The association between diet quality and mental health during the perinatal period. A systematic review

BACKGROUND: While maternal nutrition during pregnancy is known to play a critical role in the health of both mother and offspring, the magnitude of this association has only recently been realized. Novel, epigenetic data suggest that maternal dietary intake has permanent phenotypic consequences for offspring, highlighting the potency of antenatal diet. To date, the relationship between poor antenatal diet and maternal mental health specifically, remains poorly understood. Therefore, we aimed to systematically review evidence that has examined associations between antenatal diet quality and the experience of depressive, anxiety and stress symptoms during the perinatal period.

METHODS: A search for peer-reviewed papers was conducted using Medline Complete, PsycINFO, CINAHL, Academic Search Premiere and Psychology and Behavioral Science Collection.

RESULTS: Nine studies (cohort = 4, cross-sectional = 5) published between 2005 and 2013 were eligible for inclusion in this review. A synthesis of findings revealed positive associations between poor quality and unhealthy diets and antenatal depressive and stress symptoms. Healthy diets were inversely associated with antenatal depressive and anxiety symptoms. Postnatal depressive symptoms demonstrated inconsistent results.

CONCLUSIONS: Given the paucity of research examining diet quality and mental health in women during the perinatal period, further sufficiently powered studies are urgently required to examine this association.

Does Internet reporting improve the accessibility of financial reporting in a global world? A comparative study of New Zealand and Indian companies

 The accessibility of business reporting, including financial reports on company websites is not necessarily increased by providing more information on websites. The quality of Internet-based information is affected by both the accessibility and quantity of information provided. However, the accessibility of the information is an under researched area. This paper contributes to the existing body of knowledge on webbased business reporting, by considering the dimension of accessibility in terms of website appearance and visual design from four different perspectives. The aim is to consider the differences that occur in website organisation as a way of considering the accessibility of information provided on company websites. The paper considers the differences in the accessibility of website information between New Zealand and Indian companies as a means of demonstrating the variation that can occur across countries as well as within the same reporting structure. We conclude that Internet financial reporting does provide the illusion of comparability but without a more sustained focus on the harmonisation of terminology and attributes included in Internet reporting, the potential for comparison is reduced.

Mechanisms underpinning use of new walking and cycling infrastructure in different contexts: mixed-method analysis

BACKGROUND: Few studies have evaluated the effects of infrastructural improvements to promote walking and cycling. Even fewer have explored how the context and mechanisms of such interventions may interact to produce their outcomes. METHODS: This mixed-method analysis forms part of the UK iConnect study, which aims to evaluate new walking and cycling routes at three sites - Cardiff, Kenilworth and Southampton. Applying a complementary follow-up approach, we first identified differences in awareness and patterns of use of the infrastructure in survey data from a cohort of adult residents at baseline in spring 2010 (n = 3516) and again one (n = 1849) and two (n = 1510) years later following completion of the infrastructural projects (Analysis 1). We subsequently analysed data from 17 semi-structured interviews with key informants to understand how the new schemes might influence walking and cycling (Analysis 2a). In parallel, we analysed cohort survey data on environmental perceptions (Analysis 2b). We integrated these two datasets to interpret differences across the sites consistent with a theoretical framework that hypothesised that the schemes would improve connectivity and the social environment. RESULTS: After two years, 52% of Cardiff respondents reported using the infrastructure compared with 37% in Kenilworth and 22% in Southampton. Patterns of use did not vary substantially between sites. 17% reported using the new infrastructure for transport, compared with 39% for recreation. Environmental perceptions at baseline were generally unfavourable, with the greatest improvements in Cardiff. Qualitative data revealed that all schemes had a recreational focus to varying extents, that the visibility of schemes to local people might be an important mechanism driving use and that the scale and design of the schemes and the contrast they presented with existing infrastructure may have influenced their use. CONCLUSIONS: The dominance of recreational uses may have reflected the specific local goals of some of the projects and the discontinuity of the new infrastructure from a satisfactory network of feeder routes. Greater use in Cardiff may have been driven by the mechanisms of greater visibility and superior design features within the context of an existing environment that was conducive neither to walking or cycling nor to car travel.

