Contact with nature and children's mental, emotional, and social health

This research investigated the benefits of children's contact with nature as perceived by adult educators. It was found that contact with nature is perceived to: increase self-confidence and self-esteem; provide opportunities to experience mystery, privacy, and sensory engagement; connect children with school; and accommodate different learning styles and abilities.

Improving health with nutritional interventions in residential aged care

In a group of Australian aged care residents, dietary energy and nutrient intakes were generally inadequate, despite sufficient energy being served. Six months of multivitamin supplementation improved nutritional status and bone quality; and six months of fortified milk consumption improved serum 25(OH)D and folate levels, and increased vitamin D and folate intakes.

Interactive effects of exercise plus calcium-vitamin D3 on bone strength in older men

The findings from this 18-month, community-based study revealed that an exercise program involving strength training and jumping activities was feasible and effective for improving bone density, muscle mass and strength in older men. There were no additional skeletal benefits derived from consuming a high calcium-vitamin D milk drink.

The Australian longitudinal study of health and relationships

Background

Ensuring the sexual and reproductive health of the population is essential for the wellbeing of a nation. At least three aspects of sexual and reproductive health are among the key policy issues for present Australian governments: maintaining and increasing the birth rate; reducing the abortion rate; and preventing and controlling Chlamydia infections.

The overall aim of the Australian Longitudinal Study of Health and Relationships is to document the natural history of the sexual and reproductive health of the Australian adult population.
Methods/design

A nationally representative sample of Australian adults 16–64 years of age was selected in a two-phase process in 2004–2005. Eligible households were identified through random digit dialling. We used separate sampling frames for men and women; where there was more than one eligible person in a household the participant was selected randomly. Participants completed a computer-assisted telephone interview that typically took approximately 25 minutes to complete. The response rate was 56%. A total of 8,656 people were interviewed, of whom 95% (8243) agreed to be contacted again 12 months later. Of those, approximately 82% have been re-contacted and re-interviewed in 2006–07 (Wave Two), with 99% of those agreeing to be contacted again for Wave Three.
Discussion

ALSHR represents a significant advance for research on the linked topics of sexual and reproductive health. Its strengths include the large sample size, the inclusion of men as well as women, and the wide age range of the participants.

Predicting time trade-off health state valuations of adolescents in four Pacific countries using the assessment of quality-of-life (AQoL-6D) instrument

Objectives: Pacific Obesity Prevention in Communities (OPIC) is a community-based intervention project targeting adolescent obesity in Australia, New Zealand, Fiji, and Tonga. The Assessment of Quality of Life Mark 2 (AQoL-6D) instrument was completed by 15,481 adolescents to obtain a description of the quality of life associated with adolescent overweight and obesity, and a corresponding utility score for use in a cost–utility analysis of the interventions. This article describes the recalibration of this utility instrument for adolescents in each country.

Methods: The recalibration was based on country-specific time trade-off (TTO) data for 30 multiattribute health states constructed from the AQoL-6D descriptive system. Senior secondary students, in a classroom setting, responded to 10 health state scenarios each. These TTO interviews were conducted for 24 groups, comprising 279 students in the four countries resulting in 2790 completed TTO scores. The TTO scores were econometrically transformed by regressing the TTO scores upon predicted scores from the AQoL-6D to produce country-specific algorithms. The latter incorporated country-specific “corrections” to the Australian adult utility weights in the original AQoL.

Results: This article reports two methodological elements not previously reported. The first is the econometric modification of an extant multi-attribute utility instrument to accommodate cultural and other group-specific differences in preferences. The second is the use of the TTO technique with adolescents in a classroom group setting. Significant differences in utility scores were found between the four countries.

Conclusion: Statistical results indicate that the AQoL-6D can be validly used in the economic evaluation of both the OPIC interventions and other adolescent programs.

