app intervention (Step it Up Family) to increase physical activity in whole families. Telephone interviews were conducted with Queensland-based families (n = 19) who participated in the Step it Up Family intervention (N = 40, single-arm, pre/post feasibility study) in 2017/2018. Using commercial activity trackers combined with apps, the intervention included an introductory session, individual and family-level goal setting, self-monitoring, family step challenges, and weekly motivational text messages. Qualitative content analysis was conducted to identify themes, categories and sub-categories. In summary, parents reported that children were engaged with the activity tracker and app features to reach their daily step goals. Some technical difficulties were experienced with app navigation, syncing of activity tracker data, and tracker band discomfort. Although families liked that the weekly text messages reminded them to be active, they did not find them very motivating. Using text messages for physical activity motivation in families requires further testing. Overall, the intervention was well-received by families for increasing physical activity motivation.

What is the effectiveness of a personalised video story after an online diabetes risk assessment? A Randomised Controlled Trial.

BACKGROUND: Online risk assessment tools for type 2 diabetes communicate risk information to motivate individuals to take actions and reduce their risk if needed. The impact of these tools on follow-up behaviours (e.g., General Practitioner (GP) visits, improvement in health behaviours) is unknown. This study examined effectiveness of a personalised video story and text-based message on GP and health professional visitations and health behaviours, of individuals assessed as 'high risk' following completion of the online Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). METHODS: A Randomised Controlled Trial (conducted between October 2018 and April 2019) included 477 participants with a high score (≥12). The control group received a text-based message (TM) and the intervention group received both the text-based message and a personalised video story (TM+VS) encouraging them to take follow-up action. Participants reported follow-up actions (one- and three months), and physical activity (PA), dietary behaviours and body weight (baseline, one and three months). Generalized Linear Mixed Models and chi-squared tests were used to test differences in outcomes between groups over time. RESULTS: The intervention was not more effective for the TM+VS group compared to the TM only group (p-values>0.05 for all outcomes). More participants in the TM only group (49.8% compared to 40.0% in the VS+TM group) visited either a GP or health professional (p = 0.18). During the 3-month follow-up: 44.9% of all participants visited a GP (36.7%) and/or other health professional (31.0%). Significant improvements were found between baseline and three months, in both groups for weekly physical activity, daily fruit and vegetable intake and weight status. CONCLUSIONS: Messages provided with online diabetes risk assessment tools to those with high-risk, positively influence GP and health professional visitations and promote short-term improvements in health behaviours that may contribute to an overall reduction in the development of type 2 diabetes. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry; ACTRN12619000809134.

The association of resilience with depression, anxiety, stress and physical activity during the COVID-19 pandemic.

BACKGROUND: COVID-19 has resulted in substantial global upheaval. Resilience is important in protecting wellbeing, however few studies have investigated changes in resilience over time, and associations between resilience with depression, anxiety, stress, and physical activity during the COVID-19 pandemic. METHODS: Online surveys were conducted to collect both longitudinal and cross-sectional data at three time points during 2020. Australian adults aged 18 years and over were invited to complete the online surveys. Measures include the six-item Brief Resilience Scale, the 21-item Depression, Anxiety and Stress Scale, and the Active Australia Survey which have eight items identifying the duration and frequency of walking, and moderate and vigorous physical activities (MVPA), over the past 7 days. General linear mixed models and general linear models were used in the analysis. RESULTS: In the longitudinal sample, adjusted differences (aDif) in resilience scores did not significantly change over time (time 2 vs. time 1 [aDif = - 0.02, 95% CI = - 0.08, 0.03], and time 3 vs. time 1 [aDif = < 0.01, 95% CI = - 0.07, 0.06]). On average, those engaging in at least 150 min of MVPA per week (aDif = 0.10, 95% CI = 0.04, 0.16), and having depression (aDif = 0.40, 95% CI = 0.33), anxiety (aDif = 0.34, 95% CI = 0.26, 0.41), and stress scores (aDif = 0.30, 95% CI = 0.23, 0.37) within the normal range had significantly higher resilience scores. The association between resilience and physical activity was independent of depression, anxiety, and stress levels. All results were similar for the cross-sectional sample. CONCLUSIONS: Resilience scores did not change significantly during the COVID-19 pandemic. However, there were significant associations between resilience with physical activity and psychological distress. This research helps inform future interventions to enhance or nurture resilience, particularly targeted at people identified as at risk of psychological distress.

