Everyday Life Settings Research Articles

Home Hygiene and Prevention of Infections

Health is wealth - a famous proverb that almost everyone has heard of but may not have fully understood its essence. Health comes from maintaining cleanliness and hygiene which starts from home and expands to workplaces and public areas. By practicing hygiene in the home and everyday life settings, it will have impact significantly in reducing the global burden of infectious diseases that kills over 17 million people a year. Mainly caused by microorganisms, infections can easily spread by direct and indirect contact. Common infectious diseases include chickenpox, common cold, malaria and pertussis. These diseases tend to have specific symptoms such as fever, diarrhoea, fatigue and muscle aches. In institutional settings, such as schools and child-cares settings, information relating hand hygiene is routine. However, the home environment is one of the potential sources of transmission of infectious diseases. This situation, of course, needs to be re-evaluated and the promotion of home hygiene should be encouraged. Positive correlation has been found between home hygiene practices and risk of disease transmission in homes where the first line of defence against infectious diseases is cleaning and disinfecting plus maintaining good hand hygiene. But, the implementation for an effective policy to monitor home hygiene is rather complex due to varying determinants of health. In a nutshell, proper home hygiene and cleaning practices lead to reduced risk of spreading infectious diseases. They should form the key issues in the practice of health promotion in the community and institutions.

Study-Related Work and Commuting Accidents among Students at the University of Mainz from 12/2012 to 12/2018: Identification of Potential Risk Groups and Implications for Prevention.

Background: Universities represent an important setting of everyday life for health promotion. The aim of the present study was to assess whether university students of specific disciplines might have an increased risk for having a study-related work accident and to analyze what types of study-related work accidents occur most frequently. Furthermore, knowledge regarding study-related commuting accidents will be provided by identifying places where study-related commuting accidents might occur most frequently and on potential types of commuting (walking vs. biking) which might be associated with an increased risk for having a study-related commuting accident. Methods: Retrospective analyses of a dataset provided by the Accident Insurance Fund of Rhineland-Palatinate, Germany, including all accidents that happened at the University of Mainz (JGU) between December 2012 and December 2018 were performed. Binominal tests were computed to reveal whether the frequency of study-related work accidents in students affiliated with a specific faculty or institution differs significantly from the expected frequency of all reported study-related work accidents. Results: Overall, 1285 study-related accidents were analyzed—of which, 71.8% were work and 28.2% commuting accidents. Students of ‘Faculty—Medicine’ (80.5%; p = 0.003), ‘Faculty—Chemistry, Pharmaceutical Sciences, Geography and Geosciences’ (90.7%; p < 0.001), and students that participated in study-related sports activities (97.4%; p ≤ 0.001) had a significantly increased risk for the occurrence of a study-related work accident. Needlestick and sharps injuries (NSIs) as well as lab accidents play a pivotal role. Furthermore, above 40% of the study-related commuting accidents were cycling accidents. Conclusions: There is a call for prevention in order to decrease the number of NSIs among medical students, lab accidents as well as sport-related accidents. Concrete implications for prevention are discussed in the present paper. In addition, given that students are among the most likely to bicycle, and given that most bicycle-related accidents involve fatal injuries, cycling safety campaigns need to be initiated on campus.

Queer migration across the Sinophone world: queer Chinese Malaysian students’ educational mobility to Taiwan

ABSTRACT Drawing on a multi-sited ethnography of Chinese Malaysian students’ educational mobility, this article discusses the experiences, everyday practices and future aspirations of my queer informants who went to Taiwan for university and returned to Malaysia after graduation. Through examining their narratives, this article has three objectives. First, it demonstrates how tensions between my informants’ ethnic and sexual identities are reconfigured and how new forms of queer relationality and subject positions have emerged via a distinctive process of student migration across the Chinese-speaking world. Second, it contributes to the theorisation of transnational queer Chinese cultures vis-à-vis an articulation of queer Sinophone Malaysia. Third, by way of conclusion, I present a case study of transnational queer activism and demonstrate how it is practised by returned migrants in everyday life settings.

