Do mass media campaigns capture and describe the experience of stroke symptoms?

Introduction: In 2006, the National Stroke Foundation of Australia launched the FAST (Face, Arm, Speech)/ Signs of Stroke (SOS) (5 symptom categories) campaigns designed to improve public awareness of stroke symptoms and the sense of urgency to present to hospital. However, there is little published review of how well such campaigns capture and describe the experience of stroke. This study aims to examine the awareness, content and language of the FAST/SOS campaigns by those experiencing stroke symptoms.
Methods: Interviews were conducted with either the stroke patient or a witness (incapacitated patients) whilst an inpatient at Box Hill or Maroondah Hospitals between August 2006 through April 2008. They were asked to describe awareness of campaigns, symptoms experienced (recorded verbatim and coded into campaign symptom categories) and to evaluate the descriptions of “Signs of Stroke” against their own experience (exact, somewhat, or not at all).
Results: Of 239 eligible stroke cases, 167 (70%) were interviewed (100 patients and 67 witnesses). Few (n= 20, 12%) were aware of the FAST campaign and only 16% recalled all three symptoms. Most recalled that it was “something” to do with the face, however facial droop (n=6) was less commonly experienced compared to speech impairments (n=16) and arm drift (n=13). FAST symptoms detected 84% (patients 77% and witnesses 94%) and SOS symptoms 100% of stroke patients. Patients not describing a FAST symptom (n=27) described: arm or hand numbness; hand incoordination; leg impairments; vision disturbances; or collapse. Approximately, half of patients and witnesses thought the SOS descriptions of the most commonly detected symptoms (arm/leg/face weakness or paralysis or numbness and speech impairments) exactly described the experience. Common language used to describe symptoms were: incoordination of hands or limbs; sudden difficulty walking; drooped/dropped face or mouth; slurred or loss of speech; pins and needles or tingling.
Conclusion: Both campaigns identified symptoms most commonly detected in those experiencing and reacting to symptoms. Both campaigns could portray symptoms more realistically using common descriptors without impacting on the simplicity of the messages

Quantifying the impact of transient joint symptoms, chronic joint symptoms, and arthritis : a population-based approach

Objective : To estimate the prevalence and co-occurrence of self-reported doctor-diagnosed arthritis, chronic joint symptoms (pain, aching, stiffness, or swelling on most days for a month), and transient joint symptoms (pain, aching, stiffness, or swelling but not on most days for a month), and to compare the sociodemographic characteristics, activity limitations, and health-related quality of life (HRQOL) of people with joint conditions with those who have no self-reported doctor-diagnosed arthritis and no joint symptoms.
Methods : Data from the 2004 population-based South Australian Health Omnibus Survey (n = 2,840, ages 18-96 years) were used in the study. Activity limitations were assessed using 10 activity limitations questions from the Short Form 36 health survey. HRQOL was assessed using the Assessment of Quality of Life scale.
Results : Half of all respondents reported having joint problems, with 26%, 11%, and 13% reporting self-reported doctor-diagnosed arthritis, chronic joint symptoms, and transient joint symptoms, respectively. Chronic joint conditions (self-reported doctor-diagnosed arthritis and chronic joint symptoms) accounted for 74% of all joint problems and were associated with higher odds of activity limitations and poorer HRQOL. The frequency of transient and chronic joint symptoms was highest among middle-aged participants (ages 45-54 years for transient and 45-64 years for chronic joint symptoms) and those who had a body mass index in the obese range. Prevalence of self-reported doctor-diagnosed arthritis increased with age and was higher among women and those who were overweight or obese.
Conclusion : This study documented the high prevalence and impact of joint conditions in the community. Chronic joint conditions affect daily life and are substantial barriers for effective public health interventions aimed at reducing obesity and inactivity.

Examination of a multi-factorial model of body-related experiences during pregnancy : the relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes

The aim of this cross-sectional study was to investigate relationships among women's body attitudes, physical symptoms, self-esteem, depression, and sleep quality during pregnancy. Pregnant women (N = 215) at 15–25 weeks gestation completed a questionnaire including four body image subscales assessing self-reported feeling fat, attractiveness, strength/fitness, and salience of weight and shape. Women reported on 29 pregnancy-related physical complaints, and completed the Beck Depression Inventory, Rosenberg Self-esteem Scale, and Pittsburgh Sleep Quality Index. In regressions, controlling for retrospective reports of body image, more frequent and intense physical symptoms were related to viewing the self as less strong/fit, and to poorer sleep quality and more depressive symptoms. In a multi-factorial model extending previous research, paths were found from sleep quality to depressive symptoms to self-esteem; self-esteem was found to be a mediator associated with lower scores on feeling fat and salience of weight and shape, and on higher perceived attractiveness.

Staff education to manage behavioural symptoms of dementia

The thesis investigated strategies for managing behavioural symptoms of dementia in nursing homes which involved developing and implementing an eight week education program. Results demonstrated that staff education can be associated with positive outcomes for staff members, while education alone is insufficient to change residents' behaviour. The portfolio investigated grief relating to loss of health through four case studies. Attachment theory, dual processing model and meaning reconstruction model were found to be clinically useful for both bereavement--related losses and health-related losses.

