How stable is the well-being of Australian mothers who care for young children with special health care needs?

Ninety-seven percent of children who have special health care needs are cared for by their mothers. These mothers cite that their informal care work can be intrinsically rewarding, however, the role is not without substantial difficulties and consequences. We investigated differences in the health and well-being of mothers whose young children do and do not have special health care needs. Quantitative data are drawn from Growing Up in Australia: The Longitudinal Study of Australian Children. This study employs a matched-case control methodology to compare the experiences of a group of 292 mothers whose children are identified as having long term special health care needs to those mothers whose children are typically developing at two time points; Wave 1 (2004) and Wave 3 (2008). The findings support previous research that mothers of children with special health care needs have poorer general health and mental health than mothers whose children do not have special needs. Mothers of children with special health care needs also perceived life as more difficult. Longitudinally, this study also shows that maternal well-being remains relatively stable during the years when children are transitioning to formal schooling. Implications for policy makers, practitioners and early childhood professionals are discussed.

Partial mediation role of self-efficacy between positive social interaction and mental health in family caregivers for dementia patients in Shanghai

We explored the mediation effect of caregiver self-efficacy on the influences of behavioral and psychological symptoms (BPSD) of dementia care recipients (CRs) or family caregivers’ (CGs) social supports (informational, tangible and affectionate support and positive social interaction) on CGs’ mental health. We interviewed 196 CGs, using a battery of measures including demographic data of the dyads, CRs’ dementia-related impairments, and CGs’ social support, self-efficacy and the Medical Outcome Study (MOS) Short-Form (SF-36) Health Survey. Multiple regression analyses showed that gathering information on self-efficacy and managing CG distress self-efficacy were the partial mediators of the relationship between positive social interaction and CG mental health. Managing caregiving distress self-efficacy also partial mediated the impact of BPSD on CG mental health. We discuss implications of the results for improving mental health of the target population in mainland China.

Research participation by people with intellectual disability and mental health issues : an examination of the processes of consent

Balancing the demands of research and ethics is always challenging and even more so when recruiting vulnerable groups. Within the context of current legislation and international human rights declarations, it is strongly advocated that research can and must be undertaken with all recipients of health care services. Research in the field of intellectual disability presents particular challenges in regard to consenting processes. This paper is a critical reflection and analysis of the complex processes undertaken and events that occurred in gaining informed consent from people with intellectual disability to participate in a study exploring their experiences of being an inpatient in mental health hospitals within Aotearoa/New Zealand. A framework based on capacity, information and voluntariness is presented with excerpts from the field provided to explore consenting processes. The practical implications of the processes utilised are then discussed in order to stimulate debate regarding clearer and enhanced methods of gaining informed consent from people with intellectual disability.

Socio-demographic characteristics, modifiable lifestyle factors, and health as predictors of mental health in midlife and older Australian women: a multilevel investigation

Background Poor mental health is a significant cause of morbidity and mortality, yet debate continues about factors most likely to predict poor mental health outcomes. Objective This cohort study examines the influence of modifiable lifestyle factors, menopausal symptoms, and physical health on the mental health of midlife and older Australian women. Methods: Random sampling was used to recruit women aged 40-55, from rural and urban areas of Queensland, Australia. Overall, 340 women completed mailed surveys on socio-demographic characteristics, midlife symptoms (Greene Climacteric Scale©), modifiable lifestyle factors, and mental health (SF-12©) in 2001, 2004 and 2011. Hierarchical repeated-measure models were used to explore the correlates of poor mental health over time. Results The mean age [SD] at baseline was 55 [2.7] years, most were married (73%, n=248) and 18% were pre-menopausal. The model suggested that variance in mental health widened and showed a non-linear increase with age. Decrements in mental health were associated with an increase in midlife symptoms (Greene psychological scale, P <0.01; Greene somatic scale, P <0.05), time (P <0.01), poor physical health (P <0.01) and individual variance (P <0.01). Socio-demographics and lifestyle factors had little influence on mental health over time. Conclusion Findings suggest that while women’s mental health may decline during midlife, the effect is temporary; in older women, physical health and individual factors seem to be increasingly significant. This research highlights the importance of active health promotion as a means of enhancing both physical and mental health in midlife women.

