Quality of life in outpatients with depression in China

BACKGROUND: Quality of life (QOL) is an important outcome measure for patients with depression, but QOL research involving large samples of patients has been uncommon. The purpose of this study was to evaluate the QOL of Chinese outpatients with depression and its determinants. METHODS: Using a cross-sectional survey design, data were collected continuously from 19,984 outpatients; 19,950 usable questionnaires were obtained. Along with the QOL index (WHOQOL-BREF), the questionnaire also included participants' sociodemographic characteristics, outpatient visits, and medication use information. RESULTS: Less than 5% of depressed patients reported "good" or "very good" QOL, while less than 3% were satisfied with their general health. The overall score was low (54.12); four QOL domain (physical health, psychological, social relationships, and environment) scores (range, 35.03-40.10) were significantly lower than in other community population surveys. QOL scores were significantly lower among first-visit than non-first-visit patients. Medication users reported significantly higher QOL scores than non-users, with NaSSA more effective than SSRIs, followed by other types, SNRIs, and no medication, in that order. LIMITATIONS: Since this was an observational, cross-sectional survey with continuous outpatient data collection method instead of random sampling, generalization of the results is limited, and causality cannot be determined. However, the "natural" observational design, large sample size, and similarity in findings with other studies reveal the "real world" QOL of depressed outpatients in mainland China. CONCLUSIONS: Depressed patients had a low QOL, and the scores of first-visit patients with severe symptoms were significantly lower than non-first-visit patients. Though medication can improve patients' QOL, different types of medications have different impacts.

The use of correspondence analysis to develop a scale to measure workplace morale from multi-level data

This paper focuses on the issue of comparing social groups or collectivities using measures derived from individual-level multivariate data. In this case, groups need to be differentiated such that: (a) between-group differences are maximized; (b) within-group differences are minimised; and (c) `differences' are calibrated to a scale that reflects a set indicators or observed variables.This paper demonstrates empirically how correspondence analysis can achieve this. It presents a scale of `workplace morale' derived from the responses of employees in a large sample of workplaces to questions concerning satisfaction with various facets of their job and their workplace. The scale derived through correspondence analysis is shown to achieve the three criteria described above.

Research methods for media and communication

A user friendly and comprehensive introduction to media and communications research. It introduces the various qualitative and quantitative research methods commonly used in the social sciences as applied to media studies, communication, journalism, public relations and advertising. Author from Deakin University, Australia.

Risk of sexual recidivism as a function of age and actuarial risk

The study of risk for sexual recidivism has undergone substantial development in recent years. The foundation for advances in this area has been the use of actuarial measures to identify subgroups of offenders with different observed rates of sexual re-offending over time. An unresolved issue within this research area has been the moderating function of age in the assessment of risk. The current study examined sexual re-offending as a function of age and actuarial risk in a large sample of sexual offenders released from prison between 1990 and 2004. There was an overall decrease in the rate of sexual re-offending over the age of 50. However, a small group of offenders from the higher actuarial risk categories of the older age groups continued to re-offend at higher rates than their lower-risk peers.

How do school day activity patterns differ with age and gender across adolescence?

Purpose
A knowledge of how young people use their time could be instrumental in informing health interventions, modeling consumer behaviors, and planning service delivery. The aim of the present study was to describe age- and gender-related patterns in the self-reported use of time on school days in a large sample of Australian children and adolescents aged between 10 and 18 years.

Methods
A single, detailed use-of-time diary for a school day was collected from 6024 Australians aged 10–18 from several state and regional surveys conducted in the states of South Australia (SA) and Victoria between 2001 and 2006. Time–use profiles were analyzed for a range of active and sedentary state behaviors.

Results
Boys reported higher physical activity levels (PALs), moderate-to-vigorous physical activity (MVPA), and sports than girls. There were no differences in free play, and girls used more active transport. All activity-related variables decreased with age, except active transport, which peaked at 14–15 years. Boys exhibited higher levels of screen time, whereas girls had higher levels of passive transport. Screen time and its components (television, videogames, and computer use) peaked in the peripubertal years.

