68 resultados para social interventions


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Background
Sporting organisations provide an important setting for health promotion strategies that involve policies, communication of healthy messages and creation of health promoting environments. The introduction of policy interventions within sporting organisations is one strategy to target high risk behaviours such as smoking, alcohol consumption, excess sun exposure, unhealthy eating and discrimination.

Objectives
To review all controlled evaluation studies of policy interventions organised through sporting settings to increase healthy behaviour (related to smoking, alcohol, healthy eating, sun protection, discrimination, safety and access).

Search strategy
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsyclNFO, CINAHL, SPORTDiscus, Sociological Abstracts, Dissertation Abstracts, freely available online health promotion and sports-related databases hosted by leading agencies, and the internet using sport and policy-related key words. We identified further studies in the bibliographies of articles and by contacting authors of key articles in the area.

Selection criteria
We aimed to identify research that had used study designs that incorporated an evaluated intervention and comparison. Uncontrolled studies, meeting other inclusion criteria, were to be reported in an annex to the review.
Types of studies: Studies in which sporting organisations were allocated to a policy intervention or control/comparison group. No minimum follow-up required.
Types of participants: People of all ages.
Types of interventions: Any policy intervention implemented through sporting organisations to instigate and/or sustain healthy behaviour change, intention to change behaviour, or changes in attitudes, knowledge or awareness of healthy behaviour. Policies must address any of the following: smoking, alcohol, healthy eating, sun protection, access for disadvantaged groups, physical safety (not including injuries), and social and emotional health (e.g.. anti-vilification, anti-discrimination).
Types of outcome measures: Behaviour change, intention to change behaviour, change in attitudes, knowledge or awareness of healthy behaviour, and policy presence.

Data collection and analysis
We assessed whether identified citations were controlled evaluation studies and investigated the use of policy implemented in sporting settings. Abstracts were independently inspected by two reviewers and full papers were obtained where necessary. As no controlled evaluation studies were located, no data collection or analysis was undertaken. No uncontrolled studies meeting other inclusion criteria were identified and therefore no annex is presented.

Main results
No rigorous studies were located to test the effectiveness of policy interventions organised through sporting organisations to increase healthy behaviours, attitudes, knowledge or inclusion of health oriented policies within the organisarions.

Authors' conclusions
We were unable to find any controlled studies to guide the use of policy interventions used in sporting settings. The search process revealed a number of case studies with anecdotal reporting of outcomes. We strongly recommend that rigorous evaluation techniques are employed more commonly in this field to illuminate the impact of health promoting policy on outcomes, and the contexts and processes which are likely ro be effective in reducing harmful behaviours.

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Background
Obesity prevention is an international public health priority. The prevalence of obesity and overweight is increasing in child populations throughout the world, impacting on short and long-term health. Obesity prevention strategies for children can change behaviour but efficacy in terms of preventing obesity remains poorly understood.

Objectives
To assess the effectiveness of interventions designed to prevent obesity in childhood through diet, physical activity and/or lifestyle and social support.

Search strategy
MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted.

Selection criteria
Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks.

Data collection and analysis
Two reviewers independently extracted data and assessed study quality.

Main results
Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-obese children of obese or overweight parents.

Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing obesity. Two studies focused on nutrition education alone, but neither were effective in preventing obesity.

Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact.

The studies were heterogeneous in terms of study design, quality, target population, theoretical underpinning, and outcome measures, making it impossible to combine study findings using statistical methods. There was an absence of cost-effectiveness data.

Authors' conclusions
The majority of studies were short-term. Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status. Nearly all studies included resulted in some improvement in diet or physical activity. Appropriateness of development, design, duration and intensity of interventions to prevent obesity in childhood needs to be reconsidered alongside comprehensive reporting of the intervention scope and process.

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This presentation of my research examines the relationship between social capital and wellbeing.
Researchers and theorists have both been interested in the area of social capital because of its relationship to health. A relationship between social capital and individual health and wellbeing has intuitive appeal. Certainly, any identified predictors or significant relationships between social capital and health and wellbeing may lead to targeted health interventions. However, this area of research is fraught with operationalisation and methodological issues.