Local adaptation in a marine foundation species: Implications for resilience to future global change.

Environmental change is multidimensional, with local anthropogenic stressors and global climate change interacting to differentially impact populations throughout a species' geographic range. Within species, the spatial distribution of phenotypic variation and its causes (i.e., local adaptation or plasticity) will determine species' adaptive capacity to respond to a changing environment. However, comparatively less is known about the spatial scale of adaptive differentiation among populations and how patterns of local adaptation might drive vulnerability to global change stressors. To test whether fine-scale (2-12 km) mosaics of environmental stress can cause adaptive differentiation in a marine foundation species, eelgrass (Zostera marina), we conducted a three-way reciprocal transplant experiment spanning the length of Tomales Bay, CA. Our results revealed strong home-site advantage in growth and survival for all three populations. In subsequent common garden experiments and feeding assays, we showed that countergradients in temperature, light availability, and grazing pressure from an introduced herbivore contribute to differential performance among populations consistent with local adaptation. Our findings highlight how local-scale mosaics in environmental stressors can increase phenotypic variation among neighboring populations, potentially increasing species resilience to future global change. More specifically, we identified a range-center eelgrass population that is pre-adapted to extremely warm temperatures similar to those experienced by low-latitude range-edge populations of eelgrass, demonstrating how reservoirs of heat-tolerant phenotypes may already exist throughout a species range. Future work on predicting species resilience to global change should incorporate potential buffering effects of local-scale population differentiation and promote a phenotypic management approach to species conservation.

Rapid enhancement of multiple ecosystem services following the restoration of a coastal foundation species.

The global decline of marine foundation species (kelp forests, mangroves, salt marshes, and seagrasses) has contributed to the degradation of the coastal zone and threatens the loss of critical ecosystem services and functions. Restoration of marine foundation species has had variable success, especially for seagrasses, where a majority of restoration efforts have failed. While most seagrass restorations track structural attributes over time, rarely do restorations assess the suite of ecological functions that may be affected by restoration. Here we report on the results of two small-scale experimental seagrass restoration efforts in a central California estuary where we transplanted 117 0.25-m2 plots (2,340 shoots) of the seagrass species Zostera marina. We quantified restoration success relative to persistent reference beds, and in comparison to unrestored, unvegetated areas. Within three years, our restored plots expanded ~8,500%, from a total initial area of 29 to 2,513 m2 . The restored beds rapidly began to resemble the reference beds in (1) seagrass structural attributes (canopy height, shoot density, biomass), (2) ecological functions (macrofaunal species richness and abundance, epifaunal species richness, nursery function), and (3) biogeochemical functions (modulation of water quality). We also developed a multifunctionality index to assess cumulative functional performance, which revealed restored plots are intermediate between reference and unvegetated habitats, illustrating how rapidly multiple functions recovered over a short time period. Our comprehensive study is one of few published studies to quantify how seagrass restoration can enhance both biological and biogeochemical functions. Our study serves as a model for quantifying ecosystem services associated with the restoration of a foundation species and demonstrates the potential for rapid functional recovery that can be achieved through targeted restoration of fast-growing foundation species under suitable conditions.

Differential Effects of Intuitive and Disordered Eating on Physical and Psychological Outcomes for Women with Young Children.

