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The proliferation of misinformation in contemporary information environments contributes to increasing polarization and decreasing trust in institutions and experts, both of which encourage further proliferation of misinformation. Increasing attention has been brought to the role of news media in the spread and uptake of misinformation, and to the role of journalists and news organizations in combatting this spread. Constructive journalism is a relatively new approach to reporting which, among other aims, looks to increase audience engagement, reduce polarization, and provide a more accurate view of events. In early 2020, we interviewed 16 journalism professionals from Europe (UK inclusive), Australia, Africa, and North America across a range formats to explore their perceptions of the use 'constructive' reporting strategies to address the spread of misinformation. We used thematic analysis to produce three themes and six subthemes in journalists' responses, 'apathy against the machine', with subthemes 'journalism as a moderator', and 'news and mental health'; 'standards as shared reality', with subthemes, 'pluralism not postmodernism', and 'this means information war'; and 'truth, trust, and the turn to transparency', with subthemes, 'facts necessary but not sufficient', and 'principles not particulars'. Constructive journalism was thought to address misinformation by increasing engagement with news and institutions, reducing polarization, providing a sense of shared reality amidst increasingly diverse perspectives, increasing trust, and reducing misperceptions encouraged by selection and reporting strategies. Constructive journalism may be a promising approach to addressing the spread and consequences of misinformation, however, empirical work is needed to evaluate the efficacy of the approach. [ABSTRACT FROM AUTHOR]

Throughout the COVID-19 pandemic, concerns have been raised about an 'infodemic', with information and misinformation being spread across multiple channels and mediums. Information consumption has also been associated with increased anxiety throughout the pandemic. Thus, the present study investigates the mediating role of state anxiety on the relationship between information consumption (defined as mean frequency of information consumption multiplied by number of information sources) and COVID-19 protective behaviours. We compare results across Australian and United States samples and account for personal risk perception and belief in misinformation about COVID-19. Cross-sectional data collected between 28 and 30 April 2020 were analysed using Bayesian structural equation modelling among participants from Australia (N = 201), and the United States (N = 306). State anxiety scores were above the conventional clinical cut-off. Information consumption was positively associated with state anxiety, personal risk perception, and COVID-19 protective behaviours in the Australian and the United States samples. Additionally, the relationship between information consumption and COVID-19 protective behaviours was positively mediated by state anxiety in both nations, suggesting some functional benefits of anxiety. Differences in risk perception and belief in misinformation existed between the Australian and United States sample. Findings provide support for current guidance from organisations such as the WHO, APA, and APS on limiting information consumption to reduce anxiety. To effectively communicate critical public health messaging while minimising potential burdens on mental health, there is a need to develop and test interventions that assist people in calibrating the extent and nature of their information consumption. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to extend understandings of the impact of surgically diagnosed endometriosis on women's social lives, work and education. Methods: Participants (N = 200; average age: 27.1 years (±6.72)) were recruited from a range of sources, including social media and private women's health clinics. They completed an online survey comprising seven open‐ended questions about how experience with endometriosis impacted (i) overall life; (ii) family relationships; (iii) friendships; (iv) attendance at social events; (v) engagement in leisure activities; (vi) work; and (vii) education. Data were analysed using inductive classical content analysis. Results: The data set contained 1400 discrete codable statements, with 19% of women reporting some form of social impact. A key result was the role of family and friends, both positive and negative, as well as the positive role that the workplace/educational institution can play (noted by 50% of participants). Findings highlight the negative impact on leisure activities, reported by 86% of women. The exhaustion of sick and unpaid leave was reported by 41% of women. Conclusion: This study highlights the impact of endometriosis on the social and economic lives of Australian women and underscores the importance of the comprehensive response recommended in the National Action Plan for Endometriosis. [ABSTRACT FROM AUTHOR]

Throughout COVID-19, the proliferation of misinformation and the impact of negative news on mental health highlights a tension between news media as a source of essential public health information and news as a source of distress. A suggested approach to reporting which remains informative while tempering audience distress is constructive journalism. We investigated the benefits and applications of constructive news reporting during COVID-19 from the perspectives of journalism professionals interested in constructive approaches. Eleven participants from four continents were interviewed in the first two months of the pandemic. The data were analysed using thematic analysis, and two themes produced: "Sober not sensational" and "What's positive in a pandemic?" Six subthemes were also produced: "beyond the numbers", "slower reporting", "understanding uncertainty", "solutions", "we're all in the same boat" and "awakening". Constructive approaches were seen to help journalists navigate their roles as educators and to provide hope without inciting undue panic. Our interviews suggest constructive news reporting could assist in balancing informativeness and public mental health throughout the pandemic. More work is needed, however, that incorporates randomised controlled testing to establish whether constructive journalism techniques meaningfully impact audience mental health beyond standard approaches. [ABSTRACT FROM AUTHOR]

To examine undergraduate psychology and dental students' perceptions of their self-perceived ability, value and comfort in working with others in an interprofessional context. Students participated in a new interprofessional learning initiative incorporating motivational interviewing to encourage health behaviour change. Pre- and post-interprofessional learning survey data from 49 students and written reflections of 115 students were analysed. Students demonstrated significant improvement in all quantitative measures, including overall interprofessional socialisation and values as well as perceived ability, value and comfort in working with others. Three themes relating to perceptions of ability, value and comfort with interprofessional collaboration were identified: Scope of Practice, Collaboration as a Valuable Approach and Healthy Scepticism. While the findings show that even small-scale interprofessional learning programmes can significantly increase students' perceptions in these domains, student feedback can further enhance interprofessional learning. Within interprofessional learning, the scope of practice for health professions, including the students' own discipline, must be clear, knowledge about facilitators and barriers to successful interprofessional collaboration and ways to address these issues must be included, and efforts should be made to show students how professions that may initially seem quite disparate, can and do, collaborate to support positive patient outcomes. Key Points What is already known about this topic: (1) Successful interprofessional collaboration offers benefits for clients, health professionals and health systems. (2) Interprofessional learning aims to produce a collaborative practice-ready psychology workforce responsive to a range of client presentations and workplace contexts. (3) Psychologists are often employed in multidisciplinary teams, yet in Australia it has not been commonplace for psychologists-in-training to be exposed to interprofessional learning. What this topic adds: (1) Small-scale interprofessional learning initiatives may be associated with improvements in students' overall interprofessional socialisation and values, and perceived ability, value and comfort in working with individuals from other health professions. (2) For interprofessional learning to be successful, students must be knowledgeable about the scope of practice for a range of health professions, including their own. (3) Students benefit from knowledge about facilitators and barriers to successful interprofessional collaboration and guidance on how to address these to maximise the effectiveness of collaboration. [ABSTRACT FROM AUTHOR]

Aims and objectives: The current study aimed to qualitatively explore men's help‐seeking behaviours by analysing male callers' talk on an Australian health helpline. Analysis focused on identifying the ways in which men positioned themselves as help‐seekers and the extent to which help‐seeking behaviours deviated or conformed to the narrative commonly reported on in men's health literature which, generally speaking, positions men as reluctant help‐seekers and health service users. Methods: The present study utilised naturally occurring instances of men's help‐seeking during 196 calls to the helpline, Healthdirect Australia. Thematic analysis was used to explore recurrent themes in help‐seeking interactions. Findings: The analysis yielded three broad themes, which were formulated as caller archetypes. These themes included the 'reluctant caller', the 'unwell patient' and the 'concerned carer', as well as a number of associated sub‐themes within these broad categories. Conclusions: The findings demonstrated that male callers sought help in a variety of different ways, rather than prescribing to a homogenous pattern of help‐seeking. However, it was acknowledged that some data did align with help‐seeking behaviour which indicated men's reluctance to engage with their own health. So what?: The present study contributes to men's health promotion by identifying the various social devices used by men to facilitate help‐seeking. The findings highlight the changing and flexible landscape of contemporary masculinity and its impact on health engagement. Recognising the versatility in men's health behaviour is important for ensuring that men have positive experiences during healthcare encounters which, in turn, may facilitate future health service uptake and engagement. [ABSTRACT FROM AUTHOR]