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During the 1990s, states embraced legalised gambling as a means of supplementing state revenue. But gaming machines (EGMs, pokies, VLTs, Slots) have become increasingly controversial in countries such as Australia, Canada and New Zealand, which experienced unprecedented roll-out of gaming machines in casino and community settings; alongside revenue windfalls for both governments and the gambling industry. Governments have recognised that gambling results in a range of social and economic harms and, similar to tobacco and alcohol, have introduced public policies predicated on harm minimisation. Yet despite these, gaming losses have continued to climb in most jurisdictions, along with concerns about gambling-related harms. The first part of this article discusses an emerging debate in Ontario Canada, that draws parallels between host responsibility in alcohol and gambling venues. In Canada, where government owns and operates the gaming industry, this debate prompts important questions on the role of the state, duty of care and regulation ‘in the public interest’ and on CSR, host responsibility and consumer protection. This prompts the question: Do governments owe a duty of care to gamblers?

The article then discusses three domains of accumulating research evidence to inform questions raised in the Ontario debate: evidence that visible behavioural indicators can be used with high confidence to identify problem gamblers on-site in venues as they gamble; new systems using player tracking and loyalty data that can provide management with high precision identification of problem gamblers and associated risk (for protective interventions); and research on technological design features of new generation gaming products in interaction with players, that shows how EGM machines can be the site for monitoring/protecting players. We then canvass some leading international jurisdictions on gambling policy CSR and consumer protection.

In light of this new research, we ask whether the risk of legal liability poses a tipping point for more interventionist public policy responses by both the state and industry. This includes a proactive role for the state in re-regulating the gambling industry/products; instituting new forms of gaming machine product control/protection; and reinforcing corporate social responsibility (CSR) and host responsibility obligations on gambling providers – beyond self-regulatory codes. We argue the ground is shifting, there is new evidence to inform public policy and government regulation and there are new pressures on gambling providers and regulators to avail themselves of the new technology – or risk litigation

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Participation in physical activity helps prostate cancer survivors to cope with the side effects of treatment, enhances quality of life and decreases the risks of many of the comorbidities to which survivors are highly susceptible. Prostate cancer survivors, however, are less likely than other cancer survivors (e.g., breast and colorectal) to increase physical activity after diagnosis. Interventions have been only modestly successful at increasing participation in physical activity for prostate cancers survivors and more research is needed to increase our understanding of the determinants of physical activity for this group. Using a social ecological framework, this qualitative research sought to examine the individual, social and environmental determinants of participation in physical activity for prostate cancer survivors. In-depth interviews were conducted with 20 survivors of prostate cancer aged between 35 and 75 years. Participants were drawn from a public and a private health service and from a range of treatment types. We are currently collecting data for this study and preliminary themes will be discussed at the conference (abstract will be updated once findings are known).

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Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods:
Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N = 591) and confirmatory (N = 598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (α) = 0.86); Health Directed Behavior (four items, α = 0.80); Skill and Technique Acquisition (five items, α = 0.81); Constructive Attitudes and Approaches (five items, α = 0.81); Self-Monitoring and Insight (seven items, α = 0.70); Health Service Navigation (five items, α = 0.82); Social Integration and Support (five items, α = 0.86); and Emotional Wellbeing (six items, α = 0.89).

Conclusion:
The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice Implications:
The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

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Background: The Pacific OPIC Project (Obesity Prevention In Communities) includes whole-of-community intervention programs in four countries (Fiji, Tonga, New Zealand, Australia) aimed at reducing the prevalence of overweight and  obesity in youth.

Development of Action Plans
: At each intervention site, preliminary interviews  were conducted with youth to identify the potential socio-cultural barriers and  facilitators to healthy eating and regular physical activity in order to attain and sustain a healthy body size. This and other information was presented at a 2-day workshop with community stakeholders, including youth. The participants then prioritised the components for a draft action plan which was later consolidated through further community consultation.