Basic symptoms in young people at ultra high-risk of psychosis

Basic Symptoms are cognitive and emotional disturbances characteristic of the early stage of psychosis. This study established the utility of an instrument to identify Basic Symptoms amongst young people at high-risk for developing psychosis, thereby facilitating the pathway to treatment for these individuals. The portfolio focuses on how having an unwell parent contributes to and influences the development of psychopathology in offspring. The four clinical case studies are presented in detail, and the intervention strategies for each individual are evaluated.

National prevalence of urogenital pain and prostatitis-like symptoms in Australian men using the National Institutes of Health Chronic Prostatitis Symptoms Index

OBJECTIVE : To provide a summary, using the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), of the prevalence of prostatitis-like symptoms in a population-based sample of Australian men.

SUBJECTS AND METHODS : Participants were Australian men aged 16–64 years recruited as part of the Australian Longitudinal Study of Health and Relationships: a nationally representative study. In all, 1346 men completed an extensive questionnaire which included the NIH-CPSI. The index identifies six types of urogenital pain, the presence of urinary problems, and effects on quality of life. Men who reported perineal and/or ejaculatory pain or discomfort and a total NIH-CPSI pain score of ≥4 were considered as having prostatitis-like symptoms.

RESULTS : Based on a weighted population of 1373 men, some form of urogenital pain was reported by 105 (7.6%) men; with 2.8% of men reporting more than one type of urogenital pain. The mean (range) NIH-CPSI pain score for men reporting pain was 6.2 (5.6–6.8); for all men the mean score was 0.5 (0.4–0.6). About 20% of men (284) were considered to have urinary problems. The mean urinary symptom score for all men was 0.9 (0.9–1.0). The mean total NIH-CPSI score for men reporting pain was 13.3 (12.0–14.7) and for all men it was 2.6 (2.3–2.8). The estimated prevalence of prostatitis-like symptoms was ≈2%.

CONCLUSIONS : Using the NIH-CPSI the estimated prevalence for urogenital pain in Australian men is 8%; an estimated 3% of men experience pain from more than one urogenital location. The estimated prevalence of prostatitis-like symptoms in Australian men is 2%. Almost a third of Australian men experiencing urogenital pain or prostatitis-like symptoms would be less than satisfied if this was to be ongoing for the rest of their life.

Physical activity correlates in young women with depressive symptoms : a qualitative study

Background
Young women are at high risk for developing depression and participation in physical activity may prevent or treat the disorder. However, the influences on physical activity behaviors of young women with depression are not well understood. The aim of this study was to gather in-depth information about the correlates of physical activity among young women with and without depressive symptoms.

Methods
A sample of 40 young women (aged 18-30 years), 20 with depressive symptoms (assessed using the CES-D 10) and 20 without depressive symptoms participated in one-on-one semi-structured interviews. A social-ecological framework was used, focusing on the individual, social and physical environmental influences on physical activity. Thematic analyses were performed on transcribed interview data.

Results
The results indicated several key themes that were unique to women with depressive symptoms. These women more often described negative physical activity experiences during their youth, more barriers to physical activity, participating in more spontaneous than planned activity, lower self-efficacy for physical activity and being influenced by their friends' and family's inactivity.

Conclusions
Interventions designed to promote physical activity in this important target group should consider strategies to reduce/overcome early life negative experiences, engage support from family and friends and plan for activity in advance.

Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome

Background and Aim:  Reduction of short-chain poorly absorbed carbohydrates (FODMAPs) in the diet reduces symptoms of irritable bowel syndrome (IBS). In the present study, we aimed to compare the patterns of breath hydrogen and methane and symptoms produced in response to diets that differed only in FODMAP content.
Methods:  Fifteen healthy subjects and 15 with IBS (Rome III criteria) undertook a single-blind, crossover intervention trial involving consuming provided diets that were either low (9 g/day) or high (50 g/day) in FODMAPs for 2 days. Food and gastrointestinal symptom diaries were kept and breath samples collected hourly over 14 h on day 2 of each diet.
Results:  Higher levels of breath hydrogen were produced over the entire day with the high FODMAP diet for healthy volunteers (181 ± 77 ppm.14 h vs 43 ± 18; mean ± SD P < 0.0001) and patients with IBS (242 ± 79 vs 62 ± 23; P < 0.0001), who had higher levels during each dietary period than the controls (P < 0.05). Breath methane, produced by 10 subjects within each group, was reduced with the high FODMAP intake in healthy subjects (47 ± 29 vs 109 ± 77; P = 0.043), but was not different in patients with IBS (126 ± 153 vs 86 ± 72). Gastrointestinal symptoms and lethargy were significantly induced by the high FODMAP diet in patients with IBS, while only increased flatus production was reported by healthy volunteers.
Conclusions:  Dietary FODMAPs induce prolonged hydrogen production in the intestine that is greater in IBS, influence the amount of methane produced, and induce gastrointestinal and systemic symptoms experienced by patients with IBS. The results offer mechanisms underlying the efficacy of the low FODMAP diet in IBS.

Family interactions and the development of borderline personality symptoms

This thesis investigated the emergence of borderline personality disorder in adolescence. It found that adolescent sensitivity to, and maternal socialization of, aggressive behaviour is associated with borderline pathology. Change in pathology over time was related to adolescent dysphoric behaviour and sensitivity to inconsistent displays of maternal negative emotion.