Objective: To identify the modifiable psychological and behavioural coping strategies associated with low levels of psychological distress, independent of more stable personality and demographic factors, in a sample of farmers who reported being exposed to a recent stressful event during an extended drought. Design/setting/participants: Three hundred and nine South Australian, drought‐affected grain, sheep and/or cattle farmers completed printed or online questionnaires. Only those who reported experiencing a stressful event in the past month that they rated ≥7 on a scale ranging from 1 (not stressful at all) to 10 (extremely stressful) were included in the analyses (n = 175, 65.06%). Participants ranged in age from 24 to 85 years and 40% were female. Main outcome measures: Psychological distress was measured using the Kessler Psychological Distress Scale, and coping strategies were measured using a situational version of the COPE inventory. Five personality factors (extraversion, neuroticism, openness, conscientiousness and agreeableness) were assessed using the Quickscales‐R. Results: In the final multivariable model, distress was elevated among individuals reporting higher neuroticism and behavioural disengagement, and lower in individuals reporting greater use of acceptance. These 3 variables explained 44% of the variance in distress. Conclusion: Farmers recently exposed to a significant stressor, who used acceptance as a coping strategy, did not engage in behavioural disengagement and scored low on neuroticism, were least likely to experience distress. Given the stability of personality factors, interventions that foster farmers' use of acceptance and prevent behavioural disengagement as coping strategies might assist them with the management of future stressors, particularly in times of drought. [ABSTRACT FROM AUTHOR]

Introduction: This study explored the extent to which disaggregated support from family, peers, close friendships, teachers, and schools predicted membership into identified, sex-specific trajectories of depressed mood in 3210 Australian adolescents (49% females) based on self-report data collected at four annual time points from school Grade 6 to 9 (ages 10-16).Methods: The sample was initially split by sex. Group-Based Trajectory Modelling was used to identify the trajectory groups using a Censored Normal model, starting with a two-group model and increasing group size in increments of one, up to a six-group model. Overall model-fit and specific model-fit criteria were examined, and participants were allocated to best-fit groups. Multinomial Logistic Regression examined the associations between baseline social supports and allocated trajectory group membership.Results: For boys, four trajectory groups were identified which were given the qualitative labels; Low Stable, Moderate Stable, Moderate Decreasing, and High Stable. Regression analysis showed that higher rates of peer belonging were associated with membership in the low and moderate groups compared to the High Stable group. For girls, four trajectory groups were identified and labelled as Low Stable, Moderate Decreasing, Moderate Increasing and High Increasing. Regression analysis showed that higher rates of family support, school climate, and peer belonging were associated with membership in the low and moderate groups compared to the High Increasing group.Conclusions: Implications included the need for school-based early intervention programs to consider disaggregated supports and vary their interventions by sex. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objective: Regular screening for colorectal cancer (CRC) can substantially improve outcomes. This study investigated how measuring regret expected from failing to screen might lead to stronger screening intentions. Five potential moderators were evaluated: perceived threat, psychological reactance, prior screening participation, concurrently measuring faecal aversion (FA) and anticipated regret (AR). Design: A 2 (AR measured pre/post intention) × 2 (FA measured pre/post intention) single blind parallel randomised controlled trial was used. Australians aged 45 and over completed an online survey measuring AR, FA, intention, theory of planned behaviour variables and potential moderators. Main outcome measures: The primary outcome was CRC screening intention. Results: Eight hundred and three participants were randomised, with 666 analysed. Measuring AR prior to intention unexpectedly resulted in a significantly lower intention to screen (d = 0.18, 95% CI [0.03, 0.33]) compared to measuring after intention. Trait reactance predicted a significantly lower intention when it was at least 0.52 SD above the mean; other moderators were not supported. Conclusion: The processes underlying anticipated regret manipulations must be better understood in order to have practical value in health promotion. More research is required to determine how to minimise or avoid the apparent negative effects of psychological reactance in CRC screening communication. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12618001098224 [ABSTRACT FROM AUTHOR]

Purpose: This study investigated how coping impacts offspring's adaption to parental cancer in terms of post-traumatic growth, resilience, and emotion; and how coping differs between offspring. Methods: Participants (18–34 years; n = 244) completed an online survey. Data were analyzed using generalized linear modeling and multinomial regression. Findings: Higher levels of adaptive coping was associated with higher post-traumatic growth, resiliency, and positive affect; whereas maladaptive coping was associated with lower resiliency and higher negative affect. Females and offspring who did not access support for their parent's cancer reported higher adaptive coping. Offspring bereaved by parental cancer reported higher levels of maladaptive coping. Offspring whose parents' cancer was of shorter duration and those who lived with their ill parent had lower adaptive and maladaptive coping. Conclusions/Implications: Adaptive coping appeared beneficial to offspring. Supportive interventions may benefit from focusing on increasing adaptive coping, particularly among bereaved offspring. [ABSTRACT FROM AUTHOR]

Extant literature describes stress as an unavoidable occurrence that can be bifurcated into both negative and positive aspects, known as distress and eustress, respectively. Despite this theoretical conceptualization, there are no measures of adolescent stress encompassing both aspects of the construct. In pursuing the creation of such a measure, the current study explored young people's experience of stress, describing the phenomena adolescents identify as salient indicators of both distress and eustress. Semistructured qualitative interviews were conducted with 20 adolescents; thematic analysis of the transcripts focused on those indicators useful for discriminating between distress and eustress. In all, 6 key dimensions were proposed, along which eustress and distress were differentiated in adolescents: state of mind, function, perceived efficacy, affect, constitution, and connection. Although many of these identified phenomena were comparable with those proposed by the adult-focused literature, the participants demonstrated a range of distinctive perspectives. Unlike adults, the adolescents considered personal connections and self-regard as salient indicators of the stress response, whereas meaningfulness was not considered a pertinent phenomenon. These idiosyncrasies emphasize the inappropriateness of directly translating adult-focused literature to the adolescent context and robustly reiterate the need for a measure of stress that reflects and respects young people's unique experiences. [ABSTRACT FROM AUTHOR]

Little is known about men's use of online mental health (eMH) interventions and factors that promote their engagement or attrition. We aimed to synthesise the qualitative literature on men's preferences for, attitudes towards, and experiences of using eMH interventions for depression and anxiety, and develop recommendations from the findings. Systematic searches were conducted (Jan 2000-Oct 2020) in six databases; study quality was assessed using Qualsyst with a minimum total of 0.55 required for inclusion. Extracted data were synthesised using meta-aggregation. Eight studies met inclusion criteria and three synthesised findings were generated. (1) Facilitators of men's eMH use: finding apps and technology motivating and convenient, support and encouragement from important others, and interventions allowing men to take action, gain control over their mental health, and resulting in positive outcomes; (2) Barriers to men's eMH use: lack of free time, predicted or experienced lack of benefit from use, and technical difficulties; (3) What men want in eMH: personalised, tailored, relevant interventions that are bright and easy to use, with information presented in multiple formats, psychoeducation, exercises, self-monitoring, information on further resources, and the option of clinician involvement, without any repetitive questioning, boring tools, or negative feedback. All included studies were conducted in high income, 'Western' countries; most data related to experiences of using an existing eMH intervention within a trial, rather than in 'real world' settings where eMH acceptability is generally lower and experiences may differ. Practice, research, and policy recommendations are presented. • Finding technology motivating, convenient enables men's e-mental health (eMH) use. • Lack of free time, predicting little benefit from use hinder men's use of eMH. • Men want easy-to-use eMH programs that can adapt to their own situation and needs. • Some men prefer to use eMH with clinician support; others prefer independent use. • Men's voices should be centred in work to develop acceptable, effective eMH for men. [ABSTRACT FROM AUTHOR]

