Relationship between men's and women's body image and their psychological, social, and sexual functioning

This study was designed to examine the relationships between different aspects of body image and psychological, social, and sexual functioning throughout adulthood. The respondents were 211 men and 226 women (age range 18–86 years; mean = 42.26). Respondents completed measures of self-rated attractiveness, body satisfaction, body image importance, body image behaviors, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and social and sexual functioning. Body image was associated with self-esteem for all groups, but was unrelated to other aspects of psychological, social, and sexual functioning. There were some exceptions; a disturbance in body image was related to problematic social and sexual functioning among middle-aged men and to depression and anxiety symptoms in late adulthood among men and women. Middle-aged men who presented with the type of body image disturbance typical of women were more likely to have impaired interpersonal functioning. These results demonstrate that social aspects of body image appear to be important in understanding psychological functioning in later life.

Robustness of form K of the Myers-Briggs Type Indicator in an Australian sample

Analyses of the twenty facet scores for 243 females and 394 males who undertook Form K of the Myers-Briggs Type Indicator (MBTI®) revealed strong and meaningful patterns of relationships with the four preferences. A clear factor structure of four factors emerged which had a few minor cross-loadings. It was found that the facets are distinctive and generally do not correlate with preferences other than those intended. Comparisons with USA evidence revealed patterns that were even clearer in the Australian data. The previously observed differences related to gender (as found in research on Form G) were reproduced using the Form K format. The evidence implies that the robustness of Fonl1 K with an Australian sample has been demonstrated.

Patient engagement and coaching for health: the PEACH study- a cluster randomised controlled trial using the telephone to coach people with type 2 diabetes to engage with their GPs to improve diabetes care: a study protocol.

Background
The PEACH study is based on an innovative 'telephone coaching' program that has been used effectively in a post cardiac event trial. This intervention will be tested in a General Practice setting in a pragmatic trial using existing Practice Nurses (PN) as coaches for people with type 2 diabetes (T2D). Actual clinical care often fails to achieve standards, that are based on evidence that self-management interventions (educational and psychological) and intensive pharmacotherapy improve diabetes control. Telephone coaching in our study focuses on both. This paper describes our study protocol, which aims to test whether goal focused telephone coaching in T2D can improve diabetes control and reduce the treatment gap between guideline based standards and actual clinical practice.
Methods/design
In a cluster randomised controlled trial, general practices employing Practice Nurses (PNs) are randomly allocated to an intervention or control group. We aim to recruit 546 patients with poorly controlled T2D (HbA1c >7.5%) from 42 General Practices that employ PNs in Melbourne, Australia. PNs from General Practices allocated to the intervention group will be trained in diabetes telephone coaching focusing on biochemical targets addressing both patient self-management and engaging patients to work with their General Practitioners (GPs) to intensify pharmacological treatment according to the study clinical protocol. Patients of intervention group practices will receive 8 telephone coaching sessions and one face-to-face coaching session from existing PNs over 18 months plus usual care and outcomes will be compared to the control group, who will only receive only usual care from their GPs. The primary outcome is HbA1c levels and secondary outcomes include cardiovascular disease risk factors, behavioral risk factors and process of care measures.
Discussion
Understanding how to achieve comprehensive treatment of T2D in a General Practice setting is the focus of the PEACH study. This study explores the potential role for PNs to help reduce the treatment and outcomes gap in people with T2D by using telephone coaching. The intervention, if found to be effective, has potential to be sustained and embedded within real world General Practice.

Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting : Greater Green Triangle (GGT) Diabetes Prevention Project

Background
Randomised controlled trials demonstrate a 60% reduction in type 2 diabetes incidence through lifestyle modification programmes. The aim of this study is to determine whether such programmes are feasible in primary health care.

Methods
An intervention study including 237 individuals 40–75 years of age with moderate or high risk of developing type 2 diabetes. A structured group programme with six 90 minute sessions delivered during an eight month period by trained nurses in Australian primary health care in 2004–2006. Main outcome measures taken at baseline, three, and 12 months included weight, height, waist circumference, fasting plasma glucose and lipids, plasma glucose two hours after oral glucose challenge, blood pressure, measures of psychological distress and general health outcomes. To test differences between baseline and follow-up, paired t-tests and Wilcoxon rank sum tests were performed.