Action Plan objectives
: Each action plan had two overall aims: to build  community capacity and to promote healthy weight. The first three objectives in each action plan were on capacity building, social marketing messages, and evaluation. Next were a set of four to five behavioural objectives with associated strategies involving programs, events, social marketing and environmental  change. Lastly, each site had one or two innovative or developmental objectives.

Progress: Interventions began in all sites from 2005, with the action plans guiding implementation priorities. The initial behavioural objective for targeting in Fiji was eating regular breakfast and meals throughout the day, for Tonga it was physical activity, and for Australia and New Zealand it was increasing water consumption and decreasing consumption of sweet drinks.

Conclusions: The action plans have provided the basis for community engagement in the project, the guide to the implementation of activities and the template for the evaluation plan.

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Synopsis: Crossing Bowen Street Crossing Bowen Street is an extended novel set in Melbourne, Australia. The protagonist, Meg Flanagan, is accepted to teachers' college. Meg is 24 years old and has worked, and lived out of home, since 17. Having completed her year 12 studies part time while working, she has applied to the Melbourne State College for a Bachelor of Education. Melbourne State College is subsequently 'amalgamated'A into Philip University, the original 19th century sandstone institution which borders MSC. Meg has worked as a medical secretary prior to commencing her studies. An only child, she is the first member of her family to go to university, indeed to finish high school. Tertiary study is exciting for Meg and the novel explores the psychic journey as well as the intellectual one, as Meg experiences challenges to the possibilities for her life and the trajectory along which she once assumed it would flow. The narrative is told through episodic and epistolary forms, with particular periods in Meg's cultural and academic life forming the focus, picking up the integral elements of her journey and examining the psychic context and action. Characters in the undergraduate chapters of the novel are somewhat transient, although very important to Meg's rapidly developing, changing sense of herself. The constant 'trying out' of ways of being and even lifestyles sees Meg losing old 'friendships' and making new, even temporary, ones all the time. This allows the opportunity for Meg to explore her feelings about connecting to others and the nature of her relationships. The Meg reflected back to her by others is of constant interest to her, particularly as she is frequently reminded that others see a very different Meg than she does. The novel commences at the outset of Meg's tertiary career, as she initially articulates the extent of her aspiration, of her sense of the possibility of her own life. Each vignette deals, chronologically, with an aspect of Meg's expanding sense of possibility, socially, emotionally, intellectually. Certain vignettes explore her relations with friends and acquaintances in the course, which in turn provide A In 1988, Federal Labor Minister for Education John Dawkins, devised a plan to end the streaming of Australian tertiary institutions and created what is called the Unified National System. This meant that colleges of advanced education and institutes of technology were either created universities in their own right, or more commonly, merged with an appropriate existing university. This process allows a fascinating insight into the class dimensions of hierarchies and stratifications. The need of universities and their members for status has been profoundly underscored. the background and context for her sexual relationships. That aspect of her developing subjectivity provides a marked contrast, which Meg uses as leverage, when set against her sense of herself as a scholar and her growing notion of entitlement, which allows her to 'choose', where previously she believed she had no choice; the choice is a scholarly career. Within all this, Meg discovers and is deeply empowered by certain political left, and feminist, discourses within the university community. She is equally dismayed and alienated by other feminist practices; her growing engagement with her own agency sees her quickly abandoning feminist subject positions previously dear to her, which served a particular purpose and are now superseded. This notion of feeling betrayed by the promise of a value system (or rather, its practitioners) will recur throughout the action of the novel, as Meg moves into an academic role, first as doctoral student and then as academic, seeking to live her values as practice and to remain true to what her trajectory has taught her. This is crystallised in the novel as the role played by the place she came from, and how that informs, and complicates, who she becomes. The novel seeks to explore the fundamental contradictions in doing so, through Meg's increasing awareness that the academy is not the harmonious, class aware institution she has idealised, but a world driven by status and hierarchies. This realisation must be reconciled in the light of Meg's anxieties about her working-class background. Meg's doctoral training at an elite university underscores her developing sense of what constitutes excellence and the role played by highly influential conservative institutions in maintaining social arrangements. As her academic career unfolds, the holding of a Cambridge PhD allows Meg opportunities to make change as certain privileges are afforded her by virtue of her Cambridge status. Yet it is this very notion that she seeks