Electronic media use and adolescent health and well-being : cross-sectional community study

Objective : To describe time adolescents spend using electronic media (television, computer, video games, and telephone); and to examine associations between self-reported health/well-being and daily time spent using electronic media overall and each type of electronic media.

Methods : Design–Cross-sectional data from the third (2005) wave of the Health of Young Victorians Study, an Australian school-based population study. Outcome Measures–Global health, health-related quality of life (HRQoL; KIDSCREEN), health status (Pediatric Quality of Life Inventory 4.0; PedsQL), depression/anxiety (Kessler-10), and behavior problems (Strengths and Difficulties Questionnaire). Exposure Measures–Duration of electronic media use averaged over 1 to 4 days recalled with the Multimedia Activity Recall for Children and Adolescents (MARCA) computerized time-use diary. Analysis–Linear and logistic regression; adjusted for demographic variables and body mass index z score.

Results : A total of 925 adolescents (mean ± standard deviation age, 16.1 ± 1.2 years) spent, on average, 3 hours 16 minutes per day using electronic media (television, 128 minutes per day; video games, 35; computers, 19; telephone, 13). High overall electronic media use was associated with poorer behavior, health status, and HRQoL. Associations with duration of specific media exposures were mixed; there was a favorable association between computer use (typing/Internet) and psychological distress, whereas high video game use was associated with poorer health status, HRQoL, global health, and depression/anxiety. Television and telephone durations were not associated with any outcome measure.

Conclusions : Despite television's associations with obesity, time spent in other forms of media use appear more strongly related to adolescent health and well-being. This study supports efforts to reduce high video game use and further exploration of the role of computers in health enhancement.

Adaptation to mandated restrictions on smoking in dining areas : results of an Internet survey

Objective : The study aimed to measure changes in dining behaviour associated with the introduction of smoking restrictions on July 1, 2001, to describe strategies adopted by smokers and non-smokers to adapt to the changes, and to describe some of the thoughts, feelings and beliefs underlying the adaptations that people make in response to the introduction of new restrictions.

Method : Data were collected in a longitudinal study with repeated measures of a total of 257 respondents before and after the introduction of the restrictions, using a questionnaire administered via the Internet. Data collection occurred on seven occasions between April 2001 and March 2002. In addition, a series of in-depth telephone interviews was conducted among a group of 31 smokers and non-smokers, who were interviewed once before and twice after the introduction of the bans.

Results : Dining patterns, dining frequency, restaurant choice and expenditure on a meal did not change among either smoking or non-smoking patrons following the introduction of the law. The majority of Victorians approved of smokefree dining legislation before its implementation, and agreement with the law increased sharply and significantly among both smokers and non-smokers immediately following the introduction of the policy, remaining at high levels for the duration of the study period.

Conclusions : These findings suggest there was rapid adaptation to and acceptance of the restrictions among both smokers and non-smokers, and are supported by evidence from other jurisdictions, both interstate and internationally, regarding the introduction of smokefree dining.