This study addresses a knowledge gap in the literature about early adolescent cyberbullying victimization and the related positive and negative emotional wellbeing and academic achievement outcomes experienced over time. The study examines 9139 South Australian students (aged 10–13 years) who reported on cyberbullying status in Grade 6, and explores the relationship with emotional wellbeing and academic achievement outcomes measured in Grade 7 and Grade 9, while accounting for range of child, peer, school, and community covariates. Using mixed effects modeling, the results show that cyberbullying victimization is associated with significantly lower levels of happiness, life satisfaction, and higher levels of sadness, and worries over the shorter term (Grade 7), and significantly lower levels of reading and numeracy sustained across the longer term (Grades 7 and 9), compared to non‐victimization. The results indicate that early adolescent cyberbullying may be associated with poor emotional wellbeing and academic achievement as one progresses through formal school and highlights the importance of considering the outcomes of bullying victimization beyond the immediate instance. Practitioner points: The prevalence of cyberbullying victimization is 7.2% in early adolescence.Cyberbullying victimization has negative impacts on emotional wellbeing and academic performance.School staff and mental health clinicians should be aware of the potential for cyberbullying victimization to contribute to academic and wellbeing difficulties for students over the short and longer term. [ABSTRACT FROM AUTHOR]

This study reviewed the literature regarding the psychological, social, and behavioural impact of parental cancer on offspring aged 10-24 years, at the time of the parent's first diagnosis. A systematic literature review was conducted following 2015 PRISMA guidelines. Seven studies met inclusion criteria. Offspring were impacted by their parent's cancer and experienced psychological and behavioural problems. Daughters and offspring who experienced more problems at their parent's diagnosis appeared to be most impacted. Offspring refrained from communicating their disease-related concerns, but expected their parents to communicate openly. Turning to oneself and peer-support were coping strategies used by offspring. The majority of offspring were significantly impacted by their parent's cancer. The paucity of literature focusing on offspring aged 10-24 years at the time of their parent's incident cancer diagnosis indicates that research has overlooked offspring age at their parent's cancer onset as a factor that may influence their future outcomes. [ABSTRACT FROM AUTHOR]

Background: Women's views are critical for informing the planning and delivery of maternity care services. ST segment analysis (STan) is a promising method to more accurately detect when unborn babies are at risk of brain damage or death during labour that is being trialled for the first time in Australia. This is the first study to examine women's views about STan monitoring in this context.Methods: Semi-structured interviews were conducted with pregnant women recruited across a range of clinical locations at the study hospital. The interviews included hypothetical scenarios to assess women's prospective views about STan monitoring (as an adjunct to cardiotocography, (CTG)) compared to the existing fetal monitoring method of CTG alone. This article describes findings from an inductive and descriptive thematic analysis.Results: Most women preferred the existing fetal monitoring method compared to STan monitoring; women's decision-making was multifaceted. Analysis yielded four themes relating to women's views towards fetal monitoring in labour: a) risk and labour b) mobility in labour c) autonomy and choice in labour d) trust in maternity care providers.Conclusions: Findings suggest that women's views towards CTG and STan monitoring are multifaceted, and appear to be influenced by individual labour preferences and the information being received and understood. This underlies the importance of clear communication between maternity care providers and women about technology use in intrapartum care. This research is now being used to inform the implementation of the first properly powered Australian randomised trial comparing STan and CTG monitoring. [ABSTRACT FROM AUTHOR]

Resilience is related to students’ well-being and academic success. While challenges associated with students who are from historically underrepresented backgrounds (i.e. ‘non-traditional students’) have been frequently reported, their resilience has received lesser attention. The primary purpose of this study was to compare levels of resilience between ‘traditional’ and ‘non-traditional’ students. First year students participated in an online mental health survey which included a standardised measure of resilience, demographic questions and an item exploring students’ own perception of being ‘non-traditional’. The results showed that students who considered themselves to be ‘non-traditional’ in life aspects, including age, employment and parenting responsibility, had significantly higher resilience compared to self-identified ‘traditional students’. However, resilience levels of students who deemed themselves to be ‘non-traditional’ in other domains (e.g. household income, cultural background) did not differ significantly from ‘traditional’ students. The findings show that life experiences commonly affiliated with being a mature-aged student, including work and being a carer, may contribute to higher resilience. Implications in relation to practice and future research were discussed. [ABSTRACT FROM AUTHOR]

Background: Previous psychological and pharmacological interventions have primarily focused on depression disorders in populations with cardiovascular diseases (CVDs) and the efficacy of anxiety disorder interventions is only more recently being explored. Transdiagnostic interventions address common emotional processes and the full range of anxiety and depression disorders often observed in populations with CVDs. The aim of CHAMPS is to evaluate the feasibility of a unified protocol (UP) for the transdiagnostic treatment of emotional disorders intervention in patients recently hospitalized for CVDs. The current study reports the protocol of a feasibility randomized controlled trial to inform a future trial.Methods/design: This is a feasibility randomized, controlled trial with a single-center design. A total of 50 participants will be block-randomized to either a UP intervention or enhanced usual care. Both groups will receive standard CVD care. The UP intervention consists of 1) enhancing motivation, readiness for change, and treatment engagement; (2) psychoeducation about emotions; (3) increasing present focused emotion awareness; (4) increasing cognitive flexibility; (5) identifying and preventing patterns of emotion avoidance and maladaptive emotion-driven behaviors (EDBs, including tobacco smoking, and alcohol use); (6) increasing tolerance of emotion-related physical sensations; (7) interoceptive and situation-based emotion-focused exposure; and (8) relapse prevention strategies. Treatment duration is 12 to 18 weeks. Relevant outcomes include the standard deviation of self-rated anxiety, depression and quality of life symptoms. Other outcomes include intervention acceptability, satisfaction with care, rates of EDBs, patient adherence, physical activity, cardiac and psychiatric readmissions. Parallel to the main trial, a nonrandomized comparator cohort will be recruited comprising 150 persons scoring below the predetermined depression and anxiety severity thresholds.Discussion: CHAMPS is designed to evaluate the UP for the transdiagnostic treatment of emotional disorders targeting emotional disorder processes in a CVD population. The design will provide preliminary evidence of feasibility, attrition, and satisfaction with treatment to design a definitive trial. If the trial is feasible, it opens up the possibility for interventions to target broader emotional processes in the precarious population with CVD and emotional distress.Trial Registration: ACTRN12615000555550 , registered on 29/05/2015. [ABSTRACT FROM AUTHOR]