to challenge. Her growing passion for the State University of Victoria, an institution developed for the education of working-class people, informs her activism within the academy. Why are excellence and equity polarised? Why does the institution matter more than the scholarship? Why is so much practice within universities contrary to the values scholars often claim? These questions are explored through the dynamics of academic working life as student and later as a teacher at a university with an explicit equity agenda. The Start of the End (2003): The action commences on a late Friday after at SUV, when the Department of Communication & Cultural Studies has just been advised of Meg's promotion to Associate Professor. This vignette sees the initial soiree and celebrations and allows Meg to reflect on her experience. As her colleagues and friends are congratulating her, a particular student comes looking for Meg. It is clear that Angela Watson needs course advice particularly from Meg. Their discussion seems a straightforward one on the face of it, but it underscores many things; that Meg has come the full circle in her academic life, and what it is that her journey has really been about. The route to professorial appointment is considered, as is the source of Meg's greatest professional joy and fulfillment; is it scholarship, followed by leadership, in her discipline? It is knowing she has continued to speak and act to change the life chances of all students, wherever possible? Or is it the subtle distilling of both of these, along with the knowledge which emerges from the nexus of teaching and research. That scholarship, new knowledge, surely must be taking us somewhere specific in relation to others? The more we know, the more we can do...to what end? From this reflection, we see the action of the novel unfold. We return to this scene at the end of the novel, as Meg considers the trajectory of her life and its themes in her work. The novel ends as she is faced with the next challenge. Arrival (1989): Acceptance sees Meg as she is attempting to transform her life and create a new one. She has just been advised of her admission to an undergraduate Bachelor of Education program, at the major Melbourne teachers' college. Meg shares her rented home with her high school best friend, Anna, and her fiance, Jason, who appears to be superfluous in her life. Meg is aware he is a partner for who she used to be. We see Meg in her job as a medical secretary and this allows the mapping of Meg's sense of her own world, as she travels between home and work. This first stage of seeking her aspiration- to be an English teacher-evolves. As Meg considers the meaning of what she is about to do and how she knows it is right. This involves a consideration of what work means in our lives and how this is different for jobs according to how they are classed. Her relationship with the life she has known, the person she has been, is changing and this change is represented through her relationship with Jason. Meg's first day at teachers' college demonstrates that she is in a constant, often painful, dialogue with herself. The difficulties she encounters in making sense of the relation between her two 'lives' are thrown into sharp relief. The preparation for college sees Meg interrogating herself about how she can be different. Her initial experiences at the College resonate with her highest expectations of the life that awaits her, of the multiple possibilities currently being authored for her. Her first attendance at classes offers the opportunity to try out some of those possibilities, to test them against those she meets and to map the ways she could discover to 'be'. There is much tension and fear, but also endless excitement and these conflicting emotional states parallel and marble each other. It is on this day that she meets Jennifer Wren, her first real friend at university, who offers so many challenges to Meg. Their friendship involves a constant exhausting shift of subject positions, which Meg is able to look back on with affection in years to come. Going Bowling (1989): within a few weeks of commencing at university, Meg is socializing with some of her new friends, having neatly segmented her home and college lives. Meg has already realised that her friendships fall into separate groups; her friendship with Jennifer and the people Jennifer knows does not find its way into this group. They meet in the city to go bowling and have a meal. While Meg really enjoys these new people, already tensions are developing in relations between the group. Their unofficial leader, Rosemary Marshall, has a tendency to seek control and already resistance is showing. Rosemary particularly does not like Jennifer. Meg is enjoying her flirtation with Pete Danville, whom she has assumed to be gay. His very flattering attention has already developed Meg's confidence and stoked her ego, which has eroded in her stagnating relationship with Jason. Rosie has developed a crush on Pete and seems to take the flirtation with Meg personally. Dynamics in the group become slightly uncomfortable but Meg has grown quickly fond of her new friends, especially flamboyant Marina, another whom Rosemary seems to dislike. The discussions which occur during their evening deepen both the relationships and the tensions between them and draw lines which will determine the outcome of their various friendships. The Ball (1990): In the third year of her degree, much has happened to Meg. She is married to Jason, although she omits him from much of her psychic (and practical) life. Meg and her friends attend the Faculty's annual formal dinner dance. Meg has so far managed to balance the competitiveness which occurs between all of them, both academically and personally. The