Conclusion
Age- and gender-related patterns of time use vary greatly within adolescence. This may reflect a mix of biological and social factors.

Building social capital in groups : facilitating skill development for natural resource management

Analysis of the experiences of four farmer groups set up to learn how to jointly manage local natural resource issues shows that the groups are going though two simultaneous processes. One builds technical competency in natural resource management and the other is the underpinning social process that allows the groups to make decisions and work collectively, which builds social capital. Natural resource management practitioners and farmers are practical people. They are likely to be more comfortable with a process that develops monitoring tools and benchmarks for natural resource management than a process of group development and social capital formation. Yet the two are intrinsically linked. This paper reflects on and analyses the experience of establishing and working with farmer groups as they go through a process of identifying environmental issues, setting and monitoring environmental benchmarks and identifying and implementing sustainable farming practices to meet the benchmarks.

Two questions emerged from the analysis. First, how do the four groups compare to other measures of effective natural resource management groups? Second, what are the characteristics of the groups that make them more or less effective and what has occurred in the groups (either before or during this project) to make them more or less effective? Social capital emerges as a key determinant of group effectiveness. Social capital is most effective when it comprises a balance of bonding and bridging networks, and includes shared values in relation to the purpose of the group.

Policy makers and extension workers need to understand the link between the two simultaneous processes occurring as people come together in groups to define and implement best practice at a local level, and how to use knowledge of social processes when designing the more concrete process of developing and implementing best practice monitoring and benchmarking with groups. An understanding of how people build social capital as they work in groups will assist with designing and facilitating group projects in a range of contexts, not only natural resource management.

Assessing offender readiness to change problems with anger

It is widely acknowledged that offender rehabilitation outcomes can be improved by attending to responsivity issues, including the readiness and motivation of offenders to undertake and engage in treatment. The measurement of responsivity, readiness and motivation in offenders, however, has received relatively little research attention. In this paper we focus on anger management programmes and evaluate the utility and psychometric properties of a measure of stages of change in relation to changing anger - the Anger Readiness to Change Questionnaire (ARCQ). Using data from a large sample of offenders undergoing anger management interventions, we investigated the construct validity, convergent validity and predictive validity of the ARCQ. We conclude the ARCQ may have utility as a measure for selecting offenders who are suitable for anger management interventions.

Advances in self-engagement research method : the case of disadvantaged female migrant entrepreneurs in Auckland, New Zealand

The “self-engagement research method” is a set of research procedures, which aims to search latent (hidden) attitudes within a given group of individuals, such as disadvantaged women. This method also examines the research participants practises through an intensive involvement in the process of research. Research on self-regulation has also tended to emphasize having personal control over an event as the primary determinant of whether individuals can effectively monitor and alter their behaviour to attain a desired end state (W. Britt, 1999, 699).

The “self-engagement procedure” originated from fieldwork of social research, especially from the present author’s experiences as a researcher and practitioner on women’s empowerment under the micro-finance programme in Women’s Empowerment Foundation, Auckland and in Grameen Bank Micro-finance programme (Nobel prize winner Professor Mohammed Yunus on poverty reduction through micro-finance).

This technique is based on the oft-cited phenomenon of discrepancies between what research Participants say what they often believe (http://en.wikipedia.org/wiki/Participant_observation). This follows on Gabriel (1991:123-126) namely that participant observation is a useful technique for gaining insight into facts and is also useful for the rural poor or marginal groups, who are unable to communicate their problems. The problem is that since the 1980s, some anthropologists and the social scientists have questioned the degree to which participant observation can give truthful insight into the minds of other people (Geertz, Clifford,1984 & Rosaldo, Renato, 1986).

This paper discusses the difficulties found in using participant observation to discover discrepancies between what participants say and what they really believe. It also discusses self-engagement research procedures which the author has developed through the long-term research experiences with disadvantaged groups of women in Auckland. These procedures discover the discrepancies between what participants say and what is in their mind.