Shortages of rural mental health professionals

This study presents a conceptual model of the supply and demand for mental health professionals. It uses national data to profile differences in the supply of mental health professionals in different types of rural and urban areas. It contrasts the availability of general health and mental health professionals. It examines shortage areas identified in 2000 and their related community characteristics. Because of the absence of data on a national level to describe many types of mental health professionals state licensure data for one state were used to show the volume and distribution of these practitioners. To improve rural mental health service delivery it will be necessary to implement system changes to promote the increased availability, competency, and support of rural health professionals. Copyright 2003, Elsevier Science (USA). All rights reserved.

What predicts mental health in midlife and older women? Results from the Australian Healthy Aging of Women Study

Objectives: Previous research has linked unhealthy lifestyle with a range of negative health outcomes in women. As women age however, they may have fewer performance expectations, but may view their health more positively. Clearly, the experiences of midlife and older women in relation to health and wellbeing need further exploration. The purpose of this study is to examine the factors associated with poor health-related quality of life in midlife (HRQoL) and older Australian women. Methods: The Australian longitudinal Healthy Aging of Women (HOW) study prospectively examines HRQoL, chronic disease and modifiable lifestyle factors midlife and older women as they age. Random sampling was used to select rural and urban based women from South-East Queensland, Australia. Data were collected from 386 women at three time points over the last decade (2001, 2004 and 2011). Results: The average age of women in this study was 65 years (SD = 2.82). Almost three-quarters (73%, n = 248) of the sample were married or living as though married, nine per cent (n = 30) were separated or divorced and a small proportion were had never married (n = 13). Most (86%, n = 291) of the women sample reported being Australian born, around one quarter (34%, n = 114) had completed additional study since leaving school (university degree or diploma). Over half (55%, n = 186) of participants were retired, one quarter (25%, n = 85) were in paid employment and the remained were unemployed (1%, n = 4), unable to work because of illness (2%, n = 6) or worked within the home (17%, n = 56). Using data collected over time we examined the relationship between a range of modifiable lifestyle factors and mental health using structural equation modelling. The overall model exhibited a good fit with the data. Poor sleep quality was associated with reduced mental health while better mental health was reported in women who exercised regularly and satisfied with their currently weight. As hypothesized, past mental health was a significant mediator of current mental health. Conclusions: These findings demonstrate that the mental health of women is complex and needs to be understood not only in terms of current lifestyle but also in relation to previously reported health status.

Student interactivity and teacher participation: An application of legitimate peripheral participation in higher education online learning environments

Lave and Wenger’s legitimate peripheral participation is an important aspect of online learning environments. It is common for teachers to scaffold varying levels of online participation in Web 2.0 contexts, such as online discussion forums and blogs. This study argues that legitimate peripheral participation needs to be redefined in response to students’ decentralised multiple interactions and non-linear engagement in hyperlinked learning environments. The study examines students’ levels of participation in online learning through theories of interactivity, distinguishing between five levels of student participation in the context of a first-year university course delivered via a learning management system. The data collection was implemented through two instruments: i) a questionnaire about students’ interactivity perception in the online reflective learning (n = 238) and then ii) an open discussion on the reason for the diverse perceptions of interactivity (n = 34). The study findings indicate that student participants, other than those who were active, need high levels of teacher or moderator intervention, which better enables legitimate peripheral participation to occur in online learning contexts.