Results
At twelve months participants' mean weight reduced by 2.52 kg (95% confidence interval 1.85 to 3.19) and waist circumference by 4.17 cm (3.48 to 4.87). Mean fasting glucose reduced by 0.14 mmol/l (0.07 to 0.20), plasma glucose two hours after oral glucose challenge by 0.58 mmol/l (0.36 to 0.79), total cholesterol by 0.29 mmol/l (0.18 to 0.40), low density lipoprotein cholesterol by 0.25 mmol/l (0.16 to 0.34), triglycerides by 0.15 mmol/l (0.05 to 0.24) and diastolic blood pressure by 2.14 mmHg (0.94 to 3.33). Significant improvements were also found in most psychological measures.

Conclusion
This study provides evidence that a type 2 diabetes prevention programme using lifestyle intervention is feasible in primary health care settings, with reductions in risk factors approaching those observed in clinical trials.

Trial Number
Current Controlled Trials ISRCTN38031372

An exploration of sense of community, part 3: dimensions and predictors of psychological sense of community in geographical communities

Within the discipline of community psychology there remains considerable debate as to the latent structure of psychological sense of community (PSOC). One of the few theoretical discussions is that of McMillan and Chavis (1986), who hypothesized four dimensions: Belonging; Fulfillment of Needs; Influence; and Shared Connections. Discussion has also emerged in the literature regarding the role of identification within PSOC. However few studies have empirically investigated the role of identification in PSOC. The current study explored PSOC in a sample of residents of rural, regional and urban geographical communities (N = 669). In an endeavor to clarify the underlying dimensions of PSOC, a test battery included several measures of PSOC as well as measures of identification with the community. The study also examined the role of demographic factors in predicting PSOC. Results provided support for McMillan and Chavis' (1986) four dimensions of PSOC. Further, a fifth dimension emerged, that of Conscious Identification, suggesting that identification is separate to existing dimensions of PSOC. The demographic factors significantly associated with PSOC were type of region, with rural participants displaying higher PSOC than their urban counterparts; participation in local organizations; having children; and a vision of one’s neighborhood as broader than just a street or block. These results, and the implications for PSOC research, are discussed.

The mother-daughter guilt dynamic : effects of type 1 diabetes during life transitions

Aim. The aim of the study was to explore and describe the strategies young women with type 1 diabetes used to manage life transitions. The paper describes one aspect of how guilt dynamic often operates between mothers and daughters and how the women managed the guilt dynamic to create stability in their lives.
Background. When a child is diagnosed with diabetes, major transitional changes occur in the relationships between the mother and her child. The changes affect the psychological and social aspects of their lives and have a major impact on how young women manage their diabetes. A guilt dynamic between mothers and young women with diabetes emerged as a major theme in a larger study that investigated how young women with diabetes managed life transitions. Although the literature indicates that mothers of chronically ill children experience guilt feelings towards their children, little research was identified that addressed the emotional dynamics between mothers and daughters with diabetes.
Design. Using grounded theory method, interviews were conducted with 20 women with type 1 diabetes and five mothers during 2002 and 2003. Constant comparative analysis was used to analyse the data and develop an in-depth understanding of the experience of living with diabetes during life transitions.
Findings. The findings revealed that guilt feelings created a two-way dependency between mothers and their daughters with diabetes. The two-way dependency involved feelings of being a burden to each other, difficulty balancing responsibilities for diabetes management, difficulty relinquishing emotional and social dependency especially during life transitions. In addition, these issues were rarely discussed openly with each other or with health professionals. The findings provide additional information about the human experience of the mother–daughter relationship and the effect on coping with diabetes in the context of life transitions.
Conclusions. Understanding the impact diabetes has on the emotional and social well being of both women with type 1 diabetes and their mothers is critical in planning appropriate support for both groups. Most importantly, it is critical to understand the guilt dynamic that operates during young women with diabetes' life transitions when the daughters' dependency on their mother's control and responsibility for diabetes management undergo changes resulting in emotional responses, especially guilt feelings.
Relevance to clinical practice. Health professionals need to understand the emotional and social impact of the guilt dynamics between young women with type 1 diabetes and their mothers. Adequate and appropriate support can minimize the guilt feelings and enhance stability and quality of life for both mothers and their daughters, especially during major life transitions, such as motherhood.