Background: Insulin restriction and/or omission in Type 1 Diabetes Mellitus (T1DM) is a risky disordered eating behaviour increasingly reported in the literature. Most existing literature has focused on females with T1DM. Previous research, however, suggests disordered eating behaviours are over-represented in males with T1DM versus males without T1DM. This systematic scoping review sought to summarise the existing literature to contribute to the development of an understanding of males' misuse of insulin for weight and/or shape control. Methods: A systematic scoping review methodology was used. We searched six electronic databases. Eligible articles were quantitative, qualitative, or mixed methods empirical studies with primary data on the restriction and/or omission of insulin for weight and/or shape control among males, written in English from database inception to December 2021. Results: A final sample of 56 articles was included (48 quantitative, six qualitative and two mixed methods). Where it was reported to occur, estimates of the behaviour ranged from 5 to 75% in females and 1.4% to 76% in males. In 12 studies examining sex differences, only three reported higher prevalence in females. Understandings about the behavioural context of the behaviour were hampered by lack of qualitative research (n = 4 studies). Conclusion: Despite common preconceptions, this disordered eating behaviour appears to occur similarly in males and females. The findings shed light on areas for future research, including aetiology in males and the need for longitudinal and qualitative research. Clinical recommendations include being alert to the possibility of this behaviour in males with Type 1 Diabetes Mellitus and the need for health professionals to use open-ended questions to explore current and past deliberate restriction and/or omission of insulin among their patients. [ABSTRACT FROM AUTHOR]

Issue addressed: Consumption of energy drinks is a public health concern, particularly in adolescents and young adults. This study explored energy drink consumers' reactions to an energy drink‐specific warning label (risk of cardiac effects) and a more general sugary drink warning label (risk of obesity). Methods: An online experimental study randomly allocated Australian energy drink consumers aged 18‐39 years (N = 435) to view one of two label conditions (cardiac effects or obesity). Participants were assessed on: intention to reduce energy drink consumption, perceived health threat, perceived label effectiveness and policy support for energy drink warning labels. Results: Mean intentions to reduce consumption scores were similar across the two label conditions (Mobesity = 2.5, Mcardiac = 2.6) overall; and were higher for the cardiac label (compared to obesity label) for some subgroups: females (Mobesity = 2.3, Mcardiac = 2.8; p =.037), older (25‐39 years; Mobesity = 2.4, Mcardiac = 2.8; p =.016); and higher education level (Mobesity = 1.9, Mcardiac = 2.7; p =.004). While perceived health threat measures were higher for obesity than cardiac effects, perceived label effectiveness measures of 'believable' and 'relevant to me' were higher for the cardiac label than the obesity label (believable: 71.0% vs 56.1%; relevant: 42.5% vs 29.4%). Participants who viewed the cardiac label were more likely to support policy than those shown the obesity label (OR = 1.6, 95%CI [1.1, 2.3], p =.02). Conclusions: Health effect warnings labels were perceived by energy drink consumers to be impactful and are supported. Labels with energy drink‐specific health effects may offer additional benefit. So what?: Policy makers can feel confident that warning labels on energy drinks will confer public health benefit. [ABSTRACT FROM AUTHOR]

Background Social cognitive variables are often examined for their association with initial participation in colorectal cancer screening. Few studies have examined the association of these variables with adherence to multiple screening offers i.e., rescreening. This study aimed to describe patterns of participatory behaviour after three rounds of screening using faecal immunochemical tests (FIT) and to determine social cognitive, demographic and background variables predictive of variations in adherence. Methods Participants were 1,540 men and women aged 50 to 75 living in South Australia who completed a behavioural survey measuring demographic (for example, age, gender) and social cognitive variables relevant to FIT screening (for example, perceived barriers, benefits, self-efficacy). The survey was followed by three, free FIT screening offers mailed on an annual basis from 2008 to 2010. Patterns of participation after three screening rounds were described as one of five screening behaviours; 1) consistent re-participation (adherent with all screening rounds), 2) consistent refusal (adherent with no screening rounds), 3) drop out (adherent with earlier but not later rounds), 4) intermittent re-participation (adherent with alternate rounds) and 5) delayed entry (adherent with later but not initial round(s)). Univariate (Chi Square and Analysis of Variance) and multivariate (Generalised Estimating Equations) analyses were conducted to determine variables predictive of each category of non-adherence (those that did not participate in every screening offer, groups 2, 3, 4 and 5) relative to consistent re-participation. Results Significant social cognitive predictors of non-adherence were; less self-efficacy (drop out and consistent refusal), greater perceived barriers (drop out) and lower levels of response efficacy (consistent refusal). Demographic predictors of non-adherence included; male gender (delayed entry), younger age (intermittent, delayed and consistent refusal), less frequent GP visits (intermittent re-participation) and lack of adequate health insurance (drop out). Less satisfaction with screening at baseline predicted drop out, consistent refusal and delayed entry. Conclusions Different combinations of demographic and behavioural variables predicted different patterns of rescreening adherence. Rescreening interventions may benefit from a targeted approach that considers the different needs of the population subgroups. Satisfaction with past FOBT screening measured prior to the study screening offers was an important predictor of adherence. [ABSTRACT FROM AUTHOR]

Despite the prevalence of psychiatric co-morbidity in chronic hepatitis C (CHC), treatment is under-researched. Patient preferences are likely to affect treatment uptake, adherence, and success. Thus, the acceptability of psychological supports was explored. A postal survey of Australian CHC outpatients of the Royal Adelaide Hospital and online survey of Australians living with CHC was conducted, assessing demographic and disease-related variables, psychosocial characteristics, past experience with psychological support, and psychological support acceptability. The final sample of 156 patients (58 % male) had significantly worse depression, anxiety, stress, and social support than norms. The most acceptable support type was individual psychotherapy (83 %), followed by bibliotherapy (61 %), pharmacotherapy (56 %), online therapy (45 %), and group psychotherapy (37 %). The most prominent predictor of support acceptability was satisfaction with past use. While individual psychotherapy acceptability was encouragingly high, potentially less costly modalities including group psychotherapy or online therapy may be hampered by low acceptability, the reasons for which need to be further explored. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify key issues associated with the provision of psychosocial care from the perspective of rural Australian cancer patients and determine culturally appropriate methods that may reduce barriers to service use. Method: Seventeen purposively sampled adult South Australians who lived outside metropolitan Adelaide, had a diagnosis of cancer and various demographic and medical histories participated in semi-structured, face-to-face interviews. Participants also completed a demographic questionnaire. Qualitative data were analysed using thematic analysis. Results: Five key themes were identified: (1) psychosocial support is highly valued by those who have accessed it, (2) having access to both lay and professional psychosocial support is vitally important, (3) accessing psychosocial services is made difficult by several barriers (lack of information about services, initial beliefs they are unnecessary, feeling overwhelmed and concerns about stigma and dual relationships), (4) medical staff located in metropolitan treatment centres are not sufficiently aware of the unique needs of rural patients and (5) patients require better access to psychosocial services post-treatment. Methods through which rural patients believe access to psychosocial services could be improved include: (1) providing more rural-specific information on psychosocial care, (2) improving communication between health care providers and referral to psychosocial services and (3) making psychosocial services a standard part of care. Conclusions: Rural cancer patients want their unique needs to be recognised and to be treated differently to their urban counterparts. There is a need for more targeted and rurally relevant information for rural cancer patients, both to inform them of, and change their attitudes towards, psychosocial services. Other practical recommendations are also discussed. [ABSTRACT FROM AUTHOR]

Background Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to 'prime' or 'ripen' the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. Methods Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). Results Of 1,004 eligible women, 85 percent consented ( n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. Conclusion Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety. [ABSTRACT FROM AUTHOR]