OBJECTIVES: Pressure to lose weight can increase the risk of developing disordered eating behaviours, negative body image and depressive symptomatology. Eating intuitively may counteract these negative outcomes. This research examined the unique relationship between intuitive eating and disordered eating on body mass index (BMI), body image and depressive symptoms for women of young children. METHODS: A survey of women with a child aged between six and 48 months, included the Intuitive Eating Scale, Eating Attitudes Test-26, Body Shape Questionnaire and Edinburgh Postnatal Depression Scale. Multivariate analysis of variance (MANOVA) was conducted as an omnibus test to estimate the effect of intuitive and disordered eating on BMI, negative body image and depressive symptoms. RESULTS: Of the 419 sample (M age = 32.06), 32% were classified with disordered and 32% with intuitive eating. MANOVA and regression analysis found disordered eating positively associated with depressive symptoms, (ß = 0.303) and negative body image (ß = 0.318). Intuitive eating was associated with lower depressive symptoms (ß = - 0.183) and negative body image (ß = - 0.615). Disordered eating (ß = - 0.194) and intuitive eating (ß = - 0.586) both contributed to lower BMI, with the association stronger for intuitive eating. CONCLUSION: The early parenting period involves a high risk for developing disordered eating behaviours. Eating patterns are modifiable factors, illustrating the potential for positive and preventive health outcomes through adopting intuitive eating behaviours. There is an opportunity for healthcare professionals to promote physical and psychological health including for women in the early parenting period.

How are COVID-19 knowledge and concern associated with practising preventive behaviours in Australian adults?

OBJECTIVE: This study investigated the association between COVID-19 prevention knowledge and concern and practising preventive behaviour in Australian adults. METHODS: Using an online survey, knowledge of Australian COVID-19 guidelines, concerns about pandemic impact, the practice of preventive behaviours, and sociodemographic variables (i.e. age, gender, information source) were measured. Bivariate analysis and linear regression models were used. RESULTS: A total of 1,491 participants (age 50.5 ±14.9 years, 32.3% males) completed the survey. Higher knowledge and concern scores were associated with a higher practice of preventive behaviour scores (ßs:0.47 & 0.08 respectively, p<0.001). Older adults (>65 years) and women had higher knowledge and practice scores compared to their counterparts. Being younger (<45 years) and male were associated with a lower practice score (ßs:-0.88 & -2.52, respectively, p<0.001). Referring to public and government sources as primary sources of information was associated with a higher practice score (ß:1.21, p<0.001). CONCLUSIONS: Government-run campaigns appear to be effective in promoting preventive practices and achieving a high knowledge of COVID-19 guidelines in Australian adults. Implications for public health: Public health strategies are required to promote the practice of preventive behaviour for COVID-19 (or future pandemics), especially among men and younger adults using social media, given their wide use of these sources.

Willingness to Vaccinate against COVID-19 Declines in Australia, Except in Lockdown Areas.

This study investigates changes in willingness to vaccinate against COVID-19 and the effect of the extended restrictions in metropolitan Victoria on this change. Longitudinal and repeated cross-sectional data were collected from online surveys distributed in April, between July and August, and December 2020. Australian adults who were ≥18 years old were recruited through email lists, social media networks, and paid Facebook advertisement. Willingness to vaccinate against COVID-19 was self-reported. The results showed that participants were more willing to vaccinate if the vaccine was safe at survey 1 (longitudinal: adjusted OR (aOR) = 1.88, 95%CI = 1.38, 2.56; cross-sectional: aOR = 3.73, 95%CI = 2.55, 5.45) and survey 2 (longitudinal: aOR = 1.54, 95%CI = 1.19, 2.00; cross-sectional: aOR = 2.48, 1.67, 3.67), compared to survey 3. The change in willingness to vaccinate if the vaccine was safe and effective was not significant for those in Metropolitan Victoria; but was for those living in other Australian locations at survey 1 (OR = 2.13, 95%CI = 1.64, 2.76) and survey 2 (OR = 1.62, 95%CI = 1.30, 2.01), compared to survey 3. Willingness to vaccinate even if a vaccine had not been proven safe decreased at survey 3 (OR = 2.02, 95%CI = 1.14, 3.57) for those living in Metropolitan Victoria. In conclusion willingness to vaccinate against COVID-19 decreased over time among Australians, except for those living in metropolitan Victoria, where an additional strict and prolonged lockdown was implemented around the time of survey 2. Either the experience of the lockdown, or the presence of the COVID-19 virus itself had a positive influence on participants' willingness to vaccinate, even if such a vaccine was not yet proven to be safe and effective.

As the Pandemic Progresses, How Does Willingness to Vaccinate against COVID-19 Evolve?