The relationship between childhood cruelty to animals and psychological adjustment : a Malaysian study

In Western research, cruelty to animals in childhood has been associated with comorbid conduct problems and with interpersonal violence in later life. However, there is little understanding of the etiology of cruelty to animals, and what in the child's life may require attention if the chain linking animal cruelty and later violence is to be broken. The study reported in this paper investigated the association between parent-reported cruelty to animals, and parent- and self-reported psychological strengths and weaknesses in a sample of 379 elementary school children in an Eastern context, Malaysia. No gender differences were found in relation to cruelty to animals or psychological problems, as assessed with the Strengths and Difficulties Questionnaire (SDQ). However, there were different predictors of cruelty to animals for boys and girls. Regression analyses found that for boys, parent-reported hyperactivity was a unique predictor of Malicious and Total Cruelty to animals. For girls, self-reported conduct problems was a unique predictor of Typical Cruelty to animals. Parent-reported total difficulties were associated with Typical, Malicious, and Total Cruelty to animals. We suggest that routine screening of children with an instrument such as the SDQ may help to detect those children who may need to undergo further assessment and perhaps intervention to break the chain linking childhood cruelty to animals and later conduct problems.

The education and information needs of young adults with type 2 diabetes : a qualitative study

Aims and objectives. To identify the preferred content and delivery mode of education information for people aged 25 to 45 with type 2 diabetes to enable them to effectively self-manage their diabetes.

Background. People with type 2 diabetes are required to manage their own health and initiate behavioural changes. Self-management education and resources have typically been targeted at people aged 50 years and older. Little is known about the concerns and needs of younger people in managing type 2 diabetes, which are likely to be different from those of older people.

Design. A qualitative design was considered the most appropriate to elicit participants' views and perceptions of their type 2 diabetes information needs.

Methods. Data were obtained from one focus group (n = 9) and telephone interviews (n = 4) with people aged 25 to 45 with type 2 diabetes conducted in 2008.

Results. Implicit in participants' responses was their need to be active partners in managing their diabetes. Participants wanted information that is easy to understand, brief, consistent, age-specific and about a number of topics that are not adequately covered at present. They wanted a centralised source of information and a range of delivery mode options. Participants expressed some ambivalence about the Internet as a source of information. Participants also wanted age-specific group sessions, support from peers, psychological support, increased understanding of type 2 diabetes in the community, and a focus on preventing diabetes.

Conclusions. Young people with type 2 diabetes have specific diabetes needs and preferred information delivery modes. Participants felt current diabetes education programs do not cater specifically to their age group. Education and information resources need to be developed for the target group, addressing their content and format preferences.

Relevance to clinical practice. Health professionals need to utilise appropriate delivery modes and include information relevant to younger people when providing education information to young adults with type 2 diabetes.

Enablers and barriers to accessing mental health services for adults with high prevalence psychological disorders in South West Victoria

Knowing what services are available and how to access them can be challenging in rural areas. The aim of the South West Mental Health Mapping project was to identify the level, accessibility and effectiveness of mental health services for high prevalence psychological disorders amongst the adult population in the South West region of Victoria. This study includes data from a number of sources: regional records of the number and location of health professionals; a telephone survey of 1297 people in five Local Government Areas in the region; and a social network analysis of contact points. Additional qualitative interviews and surveys were conducted with 25 service recipients and 37 health professionals to identify issues from different perspective. This paper will focus on the social network analysis of the project. It highlights the relative prominence of each type of service provider within the overall network. The social network map shows the centrality of the General Practitioner and the wide range of agencies that become involved in supporting people with mental health issues. The discussion identifies primary contact points for people seeking help and places of referral. The main barrier acknowledged by people requiring assistance was lack of knowledge about where to go for help. Enablers included Medicare Better Access funded schemes. The findings show that there is a reasonable range of mental health professionals across the region, although there are challenges with recruitment and retention of staff. Even with available services, a major problem is communicating this information to potential consumers

Extreme surfing : personal and psychological aspects of big wave riders

This qualitative study investigated personal and psychological aspects of big wave riders. A cross-sectional design with non probability purposive sampling was used to gain personal interviews with 32 elite surfers who regularly ride big, life threatening waves. Each athlete was asked three open questions: 1. What do you think are the most important qualities and attributes a surfer needs for riding big waves? 2. What type of mindset is best for riding big waves?, and 3.What motivates you to ride big waves? Content analysis of the taped interview transcripts revealed seven key qualities and attributes including having a thrill seeking, confident and goal oriented personality, a high level of mental strength and control, and an intimate relationship with the ocean. The best mindset included an individually defined arousal level, a committed attitude, and a simple, yet highly aware, focus. Motivations were primarily intrinsic, though drives indicative of a behavioral addiction to the act of riding big waves also emerged. Evidence of common developmental stages for riding big waves also arose from the interviews. Optimal mental approach and preparation techniques are discussed that will enable big wave riders, and other extreme athletes, to more safely and successfully manage extreme situations.