Health satisfaction and perceived control : investigating subjective wellbeing homeostasis

Through an investigation of relationships between subjective wellbeing, health satisfaction and perceived control, the thesis contributes to a greater understanding of the psychological adaptation processes of individuals experiencing back pain. Risk factors to subjective wellbeing are also identified, thus presenting opportunities to provide assistance before the onset of psychopathology.

Damming the flow: cultural barriers to perceived ‘procedural justice’ in Wonthaggi, Victoria

 Drier conditions in Australia have compelled governments to implement projects such as the desalination plant in the South Gippsland town of Wonthaggi. The desalination plant is still under construction, but South Gippsland is already host to wind turbines and marine protected areas, reflecting public pressure to develop renewable energy sources and conserve resources. However, all projects have been met with vocal opposition. Using the desalination project as a case study, this paper will address public concerns about a perceived lack of procedural justice in implementing such projects. Drawing on data from a pilot survey of 320 residents, we argue that procedural shortcomings of the project include inattention to past political disputes in the region and to the culturally entrenched sense of division between city and country. Attention to political and cultural histories is vital to the successful and ethical implementation of projects in regional areas.

Adolescent victims with an intellectual disability : perceived credibility in cases of sexual abuse

The study aimed to assess perceptions of the credibility of adolescent victims with intellectual disability. Results revealed that victim and participant characteristics influenced perceptions of the credibility of the victim and verdict responses. Findings related to the level of ID, type of offence, perceptions of competency, honesty, suggestibility, and gender of victim and participant.

The association between perceived sweetness intensity and dietary intake in young adults

Individual differences in taste perception may influence dietary habits, nutritional status, and ultimately nutrition-related chronic disease risk. Individual differences in sweetness intensity perception and the relationship between perceived sweetness intensity, food behaviors, and dietary intake was investigated in 85 adults. Subjects (body mass index [BMI]= 21 ± 3, 21 ± 4 y) completed a food and diet questionnaire, food variety survey, 2 24-h food records, and a perceived sweetness intensity measurement using the general labeled magnitude scale (gLMS). There was interindividual variation in perceived sweetness intensity (0 to 34 gLMS units, mean 10 ± 7). One-way analysis of variance (ANOVA) revealed no difference between perceived sweetness intensity and degree of importance placed on not adding sugar to tea or coffee (P = 0.2) and the degree of importance placed on avoiding sugar-sweetened or fizzy drinks (P = 1.0). Independent t-test analysis revealed no significant association between perceived sweetness intensity and the food variety measure for sugar and confectionary intake (P = 0.6) and selected fruit and vegetable intake (P = 0.1 to 0.9). One-way ANOVA also demonstrated no difference between tertiles of sweetness intensity and BMI (P = 0.1), age (P = 0.3), and food variety score (P = 0.5). No correlation was observed with regards to perceived sweetness intensity and mean total energy (kJ) intake (r = 0.05, P = 0.7), percent energy from total fat, saturated fat, protein, carbohydrate, and grams of fiber (r =–0.1 to 0.1, P = 0.2 to 0.8) and also for intake of the micronutrients: folate, magnesium, calcium, iron, and zinc (r = 0.1 to 0.2, P = 0.1 to 0.4). Only modest correlations were observed between sodium (r = 0.3, P < 0.05), vitamin C (r = 0.3, P < 0.05), and potassium (r = 0.2, P < 0.0) intake and perceived sweetness intensity. Overall, perceived sweetness intensity does not appear to play a role in food behaviors relating to sugar consumption and dietary intake in adults.

How does perceived risk mediate associations between perceived safety and parental restriction of adolescents' physical activity in their neighborhood?