Attitudes of mental health staff to routine outcome measurement

Background: Routine outcome measurement is mandated in public mental health services in Australia, but uptake and compliance are variable. This may be because of uncertainties and resistances among clinicians.
Aims: To survey attitudes and practices to routine outcome measurement among staff in adult area mental health services and to elucidate their correlates.
Method: As part of a larger study, a specifically designed questionnaire was distributed to all staff.
Results: A high return rate was achieved. A wide range of opinion was found. Staff who had attended training reported the measures as easier to use than those who had not. Staff who had recently seen feedback rated outcome measures as more valuable but less easy to use than those who had not seen feedback. Compared to other disciplines, medical staff and psychologists tended to rate outcome measures as less useful.
Conclusions: The results have implications for the implementation and sustainability of routine outcome measurement. They highlight the need for staff to receive targeted training and usable reports, and to have access to resources to extract meaning and value from outcome measures.

The role of partners in shaping the body image and body change strategies of adult men : partners and male body image

The current study examined the relationship between perceived messages about the bodies of adult men from their sexual partners and the actual body image of these men. Interviews were conducted among 38 middle-aged men. Feedback from partners was generally complimentary, and the men were generally positive about their body image. Partners were seen to be more focused on a healthy body rather than a physically attractive body. The implications of these findings for better understanding the social influence on adult men to obtain a healthy body weight are discussed.

Lower levels of physical activity in childhood associated with adult depression

Emerging evidence indicates that early life exposures influence adult health outcomes and there is cause to hypothesise a role for physical activity (PA) in childhood as a protective factor in adult depression. This study aimed to investigate the association between self-reported levels of PA in childhood and self-reported depressive illness. Lifetime depression and levels of physical activity (low/high) in childhood (<15 yr) were ascertained by self-report in 2152 adults (20–97 yr) participating in an ongoing epidemiological study in south-eastern Australia. Data were collected between 2000 and 2006. In this sample, 141 women (18.9%) and 169 men (12.0%) reported ever having a depressive episode. Low PA in childhood was associated with an increased risk of reporting depression in adulthood (OR = 1.70, 95%CI = 1.32–2.17, p < 0.001). Adjustment for age, gender and adult PA attenuated the relationship somewhat (OR = 1.35, 95%CI = 1.01–1.78, p = 0.04), however further adjustment for SES or country of birth did not affect this relationship. In this community-based study, lower levels of self-reported PA in childhood were associated with a 35% increase in odds for self-reported depression in adulthood. These results are consistent with the hypothesis that lower levels of PA in childhood may be a risk factor for adult depression.

Depression and bone mineral density in a community sample of men : Geelong Osteoporosis Study

Background : Previous research in psychiatric and community samples has demonstrated reduced bone mineral density (BMD) in individuals with both clinical depression and depressive symptoms, although the findings are equivocal. This study aimed to investigate the association between self-reported depression and BMD in a community sample of men aged 20–96 years enrolled in the Geelong Osteoporosis Study.

Methods : A self-report questionnaire based on DSM-IV criteria was used to determine lifetime prevalence rates of depression within the study sample at baseline. Those currently taking oral glucocorticoids, testosterone or bisphosphonates were excluded from the analysis (n = 23) resulting in a sample of 1279 men.

Results : In this sample, 155 men reported a lifetime history of depression (LHX). There were no differences in age, weight, height, calcium intake, smoking rates or unadjusted BMD at the femoral neck between the cases and the controls, whereas unadjusted BMD at the spine was significantly lower in those with a LHX (1.254 ± 0.187 vs 1.293 ± 0.194 g/cm2). BMD adjusted for age, weight, calcium intake and smoking was 3.6% lower at the spine (1.255 ± 0.016 vs 1.295 ± 0.006 g/cm2) and 3.4% lower at the femoral neck (0.973 ± 0.011 vs 1.007 ± 0.004 g/cm2) in those with a LHX compared to controls.

Conclusion : These data are consistent with previous findings of diminished BMD in people with depressive disorders and symptoms and suggest that depression may be a risk factor for reduced BMD in community-dwelling adult men.