Trauma-informed schools: Supporting educators as they support the children

ABSTRACTThe focus of this article is on the important need for educators in trauma-informed schools to receive ongoing support themselves. That K-12 teachers should attend to their students’ mental health is now commonly emphasized and indeed is invaluable for prevention purposes. At the same time, teachers in general are at high risk for burnout, and there can be much additional stress from routinely providing empathic support to troubled students in classrooms. After reviewing the relevant literature, we provide preliminary data – based on first-hand reports from 10 teachers in trauma-informed K-12 schools – about major challenges faced and ways in which these might be alleviated. These exploratory insights are then discussed within the framework of current recommendations in the field of resilience in childhood. The latter clearly indicates that if adults in major socializing roles (parents as well as teachers) contend with high everyday stress, the most important protective factor is their ongoing access to supportive relationships in everyday life settings. The paper concludes with directions for future work, highlighting areas where educational and school psychologists might spearhead and support training efforts, and help to incorporate support-based interventions within schools’ institutional cultures.

Qualitative Synthesis of Young People's Experiences With Technology-Assisted Cognitive Behavioral Therapy: Systematic Review.

BackgroundCognitive behavioral therapy (CBT) for young people is increasingly being provided using technology-assisted formats. Although there is increasing evidence regarding the efficacy of such approaches, as illustrated by quantitative systematic reviews, the literature has also highlighted challenges with implementation factors, including high attrition rates and variable user engagement. Qualitative review methods can help to address the factors that impact young peoples’ experience of technology-assisted cognitive behavioral therapy (tech-assisted CBT) and, thus, enable us to better understand such implementation factors. To date, no such qualitative synthesis exists.ObjectiveThe primary aim of this review was to systematically identify and synthesize the qualitative literature concerning the experiences of young people who have used tech-assisted CBT.MethodsThis systematic review applied Thomas and Harden’s 2008 qualitative thematic synthesis approach. This involved line-by-line coding of the results sections of included studies and an inductive analysis on identified themes, followed by the generation of analytical themes through a process of iteration and interpretation of the descriptive themes. PsycINFO, ACM Digital Library, PubMed, EMBASE, and JMIR Publications databases were searched. The inclusion criteria were (1) studies involving school-aged young people over preschool age (6 years) but under the age of 18 years, (2) use of any form of tech-assisted CBT for any time period, (3) a stated focus of qualitative data to document the experiences of participants, and (4) studies published in English. The exclusion criteria were (1) interventions only provided face-to-face with no technological component, (2) only focused on the performance of the technology rather than participant experience, and (3) numerical data that sought to represent qualitative data.ResultsA total of 14 studies were included in this review. Overall, these studies represented interventions for low mood and anxiety (n=10), trauma or self-harm (n=2), and physical difficulties (n=2). Overall, 5 analytical themes emerged on young people’s experiences with tech-assisted CBT: (1) helpfulness, (2) therapeutic process, (3) transferability, (4) gameplay experience, and (5) limitations. In addition, these analytical themes contained the following subthemes: positive experiences, tech-assisted CBT versus face-to-face CBT, understanding of a CBT model, process of change, skills development, application to everyday life settings, parental involvement, character relatedness, playability, negative experiences, and broad content.ConclusionsOverall, young people’s experiences with tech-assisted CBT were mostly positive. The use of gaming environments, relatable characters, concrete metaphors, and age-appropriate narratives contributed to these positive experiences. Evidence suggests that technology can help to mediate face-to-face relationships with therapists and help young people to understand the CBT model. Clear barriers also emerged, including over-reliance on reading and writing skills and dissatisfaction with overly generalized content and comparison with commercial technologies.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42018103388; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018103388

Older adults' health information behavior in everyday life settings

Health information seeking is an important part of older adults' everyday lives as they cope with their health conditions. Semi-structured interviews conducted with 21 older adults in the United States were analyzed using Savolainen's everyday life information seeking (ELIS) model, especially its key concepts such as way of life and mastery of life. The interview data revealed that except for health care providers, a spouse or partner was mentioned as a credible interpersonal source of health information among older adults in a marital or romantic relationship. Characteristics of older adults' health information behavior in the ELIS context were identified based on types of way of life and mastery of life. For example, those who had more varied types of hobbies, including cognitive, affective, and social hobbies, were exposed to diverse people as they performed their daily routine, potentially resulting in different sources of useful health information. In couple relationships, those with an optimistic as opposed to pessimistic attitude toward a problem-solving situation played the information provider role rather than information receiver role.