These self-engagement procedures were used from the beginning of the fieldwork to locate research areas and get access to the study settings. It was found there are gaps in this method. For example, there are no systematic processes in which researchers can gain access into the community or be welcomed by research participants. It was also difficult to discover the insight into the facts that cause disempowerment and how micro-finance impacts everyday life on research participants. McCracken (1988 cited in Mertens, 1998:321) argued that researchers collect data directly through observation, but it is not possible to imitate, repeat involvement in the experiences of research participants.

This research draws on and extends the long traditional of participant observation in social research. In field research practises, participant observation was used in different ways for gaining insight into different aspects. A good example is the use and mis-use of the “field journal” in this type of research. The journal typically explained and analysed experiences and understanding of participant observation, in-depth interviews and group discussions on the impact of micro-finance on women’s lives. However, researchers later realised that there were gaps in collected knowledge that needed to be filled. This led to “self-engagement procedures” which developed greater confidence that collected data could truly give insight into patterns of behaviour.

This paper addresses sensitive issues of women’s empowerment under the micro finance programmes and makes a contribution to the literature. The “self-engagement method” detects the “silent facts” of women’s lives. In research conducted amongst disadvantaged women in Auckland, New Zealand and Grameen Bank micro-finance programme in Bangladesh. The method of self-engagement led to better data when participants (both research and subjects) clearly perceived the purpose of the research, when participants have control over providing personal information, and when subjects can build trust with researchers. One overall lesson of this research is that research data and findings are more generalisaable and valid when the participants in the research process understand the relevancy to his/her disadvantaged position and the causes of this, and when participants perceive that it is an opportunity to voice his/her disadvantages and causes.

The “self-engagement research method” involves a variety of behavioural activities. This paper also attempts to discuss in detail, these activities. This paper attempts to discuss the process of the “self-engagement method” in a systematic way. This has been addressed in the research process, in which research participants and researchers become self-engaged to detect the reality of the impact of micro finance to empower the disadvantaged. The stages of self-engagement procedures were developed and followed throughout field research into entrepreneurial behaviour of disadvantaged women in Auckland.

Research on self-regulation has also tended to emphasize having personal control over an event as the primary determinant of whether individuals can effectively monitor and alter their behaviour to attain a desired end state (W. Britt, 1999, 699).

A suitable research method could identify the empowerment/disempowerment of a disadvantaged group of individuals. The self-engagement procedures create a process, in which research participants and researchers become ‘self-engaged’ and gain insight into facts.

Spurious precision : variability in procedural validity of diagnostic procedures in psychotic disorders and implications for research and treatment

Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.

The Australian longitudinal study of health and relationships

Background

Ensuring the sexual and reproductive health of the population is essential for the wellbeing of a nation. At least three aspects of sexual and reproductive health are among the key policy issues for present Australian governments: maintaining and increasing the birth rate; reducing the abortion rate; and preventing and controlling Chlamydia infections.

The overall aim of the Australian Longitudinal Study of Health and Relationships is to document the natural history of the sexual and reproductive health of the Australian adult population.
Methods/design

A nationally representative sample of Australian adults 16–64 years of age was selected in a two-phase process in 2004–2005. Eligible households were identified through random digit dialling. We used separate sampling frames for men and women; where there was more than one eligible person in a household the participant was selected randomly. Participants completed a computer-assisted telephone interview that typically took approximately 25 minutes to complete. The response rate was 56%. A total of 8,656 people were interviewed, of whom 95% (8243) agreed to be contacted again 12 months later. Of those, approximately 82% have been re-contacted and re-interviewed in 2006–07 (Wave Two), with 99% of those agreeing to be contacted again for Wave Three.
Discussion

ALSHR represents a significant advance for research on the linked topics of sexual and reproductive health. Its strengths include the large sample size, the inclusion of men as well as women, and the wide age range of the participants.

Children's physical activity levels during school recess : a quasi-experimental intervention study

Background : Recess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention.

Methods : 150 boys and 147 girls were randomly selected from 26 elementary schools to wear uni-axial accelerometers that quantified physical activity every 5 seconds during recess. Fifteen schools located in deprived areas in one large urban city in England received funding through a national initiative to redesign the playground environment. Eleven schools served as matched socioeconomic controls. Data were collected at baseline and 6-weeks following playground intervention. Recess MVPA and VPA levels adjusted for pupil- and school-level covariates (baseline physical activity, age, gender, recess length, body mass index) were analysed using multilevel analyses.