negotiation of her respective friendships with Jennifer and Marina requires a great deal of diplomacy; the subtext in this is very disturbing to Meg. What exactly is the conflict about? She can't be sure why they don't like each other; it could be Marina's smoking, or Jennifer's confidence to spare, but these things also annoy her, yet she does not fight with either girl as they do with each other. Rose has always insisted that the problem is Jennifer's private school background, but Marina went to a catholic girls' school, so what could the difference be? The ball is initially a happy occasion; the girls dress up and they dance and drink champagne together with the boys. But dynamics operating beneath the surface force their way up. Rosie is ready to force Pete to confront her continuing crush on him; Pete confronts Meg about their ongoing flirtation. Meg gives in and admits to herself for the first time that she does want to be with Pete. He is grown up and exciting and strong. He offers her something she has never had with Jason. Married less than a year, she pushes her husband out of her thoughts. The events of the ball force Meg to confront the differences between all her friends and the discomfort this affords everyone. Rosie's continued need for control over the group is acknowledged. Future Present (1991): Meg lives in Carlton with Pete. This is the busiest year thus far in her academic career and the financial, academic and emotional pressure is showing. This vignette gives us the range of Meg's academic activities and the way her life has fallen since the events at the ball eight months earlier. We see Meg grappling with her own evaluation of the changes in her 'way of being'; trying on different ways of living that she has idealised and finding them just as wanting as the last. Meg faces some key existential questions in this vignette and seeks answers which she finally discovers only she can give. Her relationship with Pete, the values and goals they share (and don't share) are thrown into sharp relief and provide a touchstone for the clearer determination of Meg's aspiration and future. Her relationship with various female friends is also revisited and this offers insight into Meg's constant checking of herself against idealised female templates. There is a crisis of identity and strength which constitutes an important fork in Meg's road. Beyond (1992): Beyond sees Meg determinedly seeking ways she can progress towards her goal, while still constantly checking against herself that postgraduate study (let alone a scholarly life) is available to her. We accompany Meg as she seeks and locates the academic path she wants; this is the backdrop for her further psychic exploration of the women who intimidate yet fascinate her, particularly Heloise Waul, who is a significant influence through Meg's postgraduate career. The sites in which Meg's personal struggles manifest are highlighted in this vignette, particularly in terms of dress and cultural pursuit. The conversations between Meg and Heloise also allow an exploration of the feminist politics of that milieu and the class tensions which operate tacitly within those politics. Bound to the Caucus (1992); Meg has now nearly completed her undergraduate degree and has been active for some time in university life and student politics. Her feminist and socialist education is well advanced. Bound to the Caucus shows us Meg in her student politics world for the first time, where the segue of her activism and academic life have taken her. Meg has found female friends who understand that part of her which struggles with inadequacy, although at this point in the novel this common struggle is not well understood or articulated. It is in this vignette that Meg admits her growing attraction for a Liberal student activist, Stuart Noble; this proscribed liaison raises many questions about values and aspiration, as well as the dominant sexual politics of the time and place. Bound to the Caucus also offers insight into the student activism occurring at universities like Philip in the early 1990s. Divergence (1993): Set in 1993, Meg is now in the early weeks of her honours program, although she has been at work on her thesis on the poet William Blake for some months. Living unhappily in a share household near the University, her relationship with Stuart Noble continues to develop, reaching a crisis point in this period. These events occur in the context of Meg's activist career in the Student Left, particularly as she encounters issues of identity around her class, feminism and difference amongst Left women. While Meg fights these battles passionately in an intense milieu, she considers them emotionally in terms of her changing sense of herself. Meg is increasingly aware that the personal impact of her class is changing for her. Additionally, she explores her relation with a 'boyfriend' of right wing political affiliation; Meg comes to recognise that this relationship is undermining her sense of herself in a way that her relationships with women in the left previously did. Honour Roll (1993): Meg is now undertaking honours and this vignette opens with Meg seeing the honours coordinator, Professor Michaela Moore, who approximates all those apparently middle-class traits to which Meg has such a push-pull relation. We see the return of a chapter of the honours thesis, discussion of the content and the constantly shifting subject positions these experiences offer Meg. This vignette also directly introduces Agnes. Mia and Agnes meet Meg after her supervision and this conversation allows very distinct if tacit class themes to develop. Meg has warmed quickly to Agnes, who is unlike anyone she has known; they have much in common in relation to their work and this binds