Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults : a review

Time spent in non-occupational sedentary behaviours (particularly television viewing time) is associated with excess adiposity and an increased risk of metabolic disorders among adults; however, there are no reviews of the validity and reliability of assessing these behaviours. This paper aims to document measures used to assess adults' time spent in leisure-time sedentary behaviours and to review the evidence on their reliability and validity. Medline, CINAHL and Psych INFO databases and reference lists from published papers were searched to identify studies in which leisure-time sedentary behaviours had been measured in adults. Sixty papers reporting measurement of at least one type of leisure-time sedentary behaviour were identified. Television viewing time was the most commonly measured sedentary behaviour. The main method of data collection was by questionnaire. Nine studies examined reliability and three examined validity for the questionnaire method of data collection. Test–retest reliabilities were predominantly moderate to high, but the validity studies reported large differences in correlations of self-completion questionnaire data with the various referent measures used. To strengthen future epidemiological and health behaviour studies, the development of reliable and valid self-report instruments that cover the full range of leisure-time sedentary behaviour is a priority.

Sedentary lifestyle as a risk factor for low back pain : a systematic review

Objectives To review systematically studies examining the association between sedentary lifestyle and low back pain (LBP) using a comprehensive definition of sedentary behaviour including prolonged sitting both at work and during leisure time.

Methods Journal articles published between 1998 and 2006 were obtained by searching computerized bibliographical databases. Quality assessment of studies employing a cohort or case–control design was performed to assess the strength of the evidence.

Results Using pre-determined keywords, we identified 1,778 titles of which 1,391 were considered irrelevant. Then, 20 of the remaining 387 publications were scrutinized for full review after an examination of all the 387 abstracts. Finally, 15 studies (10 prospective cohorts and 5 case–controls) were included in the methodological quality assessment, of which 8 (6 cohorts and 2 case–controls; 53%) were classified as high-quality studies. One high-quality cohort study reported a positive association, between LBP and sitting at work only; all other studies reported no significant associations. Hence, there was limited evidence to demonstrate that sedentary behaviour is a risk factor for developing LBP.

Conclusions The present review confirms that sedentary lifestyle by itself is not associated with LBP.

A conditional probability approach to risk assessment for child sexual offenders with different classes of victim

Specific scales were developed for discriminating child sexual offenders with different classes of victim. The project demonstrates a method of individualising scores on actuarial risk assessment measured in a way that makes them more meaningful for those involved in decision-making about individual child sexual offenders. At present, the only quantifiable approach to specific decision-making relies on a general prediction of future behaviour, based on group data. The Bayesian approach is one method that can be used to assist decision-makers to use this information in ways that lead to the more appropriate management of risk. Ultimately, the better management of known child sexual offenders will lead to fewer offences and a reduction in the number of children who lives are profoundly affected by sexual victimisation.

Changing violent behaviour : forensic mental health and criminological models compared

Evidence-based interventions designed to reduce the risk of re-offending, particularly violent re-offending, are commonly offered in correctional systems around the world. The interventions are often based upon the application of several principles of service delivery that have become widely known as the 'what works' approach to offender rehabilitation. The applicability of these principles to forensic psychiatric services has yet to be determined. The aims are to examine the possible application of the 'what works' approach and its implications for forensic mental health practice. The method used was a review of relevant research from both the general offender and forensic psychiatry literature. The principles underlying the 'what works' approach are likely to have utility in service delivery in forensic psychiatry, particularly when a treatment target is a reduction in risk of harm to others. The individualized models of patient care practiced in forensic psychiatry are also likely to have utility in improving treatment outcomes in correctional settings. The conclusion is that an increased interchange of ideas and interventions between the two areas of practice is likely to be of mutual benefit. This is an area that requires significant development.

An ABC approach to assessing the risk of violence at triage

There is evidence to suggest that the incidence of violent behaviour in the emergency department by patients toward staff is on the rise. As part of the process of determining urgency, triage nurses must assess the risk of violence at point of entry. The risk of violence, that is, behaviour that either involves a threat of physical or psychological harm to one's self or to others, is considered a critical predictor of urgency in mental health triage. A rapid violence risk assessment strategy will be described which can be utilised in emergency department triage.

Education or regulation : managing behaviour change in the AFL

Amid the increasing commodification of sports, the off-field practices of elite performers are the source of considerable public scrutiny. Barely a week goes by when we do not hear about elite male sports stars behaving badly. Of course, when elite sportsman behave badly they not only tarnish their own reputations, they bring disrepute to their club and sport. To this end, there is a growing industry awareness of the need to manage and develop professional sporting identities via a variety of education and training processes.

This paper reports on research undertaken into the professional development activities of AFL footballers, and how they are organised, supported and practiced. Drawing on extensive interview data, the research reveals a number of tensions and contradictions between the aspirations of different players, their coaches and mentors, and a range of competing industry practices and processes. In the paper we explore the possibilities for modifying behaviours and attitudes via risk management practices that centre on the provision of compulsory educational seminars and workshops. Drawing on Foucault's later work on the care of the Self we focus on the ways in which new expectations of a professional footballing identity are being constructed and managed.