Growth restriction before and after birth increases kinase signaling pathways in the adult rat heart

To investigate the mechanisms for the previously reported development of adult cardiac hypertrophy in male rats following growth restriction, the levels of oxidative stress and activation of signaling kinases were measured in the left ventricle (LV) of adult rat offspring. In experiment one, bilateral uterine vessel ligation to induce uteroplacental insufficiency and growth restriction in the offspring (Restricted) or sham surgery was performed during pregnancy. Litters from sham mothers had litter size either reduced (Reduced Litter), which also restricted postnatal growth, or were left unaltered (Control). In males, Reduced Litter offspring had increased LV phosphorylation of AMPKa, p38 MAPK and Akt compared with Restricted and Controls (P,0.05). In females, both Restricted and Reduced Litter adult offspring had increased LV phosphorylation of p38 MAPK and Akt, however, only Restricted offspring had increased phosphorylation of AMPKa (P,0.05). In addition, only Restricted male offspring displayed LV oxidative stress (P,0.05). Experiment two investigated in mothers exposed to uteroplacental insufficiency or sham surgery the effects of cross-fostering offspring at birth, and therefore the effects of the postnatal lactational environment. Surprisingly, the cross-fostering itself resulted in increased LV phosphorylation of AMPKa and Akt in females and increased phosphorylation of Akt in males compared with Control non-cross-fostered offspring (P,0.05). In conclusion, kinase signaling in the adult LV can be programmed by uteroplacental insufficiency induced growth restriction in a gender-specific manner. In addition, the heart of adult rats is also sensitive to programming following the postnatal intervention of cross-fostering alone as well as by postnatal growth restriction.

Association between changes in habitual physical activity and changes in bone density, muscle strength, and functional performance in elderly men and women

OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women.

DESIGN: Ten-year prospective population-based study.

SETTING: Malmö-Sjöbo Prospective Study, Sweden.

PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years.

MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive–inactive (n=202), active–inactive (n=47), inactive–active (n=49), and active–active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active.

RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P<.01). Similar results were observed for balance, but there was no effect of varying habitual activity on changes in muscle strength or gait velocity. There were also no differences in fracture incidence between individuals categorized as active:more active and those categorized as inactive:less active during the follow-up (adjusted hazard ratio=0.90, 95% confidence interval (CI)=0.42–1.90).

CONCLUSION: This study showed that elderly men and women who maintained a habitually active lifestyle over 10 years had lower bone loss and retained better balance than those who remained habitually inactive.

The economic analysis of prevention in mental health programs

This article introduces the role economics can play in deciding whether programs designed to prevent mental disorders, which carry large disease and economic burdens, are a worthwhile use of limited healthcare resources. Fortunately, preventive interventions for mental disorders exist; however, which interventions should be financed is a common issue facing decision makers, and economic evaluation can provide answers. Unfortunately, existing economic evaluations of preventive interventions have limited applicability to local healthcare contexts. An approach to priority setting largely based on economic techniques— Assessing Cost-Effectiveness (ACE)—has been developed and used in Australia to answer questions regarding the economic credentials of competing interventions. Eleven preventive interventions for mental disorders and suicide, mostly psychological in nature, have been evaluated using this approach, with many meeting the criteria of good value for money. Interventions targeting the prevention of suicide, adult and childhood depression, childhood anxiety, and early psychosis have particular merit.

An examination of the health and wellbeing of childless women : A cross-sectional exploratory study in Victoria, Australia