Public and stakeholder values and knowledge of wildlife in Victoria, Australia

Prompted by a lack of human dimensions research in Australia, this study investigated the values and knowledge relating to wildlife held by members of the public within distinct demographic subsets of the Victorian population and members of wildlife management stakeholder groups; and compared these characteristics with how Victorian wildlife managers perceive these groups. A combination of semi-structured interviews and postal questionnaires were used. Fifteen in-depth interviews were conducted to explore how wildlife managers perceive the values and knowledge of wildlife held by members of various subsets of the Victorian population. A total of 1,431 questionnaires were completed by members of 13 public and stakeholder groups throughout Victoria, and these were analysed to explore values and knowledge relating to wildlife in Victoria. The findings of this study suggest that Victorian people have a strong emotional attachment to individual animals (the humanistic value), and an interest in learning about wildlife (the curiosity/learning/interacting value). The dominionistic/wildlife-consumption, utilitarian-habitat, aesthetic and negativistic values were not expressed by the majority of respondents from the public samples. The data also suggest that Victorian people have relatively low levels of factual knowledge about Australian wildlife. Thus, wildlife managers should expect support for wildlife management objectives that reflect the strong humanistic orientation of Victorians and tailor management and education programs to appeal to this value and Victorians' interest in learning about wildlife. Members of the Field Naturalists Club of Victoria (FNCV), Bird Observers Club of Australia (BOCA), Australian Conservation Foundation (ACF) stakeholder groups and management agency Parks Victoria expressed a strong interest in learning about wildlife. Members of the Royal Society for the Prevention of Cruelty to Animals (RSPCA) obtained high humanistic value scores; and members of the Victorian Field and Game Association (VFGA) obtained high domimomstic/wildlife-consumption value scores. Importantly, the humanistic and curiosity/learning/interacting values were the most strongly expressed values in all six groups and these values could be the key to more effective communication and collaboration between groups. Relationships between demographic factors, and values and knowledge relating to wildlife were found. For example, rural Victorians held a stronger dominionistic/ wildlife-consumption value than urban Victorians; females held stronger humanistic, curiosity/learning/interacting and negativistic values than males; young Victorians (18-34 years) held a lower curiosity/learning/interacting value and lower factual knowledge of wildlife than older Victorians; and more highly educated Victorians were more knowledgeable about wildlife than people with less formal education. No statistically significant differences were found between the values and knowledge of wildlife held by different income classes. While relationships between demographic factors, and values and knowledge relating to wildlife were found, they were generally much smaller than expected based on wildlife managers' perceptions and previous research. For example, the results suggest that Victorian females have a slightly stronger humanistic value of wildlife than males do. However, the important message emerging from the data is that males and females both express a strong emotional attachment to individual animals. Importantly, the results indicate that the effects of demographic factors on values and knowledge relating to wildlife are not always consistent across different geographic locations and stakeholder groups. For example, the slightly stronger interest in learning about wildlife among females when compared with males was observed in the rural and urban-fringe samples but not in the urban samples. This suggests that caution must be used when generalising the findings from human dimensions studies from one type of community or stakeholder group to another. Management programs should be tailored to the specific characteristics of the target audience. The findings also indicate that Victorian wildlife managers have diverse perceptions about the values and knowledge of wildlife held by members of different publics and stakeholder groups, and that the perceptions held by wildlife managers are not always consistent with the actual values and knowledge of wildlife held by members of different publics and stakeholders. For example, counter to the perceptions expressed by the interviewed wildlife managers, the interest in and factual knowledge of wildlife held by members of voluntary conservation groups equalled or surpassed that of wildlife managers; young Victorian adults (18-34 years) held a slightly lower curiosity/learning/interacting value and slightly lower level of factual knowledge of wildlife than older Victorians; and rural and urban communities in Victoria held low dominionistic and utilitarian values. Such discrepancies highlight the importance of investigating the actual values and knowledge held by members of such groups, so that appropriate and effective wildlife management programs can be implemented. Inaccurate perceptions and assumptions may contribute to ineffective communication between managers, stakeholders and publics; and adversely effect the success of wildlife management programs.

Changes in body mass index and health related quality of life from childhood to adolescence

