Sociocultural influences on body dissatisfaction and body change behaviors among Malaysian adolescents

Little research on body dissatisfaction and body change behaviors, and the sociocultural influences on them, has been undertaken in non-Western contexts. The current study investigated these variables and the relationships between them among a sample of 529 Malaysian high school students (103 Malays, 344 Chinese and 82 Indians), who completed a set of measures in classroom settings. Chinese girls were more dissatisfied with their bodies than Chinese boys, but no gender difference was found for Malay and Indian participants. Girls were more likely to engage in behaviors to lose weight, and boys were more likely to engage in behaviors to increase muscle. The influence of sociocultural factors on body dissatisfaction and body change behaviors was limited and varied across both sex and ethnicity. Findings are discussed in relation to Western research, and it is concluded that cultural nuances need to be considered when investigating these phenomena.<br />

Factors associated with dropout and diagnosis in child and adolescent mental health services

<b>Objective:</b> Dropout from child and adolescent mental health services has ramifications for children, families and the services themselves. Understanding the factors that are associated with dropout for different diagnoses has the potential to assist with tailoring of services to reduce dropout. The aim of the current study was to identify such factors. <br /><br /><b>Method: </b>A file audit was conducted for all referrals to a child and adolescent mental health service over a 12 month period, yielding 520 subjects for analysis (264 male, 256 female, mean age = 12.6 years). Parent, child and service variables of interest were recorded as were diagnoses, which were categorized into 25 superordinate categories. <br /><br /><b>Results:</b> Almost 50% of subjects dropped out of treatment. Factors associated with dropout varied across diagnosis, and no factor was associated with dropout for all diagnoses. <br /><br /><b>Conclusion:</b> There are differences in the factors that were associated with dropout for different disorders. This is a useful finding in terms of understanding and preventing dropout in child and adolescent mental health settings, but more research is needed.<br />

Intervening to improve health indicators among Australian farm families

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers&mdash;men (70) and women (58)&mdash;were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m2 (p = .0034), total cholesterol 48.7 mg/dl (p &lt; .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p &lt; .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p &lt; .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors. <br />

Responding to rural skills shortages : innovations using vocational education and training

Aims &amp; Rationale/Objectives<br />To locate, analyse and make accessible innovative models of health training and service delivery that have been developed in response to a shortage of skills.<br /><br />Methods<br />Drawing on a synthesis of Australian and international literature on innovative and effective models for addressing health skill shortages, 50 models were selected for further study. Models were also identified from nominations by key health sector stakeholders. Selected models represent diversity in terms of the nature of skill shortage addressed, barriers overcome in developing the model, health care specialisations, and customer groups.<br /><br />Principal Findings<br />Rural and remote areas have become home to a set of innovative service delivery models. Models identified encompass local, regional and state/national responses. Local responses are usually single health service-training provider partnerships. Regional responses, the most numerous, tend to have a specific focus, such as training young people. A small number of holistic state or national responses, eg the skills ecosystem approach, address multiple barriers to health service provision. Typical barriers include unwillingness to risk-take, stakeholder differences, and entrenched workplace cultures. Enhancers include stakeholder commitment, community acceptance, and cultural fit.<br /><br />Discussion<br />Of particular interest is increasing numbers of therapy assistants to help address shortages of allied health professionals, and work to formalise their training, and develop standards of practice and policy. Other models likely to help address skill shortage amongst VET health workers focus on recruiting, supporting and training employees from a range of disadvantaged target groups, and on providing career paths with opportunities for staff to expand their skills. Such models are underpinned by nationally recognised qualifications, but each solution is targeted to a particular context in terms of the potential workforce and local need.<br />

Skill shortages in health : innovative solutions using vocational education and training

Introduction: This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages.<br /><br />Methods: The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups.<br /><br />Results: Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers.<br /><br />Conclusions: There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.<br />

Malaysian and Australian male and female middle managers : a cross-cultural comparison of workplace attitudes, aspirations for promotion, and self-rated leadership styles

