Physical activity, sedentary behaviour and depression among socio-economically disadvantaged women

Promoting physical activity, particularly for leisure and transport, could be an important aspect in preventing depression amongst women living in disadvantaged neighbourhoods. Furthermore, including some aspect of social physical activity and reducing time spent in sedentary behaviours may further reduce risk of depression.

Child maltreatment in stepfamilies : the impact of mother's dating behaviour

This thesis explored the relative utility of evolutionary and ecological theories to understand under which conditions children in non-biological families are most at risk of childmaltreatment.  The study revealed that single-mothers have complex needs and stressors, which may increase their vulnerability and impact on decisions made in selection of partners.

Health satisfaction and perceived control : investigating subjective wellbeing homeostasis

Through an investigation of relationships between subjective wellbeing, health satisfaction and perceived control, the thesis contributes to a greater understanding of the psychological adaptation processes of individuals experiencing back pain. Risk factors to subjective wellbeing are also identified, thus presenting opportunities to provide assistance before the onset of psychopathology.

Clarifying the Effort-Reward Imbalance Model : the role of personality

The thesis aimed to identify the sources of stress experienced by a sample of Australian police officers. It was guided by the Effort-Reward Imbalance Model, augmented with Type A personality components. The findings support the research model and suggest that interventions to reduce stress should focus on reward and recognition.

Consumer-citizens of China : the role of foreign brands in the imagined future China

This book presents a comprehensive examination of Chinese consumer behaviour and challenges the previously dichotomous interpretation of the consumption of Western and non-Western brands in China.

Perceived discrimination and stigmatisation against severely obese women : age and weight loss make a difference

Aims: Patients’ perceptions about weight-related stigma and discrimination were assessed in 2 groups of patients, obese and laparoscopic adjustable gastric banding (LAGB).

Methods: Seven focus group sessions were held including a total of 32 women, 8 obese (body mass index 35+) and 24 who had lost 50% of excess weight following bariatric surgery. During the sessions, participants were asked to consider their experiences in situations including general, family, friends, work place, medical, and educational settings.

Results: Whilst perceptions of discrimination and stigmatisation were common and affected many life situations, they were less prevalent than previous reports. It appeared that it was not the frequency or number of events which affected an individual but the intensity of the experience. Younger women reported greater discrimination than older women and felt the social consequences of obesity to a greater extent. Older women were more concerned about the consequences of being overweight on their health.

Conclusions: Women who had lost weight considered that aspects of their own behaviours when obese contributed to their experiences of discrimination and stigmatisation. Perceptions of discrimination and stigmatisation appear to be influenced by age and current weight status.

A preliminary investigation of adult defence style and physiological reactivity to infant distress signals

Species whose offspring require extended care-giving ought to be predisposed to being biologically responsive to their infant's signalling. This paper examined the interplay between biological and psychological aspects of adult response to an infant's distress. HR (heart rate) and GSR (galvanic skin response) were recorded continuously, while 50 adults listened to white noise and an infant cry audio recording. Participants completed the defence style questionnaire and the state trait anxiety inventory. HR acceleration occurred in response to the control sound, while HR decelerated in response to the infant cry. GSR responsiveness was positively correlated with immature and neurotic defence styles. When controlling for other variables, immature defence was a unique and independent predictor of GSR change in response to infant distress. Defence demonstrated a stronger relationship than self-reported anxiety, than that with physiological responsiveness. Employing defence mechanisms appears to reduce an individual's perceived anxiety, though it has little effect on physiological arousal levels.

You kind of want to fix it don’t you? Exploring general practice trainees’ experiences of managing patients with medically unexplained symptoms

Background
Much of a General Practitioner’s (GP) workload consists of managing patients with medically unexplained symptoms (MUS). GP trainees are often taking responsibility for looking after people with MUS for the first time and so are well placed to reflect on this and the preparation they have had for it; their views have not been documented in detail in the literature. This study aimed to explore GP trainees’ clinical and educational experiences of managing people presenting with MUS.
Method
A mixed methods approach was adopted. All trainees from four London GP vocational training schemes were invited to take part in a questionnaire and in-depth semi-structured interviews. The questionnaire explored educational and clinical experiences and attitudes towards MUS using Likert scales and free text responses. The interviews explored the origins of these views and experiences in more detail and documented ideas about optimising training about MUS. Interviews were analysed using the framework analysis approach.