them. Mia continually presents a viewpoint which irritates Meg, in relation to entitlement: to academic life, to funding, even to questioning how these things are enabled. Honour Roll allows us to see Meg's flourishing theoretical and intellectual life and its role in assisting her emotionally as she re-frames the same conundrums that previously constituted obstacles. The Cusp (1993): Meg's developing friendship with Agnes offers her enormous insights into difference and her developing sense of self and aspiration. While the girls come from diametrical backgrounds, they are united by their passion for their research and scholarly work. Meg is increasingly self-conscious through their discussions in terms of how she has seen herself and allowed herself to dream and seek. Cusp is set at the end of the honours year, prior to the release of results. Meg and Agnes explore their feelings about academia and this leads to discussions of purpose and the role of class within that. This vignette also documents Meg's growing social confidence and those aspects of herself which have become so sure to her, that she no longer considers them at all. Whom (1996): [Not included in this abridged edition]. Set at Cambridge, two thirds into Meg's doctorate, Whom shows Meg in the mental space which will take her back to Melbourne and the State University of Victoria. Having risen to the challenge of doctoral study, she is confronted now by deeper demons, and the need to explore and challenge them in the ambivalent context of Cambridge, which so excites her still, but which has proved empty of the profoundly held higher ideals she expected to see reflected. Set in the midst of Meg's doctoral study, this vignette is dramatically abridged in the submission novel. The importance of Whom lies in its concern with Meg's rapidly shifting sense of herself and her own scholarly subjectivity and the changes to these that the culture of Cambridge has wrought. By the second year of her PhD Meg is crystal clear about her goals and decides to spend the long break at home, rather than travelling, because she wishes to 'touch base' with her future. The action described segues into that in Courting the Enemy. Whom describes Meg's ambivalent and contradictory but passionate feelings about Cambridge. Whom demonstrates Meg's increasing anger at the status and privilege to which her education now automatically admits her, and her need to find some sort of stasis and safety in her emotional life. In this vignette, Meg meets her life partner, Jeremy McCallum (I have intentionally reduced the attention in the novel to Meg's romantic life as she matures into her career). Courting the Enemy (late 1990s): By this time, Meg is a senior lecturer in English at the State University of Victoria, which was established in the nineteenth century as the Worker's College. This vignette starts with Meg's attendance at a University Committee which is considering a transformation in relation to equity in admissions policy. Meg was drawn to SUV because of its transparent and determined commitment to educate the children of working-class people. An attack on the equity admission policy of her university galvanizes Meg and some of her colleagues. The action of the vignette considers the role of the scholar, and of such an institution as SUV, in the light of daily academic life. This vignette is primary in its demonstration of the themes of the novel. In the unabridged version, I took the opportunity to illustrate some of the vast range of administrative, intellectual and even physical demands on a senior scholar in the routine of academic life. In placing Meg in this context, I sought to highlight how a scholar of her values and commitment makes sense of the constantly shifting terrain of her working world and how this continually informs her practice. This vignette is also significant for its retrospective description of Meg's employment at SUV some years earlier. Locus: (1995). This piece of writing stands apart from the rest of the novel. I wished to write in a reflective voice, which might be from Meg's journal, were it not in the (omniscient) third person, in order to consider the headspace and meaning-making which occurs as Meg settles into Cambridge, and the lifestyle her situation allows her. Locus is a deeper engagement with Meg's sense of her identity. It considers the impact on her of the physical journeys she must make to match those of her psyche. These are thoughts too personal for a letter, even to Anna. Meg is exploring her ever shifting self and the growth in her self-belief allows her to explore what is rage; that she was bounded by illusions about her worth. Locus seeks to allow some context for Meg's anger at the role Cambridge plays. I seek to create the space in which Meg's dawning self understanding will lead her to her next, driven, purpose. Letters: throughout the novel letters are used to reveal and inform Meg's relationship with her family. This is an intentional device to distance the birth family in an attempt to blur and muddy an assessment of Meg's class through traditional measures. The letters between Meg and Aunty Jean particularly reveal much of the classed emotional antecedents of Meg's life. There are also letters exchanged with Meg's high school best friend, Anna, who has moved to the country and a very different lifestyle. Meg writes to Anna often, using the acceptance she feels in the friendship and her sense that Anna understands her, to touchstone her own emotional growth. Formal letters from institutions ring changes in settings and mark significant points in the geographical and academic trajectory of the character. All the letters serve to introduce time and event changes consistent with the episodic style of the narrative.

