Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy

Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in predicting the adoption of two healthy behaviours—physical activity and fruits and vegetables consumption. Methods: This study was conducted on the Tuscan population subsample of the Italian Behavioral Risk Factor Surveillance System in 2017–2018. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results: About 40% of the 7157 interviewees reported an inadequate or problematic HL level. Female sex, poor financial status, foreign nationality, and low education were associated with a problematic HL level, while an inadequate HL level was associated with being 50–69 years old, low education level, foreign nationality, poor financial status and unemployment or inactive status. Inadequate HL level was a strong predictor of both eating less than three portions of fruits/vegetables per day and not engaging in sufficient PA during leisure times. Conclusions: Our findings showed that an inadequate level of HL could negatively affect physical activity and diet, independently from the other sociodemographic conditions, confirming the role of HL as a relevant social determinant of health.

Predictors for participation in DNA self-sampling of childhood cancer survivors in Switzerland

Background Research on germline genetic variants relies on enough eligible participants which is difficult to achieve for rare diseases such as childhood cancer. With self-collection kits, participants can contribute genetic samples conveniently from their home. Demographic and clinical factors were identified previously that influenced participation in mailed self-collection. People with pre-existing heritable diagnoses might participate differently in germline DNA collection which might render sampling biased in this group. In this nationwide cross-sectional study, we analysed predictive factors of participation in DNA self-collection including heritable diagnoses. Methods We identified childhood cancer survivors from the Swiss Childhood Cancer Registry for invitation to germline DNA self-sampling in September 2019. Participants received saliva sampling kits by postal mail at their home, were asked to fill them, sign an informed consent, and send them back by mail. Two reminders were sent to non-participants by mail. We compared demographic, clinical, and treatment information of participants with non-participants using univariable and multivariable logistic regression models. Results We invited 928 childhood cancer survivors in Switzerland with a median age of 26.5 years (interquartile range 19-37), of which 463 (50%) participated. After the initial send out of the sampling kit, 291 (63%) had participated, while reminder letters led to 172 additional participants (37%). Foreign nationality (odds ratio [OR] 0.5; 95%-confidence interval [CI] 0.4-0.7), survivors aged 30-39 years at study versus other age groups (OR 0.5; CI 0.4-0.8), and survivors with a known cancer predisposition syndrome (OR 0.5; CI 0.3-1.0) were less likely to participate in germline DNA collection. Survivors with a second primary neoplasm (OR 1.9; CI 1.0-3.8) or those living in a French or Italian speaking region (OR 1.3; CI 1.0-1.8) tended to participate more. Conclusions We showed that half of childhood cancer survivors participated in germline DNA self-sampling relying completely on mailing of sample kits. Written reminders increased the response by about one third. More targeted recruitment strategies may be advocated for people of foreign nationality, aged 30-39 years, and those with cancer predisposition syndromes. Perceptions of genetic research and potential barriers to participation of survivors need to be better understood. Trial registration Biobank: https://directory.bbmri-eric.eu/#/collection/bbmri-eric:ID:CH_HopitauxUniversitairesGeneve:collection:CH_BaHOP Research project: Clinicaltrials.gov: NCT04702321.

Predictors for participation in DNA self-sampling of childhood cancer survivors in Switzerland

Research on germline genetic variants relies on a sufficient number of eligible participants which is difficult to achieve for rare diseases such as childhood cancer. With self-collection kits using saliva or buccal swabs, participants can contribute genetic samples conveniently from their home. We identified determinants of participation in DNA self-collection in this cross-sectional study. We invited 928 childhood cancer survivors in Switzerland with a median age of 26.5 years (interquartile range 18.8-36.5), of which 463 (50%) participated. Foreign nationality (odds ratio [OR] 0.5, 95%-confidence interval [CI] 0.4-0.7), survivors aged 30-39 years at study versus other age groups (OR 0.5, CI 0.4-0.8), and those with a known cancer predisposition syndrome (OR 0.5, CI 0.3-1.0) participated less. Survivors with a second primary neoplasm (OR 1.9, CI 1.0-3.8) or those living in a French or Italian speaking region (OR 1.3, 1.0-1.8) tended to participate more. We showed that half of survivors participate in germline DNA self-sampling relying completely on mailing of sample kits. Foreign nationality, age 30-39 years, and cancer predisposition syndromes were associated with less participation. More targeted recruitment strategies may be advocated for these subgroups. To increase participation in DNA self-sampling, understanding and perceptions of survivors need to be better understood.