Background
There is evidence that adolescence is a critical period of decline in physical activity. However, adolescents may have limited opportunities to be physically active outdoors if their parents are concerned about neighborhood safety and restrict their adolescent’s physical activity within their neighborhood. Pathways that lead to parental restriction of adolescents’ physical activity (constrained behavior) are under-researched. This study aimed to examine perceived risk as a potential mediator of associations between perceived safety/victimization and constrained behavior.
Methods
Cross-sectional study of adolescents (43% boys) aged 15–17 years (n = 270) in Melbourne, Australia. Parents reported perceived safety (road safety, incivilities and personal safety) and prior victimization in their neighborhood, perceived risk of their children being harmed and whether they constrained their adolescent’s physical activity. Constrained behavior was categorized as ‘avoidance’ or ‘defensive’ behavior depending on a whether physical activity was avoided or modified, respectively, due to perceived risk. MacKinnon’s product-of-coefficients test of mediation was used to assess potential mediating pathways between perceived safety/victimization and constrained behavior.
Results
For girls only, perceived risk was a significant mediator of associations between perceived road safety and avoidance/defensive behavior, and between perceived incivilities, perceived personal safety, victimization and defensive behavior.
Conclusions
Associations between perceived safety/victimization and constrained behavior are complex. Findings may guide the design of interventions that aim to improve actual and perceived levels of safety and reduce perceptions of risk. This is of particular importance for adolescent girls among whom low and declining levels of physical activity have been observed worldwide.

Detecting and managing depressed patients : palliative care nurses' self-efficacy and perceived barriers to care

Background: Depression is a highly prevalent yet under-recognized and under-treated psychiatric illness in patients receiving palliative care. Nurses are the front-line health care professionals in these settings and are well-positioned to detect depressive symptoms and initiate pathways to care. Previous research suggests, however, that nurses' confidence and skills in relation to this task are low, and there appear to be a number of barriers within these settings that may impede nurses' engagement in this process.

Methods: To further investigate these factors, a quantitative study was carried out with 69 palliative care nurses from three palliative care services in Australia.

Results: A number of issues were identified, including the need for further training in the signs and symptoms of depression, issues around discussing depression with patients and their family members, and difficulty differentiating depressive symptoms from grief.

Conclusion: These findings provide insight into specific areas in which palliative care nurses would benefit from further training to improve detection rates for depression in this vulnerable population.

Acute rheumatic fever associated with household crowding in a developed country

Background: Acute rheumatic fever (ARF) and its sequelae, chronic rheumatic heart disease, remain important causes of morbidity and mortality worldwide, but there is little recent information about risk factors. The aim of this study was to examine the association between ARF and household crowding in New Zealand between 1996 and 2005.

Methods: This ecologic study used hospitalization data and census data to calculate incidence rates by census area unit (CAU). Rates of ARF were examined in relation to individual factors (age, ethnicity) and area factors based on the CAU of home address (household crowding, New Zealand deprivation index, household income, and proportion of children aged 5–14 years). The multivariate relationship between ARF incidence and CAU-based variables was assessed using a zero-inflated negative binomial model.

Results: This study included 1249 new cases of ARF between 1996 and 2005. At the univariate level, ARF rates were associated with household crowding across all age groups and ethnicities. ARF rates were significantly and positively related to household crowding after controlling for age, ethnicity, household income, and the density of children in the neighborhood. The incidence rate ratio was 1.065 (95% confidence interval, 1.052–1.079) for the total population.

Conclusions: In New Zealand, ARF rates are associated with household crowding at the CAU level. This finding supports action to reduce household crowding to improve health and reduce health inequalities. Our conclusion could be further investigated using a case-control study.

Tuberculosis associated with household crowding in a developed country

Background: Tuberculosis (TB) remains an important infectious disease in New Zealand (NZ) and globally, but risk factors for transmission are still poorly understood. This research aimed to identify whether household crowding contributes to TB transmission in NZ.

Methods: This ecological study used TB surveillance and census data to calculate TB incidence rates by census area unit (CAU). Census data were used to determine CAU characteristics including proportion of household crowding (a bedroom deficit of one or more), proportion of population who are migrants born in high-TB-incidence countries, median household income, and deprivation level. A negative binomial regression model was used to estimate the association between TB incidence and household crowding.

Results: The analysis included 1898 notified TB cases for the 2000–4 period. Univariate analysis showed TB incidence at the CAU level was associated with household crowding, for the total population and for all ethnic and age groups. After adjusting for the covariates of household income, existing TB burden, and proportion of migrants from high-TB-incidence countries, multivariate analysis showed statistically significant associations between TB incidence and household crowding. The incidence rate ratio (IRR) was 1.05 (95% CI 1.02 to 1.08) in the total population and 1.08 (95% CI 1.04 to 1.12) for NZ-born people <40 years.

