The importance of degree versus type of maltreatment: a cluster analysis of child abuse types

The author conducted secondary data analysis of 3 previously reported studies (D. J. Higgins & M. P McCabe, 1998, 20(K)b, 2(X)3) to examine whether respondents are best classified according to their experience of separate maltreatment types (sexual abuse, physical abuse, psychological maltreatment, neglect, and witnessing family violence) or whether their experience reflects a single unifying concept: child maltreatment.

Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy

Objective: To assess the evidence for the effectiveness of increasing numbers of drugs in antiretroviral combination therapy.

Design: Systematic review, meta-analysis, and meta-regression of fully reported randomised controlled trials. All studies included compared quadruple versus triple therapy, triple versus double therapy, double versus monotherapy, or monotherapy versus placebo or no treatment.

Participants: Patients with any stage of HIV infection who had not received antiretroviral therapy.

Main outcome measures: Changes in disease progression or death (clinical outcomes); CD4 count and plasma viral load (surrogate markers).
Search strategy: Six electronic databases, including Medline, Embase, and the Cochrane Library, searched up to February 2001.

Results: 54 randomised controlled trials, most of good quality, with 66 comparison groups were included in the analysis. For both the clinical outcomes and surrogate markers, combinations with up to and including three (triple therapy) were progressively and significantly more effective. The odds ratio for disease progression or death for triple therapy compared with double therapy was 0.6 (95% confidence interval 0.5 to 0.8). Heterogeneity in effect sizes was present in many outcomes but was largely related to the drugs used and trial quality.

Conclusions: Evidence from randomised controlled trials supports the use of triple therapy. Research is needed on the effectiveness of quadruple therapies and the relative effectiveness of specific combinations of drugs.

From transcriptome to biological function: environmental stress in an ectothermic vertebrate, the coral reef fish Pomacentrus moluccensis

Background
Our understanding of the importance of transcriptional regulation for biological function is continuously improving. We still know, however, comparatively little about how environmentally induced stress affects gene expression in vertebrates, and the consistency of transcriptional stress responses to different types of environmental stress. In this study, we used a multi-stressor approach to identify components of a common stress response as well as components unique to different types of environmental stress. We exposed individuals of the coral reef fish Pomacentrus moluccensis to hypoxic, hyposmotic, cold and heat shock and measured the responses of approximately 16,000 genes in liver. We also compared winter and summer responses to heat shock to examine the capacity for such responses to vary with acclimation to different ambient temperatures.
Results
We identified a series of gene functions that were involved in all stress responses examined here, suggesting some common effects of stress on biological function. These common responses were achieved by the regulation of largely independent sets of genes; the responses of individual genes varied greatly across different stress types. In response to heat exposure over five days, a total of 324 gene loci were differentially expressed. Many heat-responsive genes had functions associated with protein turnover, metabolism, and the response to oxidative stress. We were also able to identify groups of co-regulated genes, the genes within which shared similar functions.
Conclusion
This is the first environmental genomic study to measure gene regulation in response to different environmental stressors in a natural population of a warm-adapted ectothermic vertebrate. We have shown that different types of environmental stress induce expression changes in genes with similar gene functions, but that the responses of individual genes vary between stress types. The functions of heat-responsive genes suggest that prolonged heat exposure leads to oxidative stress and protein damage, a challenge of the immune system, and the re-allocation of energy sources. This study hence offers insight into the effects of environmental stress on biological function and sheds light on the expected sensitivity of coral reef fishes to elevated temperatures in the future.

A cross-cultural study into peer evaluations of women's leadership effectiveness

Purpose: The present paper is based on a cross-cultural exploration of middle managers in two diverse cultures and aims to focus on how the leadership styles of managerial women are perceived and evaluated. In particular, female and male peer evaluations of leadership effectiveness in Malaysia and Australia are to be explored.