Results

Eighty questionnaires out of 120 (67 %) were returned and a purposive sample of 15 trainees interviewed. Results suggested most trainees struggled to manage the uncertainty inherent in MUS consultations, feeling they often over-investigated or referred for their own reassurance. They described difficulty in broaching possible psychological aspects and/or providing appropriate explanations to patients for their symptoms. They thought that more preparation was needed throughout their training. Some had more positive experiences and found such consultations rewarding, usually after several consultations and developing a relationship with the patient.
Conclusion
Managing MUS is a common problem for GP trainees and results in a disproportionate amount of anxiety, frustration and uncertainty. Their training needs to better reflect their clinical experience to prepare them for managing such scenarios, which should also improve patient care.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

PURPOSE: To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). METHODS: Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. RESULTS: Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. CONCLUSION: This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Treating children with psychosis: an integrative play therapy approach

Children affected by psychosis often endure unresolved mental health and psychosocial disturbances that impede social, academic, and behavioral functioning (Algon, Yi, Calkins, Kohler, & Borgmann-Winter, 2012). This article provides clinicians with a discussion of play therapy and empirically informed techniques to improve treatment outcomes for children diagnosed with psychosis. The literature review comprises various aspects of this unique pediatric population, including prevalence, assessment/evaluation, symptoms, and psychosocial treatment. Additionally, an integrative play therapy approach is highlighted, comprising (a) family interventions (McFarlane, Dixon, Lukens, & Lucksted, 2003), (b) psychosocial approaches (Green & Drewes, 2013; Stewart & Green, 2015), and (c) school-based support (Flanagan, Allen, & Henry, 2010). The article concludes with a case study depicting the psychological challenges a typical child with psychosis encounters and the associated treatment options available to play therapy practitioners from an integrative standpoint.

Psychological health and lifestyle management preconception and in pregnancy

Healthful lifestyles before and during pregnancy are important to facilitate healthy outcomes for mother and baby. For example, behaviors such as a sedentary lifestyle and consuming an energy-dense/nutrient-poor diet increase the risk of overweight/obesity before pregnancy and excessive weight gain during pregnancy, leading to adverse maternal and child health outcomes. Maternal psychopathology may be implicated in the development of suboptimal maternal lifestyle behaviors before and during pregnancy, perhaps through impacts on motivation. This article explores this notion using maternal obesity and excessive gestational weight gain as examples of the health impacts of psychological states. We suggest that factors such as psychological well-being, individual motivation for behavior change, and broader environmental influences that affect both individual and system-wide determinants all play important roles in promoting healthy lifestyles periconception and are key modifiable aspects for intervention designers to consider when trying to improve dietary behaviors and increase physical activity before and during pregnancy. In addition, implementing system-wide changes that impact positively on individual and environmental barriers to behavior change that are sustainable, measureable, and effective is required.

Molecular and cellular aspects of copper transport in developing mammals

Copper is an essential trace element that requires tightly regulated homeostatic mechanisms to ensure adequate supplies without any toxic effects because of the ability of the metal ion to catalyze the formation of free radicals. The Cu-ATPases, ATP7A and ATP7B, play an important role in the physiological regulation of copper. Adequate supplies of copper are particularly important in developing animals, and in humans this is illustrated by mutations of ATP7A that cause the copper deficiency condition Menkes disease, which is fatal in early childhood. In contrast, mutations in ATP7B result in the genetic toxicosis, Wilson disease. We propose that the physiological regulation of copper is accomplished mainly by the intracellular copper-regulated trafficking of the Cu-ATPases. This process allows the overall copper status in the body to be maintained when levels of copper in the diet alter. A study of the defects in mouse models of Menkes and Wilson diseases has demonstrated that both ATPases play an important role in supplying copper to the developing fetus and neonate

Reducing sedentary behaviour and increasing physical activity among 10-year-old children: overview and process evaluation of the 'Switch-Play' intervention

Overweight and obesity has doubled among children in Australia. There is an urgent need to develop primary prevention strategies to prevent current and future unhealthy weight gain. The aims of this paper are to describe a randomized controlled trial (‘Switch-Play’) developed to prevent unhealthy weight gain among 10-year-old children and to report the findings of the process evaluation. Children from three government primary schools were randomized by class to one of four conditions: a behavioural modification group (BM; n = 69); a fundamental motor skills group (FMS; n = 73); a combined BM and FMS group (n = 90); or a control (usual classroom lessons) group (n = 61). Children in the BM group participated in 19 sessions that encouraged them to reduce screen-based behaviours, and identified physical activity alternatives. The FMS group participated in 19 lessons that focused on mastery of six skills: run, throw, dodge, strike, vertical jump and kick. The combined group participated in all the BM and FMS activities. The intervention specialist teacher reported that the children showed high enjoyment and engagement (88% lessons attended) in most aspects of the programme. At-home tasks were completed by 57–62% of the children, and 92% completed the in-class tasks. Two-thirds of the children in the BM group participated in the behavioural contracting to switch off the TV. Most of the children reported high enjoyment of the programmes, and only a small proportion (7–17%) reported difficulties in switching off their nominated TV shows. More than half the children reported reducing their TV viewing; however, less than half reported increasing their physical activity. It was found that most aspects of the intervention arms of the programme were successfully delivered to the majority of children participating in ‘Switch-Play’; that the programmes were delivered as intended; and that the programmes were favourably evaluated by participating children and their parents.