Controversy around the safety and efficacy of COVID-19 vaccines may lead to low vaccination rates. Survey data were collected in April and August 2020 from a total of 2343 Australian adults. A quarter (n = 575, 24%) completed both surveys. A generalized linear mixed model analysis was conducted to determine whether willingness to vaccinate changed in the repeated sample, and a multinominal logistic regression was conducted in all participants to determine whether willingness to vaccinate was associated with demographics, chronic disease, or media use. Willingness to vaccinate slightly decreased between April (87%) and August (85%) but this was not significant. Willingness to vaccinate was lower in people with a certificate or diploma (79%) compared to those with a Bachelor degree (87%), p < 0.01 and lower in infrequent users of traditional media (78%) compared to frequent users of traditional media (89%), p < 0.001. Women were more likely to be unsure if they would be willing to vaccinate (10%) compared to men (7%), p < 0.01. There were no associations between willingness to vaccinate and age, chronic disease, or social media use. Promotion of a COVID-19 vaccine should consider targeting women, and people with a certificate or diploma, via non-traditional media channels.

Effects of an Activity Tracker and App Intervention to Increase Physical Activity in Whole Families-The Step It Up Family Feasibility Study.

(1) Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in whole families. Further, few family-centered interventions have actively involved both parents and assessed physical activity effects separately for children, mothers and fathers. Objective: To examine the feasibility and short-term effects of an activity tracker and app intervention to increase physical activity in the whole family (children, mothers and fathers). (2) Methods: This was a single-arm feasibility study with pre-post intervention measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults; Garmin Australasia Pty Ltd., Sydney, Australia), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages and an introductory session. Parent surveys were used to assess physical activity effects measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. Objective Garmin activity tracker data was recorded to assess physical activity levels (steps, active minutes) during the intervention. (3) Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p < 0.001). In mothers, MVPA increased by 27 min/day (p < 0.001) and in fathers, it increased by 31 min/day (p < 0.001). The percentage of children meeting Australia's physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p < 0.001). The percentage of mothers and fathers meeting Australia's physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p < 0.001) in mothers and from 21% to 68% (p < 0.001) in fathers. The percentage of families with 'at least one child and both parents' meeting the physical activity guidelines increased from 0% to 41% (p < 0.001). Objective activity tracker data recorded during the intervention showed that the mean (SD) number of active minutes per day in children was 82.1 (17.1). Further, the mean (SD) steps per day was 9590.7 (2425.3) in children, 7397.5 (1954.2) in mothers and 8161.7 (3370.3) in fathers. (4) Conclusions: Acknowledging the uncontrolled study design, the large pre-post changes in MVPA and rather high step counts recorded during the intervention suggest that an activity tracker and app intervention can increase physical activity in whole families. The Step it Up Family program warrants further efficacy testing in a larger, randomized controlled trial.

Previous exposure mediates the response of eelgrass to future warming via clonal transgenerational plasticity.

Mortality and shifts in species distributions are among the most obvious consequences of extreme climatic events. However, the sublethal effects of an extreme event can have persistent impacts throughout an individual's lifetime and into future generations via within-generation and transgenerational phenotypic plasticity. These changes can either confer resilience or increase susceptibility to subsequent stressful events, with impacts on population, community, and potentially ecosystem processes. Here, we show how a simulated extreme warming event causes persistent changes in the morphology and growth of a foundation species (eelgrass, Zostera marina) across multiple clonal generations and multiple years. The effect of previous parental exposure to warming increased aboveground biomass, shoot length, and aboveground-belowground biomass ratios while also greatly decreasing leaf growth rates. Long-term increases in aboveground-belowground biomass ratios could indicate an adaptive clonal transgenerational response to warmer climates that reduces the burden of increased respiration in belowground biomass. These transgenerational responses were likely decoupled from clonal parent provisioning as rhizome size of clonal offspring was standardized at planting and rhizome starch reserves were not impacted by warming treatments. Future investigations into potential epigenetic mechanisms underpinning such clonal transgenerational plasticity will be necessary to understand the resilience of asexual foundation species to repeated extreme climatic events.

Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults.