Design/methodology/approach: Surveys from 324 middle managers from Malaysia and Australia were quantitatively analysed. The sample for the study was drawn from organisations in four industry types in both countries.

Findings:  Findings suggest that evaluations of female managers' leadership styles in general, and within the respondent's own organisations, were strongly culture specific, especially in Malaysia. The results reflected the strongly held values, attitudes and beliefs of each country. While this is not unexpected, it does highlight a need to be cautious when interpreting Western research results and attempting to transplant those into other cultures. In Malaysia, female managers were not seen as effective in the leadership styles they adopted in their roles when compared to the Australian female managers' evaluations. Such an evaluation may have had little to do with an objective appraisal of the female managers' capability, but rather with a strongly held cultural belief about the appropriate role of women in society, and in organisations in particular.

Research limitations/implications:  It is suggested that national culture manifests itself in the values, attitudes and behaviours of people. Cultural influences are therefore likely to impact on the way women and men behave in the workplace, particularly when roles of authority and power are evident, and the way in which that behaviour will be evaluated by others. Further research using different samples in different cultures are recommended. In addition, the influence of ethnicity, race or religion in plural countries such as Malaysia and Australia is also worthy of investigation.

Practical implications:  This research suggests that values and attitudes are strongly culture-specific and therefore have the ability to influence evaluations at an organisational level. Such an awareness of cultural influences should guide appropriate human resource practices, particularly within a globalized environment.

Originality/value:  The inclusion of a gender comparison in the data analysis in this paper is a significant attempt to add to the extant knowledge of the cross-cultural research. This is a unique contribution because of the omission of a gender perspective in the previous two seminal studies in culture literature (i.e. Hofstede and House et al.). In addition, the findings suggest that culture-specific influences are important determinants that impose expectations on the role of women differently from men in society and within organisations hence, making the gender comparison of the findings more significant.

Specific risk assessment based on victim type in children sexual offenders

Actuarial instruments for assessing sex offender recidivism have limited utility for specific risk assessment questions, such as the risk posed to particular types of victim. In order to obtain variables that discriminate between offenders with different classes of victim, data were coded from 324 files of child sexual offenders from a community-based sexual offender treatment program. Offenders with single or multiple victims were compared, as were offenders who did or did not offend against victims of both genders, and offenders with only intra-familial or extra-familial victims versus offenders with victims in both relationship categories. Variables that discriminated single-victim and multiple-victim offenders were similar to those identified in actuarial risk assessment scales, with the exception of history of childhood sexual abuse. With the exception of physical abuse history, the same variables discriminated specific offender groups according to victim gender and victim relationship, although in different combinations. There was limited support for the notion of specific risk variables.

Applying self-determination theory to understand the motivation for becoming a physical education teacher

This study explored the reasons people choose physical education teaching as a profession and investigated the relationship of these choices with motivation. Physical education pre-service teachers (n = 324) completed the Academic Motivation Scale (AMS) and a measure of reasons for choosing physical education teaching. Confident interpersonal service reasons were linked with intrinsic motivation; whereas sport and physical activity reasons were related to extrinsic motivation. Enrolling because teaching seemed easy was linked with amotivation. Motivation was similar for different course entry methods, however, females were more intrinsically motivated than males and third year students were lower in motivation than other year levels.

Working together : collaboration between midwives and doctors in public hospitals

While collaborative, multidisciplinary teamwork is widely espoused as the goal of contemporary hospitals, it is hard to achieve. In maternity care especially, professional rivalries and deep-seated philosophical differences over childbirth generate significant tensions. This article draws on qualitative research in several Victorian public maternity units to consider the challenges to inter-professional collaboration. It reports what doctors and midwives looked for in colleagues they liked to work with — the attributes of a “good doctor” or a “good midwife”. Although their ideals did not entirely match, both groups respected skill and hard work and sought mutual trust, respect and accountability. Yet effective working together is limited both by tensions over role boundaries and power and by incivility that is intensified by increasing workloads and a fragmented labour force. The skills and qualities that form the basis of “professional courtesy” need to be recognised as Aust Health Rev 2009: 33(2): 315–324 essential to good collaborative practice.