Objectives. A focus on individualistic coping strategies such as positivity and fighting spirit has done little to inform the development of interventions for people affected by cancer. The aim of this study was to conduct an inquiry, which focused on the 'lived experience' and the social context within which communication about cancer occurs. Design. A semi-structured interview schedule was used. These interviews were complemented by the Mini-International Neuropsychiatric Interview (M.I.N.I., Sheehan et al., 1998). Methods. Twenty participants with mixed diagnoses (13 female and seven male), ranging in age from 44 to 73 (Mean = 58.35, SD= 8.20) were interviewed. Consistent with Glaser's (1992) constant comparative method, research data were open coded, selectively coded, and then theoretically coded so that initial codes were collapsed into models and compared against existing literature for completeness. Results. Fifty percent of participants met criteria for an Axis 1 diagnosis. Three models emerged from the research interview; the first provides a description of the way in which patients evaluate the quality of care they receive across the cancer pathway. Other models refer to the cancer-coping process in which participants describe successful and unsuccessful attempts at coping via communication and whereby coping with cancer is characterized by a series of losses accompanied by increased distress. Conclusions. A research focus on the social environment in which cancer is experienced provides considerable insight into the cancer-coping process. As such, interventions focused on understanding the social context in which patients experience cancer, and attempt to cope, may facilitate improved adjustment for those directly, and potentially indirectly, affected by cancer. Further research is required to develop interventions to address the unique needs of survivors. [ABSTRACT FROM AUTHOR]

Issue addressed: This study used the Transtheoretical Model of Behaviour Change (TTM) to describe reparticipation in colorectal cancer (CRC) screening according to social cognitive and background variables. Methods: A random sample of men and women aged 50-74 years living in South Australia completed a questionnaire measuring TTM stage and attitudes toward screening using a faecal occult blood test (FOBT). Participants were categorised according to four stages of readiness to rescreen: action, maintenance, relapse and inconsistent. Multivariate techniques were used to determine predictors of lower readiness stages compared with maintenance. Results: Of the 849 study participants, 29.9% were either non-adherent or had no intentions to maintain adherence (inconsistent and relapse). Compared with maintenance rescreeners, relapse participants reported less: social influences to screen (RR=0.86, p<0.001); satisfaction with prior screening (RR=0.87, p=0.03), self-efficacy (RR=0.96, p=0.01); and screening benefits (RR=0.84, p<0.001). Relapse participants were also more likely to not have private health insurance (RR=1.33, p=0.04) and be unaware of the need to repeat screening (RR=1.41, p=0.02). Inconsistent screeners were less likely to have planned when they will next rescreen (RR= 0.84, p=0.04) and reported greater barriers to rescreening (RR=1.05, p=0.05). Action participants were younger (RR= 0.98, p=<0.001), reported less social influences to screen (RR=0.94, p<0.001) and were less likely to have known someone who has had CRC (RR=0.82, p=0.01). Conclusions: Social cognitive, demographic and background variables significantly differentiated screening maintenance from lower readiness stages. [ABSTRACT FROM AUTHOR]

Issue addressed: Consumption of energy drinks is a public health concern, particularly in adolescents and young adults. This study explored energy drink consumers' reactions to an energy drink‐specific warning label (risk of cardiac effects) and a more general sugary drink warning label (risk of obesity). Methods: An online experimental study randomly allocated Australian energy drink consumers aged 18‐39 years (N = 435) to view one of two label conditions (cardiac effects or obesity). Participants were assessed on: intention to reduce energy drink consumption, perceived health threat, perceived label effectiveness and policy support for energy drink warning labels. Results: Mean intentions to reduce consumption scores were similar across the two label conditions (Mobesity = 2.5, Mcardiac = 2.6) overall; and were higher for the cardiac label (compared to obesity label) for some subgroups: females (Mobesity = 2.3, Mcardiac = 2.8; p =.037), older (25‐39 years; Mobesity = 2.4, Mcardiac = 2.8; p =.016); and higher education level (Mobesity = 1.9, Mcardiac = 2.7; p =.004). While perceived health threat measures were higher for obesity than cardiac effects, perceived label effectiveness measures of 'believable' and 'relevant to me' were higher for the cardiac label than the obesity label (believable: 71.0% vs 56.1%; relevant: 42.5% vs 29.4%). Participants who viewed the cardiac label were more likely to support policy than those shown the obesity label (OR = 1.6, 95%CI [1.1, 2.3], p =.02). Conclusions: Health effect warnings labels were perceived by energy drink consumers to be impactful and are supported. Labels with energy drink‐specific health effects may offer additional benefit. So what?: Policy makers can feel confident that warning labels on energy drinks will confer public health benefit. [ABSTRACT FROM AUTHOR]

To examine the effects of social support and sense of community on rural men's subjective well-being, considering the main effects and stress-buffer models. Cross-sectional population-based survey, non-probability sampling frame primarily convenience sampling. Community-based setting. A total of 185 men aged 18+ years from rural South Australia. Subjective well-being, measured by the Satisfaction With Life Scale. Two-step hierarchical multiple regression analysis was conducted, with subjective well-being as the dependent variable, controlling for independent variables of age, living alone and farm employment. Social support was the most effective predictor of well-being, followed by stress, and only a very modest contribution from sense of community; total variance explained was 56% (F(6,178) = 37.77, P < 0.001, R = 0.56, adjusted R = 0.55, R change = 0.07, P < 0.001). Stress partially mediated both the social support/well-being and sense of community/well-being relationships (mediation analysis). Results demonstrated the benefits of social support on well-being using the stress-buffer and main effects models, within a sample of rural men, and explored the relatively unexamined relationship between sense of community and well-being. Rural men have considerable stress impacting their well-being. This study identifies that it is critical for individuals, organisations and policy makers to be aware of the capacity of both social supports and sense of community to buffer stress and promote well-being within rural men. Furthermore, structural, community-based approaches might have greater capacity to cost-effectively provide this support, contrasting with the growing trend towards individual-based approaches for mental health. [ABSTRACT FROM AUTHOR]

Objective: To identify pattern of change in average positive affect (PA), negative affect (NA), and state anxiety (St ANX) across three biological end points of an IVF/intracytoplasmic sperm injection (ICSI) procedure and to examine whether the pattern varied across sociodemographic and biomedical subgroups. Design: Longitudinal follow-up study of PA, NA, and St ANX at three different time points: before start of study, before ovum pick-up (OPU), and before embryo transfer. Setting: Three infertility centers in northern India. Patient(s): Baseline data were obtained from a consecutive sample of 85 women. However, final analysis was done on data obtained from 74 women who reached the embryo transfer stage and completed the questionnaires at both OPU and embryo transfer. Intervention(s): The PA, NA, and St ANX scores. Main Outcome Measure(s): Change in PA, NA, and St ANX scores at three stages of the treatment: baseline (T0), before OPU (T1), before embryo transfer (T2). Result(s): The PA scores before OPU and embryo transfer were significantly lower than those at baseline. The mean NA and St ANX scores before OPU and embryo transfer were significantly higher than baseline scores. Furthermore, mean NA before embryo transfer was significantly higher than mean NA before OPU. The PA and St ANX scores showed statistically insignificance within cycle variations. Furthermore, the mean PA and St ANX for a subgroup of women who reported more than moderate level of burden were less variable. Conclusion(s): The OPU and embryo transfer stages are more stressful than the baseline stage for most women across various sociodemographic and biomedical subgroups. Women with more than a moderate level of financial burden were relatively more stable. [Copyright &y& Elsevier]