This paper outlines the rise of women in management worldwide, and considers why so few women achieve senior or executive management positions. This slow advance of women into senior roles is unexpected given that the changes in organisations today are believed to require more &lsquo;feminine leadership&rsquo;. A decrease in the emphasis on masculine characteristics for managers is reported, and a requirement that more &lsquo;feminine leadership&rsquo; needs to be adopted by organisations in order to ensure their survival in the future (Powell, Butterfield &amp; Parent, 2002, p.189). Recent empirical research reports that there are differences in leadership style between male and female managers, and the findings suggest that women exhibit more transformational leadership than their male counterparts, with this style being strongly equated with effective leadership (Eagly, Johannesen-Schmidt, van Engen, 2003). However, these findings are based on western research, and it may be that cross cultural research will yield a different picture (House, Hanges, Javidan, Dorfman, &amp; Gupta, 2004). Leadership and leadership styles may be conceptualised differently in a more paternalistic society. To explore this possibility, a cross cultural study was conducted in Malaysia and Australia. It is hypothesised that countries that are paternalistic in cultural values will exhibit a stronger constraint on women in management roles, which may impact on workplace attitudes, aspirations for promotion and style of leadership exhibited. Therefore, it is possible that the career advancement of women may be more problematic for Malaysian managerial women than their Australian counterparts. Results from an initial pilot study in Malaysia and Australia are outlined, and highlight some interesting similarities and differences to what are reported in the western literature.<br />

Positive pathways for couples and families : meeting existing and emerging challenges of relationships

There is a growing need to develop an understanding of the positive pathways that strengthen the relationships of Australian couples and families. The couples and families in contemporary society are faced with many challenges and pressures that can mitigate against maintaining satisfying and enduring couple and family relationships. For example, increasing need for dual income families, longer working hours and demographic shifts that see older people living longer and children staying at home longer mean that couples are often required to provide familial care across two generations &ndash; frail ageing parents and children. These highlight just some of the pressures faced which can lead to couples not taking the time to cultivate their relationships. The aim of the workshop was to deal with many of these issues by linking research, policy and practice in ways that would help families meet such challenges. The two-day workshop, held 1-2 November 2008 in Melbourne, brought together leading and emerging Australian and international relationship researchers with practitioners, educators, policy makers and service-delivery organisations. Alongside the Academy, the event was sponsored by Deakin University, the University of Queensland, the Department of Families, Housing and Community Services and Indigenous Affairs (FaCHSIA), the Attorney General's Department (AG Department), the Australian Institute of Family Studies (AIFS) and Lifeworks. The workshop comprised seven sessions and two break-out discussions. A total of 28 participants attended the workshop. Of these participants, there were 19 speakers and 7 delegates from the various sponsor organisations that took part in group discussions.

Mother–infant psychotherapy and perinatal psychiatry: current clinical practice and future directions

Objective: To explore trends in the practice of mother-infant psychotherapy among perinatal psychiatry clinicians based in Melbourne.Methods: A cross-sectional survey with a purpose designed self-report questionnaire was used to assess the attitudes and practices of 47 perinatal and infant psychiatry clinicians in their use and understanding of mother-infant psychotherapy.Results: Seventy per cent of clinicians in this field of psychotherapy who responded to the questionnaire subscribe to a psychodynamic model, although cognitive behavioural models are also used. The interventions were mostly used in conjunction with other interventions, would be more accurately described as 'parent-infant psychotherapy', and non-psychiatrists in the area tended to be more likely to be formally trained in psychotherapy, but only 4% were formally trained in specific mother-infant psychotherapy. There was a unanimous request for further clinical training in this area.Conclusions: The emerging field of perinatal psychiatry needs to develop coherent therapeutic models and conduct outcome trials on specific interventions. Specific trainings in these models, in assessment and in diagnostic frameworks are required to enhance clinical efficacy, for research and service development purposes.

The relationship between familiarity and expectations

This study examines the effects of prior experience in the context of a cultural arts service. This is an exploratory study designed to investigate the role familiarity plays in shaping visitor expectations. A cross sectional sample of novice and experienced visitors to a major art exhibition was conducted to investigate expectations, perceptions and service quality. Although the results are inconclusive, the findings provide some support for the proposition that novices have more fragmented expectations in certain dimensions.<br />