Is point of care testing for anaemia (HB) and microalbumin feasible in people with type 2 diabetes attending diabetes outpatient clinics?

Introduction: Diabetes is the major cause of chronic kidney disease (CKD) in Australia. Anaemia of CKD occurs earlier than in non-diabetics and is often insidious and undetected.

Aim: A large, prospective, single-centre study was undertaken to determine the feasibility of point of care testing (POCT) haemoglobin (Hb) and microalbumin in people with type 2 diabetes (T2DM) attending routine outpatient clinic appointments (OPC).

Method: Clinic nurses measured Hb and microalbumin using the HemoCue Haemoglobin Capillary Analyser and the HemoCue Urine Albumin Analyser (Medipac Scientific), respectively when they tested blood glucose, weight and blood pressure. The nurses were trained to use the analysers before the study commenced. Standard demographic data, duration of diabetes, treatment mode, and presence of complications, comorbidities, and HbA1c were ascertained from patients’ medical records.

Results: Five hundred and fifty-four (80%) patients were screened. The nurses were able to perform the tests competently but testing, especially microalbumin, was time-consuming. Patients’ mean age was 62 years (11 SD): 230 females, mean blood glucose (BG) 10 (3.9 SD) mmol/L, mean haemoglobin 127.2 (16.3 SD) g/L; mean microalbumin 47.8 (58.7 SD) mg/L: 324 were males, mean BG 10.2 (3.9 SD) mmol/L, mean Hb 138.6 (18.8 SD) gm/L, and mean microalbumin 67.9 (73.9 SD) mg/L. 27% of males and 22% of females were anaemic. Of those with anaemia, 27% of females and 29% of males had microalbuminuria.

Conclusions: POCT is feasible in routine outpatient clinics but is time-consuming. One in four T2DM attending OPC were anaemic. POCT Hb testing in OPC is feasible and could identify T2DM who need full haematological assessment.

Return to pre-injury health status and function 12 months after hospitalisation for sport and active recreation related orthopaedic injury

Background Hospitalised sport and active recreation injuries can have serious long-term consequences. Despite this, few studies have examined the long-term outcomes of these injuries. The purpose of this study was to establish whether patients hospitalised with orthopaedic sport and active recreation injuries, have returned to their pre-injury levels of health status and function, 12 months post injury and identify factors associated with poor outcomes. The present work was a cohort study with retrospective assessment of pre-injury status and prospective assessment of outcome at 12 months post injury.

Methods Adults with orthopaedic sport and active recreation injuries, captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Pre-injury and 12-month outcomes were assessed using the 36-item Short Form Health Survey (SF-36) and the extended Glasgow Outcome Scale. Differences in pre-injury and post-injury SF-36 scores were examined and demographic, injury, hospital and physical activity variables were assessed for associations with outcome using multivariate linear regression.

Results Of the 324 participants 98% were followed-up at 12 months post injury. At 12 months, participants reported a mean 7.0-point reduction in physical health (95% CI 5.8 to 7.8) and a 2.5-point reduction in mental health (95% CI 1.2 to 3.0), with 58% (95% CI 52.6% to 63.4%) reporting reduced function. Sporting group (p=0.001), Injury Severity Score >15 (p=0.007) and high pre-injury vigorous activity levels (p=0.04), were related to poorer physical health outcomes.

Conclusions At 12 months post injury, most participants reported large reductions in physical health and reduced function. This information is important for furthering our understanding of the burden of sport and active recreation injury and setting priorities for treatment and rehabilitation.