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‘Psychosocial problems’ are psychological problems that are regarded as resulting from the interaction between the adaptive capacities of individuals and the demands of their physical and social environments. Many different factors have been theoretically proposed, and empirically established, as predictors of a range of psychosocial problems in adolescents. However, a problem exists in that this literature appears to lack an integrative framework that has validity across the range of problems that are observed. The purpose of the current research is to propose and test a model that draws together three clusters of factors that are useful in predicting the incidence of adolescent psychosocial problems. These are family structural background factors, family functioning variables and control beliefs. Data were collected from 155 adolescent males aged between 12 and 19 by a single concurrent and retrospective self-report questionnaire. This included data about the respondent (age, involvements with mental health or juvenile justice agencies) and family structural background factors (days per week worked by mother/father, occupational status for mother/father, residential mobility, number of persons in the family home). The questionnaire also incorporated the Parental Bonding Instrument (Parker, Tupling & Brown, 1979) to quantify the levels of perceived parental care and overprotection, and an adaptation of the Parental Discipline Style Scale (Shaw & Scott, 1991), to assess punitive, love withdrawing and inductive discipline practices. In addition, the (Low) Self-control Scale (Grasmick, Tittle, Bursick & Arneklev, 1993) and the Locus of Control of Behaviour Scale (Craig, Franklin, & Andrews, 1984) were used to collect data concerning adolescents’ perceived behavioural self-control and locus of control. Finally, selected sub-scales of the Child Behavior Checklist Youth Self-Report (Achenbach, 1991b) were used to collect data on the incidence of social withdrawal, somatisation, anxiety and depression, aggression and delinquency among the respondents, and in aggregated form, the incidence of ‘total problems’ and internalising and externalising behaviours. Results indicated family structural background factors, family functioning variables and control beliefs possess limited predicted validity and that the usefulness of the proposed model varies between specific psychosocial problems. Family functioning variables were generally stronger predictors than family structural background factors, particularly for internalising behaviours. Of these, levels of parental care and overprotection were generally the strongest predictors. Perceived self-control and locus of control were also generally strong predictors, but were particularly powerful with respect to externalising behaviours. The strength of predictive relationships was observed to vary between specific internalising and externalising behaviours, suggesting that individual difference variables not assessed in the current research were differentially influential. Finally, the parental and individual characteristics that predicted maximal levels of adjustment (defined in terms of minimal levels of internalising and externalising behaviours) were explored and the correlates of various parenting style typologies (Parker et al., 1979) were investigated. These results strongly confirmed the importance of family functioning and control beliefs with respect to the prediction of internalising, externalising and well-adjusted behaviours. In all analyses, substantial proportions of the variance in the incidence of problem behaviours remain unexplained. The findings are examined in relation to previous research focused on (familial) social control and (individual) self-control with respect to psychosocial problems in adolescents. In addition, methodological considerations are discussed and the implications of the findings for clinical and community interventions to address problem behaviours, and for further study, are explored.