Acculturation, body image, and eating behaviours in Muslim-Australian women

The relationship between western acculturation, body dissatisfaction, and eating behaviours was examined in a sample of 101 Muslim-Australian women between 18 and 44 years of age (M=27.3, SD=7.5). A questionnaire was completed containing measures of cultural identification (heritage and mainstream), body dissatisfaction and disordered eating (dietary control, bingeing and purging), internalization of the thin ideal, and self-esteem. A series of path analyses identified significant positive relationships between mainstream identification and the measures of body dissatisfaction and disordered eating that were mediated by thin-ideal internalization. Path analyses also identified significant negative relationships between heritage identification and the measures of body dissatisfaction and disordered eating that were mediated by self-esteem. These results are indicative of the potential risks to body image incurred by women who adopt Western values, and of the benefits in retaining heritage cultural values that promote a positive self image.<br />

Zinc and DHA have opposing effects on the expression levels of histones H3 and H4 in human neuronal cells

Zn and DHA have putative neuroprotective effects and these two essential nutrients are known to interact biochemically. We aimed to identify novel protein candidates that are differentially expressed in human neuronal cell line M17 in response to Zn and DHA that would explain the molecular basis of this interaction. Two-dimensional gel electrophoresis and MS were applied to identify major protein expression changes in the protein lysates of human Ml7 neuronal cells that had been grown in the presence and absence of Zn and DHA. Proteomic findings were further investigated using Western immunoblot and real-time PCR analyses. Four protein spots, which had significant differential expression, were identified and selected for in-gel trypsin digestion followed by matrix-assisted laser desorption ionisation MS analysis. The resultant peptide mass fingerprint for each spot allowed their respective identities to be deduced. Two human histone variants H3 and H4 were identified. Both H3 and H4 were downregulated by Zn in the absence of DHA (Zn effect) and upregulated by DHA (DHA effect) in the presence of Zn (physiological condition). These proteomic findings were further supported by Western immunoblot and real-time PCR analyses using H3- and H4-specific monoclonal antibodies and oligonucleotide primers, respectively. We propose that dietary Zn and DHA cause a global effect on gene expression, which is mediated by histones. Such novel information provides possible clues to the molecular basis of neuroprotection by Zn and DHA that may contribute to the future treatment, prevention and management of neurodegenerative diseases such as Alzheimer's disease.<br />

Ongoing colonial legacy : contemporary education beliefs and practices in Papua New Guinea

In the late 1980ˇ¦s, a realisation that the western education system bequeathed to Papua New Guinea at the time of Independence had functioned to devalue and marginalise many of the traditional beliefs, knowledge and skills students brought with them to education, led to a period of significant education reform. The Reform was premised on the report of a Ministerial Review Committee called A Philosophy of Education. This report made recommendations about how education in Papua New Guinea could respond to the issues and challenges this nation faced as it sought to chart a course to serve the needs of its citizens on its own terms. The issues associated with managing and implementing institutionalised educational change premised on importing western values and practices are a central theme of this thesis. The impact of importing foreign curriculum and associated curriculum officers and consultants to assist with curriculum change and development in the former Language and Literacy unit of the Curriculum Development Division, is considered in three related sections of this report: „P a critical review of the imported educational system and related practices and related issues since Independence „P narrative report of the experience of two colleagues in western education „P evidential research based on curriculum Reform in the Language and Literacy Unit. How Papua New Guinea has sought to come to terms with the issues and challenges that arose in response to a practice of importing western curriculum both at the time of Independence and currently through the Reform, are explored throughout the thesis. The findings issues reveal much about the capacity of individuals and institutions to respond to a post-colonial world particularly associated with an ongoing colonial legacy in the principle researcherˇ¦s work context. The thesis argues that the challenges Papua New Guinea curriculum officers face today, as they manage and implement changes associated with another imported curriculum are caught up in existing power relations. These power relations function to stifle creative thinking at a time when it is most needed. Further, these power relations are not well understood by the curriculum officers and remained hidden and unquestioned throughout the research project. The thesis also argues that in the researcherˇ¦s work context, techniques of surveillance were brought to bear and functioned to curtail critical thinking about how the reformed curriculum could be sensitive and respectful of those beliefs and traditions that had sustained life in Papua New Guinea for thousands of years. Consequently, many outmoded beliefs and practices associated with an uncritical and ongoing acceptance of the superiority of western imports have been retained, thereby effectively denying the collective voices of Paua New Guineans in the current curriculum Reform.