The impact of sport and active recreation injuries on physical activity levels at 12 months post-injury

The aim of this study was to evaluate the impact of serious sport and active recreation injury on 12-month physical activity levels. Adults admitted to hospital with sport and active recreation-related injuries, and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Changes between preinjury and 12 month post-injury physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ). Independent demographic, injury, and hospital variables were assessed for associations with changes in physical activity levels, using multivariate linear regression. A total of 324 patients were recruited, of which 98% were followed up at 12 months. Mean short IPAQ scores decreased from 7650 METS (95% CI: 7180, 8120) preinjury to 3880 METS; (95% CI: 3530, 4250) post-injury, independent of functional recovery. Education level and occupation group were the only variables independently associated with changes in physical activity levels post-injury. These results highlighted that sport and active recreation injuries lead to significant reductions in physical activity levels. Hence, the prevention of sport and active recreation injuries is important when considering promotion of activity at a population level.

Fourpoint

4pt is a publication by four designers and academics from Monash University, Faculty of Art & Design who have come together with a shared desire to critically analyse, question and debate issues facing the currency of graphic design through text, image and the medium of poster. This is the first issue of 4pt, a selection of 4 posters and essays united under the theme of Reverie by Gene Bawden, Brad Haylock, Sarah Jones and Russell Kennedy

Sports betting marketing during sporting events: a stadium and broadcast census of Australian Football League matches

OBJECTIVE: Using Australian Football League (AFL) matches as a case study, we investigated the frequency, length and content of marketing strategies for sports betting during two specific settings: 1) at stadiums during four live matches; and 2) during eight televised broadcasts of matches. METHODS: Census of sports betting marketing during Round 12 of the 2011 AFL premiership season. RESULTS: Per match, there was an average of 58.5 episodes (median 49.5, s.d 27.8) and 341.1 minutes (median 324.1 minutes and s.d 44.5) of sports betting marketing at stadiums, and 50.5 episodes (median 53.5, s.d 45.2) and 4.8 minutes (median 5.0 minutes, s.d 4.0) during televised broadcasts. A diverse range of marketing techniques were used to: a) embed sports betting within the game; b) align sports betting with fans' overall experience of the game; and c) encourage individuals to bet live during the game. There were very few visible or audible messages (such as responsible gambling or Gambler's Help messages) to counter-frame the overwhelmingly positive messages that individuals received about sports betting during the match. CONCLUSIONS AND IMPLICATIONS: This study raises important questions about the impacts of saturation, integrated and impulse gambling marketing strategies in sporting matches. Future research should explore: 1) how wagering industry marketing strategies may affect the attitudes and behaviours of community sub-groups (e.g. young male sports fans, and children); and 2) which public health and policy strategies, including regulation and harm minimisation messaging, will be effective in responding to wagering industry marketing strategies during sporting matches.

Psychological wellbeing among same-sex attracted and heterosexual parents: Role of connectedness to family and friendship networks

© 2015 Australian Association of Family Therapy. Increasing numbers of lesbian, gay and bisexual (LGB) adults are entering into parenthood. Previous studies indicate many of these parents receive little or no support from their families of origin due to family members' negative attitudes toward homosexuality. This study looks at the extent to which LGB parents report a lower sense of connectedness to family of origin and friendship networks than heterosexual parents and whether this has an impact on psychological wellbeing in either of these groups. Data were derived from two studies of parents: Work, Love, Play, a study of Australian and New Zealand LGB parents (n=324); and the Longitudinal Study of Australian Children, a population-based study of young children and parents (n=6460). Structural equation modelling was used to explore the relationships between: parent sexuality and family/friendship connectedness, family/friendship connectedness and psychological wellbeing, parent sexuality and psychological wellbeing. LGB parents reported feeling less connected to their families of origin but more connected to their friendship groups than heterosexual parents. Counter to previous studies, we found no difference in the psychological wellbeing of LGB parents compared to heterosexual parents when examining the direct effect of sexuality on psychological wellbeing. Clinical implications for counsellors and family therapists are discussed.