Prevention of Sexually Transmitted Infections: Level of Knowledge Among Freshmen of Four Italian Universities

Background. With the aim to inform potential SHE programs in Italian schools, we run a survey on 4,552 freshmen of four different Italian universities (Padua, Palermo, Bergamo and Milan) to investigate their level of SHK on STI prevention and associated factors. Methods. The survey was conducted with an anonymous self-reported paper questionnaire administered during teaching lectures to university freshmen of four Italian universities and different undergraduate courses. Results. The final number of freshmen surveyed was 4,552 (97.9% response rate), 1,842 (40.5%) from the university of Padua; 1,743 (38.3%) from the university of Palermo; 667 (14.7%) from the university of Bergamo and 300 (6.6%) from the university of Milan. The mean age of respondents was 21.4 2.2 years and most of them (70.3%) were females. An overall low STI knowledge among sample students was found. Only 28% respondents knew the most effective contraceptives to prevent STI (i.e. condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs reported referring mostly to their GP (38.1%), rather than discussing the problem with a family member (15.1%), booking an appointment with a consultant gynecologist (13.1%), discussing with their partner (13.1%) or with an experienced friend (12.5%). At multivariable analysis significantly lower levels of STI knowledge was found among males, students of the university of Palermo, those who completed a vocational secondary school education and non-Italian nationals. Categories with significantly less SHK on the most effective contraceptives to prevent STIs included males, students of the university of Palermo, students of educational sciences, students of economics/political sciences, those of foreign nationality, those with two siblings and those whose fathers had a lower educational level. Conclusions. The above findings provided indirect information on the standard of SHE delivered in Italian schools and call for the development of tailored multi-agency SHE programs involving several actors. In addition to school-based SHE programs, primary care services dedicated to sexual health should be strengthened in Italy.

12 Right to Equality

This chapter focuses on the right to equality before courts and tribunals, which requires that all parties to criminal proceedings are treated without discrimination. The right underlies the rule of law. It is codified in Article 14(1) of the International Covenant on Civil and Political Rights (ICCPR), which provides ‘[a]ll persons shall be equal before the courts and tribunals’. It is also enshrined in Article 14(3), which refers to the minimum guarantees of a fair trial ‘in full equality’. This chapter considers three areas in which the right to equality before courts and tribunals may arise in criminal proceedings: equality of treatment, equality of arms, and equality of access. In terms of equal treatment, Article 26 of the ICCPR provides ‘that all persons are equal before the law and are entitled to equal protection of the law without discrimination, and that the law shall guarantee to all persons equal and effective protection against discrimination on any of the enumerated grounds’. These grounds include ‘race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status’. Equality of treatment applies to all individuals, not just to defendants, and requires equal treatment by all organs of the state, not just judicial authorities. Meanwhile, equality of arms ensures that the same procedural rights are to be provided to all the parties to a case, ‘unless distinctions are based on law and can be justified on objective and reasonable grounds, not entailing actual disadvantage or other unfairness to the defendant’. It does not necessarily require mathematical equality between the prosecution and the defence. Equality of access issues may arise in criminal proceedings when a defendant’s access to court is hindered because of his detention, disability, or his foreign nationality, or when a defendant is forced to be tried before a military or special court rather than having access to a regular civilian court. The right to equality before courts and tribunals has been used relatively infrequently to vindicate fair trial violations, which may in part be attributed to the challenges of proving discrimination.

Investigation of Nurses' Opinions on Foreign Nationality Patient Care

INTRODUCTION: This research has been planned to examine the professional and institutional preparations of nurses for foreign patients, and to identify the difficulties they experience regarding their care. METHODS: The descriptive study was carried out in two private hospitals in Istanbul. 180 volunteer nurses participated in the study. The data were collected using the Information Form created by the researchers. Frequency, percentage and chi square test were used in the analysis of the data. RESULTS: It has been determined that 62.8% of the nurses’ foreign language is insufficient, 67.2% of foreign students negatively affect nursing care practices, undergraduate graduates nurses, those who know a foreign language and those who work less than five years have less difficulty in the care of foreign students. DISCUSSION AND CONCLUSION: It was demonstrated that they were unable to communicate with the patient and their relatives, therefore the data collection process from the patient was negatively affected and affected other processes. For this reason, it is recommended that schools provide a supportive environment to students, in practice, and administrators and nurses to provide guidance, create continuing education resources, provide care procedures and communication resources during the learning process

