Shining a light on food insecurity in Aotearoa New Zealand: Modification of a food security scale for use with individuals who have extreme food security needs

INTRODUCTION: Food insecurity in Aotearoa New Zealand is a growing concern but quantitative evidence focused on those in most need of support is scarce in the Aotearoa New Zealand context. This limits policy and practice decisions.METHODS: We modified Parnell and Gray’s (2014) Aotearoa New Zealand based food security scale to better capture the severity of food insecurity for individuals living in poverty and used a questionnaire to collect data from a sample of individuals seeking food assistance from foodbanks in Tāmaki Makaurau (Auckland). We used confirmatory factor analysis to assess the psychometric validity of the modified scale. We also tested group differences in food insecurity by gender and ethnicity using analysis of variance and investigated correlations between age, household size and food insecurity.FINDINGS: We found a six-item version of Parnell and Gray’s (2014) scale to be psychometrically robust for use with the study population. The sample participants reported concerning and chronic levels of food insecurity. We did not find any group differences.CONCLUSIONS: At the severe end of the food insecurity continuum, gender and ethnic subgroups appear to suffer at similar levels; however, this does not suggest that different approaches are not required to best meet the needs of different demographic subgroups. Further research is needed to ascertain how similar levels of food insecurity may produce differential effects on wellbeing outcomes for different groups. We recommend more widespread and regular use of the modified scale to assess the experience and impact of food insecurity for individuals living in poverty because it provides a more fine-grained understanding of the severity of food insecurity challenges experienced by individuals seeking food assistance. Fit for purpose measures enable accurate assessments that can better inform policymaking and practice decisions to reduce inequality and promote economic justice.

Global epidemiology of SARS-CoV-2 infection: a systematic review and meta-analysis of standardized population-based seroprevalence studies, Jan 2020-Oct 2021

Background COVID-19 case data underestimates infection and immunity, especially in low- and middle-income countries (LMICs). We meta-analyzed standardized SARS-CoV-2 seroprevalence studies to estimate global seroprevalence. Objectives/Methods We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence studies aligned with the WHO UNITY protocol published between 2020-01-01 and 2021-10-29. Eligible studies were extracted and critically appraised in duplicate. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time; compared seroprevalence from infection to confirmed cases to estimate under-ascertainment; meta-analyzed differences in seroprevalence between demographic subgroups; and identified national factors associated with seroprevalence using meta-regression. PROSPERO: CRD42020183634. Results We identified 396 full texts reporting 736 distinct seroprevalence studies (41% LMIC), including 355 low/moderate risk of bias studies with national/sub-national scope in further analysis. By April 2021, global SARS-CoV-2 seroprevalence was 26.1%, 95% CI [24.6-27.6%]. Seroprevalence rose steeply in the first half of 2021 due to infection in some regions (e.g., 18.2% to 45.9% in Africa) and vaccination and infection in others (e.g., 11.3% to 57.4% in the Americas high-income countries), but remained low in others (e.g., 0.3% to 1.6% in the Western Pacific). In 2021 Q1, median seroprevalence to case ratios were 1.9:1 in HICs and 61.9:1 in LMICs. Children 0-9 years and adults 60+ were at lower risk of seropositivity than adults 20-29. In a multivariate model using data pre-vaccination, more stringent public health and social measures were associated with lower seroprevalence. Conclusions Global seroprevalence has risen considerably over time and with regional variation, however much of the global population remains susceptible to SARS-CoV-2 infection. True infections far exceed reported COVID-19 cases. Standardized seroprevalence studies are essential to inform COVID-19 control measures, particularly in resource-limited regions.

The COVID States Project #71: Childhood COVID-19 vaccine uptake and intentions

In early November 2021, children ages 5-11 were authorized by the Centers for Disease Control and Prevention (CDC) to receive the Pfizer-BioNTech COVID-19 vaccine, making an additional 28 million children eligible for the shot. Given this significant advancement in COVID-19 vaccine availability - particularly in light of recent concerns over the Omicron variant - in this report we examine parent-reported COVID-19 vaccination intentions and uptake for children.Below, we examine reported childhood vaccination rates by childhood age and across different parent demographic subgroups. Additionally, we report parents’ expressed likelihood of vaccinating their children against COVID-19 across five survey waves from February, April, June, September, and November 2021.

Changes in Australian community perceptions of non-communicable disease prevention: a greater role for government?