Background: Numerous researchers studied risk factors associated with smoking uptake, however, few examined protective factors associated with smoking resilience. This study therefore aims to explore determinants of smoking resilience among young people from lower socioeconomic backgrounds who are at risk of smoking. Methods: Overall, 92 out of 92 vocational education students accepted invitation to participate in this exploratory study. The Adelaide Technical and Further Education (TAFE) Arts campus was chosen for the study given the focus on studying resilience in young people of lower socioeconomic status i.e. resilient despite the odds. A self-report questionnaire comprising a measure of resilience: sense of coherence, sense of humour, coping styles, depression, anxiety and stress, and family, peers and community support, was distributed among participants aged 15 to 29. Additional factors researched are parental approval and disapproval, course type, and reasons for not smoking. Using the Statistical Package for the Social Sciences (SPSS, version 13.0), analyses were undertaken using frequencies, means, standard deviations, independent sample t-tests, correlations, analysis of variance, logistic regression, and chi-square test. Results: Twenty five (27%) out of 92 students smoked. Young people with peer support tended to smoke (p < .05). A relationship between daily smoking and depression, anxiety and stress was also found (p < .05). When both mothers and fathers disapproved of their children smoking, it had a greater influence on females not smoking, compared with males. The majority of students chose 'health and fitness' as a reason for not smoking. Students in the Dance course tended to not smoke. Conclusions: The current study showed that most students chose 'health and fitness' as the reason for not smoking. Single anti-smoking messages cannot be generalised to all young people, but should recognise that people within different contexts, groups and subcultures will have different reasons for choosing whether or not to smoke. Future studies should use larger samples with a mixed methods design (quantitative and qualitative). [ABSTRACT FROM AUTHOR]

Background and Aim: The prevalence of psychological disorders is high in patients with irritable bowel syndrome (IBS) but their role in symptom reporting is uncertain. It is thus interesting whether the number of functional gastrointestinal disorders (FGID) determines the load of psychological comorbidity. The Rome III criteria have not been used to evaluate such a relationship as yet. Moreover, not many studies have examined the sensitivity of the Rome III criteria in detecting IBS. Our aims were therefore: (i) to determine whether those IBS participants with more FGID had a tendency to greater psychological comorbidity than those with fewer FGID; and (ii) to assess the performance of the Rome III criteria in detecting IBS versus the diagnosis of the gastroenterologist. Methods: A cross-sectional survey of 32 consecutive outpatients with clinically diagnosed IBS was performed. The Hospital Anxiety and Depression Scale (HADS), the Short Form 12 Health Survey (SF-12), and the Rome III criteria questionnaire (BDQ-6) were administered. Multiple linear regression was conducted to detect associations among FGID, anxiety, depression and quality of life. Results: Overall, 50% of participants were anxious and 12% were depressed. Forty-four percent of participants had >two FGID; however, the number of FGID did not correlate with scores for anxiety, depression or quality of life. Amazingly, only 50% (CI: 33–67) of participants clinically diagnosed with IBS met Rome III criteria for IBS. Conclusion: Contrary to our expectations, a greater load of FGID did not correlate with a greater load of psychological comorbidity. Surprisingly, the Rome III criteria detected only 50% of clinical cases of IBS. [ABSTRACT FROM AUTHOR]

Background: Interest in psychological factors in patients with inflammatory bowel disease (IBD) has increased in recent years. It has even been proposed that treating psychological co-morbidities with antidepressants may control disease activity and improve quality of life. Despite this, there is no data on gastroenterologists' attitudes to, and experiences with, antidepressant therapy in patients with IBD. Methods: We conducted semi-structured interviews with 18 gastroenterologists associated with metropolitan teaching hospitals. Qualitative content analysis was used to examine their responses. Results: Seventy-eight percent of gastroenterologists had treated IBD patients with antidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reported to be useful in improving psychosocial well-being, quality of life, and self-management of the disease by patients. However, in this group of gastroenterologists, there appears to be skepticism towards psychological disorders themselves or antidepressant therapy having a central role in either the causation of IBD or its clinical course. Nevertheless, these gastroenterologists were receptive to the idea of conducting a trial of the role of antidepressants in IBD. Conclusion: While the majority of specialists have treated IBD patients with antidepressants, there is considerable skepticism with regard to efficacy of antidepressive therapy or the role of psychological factors in the outcome of IBD patients. [ABSTRACT FROM AUTHOR]

Background: Although antenatal day care is becoming increasingly common, there is little evidence as to the psychosocial efficacy of this model of care. Aim: We aimed to assess the broader psychosocial impact of antenatal day care compared with admission to hospital. Methods: We carried out a randomised trial of 395 women, randomly assigned in a 2 : 1 ratio between day care and antenatal ward, stratified for major diagnostic categories (proteinuric hypertension, non-proteinuric hypertension and preterm premature rupture of membranes). Main outcome measures – self-report questionnaires (response rates ranging from 80 to 90%) were sent to women's homes four days after randomisation and seven weeks after delivery. Results: Overall, there were statistically significant differences favouring day care in 12 of 28 items at four days post-randomisation, with no differences in the two groups for the other 16 items. At seven weeks postdelivery, we found differences in eight of 28 items favouring day care, with no differences in the two groups for the other 20 items. The types of items indicating a sustained difference covered a range of aspects of care and included satisfaction with staff, continuity of carer, information transfer, and social support. There were no differences in relation to infant feeding and relationship with the baby. Conclusions: Day care has an effect on women's satisfaction with care but does not produce broader psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess the feasibility of implementing, within Australian general practice, an innovative disease management program for hypertension. The central platform of this program is an information communication technology package for risk assessment and management, access to a dietitian commissioned by the program and a tailored set of audiovisual and written material. Methods: We carried out a pilot cluster randomized controlled trial (stratified for rurality) of 67 general practices (including 371 patients) across two Australian states. Our primary hypothesis was that a disease management program would improve the cardiovascular risk score in patients with mild to moderate hypertension, compared with that of patients being treated according to current clinical practice. Analysis was by intention to treat. Results: There was a borderline significant favorable treatment effect of the disease management program on the cardiovascular risk score of 4.6 percentage points (95% CI -9.7, 0.6) (theoretical range: 0–100%) at 6 months. At 12 months there was a non-statistically significant effect of approximately 2 percentage points. The proportion of patients achieving the target blood pressure of ≤130/85mm Hg was modest at between 20% and 30%. There was no treatment effect of the disease management program on this outcome at 6 months and a treatment effect favoring the control group was seen at 12 months (difference = -11.6%; 95% CI -21.1, -2.1). There was a modest short-term treatment effect in favour of the disease management program in terms of change in blood pressure from baseline. At 12 months follow-up, 70% of general practitioners were still accessing the program's CD-ROM and improvements were noted for five of nine items measuring their satisfaction in relation to the provision of hypertension care. A treatment effect was found for 5 of 16 items on the patient satisfaction questionnaire at 6 months and 12 of 16 items at 12 months. Conclusions: Disease management for hypertension incorporating information communication technologies is pragmatic in general practice and results in modest short-term health gains. More research is required to ensure feasibility over a longer period. [ABSTRACT FROM AUTHOR]