Objective . To determine longitudinal relationships between body mass index (BMI) and health-related quality of life (HRQoL) in an adolescent population sample.
Design. Data collected in 2000 and 2005 within the Health of Young Victorians longitudinal cohort study.
Setting. Originally a community sample of elementary school students in Victoria, Australia. Follow-up occurred in either secondary schools or individuals homes.
Participants. Cohort recruited in 1997 via a random sampling design from Victorian elementary schools. Originally comprising 1 943 children, 1 569 (80.8%) participated in 2000 (wave 2, 8 – 13 years) and 851 (54%) in 2005 (wave 3, 13 – 19 years).
Main outcome measures. In both waves participants and their parents completed the PedsQL, a 23-item child HRQoL measure, and BMI z-scores and status (non-overweight, overweight or obese) were calculated from measured height and weight. Associations were tested cross-sectionally and longitudinally (linear regression, adjusted for baseline values)
Results. A total of 81.6% remained in the same BMI category, while 11.4% and 7.0% moved to higher and lower categories, respectively. Cross-sectional inverse associations between lower PedsQL and higher BMI categories were similar to those for elementary school children. Wave 2 BMI strongly predicted wave 3 BMI and wave 2 PedsQL strongly predicted wave 3 PedsQL. Only parent-reported Total PedsQL score predicted higher subsequent BMI, though this effect was small. Wave 2 BMI did not predict wave 3 PedsQL.
Conclusions. This novel study confi rmed previous cross-sectional associations, but did not provide convincing evidence that
BMI is causally associated with falling HRQoL or vice versa across the transition from childhood to adolescence.

Indigenous place-making in the city : dispossessions, occupations and implications for cultural architecture

This paper considers Indigenous place-making practices in light of an idea for a major Victorian Indigenous Cultural Knowledge and Education Centre in central Melbourne as championed by Traditional Owners in Victoria. With only eight Aboriginal architects in the country, collaboration with non-Indigenous architects will be inevitable. Two case studies from the recent past—the Tent Embassy in Canberra and a street corner in Collingwood—reveal that dominant cultures of place-making continue to marginalise Aboriginal people in urban Australia. This paper will contend that delivering spatial justice will require both an opportunity for Indigenous Victorians to build visibility in the centre of the city and a willingness within the dominant culture to be deterritorialised.

Scaling up diabetes prevention in Victoria, Australia: policy development, implementation and evaluation

Objective
The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This paper describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation.

Research
Design and Methods Life!, a behavior change intervention, comprises six group sessions over eight months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, was recorded on a central database.

Results
Life! has a state-wide workforce of 302 trained facilitators within 137 organizations. 29,000 Victorians showed interest in Life! and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011. 37% of the original participants completed the eight month program. Participants completing sessions one to five lost an average of 1·4 kg weight (p<0·001) and waist circumference of 2·5cm (p<0.001). Those completing six sessions lost an average of 2·4 kg weight (p<0·001) and waist circumference of 3·8 cm (p<0·001). The weight loss of 2.4 kg represents 2.7% of participants’ starting body weight.

Conclusion
The impact of Life! is attributable to applying available evidence for the systems design of the intervention, and collaboration between policy makers, implementers and evaluators using the principles of continuous quality improvement to support successful, large scale recruitment and implementation.

Job strain — attributable depression in a sample of working Australians: assessing the contribution to health inequalities

Background The broad aim of this study was to assess the contribution of job strain to mental health inequalities by (a) estimating the proportion of depression attributable to job strain (low control and high demand jobs), (b) assessing variation in attributable risk by occupational skill level, and (c) comparing numbers of job strain–attributable depression cases to numbers of compensated 'mental stress' claims. Methods Standard population attributable risk (PAR) methods were used to estimate the proportion of depression attributable to job strain. An adjusted Odds Ratio (OR) of 1.82 for job strain in relation to depression was obtained from a recently published meta-analysis and combined with exposure prevalence data from the Australian state of Victoria. Job strain exposure prevalence was determined from a 2003 population-based telephone survey of working Victorians (n = 1101, 66% response rate) using validated measures of job control (9 items, Cronbach's alpha = 0.80) and psychological demands (3 items, Cronbach's alpha = 0.66). Estimates of absolute numbers of prevalent cases of depression and successful stress-related workers' compensation claims were obtained from publicly available Australian government sources. Results Overall job strain-population attributable risk (PAR) for depression was 13.2% for males [95% CI 1.1, 28.1] and 17.2% [95% CI 1.5, 34.9] for females. There was a clear gradient of increasing PAR with decreasing occupational skill level. Estimation of job strain–attributable cases (21,437) versus "mental stress" compensation claims (696) suggest that claims statistics underestimate job strain–attributable depression by roughly 30-fold. Conclusion Job strain and associated depression risks represent a substantial, preventable, and inequitably distributed public health problem. The social patterning of job strain-attributable depression parallels the social patterning of mental illness, suggesting that job strain is an important contributor to mental health inequalities. The numbers of compensated 'mental stress' claims compared to job strain-attributable depression cases suggest that there is substantial under-recognition and under-compensation of job strain-attributable depression. Primary, secondary, and tertiary intervention efforts should be substantially expanded, with intervention priorities based on hazard and associated health outcome data as an essential complement to claims statistics.