Internationalisation of Singapore television : Singaporean regional and global perspectives and contexts

In this study l investigate the Singaporean characteristics of broadcast media internationalisation. I ask the question &quote; Does Internationalisation lead to homogenisation and commercialisation of the television culture in Singapore or does it give way to more diversity, thus stimulating cultural differentiation?&quote; . I articulate the constraints and/or tensions of supranational regulation, foreign policy, regional and intraregional alliances upon communication and the cultural and social effects as they impact on and respond to production, programming, scheduling and output in Singapore. I explain how Singaporean Television media culture takes part in the processes of globalisation, and how it challenges existing cultures and creates new and alternative symbolic and cultural communities, within the context of regional communication. In this thesis 1 conclude that whilst Singapore definitely does not have equity in information, wealth or resource flows it is attempting to liberalise. To do so, the government recognises that serious inadequacies and imbalances must be addressed and that the path to greater political and economic growth is through an actively informed public. Despite regulatory restrictions on data flow and technical and service ownership, Singapore is encouraging regional alliances, depoliticising cultural differences and concentrating on economic imperatives to build mutual knowledge and understanding, multilateral agreements, collective ownership, mutual exchange and cooperative dissemination.

Variation in age and physical status prior to total knee and hip replacement surgery : a comparison of centers in Australia and Europe

<b>Objective : </b>To investigate whether variation exists in the preoperative age, pain, stiffness, and physical function of people undergoing total knee replacement (TKR) and total hip replacement (THR) at several centers in Australia and Europe. <br /><b>Methods :</b> Individual Western Ontario and McMaster Universities Osteoarthritis Index data (range 0-100, where 0 = best and 100 = worst) collected within 6 weeks prior to primary TKR and THR were extracted from 16 centers (n = 2,835) according to specified eligibility criteria. Analysis of covariance was used to evaluate differences in pain, stiffness, and physical function between centers, with adjustment for age and sex. <br /><b>Results : </b>There was marked variation in the age of people undergoing surgery between the centers (TKR mean age 67-73 years; F[6,1004] = 4.21, P &lt; 0.01, and THR mean age 63-72 years; F[14,1807] = 7.27, P &lt; 0.01). Large differences in preoperative status were observed between centers, most notably for pain (TKR adjusted mean pain 52.5-61.1; F[6,1002] = 4.26, P &lt; 0.01, and THR adjusted mean pain 49.2-65.7; F[14,1802] = 8.44, P &lt; 0.01) and physical function (TKR adjusted mean function 52.7-61.4; F[6,1002] = 5.27, P &lt; 0.01, and THR adjusted mean function 53.3-71.0; F[14,1802] = 6.71, P &lt; 0.01). Large effect sizes (up to 0.98) reflect the magnitude of variation between centers and highlight the clinical relevance of these findings. <br /><b>Conclusion : </b>The large variations in age and preoperative status indicate substantial differences in the timing of joint replacement across the centers studied, with potential for compromised surgical outcomes due to premature or delayed surgery. Possible contributing factors include patient preferences, the absence of concrete indications for surgery, and the capacity of the health care systems.<br />

Theoretical passages and boundaries : the indigenous subject, colonialism, and governmentality

Theoretical paternalism and the convenience of working within &lsquo;accepted&rsquo; frameworks have appropriated the Indigenous subject within the boundaries of colonial relations. The establishment of post-colonial theory as one of the only &lsquo;acceptable&rsquo; frameworks for exploring the Indigenous subject has limited the subject&rsquo;s theoretical development within the binary of coloniser/colonised. Breaking from this tradition, the Foucauldian concepts of governmentality, ethics and care-ofthe-self will be used as a template for expansion. This paper will explore the passages of the Indigenous subject in theoretical development. It will examine the significance of post-colonial and settler colonial theories in the conceptualisation of the subject, and consider the transformations that occur when the borders established by these theories are crossed. The paper will therefore be comprised of four sections. The first will address the value and limitations of post-colonial and settler colonial theory. The second will posit reasons and implications for why theoretical neglect has occurred. The third will present and critique the Foucauldian concepts of governmentality, ethics and care-of-the-self. Applying Foucault&rsquo;s concepts to examples of Indigenous offenders in the settler societies of Australia and New Zealand, the final section will examine the impact of the Indigenous subject in Western thought and institutional practice.<br />