The role of goal importance in predicting university students’ high academic performance

We examined goal importance, focusing on high, but not exclusive priority goals, in the theory of planned behaviour (TPB) to predict students’ academic performance. At the beginning of semester, students in a psychology subject (N = 197) completed TPB and goal importance items for achieving a high grade. Regression analyses revealed partial support for the TPB. Perceived behavioural control, but not attitude or subjective norm, significantly predicted intention, with intention predicting final grade. Goal importance significantly predicted intention, but not final grade, indicating that perceiving a performance goal as highly, but not necessarily exclusively, important impacts on students’ achievement intentions.

Building a community of learners within the STEM higher education classroom

Building rich and authentic learning experiences in the STEM classroom, is a challenge for many educators within Higher Education. While many Higher Education Institutions have embraced the need to transform current teaching and learning practices and include a range of online tools, this has often been met with some resistance and approaches that do not always recognise the academic who are a critical component to the success of the transformational process. Over the last decade the Internet has evolved from being a tool used by a few dedicated educators to one that is being used by the majority of educators. However, what is important is how this great resource is used in teaching and learning to allow students to build knowledge. The ability for students to construct knowledge and engage in higher order thinking skills is at the heart of educational practices, and building a community of learners has the potential to support these practices, especially within STEM education. This paper explores the relationship between students and an academic teaching in a technology rich STEM learning environment and their adoption of social community and shared tools. In particular the paper reports on the critical components that make a successful community of learners and the educational tools and approaches that were successfully used to enhance the student learning experience in a STEM classroom.

Discrimination and mental health

The purpose of this study was to investigate the nature and prevalence of discrimination against people living with HIV/AIDS in West Bengal, India, and how discrimination is associated with depression, suicidal ideation and suicidal attempts. Semi-structured interviews and the Beck Depression Inventory were administered to 105 HIV infected persons recruited by incidental sampling, at an Integrated Counseling and Testing Center (ICTC) and through Networks of People Living with HIV/AIDS, in the West Bengal area. Findings showed that 40.8% of the sample has experienced discrimination at least in one social setting – such as family (29.1%), health centers (18.4%), community (17.5%) and workplace (6.8%). About two-fifths (40.8%) reported experiencing discrimination in multiple social settings. Demographic factors associated with discrimination were gender, age, occupation, education, and current residence. More than half of the sample was suffering from severe depression while 8.7% had attempted suicide. Discrimination in most areas was significantly associated with suicidal ideation and suicidal attempts. Prevalence of discrimination associated with HIV/AIDS is high in our sample from West Bengal. While discrimination was not associated with depressive symptomatology, discrimination was associated with suicidal ideation and attempts. These findings suggest that there is an urgent need for interventions to reduce discrimination of HIV/AIDS in the West Bengal region.

Comparing the effectiveness of education and technology in reducing wood smoke pollution: A field experiment

This study describes a field experiment assessing the effectiveness of education and technological innovation in reducing air pollution generated by domestic wood heaters. Two-hundred and twenty four households from a small regional center in Australia were randomly assigned to one of four experimental conditions: (1) Education only – households received a wood smoke reduction education pack containing information about the negative health impacts of wood smoke pollution, and advice about wood heater operation and firewood management; (2) SmartBurn only – households received a SmartBurn canister designed to improve combustion and help wood fires burn more efficiently, (3) Education and SmartBurn, and (4) neither Education nor SmartBurn (control). Analysis of covariance, controlling for pre-intervention household wood smoke emissions, wood moisture content, and wood heater age, revealed that education and SmartBurn were both associated with significant reduction in wood smoke emissions during the post-intervention period. Follow-up mediation analyses indicated that education reduced emissions by improving wood heater operation practices, but not by increasing health risk perceptions. As predicted, SmartBurn exerted a direct effect on emission levels, unmediated by wood heater operation practices or health risk perceptions.

