Individual, family, school, and community risk and protective factors for depressive symptoms in adolescents : a comparison of risk profiles for substance use and depressive symptoms

This study examines the relationship between adolescent depressive symptoms and risk and protective factors identified for substance use. A questionnaire, developed to measure these factors in a young persons community, family, school, peer group, and individual characteristics for substance use, was used to assess associations with self-reported depressive symptoms. Data were provided by a representative sample of 8984 secondary school students in Victoria, Australia. The prevalence of depressive symptoms was 10.5% (95% CI 9.2,12.0) for males and 21.7% (95% CI 20.3,23.7) for females. Depressive symptoms were associated with factors in all domains, with the strongest associations in the family domain. Strong relationships were found between the number of elevated risk and protective factors and depressive symptoms, maintained after adjusting for substance use. Patterns of associations were similar for users and nonsubstance users. The findings indicate that prevention programs targeting factors for substance use have the potential to impact on depression.

Family risk factors for cannabis use: a population-based survey of Australian secondary school students

The objective of this study was to investigate relationships between adolescent cannabis use and indices of parent - child attachment, family functioning and parent attitudes to drugs and delinquency. A total of 2848 year 9 and 2363 year 11 students participated in the Victorian Adolescent Health and Well-Being Survey (1999). The study was a school-based random sample of 535 metropolitan and rural, government and non-government secondary schools throughout Victoria, Australia. Cannabis use was defined as 'any' and 'weekly' use in the last 30 days. Multivariate logistic regression was used to identify independent associations between cannabis use and parent - child attachment, family functioning and parent attitudes to drugs and delinquency. Cannabis use in year 9 was associated with permissive parent attitudes to drugs and delinquency (any use: adjusted odds ratio (OR) = 8.1; weekly use: adjusted OR = 7.6), and was particularly sensitive to small changes in the quality of the parent - child relationship with risk increasing threefold for those describing their attachment as 'good' compared with 'very good' (any use: adjusted OR = 2.8, weekly use adjusted OR = 2.9). A similar, but more moderate pattern association was evident in year 11. After adjusting for other family and background factors, poor family functioning showed minimal association with level of cannabis use at both year levels. Results suggest that intervention efforts might sensibly target strengthening parent - children relationships and promoting less permissive parent attitudes to drug use.

The management of depressed elderly care recipients : family perspectives on the skills of professional carers

Recent studies have identified high levels of depression among older people, both those in their own homes and those in residential care. With the world's population ageing, it is timely for health service providers to consider how the escalating population of depressed elderly people will be managed. Although treating general practitioners may be the health professionals most expected to detect, treat, and monitor depression among the elderly, professional carers are well placed to assist in the detection and monitoring of the disorder. This study conducted individual interviews with 15 family members of depressed aged-care recipients to determine their perceptions of the skills and knowledge of depression of professional carers. Family members reported that carers are more likely to avoid than engage with their clients about depressive symptomatology and do not communicate their concerns with managers or general practitioners (GPs). Family members believed that, in general, professional carers were undertrained in these areas. The implications of these findings for health service planning and staff training are discussed.

Genome - wide association study identifies novel breast cancer susceptibility loci

Breast cancer exhibits familial aggregation, consistent with variation in genetic susceptibility to the disease. Known susceptibility genes account for less than 25% of the familial risk of breast cancer, and the residual genetic variance is likely to be due to variants conferring more moderate risks. To identify further susceptibility alleles, we conducted a two-stage genome-wide association study in 4,398 breast cancer cases and 4,316 controls, followed by a third stage in which 30 single nucleotide polymorphisms (SNPs) were tested for confirmation in 21,860 cases and 22,578 controls from 22 studies. We used 227,876 SNPs that were estimated to correlate with 77% of known common SNPs in Europeans at r² > 0.5. SNPs in five novel independent loci exhibited strong and consistent evidence of association with breast cancer (P < 10^-7). Four of these contain plausible causative genes (FGFR2, TNRC9, MAP3K1 and LSP1). At the second stage, 1,792 SNPs were significant at the P < 0.05 level compared with an estimated 1,343 that would be expected by chance, indicating that many additional common susceptibility alleles may be identifiable by this approach.

Family relationship quality and early alcohol use : evidence for gender-specific risk processes

Objective: Family characteristics (relationship quality, parental behaviors, and attitudes relating to alcohol use) are known to influence alcohol use in the mid-teen years, and there is evidence that family characteristics have different influences on mid-teen girls versus boys. This study examined child gender differences in the association of family relationship quality, parental disapproval of children's alcohol use, and parental alcohol use with early adolescent alcohol use.