Conclusion: At the CAU level, TB incidence in NZ is associated with household crowding. An individual-based study (e.g. case–control) in recently infected cases (detected by molecular epidemiology techniques) is suggested to complement these findings. Reducing or eliminating household crowding could decrease TB incidence in NZ and globally.

The impact of self-efficacy and perceived system efficacy on effectiveness of virtual training systems

This study developed and tested a research model which examined the impact of user perceptions of self-efficacy (SE) and virtual environment (VE) efficacy on the effectiveness of VE training systems. The model distinguishes between the perceptions of one’s own capability to perform trained tasks effectively and the perceptions of system performance, regarding the established parameters from literature. Specifically, the model posits that user perceptions will have positive effects on task performance and memory. Seventy-six adults participated in a VE in a controlled experiment, designed to empirically test the model. Each participant performed a series of object assembly tasks. The task involved selecting, rotating, releasing, inserting and manipulating 3D objects. Initially, the results of factor analysis demonstrated dimensionality of two user perception measures and produced a set of empirical validated factors underlining the VE efficacy. The results of regression analysis revealed that SE had a significant positive effect on perceived VE efficacy. No significant effects were found of perceptions on performance and memory. Furthermore, the study provided insights into the relationships between the perception measures and performance measures for assessing the efficacy of VE training systems. The study also addressed how well users learn, perform, adapt to and perceive the VE training, which provides valuable insight into the system efficacy.
Research and practical implications are presented at the end of the paper.

Perceived quality and availability of fruit and vegetables are associated with perceptions of fruit and vegetable affordability among socio-economically disadvantaged women

Objective Perceptions that fruit and vegetables are expensive have been found to be associated with lower consumption of fruit and vegetables among disadvantaged women; however, the determinants of these perceptions are relatively unknown. The purpose of the current paper is to examine whether perceived availability and quality of fruit and vegetables, and social support for healthy eating, are associated with perceptions of fruit and vegetable affordability among women residing in disadvantaged neighbourhoods.

Design Cross-sectional self-report survey.

Setting The study was conducted in Melbourne, Australia.

Subjects An Australian sample of 4131 women, aged 18–45 years, residing in neighbourhoods ranked in the lowest Victorian tertile of relative disadvantage by the Australian Bureau of Statistics, an index that considers aspects of disadvantage such as residents’ income, education, motor vehicle access and employment.

Results Results showed that irrespective of education, income and other key covariates, women who perceived poor availability and quality of fruit and vegetables in their local neighbourhood were more likely to perceive fruit and vegetables as expensive.

Conclusions Our results suggest that perceptions of fruit and vegetable affordability are not driven exclusively by lack of financial or knowledge-related resources, but also by women's psychological response and interpretation of their local nutrition environment.

Educational inequalities in women's depressive symptoms : the mediating role of perceived neighbourhood characteristics

Socio-economically disadvantaged (e.g., less educated) women are at a greater risk of depression compared to less disadvantaged women. However, little is known regarding the factors that may explain socioeconomic inequalities in risk of depression. This study aimed to investigate the contribution of perceived neighbourhood factors in mediating the relationship between education and women’s risk of depression. Cross-sectional data were provided by 4,065 women (aged 18–45). Women self-reported their education level, depressive symptoms (CES-D 10), as well as four neighbourhood factors (i.e., interpersonal trust, social cohesion, neighbourhood safety, and aesthetics). Single and multiple mediating analyses were conducted. Clustering by neighbourhood of residence was adjusted by using a robust estimator of variance. Multiple mediating analyses revealed that interpersonal trust was the only neighbourhood characteristic found to partly explain the educational inequalities in women’s depressive symptoms. Social cohesion, neighbourhood aesthetics and safety were not found to mediate this relationship. Acknowledging the cross-sectional nature of this study, findings suggest that strategies to promote interpersonal trust within socioeconomically disadvantaged neighbourhoods may help to reduce the educational inequalities in risk of depression amongst women. Further longitudinal and intervention studies are needed to confirm these findings.