Results : Positive but non-significant intervention effects were found for MVPA and VPA when confounding variables were added to the model. Gender was a significant predictor of recess physical activity, with boys engaging in more MVPA and VPA than girls. Significant interactions for MVPA revealed that the intervention effect was stronger for younger elementary aged school children compared to older children, and the intervention effect increased as daily recess duration increased.

Conclusion : The playground redesign intervention resulted in small but non-significant increases in children's recess physical activity when school and pupil level variables were added to the analyses. Changing the playground environment produced a stronger intervention effect for younger children, and longer daily recess duration enabled children to engage in more MVPA following the intervention. This study concludes that the process of increasing recess physical activity is complex when school and pupil-level covariates are considered, though they should be taken into account when investigating the effects of playground intervention studies on children's physical activity during recess.

Alcohol expectancies and drinking refusal self-efficacy mediate the association of impulsivity with alcohol misuse

Background: Recent work suggests that 2 biologically based traits convey risk for alcohol misuse: reward sensitivity ⁄ drive and (rash) impulsiveness. However, the cognitive mechanisms through which these traits convey risk are unclear. This study tested a model predicting that the risk conveyed by reward sensitivity is mediated by a learning bias for the reinforcing outcomes of alcohol consumption (i.e., positive alcohol expectancy). The model also proposed that the risk conveyed by rash impulsiveness (RI) is mediated by drinkers’ perceived ability to resist alcohol (i.e., drinking refusal self-efficacy).
Methods: Study 1 tested the model in a sample of young adults (n = 342). Study 2 tested the model in a sample of treatment-seeking substance abusers (n = 121). All participants completed a battery of personality, cognitive, and alcohol use questionnaires and models were tested using structural equation modeling.
Results: In both studies, the hypothesized model was found to provide a good fit to the data, and a better fit than alternative models. In both young adults and treatment-seeking individuals, positive alcohol expectancy fully mediated the association between reward sensitivity and hazardous alcohol use. For treatment seekers, drinking refusal self-efficacy fully mediated the association between RI and hazardous drinking. However, there was partial mediation in the young adult sample. Furthermore, neither trait was directly associated with the other cognitive mediator.
Conclusions: The hypothesized model was confirmed on a large sample of young adults and replicated on a sample of treatment-seeking substance abusers. Taken together, these findings shed further light on the mechanisms through which an impulsive temperament may convey risk for alcohol misuse.

Investigating directionality for a media consumption construct : establishing the utility of confirmatory vanishing tetrad analysis

Purpose – When assessing the psychometric properties of measures and estimate relations among latent variables, many studies in the social sciences (including management and marketing) often fail to comprehensively appraise the directionality of indicants. Such failures can lead to model misspecification and inaccurate parameter estimates. The purpose of this paper is to apply a post hoc test called confirmatory vanishing tetrad analysis (CTA hereafter) to a single construct called mass media consumption information exposure, which antecedent studies conceptually posited to be a formative (causative) representation.
Design/methodology/approach – This paper analyses a consumer sample of 585 US respondents and applies the CTA test to a single construct by its inclusion in various matrices within a statistical analysis system-macro that takes into account nonnormal data characteristics. The matrices are derived from Mplus 5 through the estimation of a single-factor congeneric model. The CTA test calculates a test statistic similar to an asymptotic x2 distribution with degrees of freedom equal to the number of nonredundant tetrads tested.
Findings – The preliminary data analyses reveal that the data characteristics are nonnormal which is not uncommon in social research. The CTA results reveal that the reflective (emergent) item orientation cannot be fully ruled out as being the correct model representation. This is in contrast to prior theoretical conceptual work which would strongly support this construct being a formative representation.
Originality/value – Insofar as the authors are aware, there is no paper with a particular focus on how the CTA might not provide sound results with a demonstrated example. The paper makes a valuable contribution by discussing modelling philosophy and a procedure for directionality testing. The authors advocate the implementation of pre and post hoc tests as a key component of standard research practice.