The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18-45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed.

Barriers to healthy lifestyle behaviors in Australian nursing students: A qualitative study.

Studying at university is stressful, which can lead to unhealthy lifestyle behaviors. This study aimed to explore perceived reasons and barriers preventing Australian nursing students from engaging in a healthy lifestyle and strategies to overcome barriers. Fifty-four bachelor of nursing students participated in seven focus groups between July and November 2018. Participants defined healthy lifestyle behaviors as eating well; regular physical activity; regular water consumption; limiting alcohol, caffeine, and nicotine; good sleep quality; stress management and relaxation; and regular social interaction and support. They identified individual (lack of motivation, existing bad habits, lack of knowledge), environmental (time, finances, limited access to healthy food and physical activity resources), and psychosocial (competing priorities, increased learning cognitive load, lack of social interaction and support, compassion fatigue, and shift work) barriers preventing healthy lifestyle. Participants proposed several individual and system-related strategies to overcome barriers. Despite portraying a comprehensive understanding of healthy lifestyle behaviors, students reported finding difficulty in attaining healthy lifestyles. Strategies proposed by students may inform targeted interventions aiming to increase overall health of students, reduce attrition rates, and promote workforce retention post-graduation.

Association between dietary patterns and sociodemographics: A cross-sectional study of Australian nursing students.

Lack of time, financial issues, and stressful clinical and educational environments in nursing studies promote higher intakes of convenience and fast foods loaded with fat and sugar, which are linked to reduced mental and physical health. In this study, we examined the dietary patterns of nursing students and their associated sociodemographic factors to inform the development of future health-promotion interventions. A total of 548 Bachelor of Nursing students were invited to complete a survey. Associations were explored using χ2 and logistic regression. Three dietary patterns were identified: healthy (fruit, vegetables, and legumes), Western (loaded with fat, sugar, and salt), and unbalanced. Only 21% of participants were classified as following a healthy dietary pattern, and more likely to be older (>35 years old) and have a personal annual income between $AUD20 000-$59 999 and $60 000-$99 999. Students with one to two and three or more children were more likely to follow a Western dietary pattern. There is a need to develop interventions to improve the dietary behaviors of nursing students by health-promoting activities and the provision of online health resources.

Striving for the thin ideal post-pregnancy: a cross-sectional study of intuitive eating in postpartum women.

Objective: To conduct a cross-sectional study of women in the postpartum period to identify relationships between intuitive eating, body image satisfaction, eating attitudes and depressive symptomology.Methods: Women with at least one child born in the previous 6-48 months were recruited via Facebook to complete an online survey which included: sociodemographic and health questions, the Intuitive Eating Scale, the Body Shape Questionnaire, the Multi-dimensional Body-Self Relations Questionnaire, the Eating Attitudes Test-26 and the Edinburgh Postnatal Depression Scale. Descriptive statistics were calculated for all variables and hierarchical regressions used to examine associations between intuitive eating styles, body image satisfaction, eating attitudes and depressive symptomology.Results: Of the 419 women (mean age 32 ± 5.3 years), 32% were classified with intuitive eating styles and were more likely to have higher body image satisfaction (F = 476.80, p < .001), less disordered eating attitudes (F = 30.74, p < .001) and lower depressive symptomology (F = 4.14, p = .042).Conclusions: The postpartum period is a time of high risk for developing/maintaining eating styles that may negatively impact psychological health and well-being. Providing education to new mothers about the benefits of intuitive eating could positively influence their health and well-being.

Species recovery and recolonization of past habitats: lessons for science and conservation from sea otters in estuaries.