Working hours and mental health in Australia: evidence from an Australian population-based cohort, 2001-2012

Objectives: This paper assesses the impact of working less than or more than standard full-time hours on mental health, as well as possible differences in this relationship by gender and skill level. Methods: The study design was a longitudinal cohort with 12 annual waves of data collection over the period 2001-2012, yielding a sample of 90 637 observations from 18 420 people. Fixed effects within-person regression was used to control for time invariant confounding. The Mental Component Summary of the Short Form 36 (SF-36) measure was used as the primary outcome measure. Working hours over the preceding year was measured in five categories with standard full-time hours (35-40 h/week) as the reference. Results: Results indicated that when respondents were working 49-59 h (-0.52, 95% CI -0.74 to -0.29, p<0.001) and 60 h or more (-0.47, 95% CI -0.77 to -0.16, p=0.003) they had worse mental health than when they were working 35-40 h/week (reference). The difference in mental health when working 49-59 h was greater for women than for men. There were greater declines in mental health in relation to longer working hours among persons in higher compared to lower occupational skill levels. Conclusions: Study results suggest the need for employers and governments to regulate working hours to reduce the burden of mental ill health in the working population.

Mental health consumers' perceptions of quality of life and mental health care

Research spanning the past decade consistently reports that people with severe mental illnesses experience lower quality of life than the general population, however, little is known about what "quality of life" means to consumers, or how quality of life can be promoted in mental health care. This study measured the Quality of Life of mental health consumers receiving care from a Mental Health Nurse Incentive Program, and examined consumer perceptions of quality of life. The study used an exploratory design incorporating the WHOQOL-brèf survey and four additional qualitative questions for data collection. Data were analysed using descriptive and correlational statistics. Participants (n = 49) reported lower quality of life scores on all four domains of the WHOQOL-brèf and lower overall ratings for "quality of life" than the general population. Having basic needs met, good relationships with family and friends, regular support, and improved social connectedness were identified by consumers as important to their quality of life.

A longitudinal analysis of changes in job control and mental health

Deteriorating job control has been previously shown to predict poor mental health. The impact of improvement in job control on mental health is less well understood, yet it is of policy significance. We used fixed-effects longitudinal regression models to analyze 10 annual waves of data from a large Australian panel survey (2001-2010) to test within-person associations between change in self-reported job control and corresponding change in mental health as measured by the Mental Component Summary score of Short Form 36. We found evidence of a graded relationship; with each quintile increase in job control experienced by an individual, the person's mental health increased. The biggest improvement was a 1.55-point increase in mental health (95% confidence interval: 1.25, 1.84) for people moving from the lowest (worst) quintile of job control to the highest. Separate analyses of each of the component subscales of job control-decision authority and skill discretion-showed results consistent with those of the main analysis; both were significantly associated with mental health in the same direction, with a stronger association for decision authority. We conclude that as people's level of job control increased, so did their mental health, supporting the value of targeting improvements in job control through policy and practice interventions.

Relationship between severity of obesity and mental health: an Australian community survey

Introduction
In Australia the incidence of obesity is increasing rapidly and has become a significant public health concern. In addition to the many physical consequences of obesity many studies have reported significant mental health consequences, including major depression, mood and anxiety disorders. The purpose of this study was to explore the relationship between severity of obesity and perceived mental health in an Australian community sample.

Methods
A cross-sectional survey design was used. A total of 118 participants, aged between 19 and 75 years with a body mass index (BMI) ≥ 30 kg/m2 returned a completed questionnaire. The SF-36 Health Survey, Kessler Psychological Distress Scale, Social Interaction Anxiety Scale and the Multidimensional Scale of Perceived Social Support were used.

Results
After adjusting for age, gender, perceived social support and physical health quality of life, obesity was not significantly associated with mental health quality of life (SF-36). The strongest factor influencing mental health was perceived physical health. Mediation analyses suggest that physical health mediates the relationship between obesity and mental health quality of life.

Discussion
Our findings support the view that physical health mediates the relationship between obesity and mental health. Public health interventions should focus on reducing the impact of obesity on physical health by encouraging participation in healthy lifestyles, which in turn, may improve mental wellbeing.