Dare to care

Paper is divided into two parts. The first contains two philosophical discussions about comprehension of courage and the second focuses on the findings in an empirical study with care home managers about the virtue of courage. First discussion revolves around the question whether the virtue of courage is expressed a) only in life–threatening situations or is it a virtue trained and exemplified in b) everyday life settings, while the second emphasises the difference between i) courage of efficiency as a skill and ii) courage of excellence as a virtue. Arguments here support a vision of courage as the virtue of excellence expressed in everyday life settings. The second part of the paper highlights a new perspective of courage with regards to the notion of care towards the aim of the courageous endeavour. The ‘courage of care’ supports the idea that the courage practised as the virtue of excellence aims to develop the moral character of the actor fundamentally outside of the life–threatening situation. Care for the self, other people, animals and intangible moral principles inspire us to do brave deeds. Thus, by accepting Alasdair MacIntyre’s statements that a) in the times of the peace managers represent moral idols and b) idea that the notion of courage should be closely related to the practice of care and compassion, the research continued with the interviews with the care home managers in Kent county in England. Conversations with care home managers released further insights into how care and compassion influence the understanding of the virtue of courage.

ТЕОРІЯ ТА МЕТОДИКА НАВЧАННЯ ІНОЗЕМНОЇ МОВИ У СЕРЕДНІЙ ТА ВИЩІЙ ШКОЛАХ

Background: Cognitive approach to teaching foreign languages at high school proves rather effective given the level of intellectual development and interests of learners in their early youth. The approach, based on conscious learning, currently finds support in the documents on school reform being conducted in Ukraine. Purpose: The purpose of the article is to discuss provisions of cognitive approach to teaching a foreign language at high school and establish correlation between logical operations of thinking and types of syntactic exercises in the process of learning grammar. Discussion: Teaching grammar is a challenging task, especially if combined with the basic vocabulary taught parallelly. However, cognitively and thematically oriented exercises facilitate the learning process, making it more sensible and smoother. Cognitive grammar exercises also meet the learners’ expectations and develop their intellectual abilities, deepen memory, train attention and logical thinking. Besides developing their grammatical and lexical skills, the students acquire cognitive abilities to make a choice, find out necessary answers, solve problems, etc., which can be exceptionally useful in everyday life and professional setting. The proposed grammar exercises which are classified according to their types into multiple choice, transformation, comparing, grouping, logical thinking, formulation of definitions and language games can be further completed with different variations which will add additional quest to the learners. Results: The latest achievements of cognitive linguistics and cognitive psychology have a powerful impact on the development of new methods and approaches to language teaching. Cognitive approach to teaching foreign languages proves to be one of the most effective instruments of teaching-learning process, especially based on the knowledge of psycho-physiological development of the object of study.

Measuring child and adolescent emotional lability: How do questionnaire-based ratings relate to experienced and observed emotion in everyday life and experimental settings?

Emotional lability (EL) is an important trans-diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating-based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention-deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N=67). In Study2, we examined the relationship between parental ratings and real-time measures of emotional experiences in daily life in adolescents (N=65). EL ratings were associated with different elements of real-time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD.

In silico vs. Over the Clouds: On-the-Fly Mental State Estimation of Aircraft Pilots, Using a Functional Near Infrared Spectroscopy Based Passive-BCI.

There is growing interest for implementing tools to monitor cognitive performance in naturalistic work and everyday life settings. The emerging field of research, known as neuroergonomics, promotes the use of wearable and portable brain monitoring sensors such as functional near infrared spectroscopy (fNIRS) to investigate cortical activity in a variety of human tasks out of the laboratory. The objective of this study was to implement an on-line passive fNIRS-based brain computer interface to discriminate two levels of working memory load during highly ecological aircraft piloting tasks. Twenty eight recruited pilots were equally split into two groups (flight simulator vs. real aircraft). In both cases, identical approaches and experimental stimuli were used (serial memorization task, consisting in repeating series of pre-recorded air traffic control instructions, easy vs. hard). The results show pilots in the real flight condition committed more errors and had higher anterior prefrontal cortex activation than pilots in the simulator, when completing cognitively demanding tasks. Nevertheless, evaluation of single trial working memory load classification showed high accuracy (>76%) across both experimental conditions. The contributions here are two-fold. First, we demonstrate the feasibility of passively monitoring cognitive load in a realistic and complex situation (live piloting of an aircraft). In addition, the differences in performance and brain activity between the two experimental conditions underscore the need for ecologically-valid investigations.