'Women on a Wiki’ : the role of interactive websites in reflective learning practices for undergraduate women’s health students

Aim Our pedagogical research addressed the following research questions: 1) Can shared ‘cyber spaces’, such as a ‘wiki’, be occupied by undergraduate women’s health students to improve their critical thinking skills? 2) What are the learning processes via which this occurs? 3) What are the implications of this assessment trial for achieving learning objectives and outcomes in future public health undergraduate courses? Methods The students contributed written, critical reflections (approximately 250 words) to the Wiki each week following the lecture. Students reflected on a range of topics including the portrayal of women in the media, femininity, gender inequality, child bearing and rearing, domestic violence, mental health, Indigenous women, older women, and LGBTIQ communities. Their entries were anonymous, but visible to their peers. Each wiki entry contained a ‘discussion tab’ wherein online conversations were initiated. We used a social constructivist approach to grounded theory to analyse the 480 entries posted over the semester. (http://pub336womenshealth.wikispaces.com/) Results The social constructivist approach initiated by Vygotsky (1978) and further developed by Jonasson (1994) was used to analyse the students’ contributions in relation to four key thematic outcomes including: 1) Complexities in representations across contexts; 2) Critical evaluation in real world scenarios; 3) Reflective practice based on experience, and; 4) Collaborative co-construction of knowledge. Both text and image/visual contributions are provided as examples within each of these learning processes. A theoretical model depicting the interactive learning processes that occurred via discussion of the textual and visual stimulus is presented.

A qualitative study of mental health practices with Culturally and Linguistically Diverse (CALD) clients

Practitioners are expected to be culturally competent in order to offer appropriate counselling to culturally and linguistically diverse (CALD) clients in Australia. However, not much is known about their practices and therapeutic experiences with CALD clients. Using a qualitative approach, 15 mental health professionals from different disciplines were interviewed about the counselling process as well as their practice with CALD clients. Participants who had worked with CALD clients in a range of settings were invited to participate. Themes identified by the thematic analysis highlighted the importance of awareness and skills over knowledge, suggesting that respect and rapport could compensate for a lack of cultural knowledge. Further, practitioners reported that knowing where to find cultural information as it was required was more important than being expected to know this cultural knowledge. The findings supported concepts from existing models of multicultural competence and identified concrete practices associated with these constructs, thereby narrowing the gap between the theory and practice of cultural competence.

Health consequences of exposure to e-waste : a systematic review

Background The population exposed to potentially hazardous substances through inappropriate and unsafe management practices related to disposal and recycling of end-of-life electrical and electronic equipment, collectively known as e-waste, is increasing. We aimed to summarise the evidence for the association between such exposures and adverse health outcomes. Methods We systematically searched five electronic databases (PubMed, Embase, Web of Science, PsycNET, and CINAHL) for studies assessing the association between exposure to e-waste and outcomes related to mental health and neurodevelopment, physical health, education, and violence and criminal behaviour, from Jan 1, 1965, to Dec 17, 2012, and yielded 2274 records. Of the 165 full-text articles assessed for eligibility, we excluded a further 142, resulting in the inclusion of 23 published epidemiological studies that met the predetermined criteria. All studies were from southeast China. We assessed evidence of a causal association between exposure to e-waste and health outcomes within the Bradford Hill framework. Findings We recorded plausible outcomes associated with exposure to e-waste including change in thyroid function, changes in cellular expression and function, adverse neonatal outcomes, changes in temperament and behaviour, and decreased lung function. Boys aged 8–9 years living in an e-waste recycling town had a lower forced vital capacity than did those living in a control town. Significant negative correlations between blood chromium concentrations and forced vital capacity in children aged 11 and 13 years were also reported. Findings from most studies showed increases in spontaneous abortions, stillbirths, and premature births, and reduced birthweights and birth lengths associated with exposure to e-waste. People living in e-waste recycling towns or working in e-waste recycling had evidence of greater DNA damage than did those living in control towns. Studies of the effects of exposure to e-waste on thyroid function were not consistent. One study related exposure to e-waste and waste electrical and electronic equipment to educational outcomes. Interpretation Although data suggest that exposure to e-waste is harmful to health, more well designed epidemiological investigations in vulnerable populations, especially pregnant women and children, are needed to confirm these associations. Funding Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Australia.