Background Monitoring trends in community opinion can identify critical opportunities to implement upstream health policies or interventions. Our study examines change and demographic modifiers of change in community perceptions of government intervention for prevention of lifestyle-related chronic disease across two time points in Australia. Methods Data were drawn from the 2016 (n = 2052) and 2018 (n = 2601) waves of a nationally representative cross-sectional telephone survey, ‘AUSPOPS’. Survey questions gauged perceptions of government intervention for health in general, peoples’/organizations’ role in maintaining health (e.g., parents, government) and support for specific health interventions (e.g., taxing soft drink). Bivariate and multivariate regression models tested for change between the two surveys, adjusted for demographic characteristics. Models with interactions between survey wave and demographic variables tested for differential change. One-tailed variance ratio tests examined whether opinions had become more polarized in 2018 compared with 2016. Results The large, significant increase observed in the perceived size of the role that government has in maintaining people’s health was uniform across demographic subpopulations. The role for employers and private health insurers was also perceived to be larger in 2018 compared with 2016, but the degree of change varied by gender, age and/or socioeconomic status. Support for some government interventions (e.g., taxing soft drinks) increased among specific demographic subgroups whilst exhibiting no overall change. Opinion was more polarized on general attitudes to government intervention for population health in 2018 compared to 2016, despite little change in central tendency. Conclusions Opportunities may exist to implement government health-promoting policies (e.g., taxing soft drinks), although advocacy may be needed to address the concerns of less supportive subpopulations. Attitudes on government intervention in general may be becoming more polarized; future research examining the association of such changes with exposure to different information sources could inform communication strategies for future health policy change.

Exposure to Arguments and Evidence Changes Partisan Attitudes Even in the Face of Countervailing Leader Cues

Patterns of public opinion recently observed in American politics tempt the conclusion that substantive arguments and evidence are less effective, or ineffective, at changing partisan minds when they overtly contradict cues from in-party leaders. This conclusion follows naturally from theories of partisan motivated reasoning. However, observations of public opinion do not provide the counterfactual outcomes required to draw this conclusion. Here we report a large-scale survey experiment in which we randomized exposure to the policy positions of Donald Trump and Joe Biden, as well as information that overtly contradicts their positions. Our design incorporates 24 policy issues and 48 information treatments. We find that the information does persuade partisans on average, and, critically, fully retains its persuasive force even when paired with countervailing cues from in-party leaders. This result holds across policy issues, demographic subgroups, and one- and two-sided cue environments, and is puzzling for partisan motivated reasoning theory.

Coping with the COVID-19 Pandemic: An adapted approach to preclinical teaching of Pathology- Pathophysiology

Introduction/Objective The COVID-19 pandemic affected all aspects of medicine, from patient care to medical education. Pandemic-related restrictions regarding in-person teaching activities at our medical college required adoption of an online, live, virtual format for all activities in our preclinical Pathology-Pathophysiology (PP) courses. Adaptation of teaching approaches using available technology allowed for uninterrupted learning and may serve to contribute to future innovations in medical education. Methods/Case Report Using Zoom as a platform, all lectures and interactive group exercises were converted to a live virtual format. Live Zoom lectures were also recorded and, subsequently, made available to students, in order to provide additional opportunities for engaged learning. Interactive, case-based and self-directed exercises, and gross specimen reviews were also held using the live virtual format. Fourth year students enrolled in our education concentration helped provide intermittent virtual peer reviews for the 2nd year students. All exams were administered via an electronically monitored virtual format. Results (if a Case Study enter NA) Overall, performance of the 2020-2021 class on in-house, multiple choice question (MCQ) exams in our PP courses was typically at or above the performance of prior classes, while class performance on a standardized national subject exam (NBME) in Pathology was above the national average, which was consistent with prior class performances, and significantly higher (p = 0.01) on average in 2021 than in 2019 (2.28 points) and 2020 (2.27 points). Additional analyses are being conducted on demographic subgroups within each cohort (sex, MCAT score, socioeconomic status, underrepresented in medicine, registered for disability accommodations) to determine if any particular group’s performance was impacted by this change of format. Conclusion Despite the restrictions imposed by the pandemic, student performance on in-house and standardized national exams in the NYMC Pathology-Pathophysiology courses were similar to recent pre-pandemic years. Our endeavors to provide a strong preclinical educational experience in Pathology-Pathophysiology during the pandemic resulted in learning outcomes on a par with those in recent years, despite the rapid transition to a completely online, live virtual format.Our data suggest that continued use of virtual teaching methods is a viable option in on-going medical curricula

Pornography Viewers

It is of interest to public health to determine the percentage of people who view pornography and to characterize the population of pornography viewers. This chapter presents estimates of lifetime and past-year pornography viewing for US populations, discusses whether pornography viewers consume pornography more frequently than in decades past, and presents estimates for pornography exposure for children and by demographic subgroups. The chapter concludes that pornography use is not rare and is not restricted to only males, young people, or the nonreligious. The chapter argues that the prevalence of pornography use alone is insufficient to qualify it as a public health crisis. If pornography use is both common and causes harm, that would be a compelling argument for addressing it as a public health concern.

