Spatial heterogeneity of climate change as an experiential basis for skepticism.

We postulate that skepticism about climate change is partially caused by the spatial heterogeneity of climate change, which exposes experiential learners to climate heuristics that differ from the global average. This hypothesis is tested by formalizing an index that measures local changes in climate using station data and comparing this index with survey-based model estimates of county-level opinion about whether global warming is happening. Results indicate that more stations exhibit cooling and warming than predicted by random chance and that spatial variations in these changes can account for spatial variations in the percentage of the population that believes that "global warming is happening." This effect is diminished in areas that have experienced more record low temperatures than record highs since 2005. Together, these results suggest that skepticism about climate change is driven partially by personal experiences; an accurate heuristic for local changes in climate identifies obstacles to communicating ongoing changes in climate to the public and how these communications might be improved.

Changing medical students' attitudes to and knowledge of deafness: a mixed methods study.

BACKGROUND AND AIM: Communication with healthcare professionals is challenging for those with hearing loss. This study aimed to determine the impact dedicated deaf awareness training could have on medical student's attitudes to and knowledge of deafness, and to explore ways of incorporating deaf awareness training into the core undergraduate medical curriculum. METHODS: A validated questionnaire was used to measure attitudes to and knowledge of deafness in those taking an optional deaf awareness and basic sign language module for second year medical students compared to students who took another module. Previous students on this module were also contacted and asked to complete the same questionnaire. Focus groups with these students explored ways to incorporate deaf awareness training into the core undergraduate medical curriculum. RESULTS: After completing the module, students had a more positive attitude to deaf individuals (p < 0.001), and higher knowledge scores (p = 0.027) in comparison to the control group. Examination of data revealed a significant negative association between years since undertaking the module and attitudes score (r = - 0.29, p = 0.04, n = 51), with no significant association for knowledge score (r = 0.22, p = 0.11, n = 52). Focus groups suggested integrating deaf awareness training into existing undergraduate communication skills teaching, with the inclusion of deaf tutors. CONCLUSIONS: This study indicates that incorporating a specialist module on deafness can improve attitudes to and knowledge of deafness. Importantly, this effect decreases over time, demonstrating the need for refresher training amongst junior doctors.

First Nations Peoples' Participation in the Development of Population-Wide Food and Nutrition Policy in Australia: A Political Economy and Cultural Safety Analysis.

BACKGROUND: Healthy and sustainable food systems underpin the well-being of Indigenous peoples. Increasingly governments are taking action to improve diets via population-wide policies. The United Nations Declaration on the Rights of Indigenous People states that Indigenous peoples have the right to participate in all decisions that affect them. We analysed Australian national food and nutrition policy processes to determine: (i) the participation of Aboriginal organisations, (ii) the issues raised in Aboriginal organisations' policy submissions, and (iii) the extent to which Aboriginal organisations' recommendations were addressed in final policy documents. METHODS: Political economy and cultural safety lenses informed the study design. We analysed publicly-available documents for Australian population-wide food and nutrition policy consultations occurring 2008-2018. Data sources were policy documents, committee reports, terms of reference and consultation submissions. The submissions made by Aboriginal organisations were thematically analysed and key policy recommendations extracted. We examined the extent to which key recommendations made by Aboriginal organisations were included in the subsequent policy documents. RESULTS: Five food and nutrition policy processes received submissions from Aboriginal organisations. Key themes centred on self-determination, culturally-appropriate approaches to health, and the need to address food insecurity and social determinants of health. These messages were underrepresented in final policy documents, and Aboriginal people were not included in any committees overseeing policy development processes. CONCLUSION: This analysis suggests that very few Aboriginal organisations have participated in Australian population-wide food and nutrition policy processes and that these policy development processes are culturally unsafe. In order to operationalise First Nations peoples' right to self-determination, alternative mechanisms are required to redress the power imbalances preventing the full participation of Aboriginal and Torres Strait Islander peoples in population-wide food and nutrition policy decisions. This means reflecting on deeply embedded institutional structures and the normative assumptions upon which they rest.