Recovering species are often limited to much smaller areas than they historically occupied. Conservation planning for the recovering species is often based on this limited range, which may simply be an artifact of where the surviving population persisted. Southern sea otters (Enhydra lutris nereis) were hunted nearly to extinction but recovered from a small remnant population on a remote stretch of the California outer coast, where most of their recovery has occurred. However, studies of recently-recolonized estuaries have revealed that estuaries can provide southern sea otters with high quality habitats featuring shallow waters, high production and ample food, limited predators, and protected haul-out opportunities. Moreover, sea otters can have strong effects on estuarine ecosystems, fostering seagrass resilience through their consumption of invertebrate prey. Using a combination of literature reviews, population modeling, and prey surveys we explored the former estuarine habitats outside the current southern sea otter range to determine if these estuarine habitats can support healthy sea otter populations. We found the majority of studies and conservation efforts have focused on populations in exposed, rocky coastal habitats. Yet historical evidence indicates that sea otters were also formerly ubiquitous in estuaries. Our habitat-specific population growth model for California's largest estuary-San Francisco Bay-determined that it alone can support about 6,600 sea otters, more than double the 2018 California population. Prey surveys in estuaries currently with (Elkhorn Slough and Morro Bay) and without (San Francisco Bay and Drakes Estero) sea otters indicated that the availability of prey, especially crabs, is sufficient to support healthy sea otter populations. Combining historical evidence with our results, we show that conservation practitioners could consider former estuarine habitats as targets for sea otter and ecosystem restoration. This study reveals the importance of understanding how recovering species interact with all the ecosystems they historically occupied, both for improved conservation of the recovering species and for successful restoration of ecosystem functions and processes.

Predictors of Dietary Diversity of Indigenous Food-Producing Households in Rural Fiji.

Fiji, like other Pacific Islands, are undergoing economic and nutrition transitions that increase the risk of noncommunicable diseases (NCDs) due to changes of the food supply and dietary intake. This study aimed to examine dietary diversity (DD) in indigenous food-producing households in rural Fiji. Surveys were conducted with households from the Nadroga-Navosa, Namosi and Ba Provinces of Western Fiji in August 2018. Participants reported on foods consumed in the previous 24 h per the Household Dietary Diversity Score. Data was analysed using multinomial logistic regression. Of the 161 households, most exhibited medium DD (66%; M = 7.8 ± 1.5). Commonly consumed foods included sweets (98%), refined grains (97%) and roots/tubers (94%). The least consumed foods were orange-fleshed fruits (23%) and vegetables (35%), eggs (25%), legumes (32%) and dairy (32%). Households with medium DD were more likely to be unemployed (OR 3.2, p = 0.017) but less likely to have ≥6 occupants (OR = 0.4, p = 0.024) or purchase food ≥2 times/week (OR = 0.2, p = 0.023). Households with low DD were more likely to have low farm diversity (OR = 5.1, p = 0.017) or be unemployed (OR = 3.7, p = 0.047) but less likely to have ≥6 occupants (OR = 0.1, p = 0.001). During nutrition transitions, there is a need for public health initiatives to promote traditional diets high in vegetables, fruits and lean protein and agricultural initiatives to promote farm diversity.

Low Health Literacy Is Associated With Risk of Developing Type 2 Diabetes in a Nonclinical Population.

PURPOSE: The purpose of this study was to examine associations among risk of type 2 diabetes (T2D), health literacy levels, and sociodemographic characteristics in a nonclinical adult population to assist in the development of effective T2D prevention programs. METHODS: The Health Literacy Questionnaire and Australian Type 2 Diabetes Risk Assessment Tool were included in an online survey. Participants were a random sample of adults residing in each Australian state and territory. Data were analyzed with descriptive statistics and multinomial logistic regression. RESULTS: A total of 1279 Australian adults participated (52% female; mean ± SD age, 61 ± 12 years). Most were at medium (42.4%) or high (46.9%) risk of developing T2D. The lowest health literacy scores were found for the domains "critical appraisal of health information" and "navigating the health care system." After controlling for covariates, participants at the highest risk of developing T2D were significantly more likely to be unemployed, have ≥1 chronic conditions, or have a mental health condition. Furthermore, they were significantly more likely to develop T2D if they scored low in 1 of the following health literacy domains: critical appraisal of health information, navigating the health care system, actively managing health, social support, and health care provider support. CONCLUSIONS: Health literacy was associated with increased risk for developing T2D and should therefore be part of diabetes prevention initiatives. Specifically, new health promotion initiatives need to help people develop skills required to critically appraise health information and navigate the health care system. Health practitioners and educators should ensure that health information developed for consumers is uncomplicated and easily understood.