Participation and Dropout of Hockey New South Wales Participants in 2017 and 2018: A Longitudinal Study

Background Sports have a focus on increasing participation, which contributes to increasing population levels of physical activity, social cohesion and longevity of the sport. The primary aim of this study was to examine reasons for drop-out of a popular team sport in Australia, Field Hockey and identify opportunities to increase participation. Methods This longitudinal study obtained routinely collected registered player data from Hockey New South Wales over two consecutive years, and survey data from registered players who dropped out. Logistic regression models identified demographic subgroups who were more likely to drop out of sport, and the reasons for dropping out. Results In 2018, 8,463 (31%) of hockey players did not return to play hockey after the previous season and 805 (10%) of these completed a survey. Specific groups who were more likely to stop playing included 5–6 years (OR: 2.1, 95% CIs 1.8, 2.6; reference: 12–17 years), females (OR: 1.1, 95% CIs 1.3, 1.2; reference: males), Indigenous (OR: 1.2, 95% CIs 1.1, 1.4; reference: non-indigenous), most disadvantaged (OR: 1.1, 95% CIs 1.0, 1.2; reference: least disadvantaged) or regional and remote (1.1, 95% CIs 1.0, 1.2; reference: major cities). Top reasons for drop out were; medical/age (17%), change in circumstances (16%) and high cost (13%), lack of time (13%) and lack of enjoyment (7%). Conclusions This research makes recommendations to sport on how to reduce dropout and specifically amongst 5–6 year olds, females, Indigenous, disadvantaged and regional or remote areas through enjoyable flexible, modifiable versions of the game.

Suicidal Ideation, Planning, and Attempts Among Synthetic Cannabinoid Users Across Different Demographic Subgroups

Background: Case studies have linked synthetic cannabinoid (SC) use to suicide risk both during and following acute psychoactive effects. No study has explored whether a meaningful relationship exists between SC use and suicidal ideation, planning, and attempts within a generalizable sample. Aims: This work attempted to determine whether SC use is significantly associated with suicidal thoughts, planning, or attempts and whether the association between SC use and suicide may be stronger in certain demographic groups. Method: Cross-sectional self-report data from the Youth Risk Behavior Surveillance System were utilized. Logistic regression models were explored within a sample of 29,384 adolescents. Results: A clear connection emerged between SC use and suicidal thoughts and attempts. SC use and suicide risk were strongly related within the lesbian, gay, and bisexual and African Americans populations, even after controlling for depressive symptoms. Limitations: The study was cross-sectional and respondents may have underreported substance use or suicidal thoughts. Conclusion: Whether SC use has an impact on suicidal ideation directly, indirectly, or if it is simply a co-occurring phenomenon, it may serve as a flag of enhanced risk. Physicians must remain cognizant of the SC–suicide risk connection, particularly among African American and/or lesbian, gay, or bisexual patients.

COVID-19 pandemic reveals persistent disparities in nitrogen dioxide pollution

The unequal spatial distribution of ambient nitrogen dioxide (NO2), an air pollutant related to traffic, leads to higher exposure for minority and low socioeconomic status communities. We exploit the unprecedented drop in urban activity during the COVID-19 pandemic and use high-resolution, remotely sensed NO2 observations to investigate disparities in NO2 levels across different demographic subgroups in the United States. We show that, prior to the pandemic, satellite-observed NO2 levels in the least White census tracts of the United States were nearly triple the NO2 levels in the most White tracts. During the pandemic, the largest lockdown-related NO2 reductions occurred in urban neighborhoods that have 2.0 times more non-White residents and 2.1 times more Hispanic residents than neighborhoods with the smallest reductions. NO2 reductions were likely driven by the greater density of highways and interstates in these racially and ethnically diverse areas. Although the largest reductions occurred in marginalized areas, the effect of lockdowns on racial, ethnic, and socioeconomic NO2 disparities was mixed and, for many cities, nonsignificant. For example, the least White tracts still experienced ∼1.5 times higher NO2 levels during the lockdowns than the most White tracts experienced prior to the pandemic. Future policies aimed at eliminating pollution disparities will need to look beyond reducing emissions from only passenger traffic and also consider other collocated sources of emissions such as heavy-duty vehicles.