Objective Few strategies aimed at addressing rising rates of caesarean section have explicitly involved information-based approaches for pregnant women. This study describes the development and evaluation of such an intervention for pregnant women, encompassing pamphlets and a peer support network (PSN). Design Process evaluation. Setting The study was undertaken at a metropolitan teaching hospital in Adelaide, South Australia. Population A consecutive sample of pregnant women attending the ultrasound clinic over a two-month period, recruited at 18 weeks of gestation. Methods Participants received two pamphlets at 18 weeks of gestation and information on a PSN at around 28 weeks of gestation. A questionnaire was sent to women at seven weeks postnatal, asking them to evaluate the intervention. Main outcome measures The extent to which the intervention resources were used and participants were satisfied with the resources they received. Results Ninety-two women returned questionnaires (response rate of 62%). Women generally resisted engaging with the informational resources, citing irrelevance to their situation, for example, 53% (49/92) read all of the pamphlets. None of the women used the PSN. Women who had experienced childbirth previously and those of higher education were significantly more likely to read the pamphlets. While generally satisfied with pamphlet content, one in five women reported feeling distressed by some of the information. Conclusions This exploratory study casts doubt on the notion of information provision for pregnant women as a panacea for addressing rising rates of caesarean section. [ABSTRACT FROM AUTHOR]

The extent and course of psychological distress were examined in a representative sample of patients attending a primary health care practice in metropolitan Adelaide where general practitioner (GP) and clinical psychologist services are co-located. Scores for psychological distress were similar to national norms. Approximately one in six patients expressed a wish to discuss their feelings with a GP and/or psychologist, but the association between distress scores and wish to discuss feelings was only moderate. At follow-up 5 months later, average distress scores had fallen. Half of those who had expressed a wish for discussion had done so, and they had significantly lower scores for anxiety and stress. The results provide a context within which subsequent national mental health initiatives can be interpreted. [ABSTRACT FROM AUTHOR]

Prior to 1997, the University of Adelaide, Australia selected medical students according to matriculation marks alone. After extensive consultation with relevant stakeholders and examination of empirical evidence, the selection process is now based on a national written examination of reasoning and interaction skills, a structured oral assessment and a threshold matriculation score. This paper presents a series of 4 case studies examining the process related to the procedure and early interim outcomes, with the aim of adding to the evidence base for methods of medical student selection. Data were collected from a range of sources between 1996 and 2001, including the University's central administration system, the Faculty of Health Sciences, and purpose-designed oral assessment forms and self-report student questionnaires. The oral assessment process has shown itself to be characterised by a high level of interassessor reliability. Equity of access has been addressed and the number of schools represented in the student intake has increased from between 10 and 15 in the final years of the old selection process to over 30 statewide under the new process. There has been a corresponding increase in the proportion of students from rural backgrounds (from an original 4–12% to 20–22%). These investigations add to the evidence base for medical school selection in that they demonstrate that an oral assessment process can be reliable and lead to early positive results in relation to student outcomes and access. [ABSTRACT FROM AUTHOR]

Background: The steadily increasing global rates of cesarean section has become one of the most debated topics in maternity care. This paper reviews and reports on the success of strategies that have been developed in response to this continuing challenge. Methods: A literature search identified studies conducted between 1985 and 2001 from the Cochrane Database of Systematic Reviews, Medline, Sociofile, Current Contents, Psyclit, Cinahl, and EconLit databases. An additional search of electronic databases for Level 1 evidence (systematic reviews), Level 2 (randomized controlled trials), Level 3 (quasi-experimental studies), or Level 4 (observational studies) was performed. Selection criteria used to identify studies for review included types of study participant, intervention, outcome measure, and study. Results: Interventions that have been used in an attempt to reduce cesarean section rates were identified; they are categorized as psychosocial, clinical, and structural strategies. Two clinical interventions, (external cephalic version, vaginal birth after a previous cesarean) and one psychosocial intervention (one-to-one trained support during labor) demonstrated Level 1 evidence for reducing cesarean section rates. Conclusions: Although the evidence for one-to-one care and external cephalic version came from both developed and developing settings, the systematic review for vaginal birth after a cesarean was restricted to studies conducted in the United States. The effective implementation of the preceding strategies to reduce cesarean rates may depend on the social and cultural milieu and on associated beliefs and practices. (BIRTH 29: 1 March 2002). [ABSTRACT FROM AUTHOR]

Background: Current forms of analgesia often have significant side effects for women in labor. Bathing in warm water during labor has been reported to increase a woman's comfort level and cause a reduction in painful contractions. The objective of this trial was to compare immersion in warm water during labor with traditional pain management for a range of clinical and psychological outcomes. Methods: A prospective randomized controlled trial of 274 pregnant women, who were free from medical and obstetric complications and expecting a singleton pregnancy at term, was conducted at the Women's and Children's Hospital, a maternity tertiary referral center in Adelaide, South Australia. Women in labor were randomized to an experimental group who received immersion in a bath or to a nonbath group who received routine care. Pharmacological pain relief was the primary outcome that was measured, and secondary outcomes included maternal and neonatal clinical outcomes, factors relating to maternal and neonatal infectious morbidity, psychological outcomes, and satisfaction with care. Results: The use of pharmacological analgesia was similar for both the experimental and control groups; 85 and 77 percent, respectively, used major analgesia. No statistical differences were observed in the proportion of women requiring induction and augmentation of labor or in rates of perineal trauma, length of labor, mode of delivery, or frequency of cardiotocographic trace abnormalities. Neonatal outcomes (birthweight, Apgar score, nursery care, meconium-stained liquor, cord pH estimations) revealed no statistically significant differences. Infants of bath group women required significantly more resuscitation than routine group women. Routine group women rated their overall experience of childbirth more positively than bath group women. Psychological outcomes, such as satisfaction with care or postnatal distress, were the same for both groups. Conclusion: Bathing in labor confers no clear benefits for the laboring woman but may contribute to adverse effects in the neonate. [ABSTRACT FROM AUTHOR]

Shares the results of a study which compares midwife-managed care with so-called shared care. Seeing if midwife-managed care produces fewer interventions, similar outcome and complications, and greater satisfaction with care; Shared care being divided among midwives, hospital doctors and general practitioners; Conclusions that midwife-managed care is clinically effective and enhances satisfactions with maternity care; Statistics; Midwifery Development Unit.

Background: Dementia is a major public health priority. Although there is abundant evidence of an association between dementia and poor cardiovascular health, findings have been inconsistent and uncertain in identifying which factors increase dementia risk in those with cardiovascular disease. Indeed, multiple variables including sociodemographic, economic, health, lifestyle and education may indicate who is at higher vs. lower dementia risk and could be used in prediction modelling. Therefore, the aim of this review is to synthesise evidence on the key risk factors for dementia in those with a history of cardiovascular disease. Methods: This is an overview of reviews protocol, registered on PROSPERO (CRD42021265363). Four electronic databases including MEDLINE, EMBASE, PsycINFO, and the Cochrane Database of Systematic Reviews will be searched. Studies will be included if they are systematic reviews and/or meta-analyses that have investigated the risk of incident dementia (all-cause and subtypes including Alzheimer's disease and vascular dementia) in people with a history of coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and vascular stiffness. Study selection will be completed by two independent researchers according to the eligibility criteria, and conflicts resolved by a third reviewer. References will be exported into Covidence for title and abstract sifting, full-text review, and data extraction. Methodological quality will be assessed using the AMSTAR-2 criteria and confidence of evidence will be assessed using the GRADE classification. This overview of reviews will follow PRISMA guidelines. If there is sufficient homogeneity in the data, the results will be pooled, and a meta-analysis conducted to determine the strength of association between each risk factor and incident all-cause dementia and its subtypes for each cardiovascular diagnoses separately. Discussion: We will create a comprehensive summary of the key risk factors linking cardiovascular diseases to risk of incident dementia. This knowledge is essential for informing risk predictive model development as well as the development of risk reduction and prevention strategies. [ABSTRACT FROM AUTHOR]

We thank the authors for this very interesting insight into their investigations of the sagittal plane changes in braced patients with adolescent idiopathic scoliosis (AIS). While it is a well-known fact that Boston-style braces reduce lumbar lordosis and increase thoracic flatback, in the recent Chêneau developments (Rigo-Chêneau/Gensingen brace) lumbar lordosis and thoracic kyphosis is implemented. In figure 8, an X-ray of a patient with kyphoscoliosis is shown with and without a brace apparently demonstrating that the (undefined) brace used reduces thoracic kyphosis and lumbar lordosis as well. [Extracted from the article]

The article talks about the implementation of primary health care (PHC) policies under the changing global political conditions. Topics discussed include the improvement in population health because of PHC; the impact of social inequality on life expectancy, crime, and education; and the challenges in general practice in Great Britain. Also mentioned is the primary care physician shortage in Canada.