Assessment of Emotional and Behaviour Disorders of Girls Living in Restricted Environment and Intervention Strategies Through Physical Activity

Background. Students with emotional and behavioural disorders (EBD) represent one of the most challenging groups not only to provide effective educational services, but often present complex challenges for schools, families, and society. There is a lack of information about concrete research-based interventions and practices which could be helpful for delinquent students with EBD to cope with problem behaviour more effectively. The aim of the study was to assess the emotional and behaviour disorders of girls living in socialization centres and to review intervention strategies for changing behaviour through physical activity. Methods. The study was conducted in two Children Socialization Centres where 50 girls aged 12 – 18 are housed following the decision of Child Welfare Commission. Behaviour Assessment System for Children (BASC-2), a Self-Report Personality Scale was used to find out emotional and behavioural disorders of girls. Results. Analysis of our study results reveals that the girls with delinquent behaviour living in CSC show the risk of having problems in school, high level of social stress, anxiety, sense of inadequacy, atypicality, attention problems, hyperactivity and lower levels of self-esteem, self-reliance, interpersonal relations. The results support the conclusions of other studies which found significant relations between EBD students and weak levels of social skills, self-esteem and self-efficacy, cooperation.Conclusion. Sport and physical activity settings are effective intervention setting for creation, practicing and maintenance of pro-social behaviour and emotion managing; furthermore those skills could be transferred to community settings in everyday life. The best education setting for EBD students could be provided in inclusive environment, where the positive behaviour skills could be copied and maintained.Keywords: emotional and behavioural disorders, intervention strategies, delinquent behaviour, restricted environment.

The Translational Value of Psychophysiology Methods and Mechanisms: Multilevel, Dynamic, Personalized.

It has been nearly 15 years since Kazdin and Nock published methodological and research recommendations for understanding mechanisms of change in child and adolescent therapy. Their arguments and enthusiasm for research on mechanisms of behavior change (MOBCs) resonated across disciplines and disorders, as it shined a light on the crucial importance of understanding how and for whom treatments instigate behavior change and how therapeutic mechanisms might be extended to "situations and settings of everyday life." Initial efforts focused on how psychotherapy works and linear models, yet the use of theory to guide the study of mechanisms, and laboratory experiments to manipulate them, is broadly applicable. This article considers dynamic physiological processes that support behavior change. Specifically, it examines the utility of psychophysiological methods to measure and promote behavior change. Moreover, it embeds the baroreflex mechanism, a well-defined heart-brain feedback loop, within the theories and strategies of MOBC research. Individuals' subjective and expressive experience of change does not always align with their physiological reactivity. Thus, behavior change may be best understood when concurrently assessed across multiple biobehavioral levels. Further, behavior is initiated in the moment, often before conscious deliberation, suggesting that multilevel behavior change research may benefit from real-time methodological designs. Last, substance use trajectories vary widely, suggesting that different MOBCs are more or less active in individuals depending on their personal constituency and the functional need that their substance use serves; thus, methods that are amenable to personalized modeling approaches are important.

Story versus info: Tracking blog readers’ online viewing time of sponsored blog posts based on content-specific elements

Advertising researchers have compared the persuasiveness of a storytelling message appeal to an informational message appeal in different advertising contexts. A majority of these studies confirm that stories are powerful since they “capture audience attention”. However, no previous research has measured whether storytelling message appeals actually capture audience attention differently than informational message appeals in an everyday life setting. This study attempts to fill this gap by comparing the influence of a storytelling message appeal and an informational message appeal on audience real-time attention in a blog context. The sample consists of 94 sponsored blog posts from a current blog with 15,000 weekly readers. The results reveal that the sponsored blog post format has a direct effect on blog readers' online viewing time of the content. Using a storytelling message format compared to an informational message format when a blogger reviews a sponsored product increases the blog readers’ viewing time of the sponsored blog post. This has important implications for advertising attention, since increased attention towards an advertisement can result in enhanced brand recall and purchase intentions.

‘Together apart’ or ‘apart together’? – middle-class parents’ choice of playgrounds and playground interactions in socially diverse neighbourhoods

Taking an everyday life setting, namely playgrounds, as a starting point, the paper foregrounds a nuanced analysis of the internal differentiations of the middle class’s positioning in regard to social diversity. In so doing, the paper contributes to debates on contemporary segregation research, (dis-)affiliation of the middle classes in inner-city diverse neighbourhoods and geographies of encounter. Empirical findings are based on an analysis of the narratives and daily spatial routines of middle-class parents in three inner-city neighbourhoods in a major German town. The findings contradict the conventional wisdom that middle-class parents would always seek a socially homogeneous environment in which to raise their children and show the presence of a middle-class fraction with a collective orientation. The analysis highlights the need for a closer look at playgrounds as a setting for cross-social interaction and, in terms of micro-level politics, a setting to promote diverse and inclusive neighbourhoods.

'I didn't mean that: It was just a slip of the tongue': Racial slips and gaffes in the public arena.