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Objective. To examine associations between social ecological factors and Dutch adolescents’ TV viewing. Design. Cross-sectional examination of predictors of adolescents’ TV viewing.

Participants. A total of 338 adolescents, aged 14 years (55% boys).

Measurements. Adolescents self-reported their age, ethnicity and TV viewing (dichotomized at two hours/day) and responded to items from all three social ecological domains; individual (cognitions based on the Theory of Planned Behaviour and TV viewing habit strength, and other behaviours, such as computer use), social (parental rules about TV viewing and parental TV viewing behavior) and physical environmental factors (TV in bedroom, physical activity equipment available). Parents reported demographic factors (e.g., ethnicity, education level), and their own TV viewing (mins/day); adolescents’ weight status (not overweight vs. overweight/obese) was calculated from objective measures of height and weight. Logistic regression analyses examined associations between socio-ecological factors and adolescents’ TV viewing, and whether associations were moderated by adolescents’ sex, parents’ education and ethnicity.

Results. Compared with others, overweight/obese adolescents (odds ratio (OR)=3.0; p≤0.001), those with high computer use (OR=2.3; p≤0.0001), with high TV viewing habit strength (OR=1.3; p≤0.0001), and those whose parents had high levels of TV viewing (OR=2.4; p≤0.01) were more likely to exceed two hours of TV viewing per day. The association with habit strength was moderated by gender, and the association with parents’ TV viewing was moderated by parents’ education and ethnicity.

Conclusions. Interventions should target parents’ TV viewing behaviors and aim to amend habitual, ‘mindless’ TV viewing among adolescents.

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The purpose of this paper was to examine the contribution of individual, social and environmental factors to predicting fruit and vegetable consumption among women of low socioeconomic position (SEP). An Australian community sample of 355 women of low SEP provided survey data on sociodemographic information, diet (fruit and vegetable consumption), and various cognitive, behavioural, social and perceived environmental influences on healthy eating. Information on the availability and accessibility of major chain supermarkets and fruit and vegetable stores from participant's residence was collected through objective audits. Women who were older, dieting to lose weight, had a greater taste preference for fruit and perceived the cost of fruit to be lower were more likely to be high fruit consumers. Women who had a high BMI were more likely to be high vegetable consumers. Women who perceived a greater availability of healthy foods in their neighbourhoods were more likely to be high fruit and vegetable consumers. Strategies aimed at increasing fruit and vegetable consumption among low SEP women should focus on modifying perceptions about the cost, availability and taste of fruits and vegetables. Tailoring nutrition interventions to accommodate differences in age, weight-control practices and weight status may also prove beneficial.

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The results of this thesis indicated that males engage in comparisons when evaluating their bodies and more frequently use similar others, such as friends and the average male for comparison. The results showed that comparisons to males in the media and professional athletes indicated body dissatisfaction and drive for muscularity.The portfolio presents four eating disorder case studies to illustrate how a therapist can use manual-based CBT techniques in a flexible manner and adapt interventions to the individual needs of clients who have motivational issues or present with complex comorbidity, in order to improve treatment outcomes.

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Purpose Caring for someone with an eating disorder is associated with a high level of burden and psychological distress. While models for the prediction of carer burden have previously been investigated, these have typically neglected the role of coping strategies and social support. Thus, the current study will examine predictors of both carer burden and carer psychological distress in eating disorder carers. Further, the mediating roles of coping strategies and social support will be investigated.
Methods Fifty-six carers completed a self-report questionnaire assessing burden, psychological distress, needs, expressed emotion, coping strategies and social support.
Results Use of maladaptive coping strategies was a unique predictor of both burden and psychological distress. Further, maladaptive coping was a consistent mediator on the outcome of carer burden. Social support, however, did not significantly predict, or mediate, carer burden.
Conclusions Interventions focusing on teaching appropriate coping strategies would benefit carers.

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This thesis outlined the role and potential impact of a range of policy options for obesity prevention. It provided evidence that population-wide interventions, such as changes to food labelling and taxes on unhealthy foods, are likely to offer excellent 'value for money' for governments from an obesity prevention perspective.