Background
Childlessness among Australian women is increasing. Despite this, little is known about the physical and mental health and wellbeing of childless women, particularly during the reproductive years. The aims of this exploratory study were to: 1) describe the physical and mental health and wellbeing and lifestyle behaviours of childless women who are currently within the latter part of their reproductive years (30 – 45 years of age); and 2) compare the physical and mental health and wellbeing and lifestyle behaviours of these childless women to Australian population norms.
Methods
A convenience sample of 50 women aged between 30 and 45 years were recruited to participate in a computer assisted telephone interview. The SF-36 Health Survey v2 and lifestyle indicators were collected in regards to women’s health and wellbeing. Data were analysed using descriptive statistics, t-tests for independent sample means and 95% confidence intervals for the difference between two independent proportions.
Results
Childless women in this study reported statistically significant poorer general health, vitality, social functioning and mental health when compared to the adult female population of Australia. With the exception of vegetable consumption, lifestyle behaviours were similar for the childless sample compared to the adult female population in Australia.
Conclusions
Childless women may be at a greater risk of experiencing poor physical and mental health when compared to the Australian population. A woman’s health and wellbeing during her reproductive years may have longer term health consequences and as such the health and wellbeing of childless women requires further investigation to identify and address implications for the provision of health (and other social) services for this growing population group.

Association between the COMT Val158Met polymorphism and propensity to anxiety in an Australian population-based longitudinal study of adolescent health

Objectives: Catechol-O-methyltransferase plays a central role in the metabolism of biogenic amines such as norepinephrine, dopamine and serotonin. Functional studies have demonstrated a dose relationship between Val158Met genotypes and catechol-O-methyltransferase activity. Compared with the Val158Val genotype, the Val158Met and Met158Met genotypes result in two- and four-fold reductions in catechol-O-methyltransferase activity, respectively. Two recent reports have observed the association between the Met158Met genotype and risk of anxiety in adult populations. We examined the association between the Val158Met genotypes and propensity to anxiety across adolescence.

Methods: Participants were drawn from an eight-wave study of the mental and behavioural health of over 2000 young Australians followed from 14 to 24 years of age (Victorian Adolescent Health Cohort Study, 1992 to present). DNA was received from 962 participants using a cheek swab collection method.

Results: The odds of reporting persistent episodic anxiety (phobic avoidance, panic attacks) were doubled among carriers of the Met158Met genotype (odds ratio 2.0, 95% confidence interval 1.1-3.4, P=0.014). A dose relationship between additional copies of the Met158 allele and persistent episodic anxiety was also observed (1.5, 1.1-1.94, P=0.007). Stratification by sex showed that the risk effect of the Met158 allele was among females only. No association was observed for measures of neuroticism, persistent generalized anxiety, or a composite measure of psychiatric distress.

Conclusion: These data replicate previous findings suggesting association between the Val158Met polymorphism and specific expressions of anxiety among females.

Endogenous parathyroid hormone is associated with reduced cartilage volume in vivo in a population-based sample of adult women

Objectives Animal and in vitro studies suggest that parathyroid hormone (PTH) may affect articular cartilage. However, little is known of the relationship between PTH and human joints in vivo.

Design Longitudinal.

Setting Barwon Statistical Division, Victoria, Australia.

Participants 101 asymptomatic women aged 35–49 years (2007–2009) and without clinical knee osteoarthritis, selected from the population-based Geelong Osteoporosis Study.

Risk factors Blood samples obtained 10 years before (1994–1997) and stored at −80°C for random batch analyses. Serum intact PTH was quantified by chemiluminescent enzyme assay. Serum 25-hydroxyvitamin D (25(OH)D) was assayed using equilibrium radioimmunoassay. Models were adjusted for age, bone area and body mass index; further adjustment was made for 25(OH)D and calcium supplementation.

Outcome Knee cartilage volume, measured by MRI.

Results A higher lnPTH was associated with reduced medial—but not lateral—cartilage volume (regression coefficient±SD, p value: −72.2±33.6 mm3, p=0.03) after adjustment for age, body mass index and bone area. Further sinusoidal adjustment (−80.8±34.4 mm3, p=0.02) and 25(OH)D with seasonal adjustment (−72.7±35.1 mm3, p=0.04), calcium supplementation and prevalent osteophytes did not affect the results.

Conclusions A higher lnPTH might be detrimental to knee cartilage in vivo. Animal studies suggest that higher PTH concentrations reduce the healing ability of cartilage following minor injury. This may be apparent in the presence of increased loading, which occurs in the medial compartment, placing the medial cartilage at higher risk for injury.