Simple Summary: Breast density is an independent risk factor for breast cancer and can impede detection of cancer by mammography. There is growing awareness of breast density in Australia and globally, but it is unclear whether this awareness is increasing knowledge of what breast density is and what it means to have dense breasts. This study was conducted to investigate South Australian women's knowledge of the common facts and misconceptions about breast density. This study reports that women who had previously heard the term breast density had increased knowledge compared to those who had not, suggesting that current efforts to raise awareness are leading to better knowledge. Despite this, the study shows that there are widespread misconceptions that must be actively dispelled, including the misunderstanding that breast density can be determined by touch. Background: There is growing awareness of breast density in women attending breast cancer screening; however, it is unclear whether this awareness is associated with increased knowledge. This study aims to evaluate breast density knowledge among Australian women attending breast cancer screening. Method: This cross-sectional study was conducted on women undergoing breast cancer screening at The Queen Elizabeth Hospital Breast/Endocrine outpatient department. Participants were provided with a questionnaire to assess knowledge, awareness, and desire to know their own breast density. Result: Of the 350 women who participated, 61% were familiar with 'breast density' and 57% had 'some knowledge'. Prior breast density notification (OR = 4.99, 95% CI = 2.76, 9.03; p = 0.004), awareness (OR = 4.05, 95% CI = 2.57, 6.39; p = 0.004), younger age (OR = 0.97, 95% CI = 0.96, 0.99; p = 0.02), and English as the language spoken at home (OR = 3.29, 95% CI = 1.23, 8.77; p = 0.02) were independent predictors of 'some knowledge' of breast density. A significant proportion of participants (82%) expressed desire to ascertain their individual breast density. Conclusions: While knowledge of breast density in this Australian cohort is generally quite low, we have identified factors associated with increased knowledge. Further research is required to determine optimal interventions to increase breast density knowledge. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions In an Australian randomized controlled trial (RCT), two techniques for intrapartum fetal surveillance were compared: ST analysis (STan) as an adjunct to cardiotocography (CTG), compared with CTG alone. The aim was to determine whether CTG + STan could reduce emergency cesarean birth rates while maintaining or improving neonatal outcomes. Secondary aims were to compare clinical, economic, and psychosocial outcomes. The purpose of this paper was to present psychosocial outcomes from one cohort enrolled in the trial.The study was conducted at one tertiary referral hospital. Participants who had taken part in the trial from the outset were invited to complete a questionnaire between March 2018 and January 2020, approximately 8 weeks after giving birth. Outcomes included depression, psychological distress, health‐related quality of life, and infant feeding practices. Analysis was by intention to treat.N = 207/527 participants completed the questionnaire (n = 113, STan; n = 94, CTG alone). Overall, no statistically significant or clinically meaningful differences were found in the two groups for symptoms of depression, psychological distress, quality of life, or infant feeding. A statistically significant difference was observed for the subscale of pain‐discomfort, where scores were higher on average in the CTG alone arm relative to that in the CTG + STan arm.Although STan as an adjunct to CTG constitutes a different clinical technology from CTG alone, both monitoring types appeared to produce similar results in terms of postnatal psychosocial outcomes for women. Findings from this study provide service users and staff with a comprehensive assessment of STan that can be used to make evidence‐informed decisions about monitoring options should STan become more widely available. [ABSTRACT FROM AUTHOR]

The article discusses the health reform in Mexico which highlights the suggestions derived during the international primary health care conference in 2015. It includes translating the general principles of primary care, articulating its contribution to population health and collaborating with multiple stakeholders to address population need.

Information about the conference of medical organization North American Primary Care Research Group (NAPCRG) held on October 22-23, 2014 is presented. Topics include global health care reform, diabetes care and risk reduction, and primary health care as well as health systems innovation, medical research and policies. The conference was attended by various medical professionals including family physicians and endocrinologists.

Background: Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers' and health professionals' preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults. Methods: Thirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics. Results: Stage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and 'get unstuck'; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported. Conclusions: These findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them. [ABSTRACT FROM AUTHOR]

A response from the authors of the study " A randomised controlled trial of outpatient compared with inpatient cervical ripening with prostaglandin E2 ( OPRA study)," published in a 2015 issue is presented.

Objectives: Farmers are faced with many stressors, along with numerous barriers to accessing traditional forms of mental health support. The ifarmwell online intervention was co-designed with farmers and is informed by Acceptance and Commitment Therapy to equip farmers with transferable coping strategies, particularly to help them cope with circumstances beyond their control. We aimed to evaluate the effect of ifarmwell on farmers' short- and long-term distress and mental wellbeing. Methods: Australian farmers (21–73 years) who registered on completed measures at the commencement of module 1 (N = 228), the end of the intervention (N = 77) and 6-months post-intervention (N = 61). Primary outcomes included distress (Kessler Psychological Distress Scale) and mental wellbeing (Mental Health Continuum – Short Form). We also examined the relationship between distress, mental wellbeing, neuroticism (Quickscales-R) and ACT-based psychological mechanisms; psychological inflexibility (Acceptance and Action Questionnaire-II), cognitive fusion (Cognitive Fusion Questionnaire), believability of automatic thoughts (Automatic Thoughts Questionnaire-B), coping via acceptance (4 items from the situational COPE) and mindfulness (Five Facet Mindfulness Questionnaire-Short Form). Secondary outcomes of acceptability (Client Satisfaction Questionnaire-8) and usability (System Usability Scale) were also explored. Results: Pre- to post-intervention, farmers' distress decreased and mental wellbeing increased. These effects were maintained at 6-month follow-up. Changes in these outcomes were greatest for participants who entered the intervention with high baseline distress ( β ˆ = −0.59, 95%CI =[−0.70, −0.47]) and low mental wellbeing ( β ˆ = −0.33, 95%CI = [−0.47, −0.19]). Decreases in distress and increases in mental wellbeing were associated with decreases in psychological inflexibility, cognitive fusion, and believability of thoughts, and increases in coping via acceptance and mindfulness. Levels of satisfaction (M = 26.92/32) and usability (M = 84.70/100) were high, and 94.6% of participants said they would recommend ifarmwell to a friend in need of similar advice and tools. Conclusions: ifarmwell is an effective and usable intervention that is likely to help farmers reduce their levels of distress and improve their mental wellbeing, by improving their psychological flexibility, ability to focus on the present and accept things beyond their control, as well as by reducing the extent to which they believe unhelpful thoughts. [ABSTRACT FROM AUTHOR]