Caratube International Oil Company LLP v. Republic of Kazakhstan

424Jurisdiction — Foreign investor — ICSID Convention, Article 25(2)(b) — Foreign nationality — Ownership or control — Investment — Economic contribution — Whether the scope of protection under the BIT for companies under foreign control fell within the outer limit of ICSID jurisdiction — Whether the national of another contracting State had made an investment — Whether establishing foreign ownership under the BIT was sufficient in light of the requirement for foreign control in the ICSID ConventionJurisdiction — Investment — Interpretation — “Every kind of investment” — Economic contribution — Origin of capital — Whether the definition of investment required an economic contribution by a foreign national — Whether origin of capital was relevant to the existence of an investmentJurisdiction — Investment — Interpretation — ICSID Convention, Article 25(1) — Whether the inherent meaning of investment under ICSID jurisprudence was relevant in determining ownership or control by a foreign national — Whether there was an economic arrangement requiring a contribution to make a profit and some degree of riskJurisdiction — Investment — Foreign nationality — Ownership or control — Evidence — Burden of proof — Adverse inferences — Whether the burden of proof can shift from the claimant to the State due to seizure of document — Whether adverse inferences may be drawn from the failure to produce documentsAnnulment — Failure to state reasons — Manifest excess of powers — Serious departure from a fundamental rule of procedure — ICSID Convention, Article 52(1) — Foreign nationality — Applicable law — Obiter dictum — Translation — Whether a tribunal’s misapplication of or failure to apply the applicable law justified annulment if its interpretation was reasonable or tenable — Whether reliance on an incorrect translation warranted annulment if the reasoning was incidental to the operative part of the award — Whether obiter dictum issued without hearing warranted annulment

CITIZENSHIP STATUS AND INHERITANCE OF ADOPTED CHILDREN CARRIED OUT BY SPOUSES OF FOREIGN NATIONALS IN INDONESIA

Children are a gift from God Almighty that is dreamed of by every couple. Couples who do not have offspring usually adopt children to continue their lineage and maintain their marriage. Appointment of children in Indonesia is the adoption of children between Indonesian citizens (domestic adoption) and the adoption of children by Foreign Citizens (Intercountry adoption). Requirements and procedures the appointment of an Indonesian citizen by a foreign national is explained in PP No. 54 of 2007 concerning Implementation of Child Appointment, Minister of Social Affairs Regulation No. 110 / HUK / 2009 Regarding the Requirements for Appointment of Children, the two regulations are inseparable from Law No. 35 of 2014 concerning Child Protection. The purpose of this study is to examine and determine the status of inheritance and legal consequences on the citizenship status of the process of adopting Indonesian Citizens' children by Foreign Citizens after a court ruling. The research method used is a normative juridical approach that is by focusing on data and field interviews to study primary, secondary, tertiary data collected in the form of traditional materials that are related to the problem under study which will then be analyzed in a qualitative juridical manner, then analyzed descriptively analytically to obtain a comprehensive and systematic picture of the problem under investigation connected with applicable legal regulations. The results showed that there were still many Indonesian citizens being adopted by foreign citizens who did not comply with the procedures. Problems that arise are regarding citizenship status and inheritance of adopted children. If the adopted child has a foreign nationality, he/she cannot obtain an estate with ownership status, but can only control the usage rights. This is stated in Article 21 of the Basic Agrarian Law.

Walking on Gender Tightrope in the New World: International Female Students in STEM Graduate Programs

This phenomenological research explored how international female students understand the role of gender and national origin in their program experiences and how they cope with the challenges derived from their triple marginalities—gender, race/ethnicity, and foreign nationality. Based on in-depth interviews with 22 international female students enrolled in various STEM disciplines, we drew four thematic findings that illustrate the participants’ multiple marginalities and ironic coping strategies grounded in their prior cultural upbringing and contextualized in the hostile cultural environment of STEM programs against women. This study suggests that STEM educators in higher education understand the multifaceted struggles of international female students as a triple minority in their graduate programs and provide culturally relevant support and professional mentoring.