Associations between early adrenarche, affective brain function and mental health in children

Early timing of adrenarche, associated with relatively high levels of Dehydroepiandrosterone (DHEA) in children, has been associated with mental health and behavioral problems. However, little is known about effects of adreneracheal timing on brain function. The aim of this study was to investigate the effects of early adrenarche (defined by high DHEA levels independent of age) on affective brain function and symptoms of psychopathology in late childhood (N = 83, 43 females, M age 9.53 years, s.d. 0.34 years). Results showed that higher DHEA levels were associated with decreased affect-related brain activity (i) in the mid-cingulate cortex in the whole sample, and (ii) in a number of cortical and subcortical regions in female but not male children. Higher DHEA levels were also associated with increased externalizing symptoms in females, an association that was partly mediated by posterior insula activation to happy facial expressions. These results suggest that timing of adrenarche is an important moderator of affect-related brain function, and that this may be one mechanism linking early adrenarche to psychopathology.

Environmental contributions to social and mental health outcomes following pediatric stroke

Mental health and social outcomes following acquired brain injury (ABI) in children are often considered to be due to brain insult, but other factors, such as environment, may also play a role. We assessed mental health and social function in children with chronic illness, with and without stroke (a form of ABI), and typically developing (TD) controls to examine environmental influences on these outcomes. We recruited 36 children diagnosed with stroke, 15 with chronic asthma, and 43 TD controls. Children and parents completed questionnaires rating child mental health and social function and distal and proximal environment. TD children had significantly less internalizing and social problems than stroke and asthma groups, and engaged in more social activities than children with stroke. Poorer parent mental health predicted more internalizing and social problems and lower social participation. Family dysfunction was associated with internalizing problems. Lower parent education contributed to children's social function. Children with chronic illness are at elevated risk of poorer mental health and social function. Addition of brain insult leads to poorer social participation. Quality of home environment contributes to children's outcomes, suggesting that supporting parent and family function provides an opportunity to optimize child mental health and social outcomes.

Transforming narratives of colonial danger: imagining the environments of New Zealand and Australia in children's literature, 1862–1899

Nineteenth-century British children’s literature set in Australia and New Zealand fixates on the dangers of colonial environments. This chapter examines four British novels of the period, observing the ways in which they manifest elements of ecological imperialism and environmental racism in order to depict successful settlement. It compares these novels with fantasy fictions by Australian and New Zealand children’s authors that constitute more complicated attempts both to understand and co-exist with the natural environment. The chapter proposes that by the 1890s earlier British anxieties had dissipated in popular Australian and New Zealand fiction, in which child protagonists were newly charged with the ability to interpret and control nature.

Does disability status modify the association between psychosocial job quality and mental health? A longitudinal fixed-effects analysis

BACKGROUND: People with disabilities have difficulties in obtaining work. However, evidence suggests that those with disabilities derive substantial mental health benefits from employment. This paper assesses how the relationship between work and mental health is influenced by psychosocial job quality for people working with a disability. METHODS: The study design was a longitudinal cohort with 13 annual waves of data collection, yielding a sample of 122,883 observations from 21,848 people. Fixed-effects within-person regression was used to control for time invariant confounding. The Mental Component Summary (MCS) of the Short Form 36 (SF-36) measure was used as the primary outcome measure. The main exposure was a six-category measure of psychosocial job quality and employment status (including 'not in the labour force' [NILF] and unemployment). Disability status ('no waves of disability reported' and 'all contributed waves with reported disability') was assessed as an effect modifier. We also conducted a secondary analysis on respondents contributing both disability and non-disability waves. RESULTS: For those with no disability, the greatest difference in mental health (compared to optimal employment) occurs when people have the poorest quality jobs (-2.12, 95% CI -2.48, -1.75, p < 0.001). The relative difference in mental health was less in relation to NILF and unemployment (-0.39 and -0.66 respectively). For those with consistent disability, the difference in mental health when employed in an optimal job was similar between the poorest quality jobs (-2.25, 95% CI -3.84, -0.65, p = 0.006), NILF (-2.84, 95% CI -4.49, -1.20, p = 0.001) or unemployment (-2.56, 95% CI -4.32, -0.80, p = 0.004). These results were confirmed by the secondary analysis. CONCLUSIONS: Efforts to improve psychosocial job quality may have significant mental health benefits for people with disabilities. This will contribute to the economic viability of disability employment insurance schemes in Australia and other high-income countries.

The monologic, power and mental illness

 This thesis considers the issue of the ‘Monologic, Power and Mental Illness’. Bakhtin’s concept of ‘Heteroglossia’, Foucault’s concept of ‘Subjectivation’, and the work of other writers in relation to mental illness are covered both in the Exegesis and throughout the creative component comprising excerpts from Kemp’s novella entitled, Haven.