Method: Grade 6 and 8 students (modal age 11 and 13, respectively; N = 6,837; 52.6% female) were recruited from 231 schools across three Australian states. Hypotheses were tested using two-level ordinal logistic regression (individuals nested within schools). The main dependent measure was lifetime frequency of early adolescent alcohol consumption. Independent variables included mother's/father's alcohol use, closeness, conflict, and disapproval of adolescent alcohol use. Control variables included sensation seeking, peer alcohol use, and socioeconomic disadvantage.

Results: The key findings were that for the young age group (Grade 6), emotional closeness to the parent of the opposite sex was protective. Family conflict was associated with females' drinking in both age groups but not males' drinking.

Conclusions: There was evidence of gender differences in the epidemiology of family relationship quality and early alcohol use. Social developmental models may need revision to account for these child gender differences. Gender-specific family dynamics may be an important consideration for family-oriented prevention strategy.

The role of board independence in mitigating agency problem II in Australian family firms

We investigate the impact of board independence on earnings management on a sample of family controlled firms listed on the Australian Securities Exchange (ASX). Using panel data over the period 2000–2004, we find evidence of earnings management among family controlled firms in Australia, an environment of high investor protection and private benefits of control. Findings show that a higher proportion of independent directors on boards is effective in reducing earnings management, thereby mitigating agency problems associated with entrenchment and expropriation in family firms. We also find that managers of family firms are less aggressive in managing earnings via discretionary long-term accruals compared to non-family firms.

Gaze behavior among experts and trainees during optic disc examination : does how we look affect what we see?

Purpose. The authors compared the visual gaze behaviors of glaucoma subspecialists with those of ophthalmology trainees during optic disc and retinal nerve fiber layer (RNFL) examination.

Methods. Seven glaucoma subspecialists and 23 ophthalmology trainees participated in the project. Participants were shown eight glaucomatous optic disc images with varied morphology. Eye movements during examination of the optic disc photographs were tracked. For each disc image, graders were asked to assign a presumptive diagnosis for probability of glaucoma. There was no time restriction.

Results. Overall, trainees spent more time looking at disc images than glaucoma subspecialists (21.3 [13.9–37.7] vs. 16.6 [12.7–19.7]) seconds; median [interquartile range (IQR)], respectively; P < 0.01) and had no systematic patterns of gaze behavior, and gaze behavior was unaltered by disc morphology or topographic cues of pathology. Experienced viewers demonstrated more systematic and ordered gaze behavior patterns and spent longer times observing areas with the greatest likelihood of pathology (superior and inferior poles of the optic nerve head and adjacent RNFL) compared with the trainees. For discs with focal pathology, the proportion of total time spent examining definite areas of pathology was 28.9% (22.4%–33.6%) for glaucoma subspecialists and 13.5% (12.2%–19.2%) for trainees (median [IQR]; P < 0.05). Furthermore, experts adapted their viewing habits according to disc morphology.

Conclusions. Glaucoma subspecialists adopt systematic gaze behavior when examining the optic nerve and RNFL, whereas trainees do not. It remains to be elucidated whether incorporating systematic viewing behavior of the optic disc and RNFL into teaching programs for trainees may expedite their acquisition of accurate and efficient glaucoma diagnosis skills.

The demise of Bicycle George : a life of crime

This short piece looks at the life of a murderer, George Blunderfield (alias Arthur Oldring), who was hanged in Melbourne in 1918. Melburnians, or visitors to the city, may have seen his image on the wall at the Old Melbourne Gaol. Blunderfield's life started out normally
enough, and then descended into horrific crime. His story includes bicycle racing, escape from an island prison, and then recruitment for service with the Australian Imperial Forces in wartime Victoria. In the last years of his life, Blunderfield wreaked havoc from the western to the eastern coasts of Australia. This in turn had a dramatic effect on his immediate family, which is also detailed here. This story draws on the archives at PROV as well as on State Records Office of Western Australia material, with help from Ms Jean
Bellamy, a distant relative of George Blunderfield.

Gender differences in adolescent depression: Differential female susceptibility to stressors affecting family functioning

Objective: The aim of this study was to examine associations between family-based stressors and depressive symptoms in adolescents.

Method: Participants were 10-14 year olds who participated in a large Australian population study (n=6,552). Depressive symptoms and pubertal development were assessed using the self-report Short Mood and Feelings Questionnaire and the Pubertal Development Scale. Three indicators of stress exposure were examined-low emotional closeness to parents, residential and school transitions, and family conflict. The effect of gender, stress exposure and the interaction of gender and stress exposure on depressive symptoms was tested using multivariate logistic regression.

Results: High family conflict, residential instability and low emotional closeness with parents were independently associated with adolescent depressive symptoms. There was a significant gender by emotional closeness interaction; females reporting low emotional closeness to their parents were 2.3 times more likely to report high depressive symptoms than females reporting high emotional connections with parents.

Conclusions: Female adolescents may be more susceptible to particular types of stresses and particularly the quality of the parent-child relationship.