Speech errors, slips, and gaffes made in the public arena that are perceived to be either implicitly or explicitly racially offensive often result in significant social consequences to the responsible speaker and generate public controversy. The current research, informed by conversation analysis and discursive psychology, examines how speakers manage such troubles-in-speaking in public settings. The sample of naturalistic data includes five such instances and related apologies sourced from YouTube and news websites. The analysis examined how speakers initiated repairs when making offensive racial slips and gaffes and followed these up with apologies. Self-detected transgressions were repaired in fewer turns than other-detected blunders. Speakers accounted for their transgressions as innocent mishaps (e.g., 'it was just a slip of the tongue', 'an honest mistake') to fend off attributions of prejudice or a racist identity. Thus, a common resource that speakers drew upon to exonerate themselves was that what they said, did not align with their psychological intentions. Intention then was a notable psychological resource for denying and fending off attributions of prejudice. Follow-up apologies were related organizationally and worked to either address or decrease the likelihood of dispreferred responses from the public/audience. These apologies included the use of affect, graduation, amplification, and judgements of capacity. Although this research does not address the possible psychological nature of racial slips and gaffes - the question of what they really mean - their occurrence in everyday life and institutional settings suggest that their repressive qualities reflect shared patterns of understanding in societies structured by racial inequality.

Towards an everyday life information literacy mind-set: a review of literature

PurposeInformation literacy (IL) within the everyday life context is regarded as an important condition for civic participation and engagement, informed citizenship, health and well-being. However, compared to the significant amount of IL research within educational and workplace settings, there has been relatively little research in relation to the value of IL within everyday life situations. The purpose of this paper is to explore existing empirical research that addresses aspects of IL within the context of everyday life, identifying current gaps in the literature, highlighting key theoretical positions, and mapping trends.Design/methodology/approachThe review has been conducted in the form of a scoping study that aims to map the key concepts underpinning this research area and the main sources and types of evidence available. It is based on journal literature reporting primary research, published from 2000 to 2016 and sourced from a range of different databases covering IL research.FindingsIL practices take place within diverse everyday life contexts. The key research directions have been categorised into four broad contextual areas, encompassing leisure and community activities, citizenship and the fulfilment of social roles, public health and critical life situations. These point to the need for developing an IL mind-set which is discussed as an adaptive, transferable and ongoing activity that transgresses the boundaries of prescribed skills within the specific contexts of work and education.Originality/valueThis research area is still in its infancy and more varied contexts need to be explored to nurture a robust understanding of the use and impact of IL in people’s everyday lives. The paper also highlights the implications of the lack of IL and identifies the key players in the advocacy of IL within different everyday life settings.

Applications for self-administered mobile cognitive assessments in clinical research: A systematic review.

Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14days. Samples ranged in age from 14 to 83years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n=7), followed by attention/reaction time (n=4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research.

A national population-based cohort study of urethral injection therapy for female stress and mixed urinary incontinence: the Danish Urogynaecological Database, 2007–2011

Urethral injection therapy (UIT) has been performed since the early 20th century and a variety of agents have been launched. In 2006, polyacrylamide hydrogel (PAGH) was introduced and is now widely used as an agent. The objective was to evaluate the efficacy of PAGH based on a national population over a 5-year period (2007-2011) and the influence of patient-related factors, surgeon experience, and department volume. A retrospective cohort study was carried out based on data from the Danish Urogynaecological Database (DugaBase). A total of 731 women were registered in the DugaBase. Cure was achieved in 75 out of 252 women (29.8%) and no leakage at all in 23 out of 252 (9.1%) at the 3-month follow-up. The mean total International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score decreased from 16 (SD 3.8) to 10.6 (SD 6.2; p < 0.001). UIT was performed at 16 departments, of which four high-volume departments performed 547 out of 814 UITs (67.2%). Women with severe UI had a decreased chance of cure (all ICIQ-SF scores), as did women on antimuscarinic drugs (adjusted OR 0.14; 95%, CI 0.04-0.41 "frequency") and (adjusted OR 0.33; 95%, CI 0.13-0.82, "amount"). Women treated by a high-volume surgeon had a higher chance of cure (OR 4.51; 95% CI, 1.21-16.82, "frequency") and a lower risk of 30-day hospital contacts (OR 0.27; 95% CI 0.09-0.76). The study represented a cure for UIT among women in an everyday life setting. A surgeon learning curve for UIT was indicated, as was assigning interventions to fewer hands to improve the surgical training value and consequently the cure rate for women with UIT.