Aboriginal health promotion through addressing employment discrimination

The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered.

If the land is healthy… it makes the people healthy

This PhD explores the connection Aboriginal Victorian people have to their traditional lands (known as Country) and its relationship with health. Findings identify the deep connection Aboriginal Victorian people have to their Country and the need for public health clinicians to engage with diverse Indigenous practices and knowledge when applicable.

The Great War In Victorian Private Life - Mildura

Join Dr Bart Ziino as he examines the private experience of the Great War in Victoria, drawing on personal letters and diaries to tell a story of the war as an individual, familial, and communal trial. Through an examination of anxieties over loved ones at the front, and tensions over who was bearing the greater burden. This talk offers new ways of understanding the costs of the war, the capacities of Victorians to meet and endure its demands, and its increasingly corrosive social effects within their communities.

At home with the war: The Great War in Victorian private life. The 2014 Augustus Wolskel lecture

This article examines the Great War in Victoria through the lens of private sentiment. It exposes not only the diversity of perspectives and sentiment surrounding the war, but also the stresses endured by Victorians trying to reconcile their commitment to the war with personal and familial needs.Their experience was dominated by a confrontation with powerful currents of anxiety over the war and their loved ones, and increasing tensions within their communities over who was bearing the greater burdens of the war. Investigating private experience of total war at home allows us to see how Victorians made as well as endured the Great War, as their communities struggled to remain cohesive, and individuals struggled to cope with its demands.

Morbidity patterns among the underweight, overweight and obese between 2 and 18 years: population-based cross-sectional analyses

CONTEXT: No study has documented how symptomatic morbidity varies across the body mass index (BMI) spectrum (underweight, normal weight, overweight and obese) or across the entire child and adolescent age range. OBJECTIVE: To (1) quantify physical and psychosocial morbidities experienced by 2-18-year-olds according to BMI status and (2) explore morbidity patterns by age. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional data from two Australian population studies (the Longitudinal Study of Australian Children and the Health of Young Victorians Study) were collected during 2000-2006. Participants were grouped into five age bands: 2-3 (n=4606), 4-5 (n=4983), 6-7 (n=4464), 8-12 (n=1541) and 13-18 (n=928) years. MAIN MEASURES: Outcomes-Parent- and self-reported global health; physical, psychosocial and mental health; special health-care needs; wheeze; asthma and sleep problems. Exposure-measured BMI (kg m(-2)) categorised using standard international cutpoints. ANALYSES: The variation in comorbidities across BMI categories within and between age bands was examined using linear and logistic regression models. RESULTS: Comorbidities varied with BMI category for all except sleep problems, generally showing the highest levels for the obese category. However, patterns differed markedly between age groups. In particular, poorer global health and special health-care needs were associated with underweight in young children, but obesity in older children. Prevalence of poorer physical health varied little by BMI in 2-5-year-olds, but from 6 to 7 years was increasingly associated with obesity. Normal-weight children tended to experience the best psychosocial and mental health, with little evidence that the U-shaped associations of these variables with BMI status varied by age. Wheeze and asthma increased slightly with BMI at all ages. CONCLUSIONS: Deviation from normal weight is associated with health differences in children and adolescents that vary by morbidity and age. As well as lowering risks for later disease, promoting normal body weight appears central to improving the health and well-being of the young.