Conceptions of Immigrant Integration and Racism Among Social Workers in Sweden

ABSTRACTDrawing on 22 qualitative interviews with social workers in Sweden, this article analyzes how social workers conceive immigrant integration and racism and tackle racism within their institutions and the wider Swedish society. The majority of the white social workers framed integration in relation to cultural differences and denied or minimized the role of racism in structuring their services and the ethnic relations in Sweden. In contrast, social workers with immigrant backgrounds were less compromising in discussing racism and assumed it as a problem both for themselves as institutional actors and as immigrants in everyday life and institutional settings. Social institutions in Sweden have been important actors in endorsing equality and accommodating differences. However, it is of paramount importance for social justice-minded social workers to identify and unsettle those structures and discourses that enable racist and discriminatory policies and practices against those groups who are not viewed as “core” members of the Swedish society. The absence of anti-racist social work within Swedish social work is primarily related to the idea of color-blind welfare universalism that is assumed to transcend the particularity of the needs, experiences, and perspectives of different groups in Sweden. While integration is envisioned and framed as a political project of inclusion of non-white immigrants, it tends to become a political device through which hierarchies of belonging are constructed. Following such conception of integration, cultural/religious differences and equality are framed as conflicting where cultural conformity underpinned by assimilationist discourses becomes a requirement for political, social, and economic equality.

Infectious disease prevention in the home and community: closing the circle.

In 1970, the Surgeon General of the United States indicated that 'it is time to close the book on infectious diseases, declare the war against pestilence won, and shiftnational resources to such chronic problems as cancer and heart disease'. Complacency about the threat of communicable diseases and ready access to vaccines and antibiotics led to complacency about prevention measures such as hygiene.During the last three decades, this opinion has been reversed, and there is renewed concern about the importance of communicable disease and the role of hygiene. However, where investments have been made in the last 30 or more years, they have focussed on hospital, institutional and manufacturing hygiene. The general assumption in the 1980s was that home and everyday life settings are predominantly occupied by 'normal healthy adults' with healthy immune systems. There was also little surveillance data on infectious diseases in the home and community to suggest otherwise.Data now show that infectious disease circulating in the community continues to exert a heavy burden on health, healthcare systems and prosperity. It also suggests that much of this disease could be prevented by better hygiene. It is recognised that infections in hospitals largely originate in the home and community. Patients entering hospitals who are infected or carrying noroviruses, for example, are the main source of hospital outbreaks, while patients who are unwittingly carrying organisms such as Staphylococcus aureus when they enter hospital may be self-infected following surgical procedures and spread these infections to other patients. Healthcare workers now recognise that reducing infection in healthcare settings cannot be achieved without also reducing circulation of pathogens (or the 'silent carriage of infectious strains') in the home and community.No single issue drives the increasing concern about importance of home and community hygiene. The various issues are usually considered in isolation but, when viewed together, represent a powerful argument for increased emphasis on hygiene promotion. The majority of the following data in this short review are taken from a 2009 report compiled by the International Scientific Forum on Home Hygiene (IFH).1 More recent references are added where appropriate.Gastrointestinal And Respiratory DiseasesFood-related, waterborne and non-foodrelated infectious intestinal diseases remain at unacceptably high levels. A community-based study suggests that the annual number of cases in the United Kingdom is 17 million, including 3 million cases of norovirus.2 Using data from 18 European countries, a World Health Organization report concluded that about 31% of reported food-borne outbreaks occur in private homes.3 Norovirus, which is mainly spread from person-toperson, is now the most significant cause of gastrointestinal infections in the developed world, while rotavirus is the leading cause of gastroenteritis in children under five.Evidence increasingly shows that hands and surfaces contribute to the spread of respiratory infectionsparticularly colds, but also influenza- and that good respiratory hygiene can limit spread.4 A significant proportion of intestinal and respiratory infections circulating in the community are viral in origin. Since viral infections are not treatable by antibiotics, prevention through hygiene is key.Emerging PathogensEmergence of new pathogens and new strains of existing pathogens remains a significant concern. As soon as we begin to get one pathogen under control, another emerges. It is difficult to believe that pathogens such as norovirus, Campylobacter and Legionella were largely unheard of in 1980.International and national agencies recognise that the threat posed by emerging diseases such as avian influenza and severe acute respiratory syndrome (SARS) demands an immediate response and that, in the event of a pandemic, hygiene in the community must be a first line of defence during the early critical period before mass vaccination or other measures become available. …