Longitudinal evaluation of a risk-factor model for adolescent suicidality

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

Prevention of body concerns and risk behaviours in adolescent boys

Overall, this thesis was designed to explore the nature of adolescent boys' body image, the effects of body image on body change strategies and psychological adjustment, and the factors that influence body image. The first study examined body image in 362 adolescent boys. Body image was considered in terms of attitudes to different body parts and attributes, including, lower, middle and upper body, as well as weight, shape and muscles. The relationships between Body Mass Index (BMI), body image, sociocultural messages, psychological adjustment and body change strategies, including strategies to decrease weight and increase muscles using food and exercise, drive for thinness, bulimic attitudes and behaviour, excessive exercise, food supplements to lose weight, increase muscles and steroids, were also investigated. Multiple regression analyses were used to examine the role of body image, sociocultural messages and psychological adjustment to predict satisfaction with different body attributes and body change strategies. The findings from study one led to the development of a program aimed at preventing the development of unhealthy attitudes and behaviours among adolescent boys. Study two involved the implementation and evaluation of this prevention program. One hundred and twenty one boys participated in the program. The program was based on social-cognitive theory, and included a focus on accepting differences and the development of self-esteem. The boys who participated in the program indicated some change in existing attitudes and showed less development of risk behaviours relative to the control group. The implications of the findings from this thesis in relation to future research, as well as the prevention of adolescent boys' body image problems are discussed.

Contextual influences on femoral injecting behaviour in the UK Randomised Injectable Opiate Treatment Trial

Femoral injecting amongst participants of the Randomised Injectable Opiate Treatment Trial (RIOTT) has created a number of procedural, ethical and medical dilemmas for staff, clients and researchers. This study investigated the effect on femoral injecting behaviour of a drug consumption room (DCR) in the context of the RIOTT currently being conducted at the Maudsley Hospital, South London. It uses in-depth qualitative interviews with 10 RIOTT clients to investigate the effects of this environmental intervention on the injecting behaviour of individuals who injected femorally upon treatment entry. Interviewees were selected on the basis of membership in one of four groups: 1) never injected femorally, 2) injected femorally prior to trial and have ceased completely, 3) injected femorally prior to trial and have ceased within the DCR, and 4) have continued to inject femorally the inside and outside clinical settings. The paper uses case studies and clinical protocols to interpret changes in behaviour in injecting behaviour in regards to the goals of treatment. Preliminary results indicate that there are major advantages and disadvantages associated with femoral injecting. The most commonly reported reason for commencing femoral injecting was a lack of other viable veins and interviewee narratives illustrate how this issue use addressed within the context of the DCR. Within this setting, the paper explores the boundaries of harm reduction in the context of a traditional 'risk boundary' within the 'ideal' risk environment. Other issues explored include: gender differences in femoral injecting episodes, femoral injecting as a risk boundary and the importance of time pressures as a major predictor of choosing to inject femorally.

Media reports of heroin overdose spates: public health messages, moral panics or risk advertisements?

This article reports on an investigation of the public health utility of media messages concerning spates (temporal clusters) of heroin-related overdose (HOD) from the perspective of some injecting drug users (IDUs). In-depth qualitative interviews were carried out with a convenience sample of 60 IDUs, in the setting of two Needle and Syringe Programs in an Australian regional city (Geelong) between April and May 2000. Very few interviewees reported that they had personally experienced a spate of overdoses. None of the interviewees reported communicating the existence of a killer batch to other IDUs. No interviewees reported having changed either their injecting practices or the amount of heroin they used following such a media alert. Indeed, a substantial minority of the interviewees reported seeking out these stronger batches and participant narratives illustrate that, for a substantial group of interviewees, the media reporting of a hypothetical 'killer batch' of heroin may have implications for their drug-seeking and health-related behaviour. It was found that the accuracy of information available to IDUs is mixed and that the flow of information within this social network was slow. Findings demonstrate that media reporting of killer batches of heroin has little value as a public health strategy and provide an example of how some activities that are proposed as public health measures may in fact have the opposite effect.

Scapegoating, self-confidence and risk comparison : the functionality of risk neutralisation and lay epidemiology by injecting drug users

This paper investigates the competing rationalities of scientific and lay epidemiology and how the tension between the two impacts on the efficacy of health promotion messages for injecting drug users (IDUs). It proposes that behaviours, which may be difficult to understand when viewed at an individual level, are, in fact, rational within particular cultural contexts. The study used qualitative semi-structured interviews with 60 heroin users. A number of different types of risk neutralisation were observed in this group of interviewees, including: scapegoating, self-confidence and risk comparison. Interviewees commonly used lay epidemiology to justify and rationalise their risk neutralisation strategies. The paper provides concrete examples of the ways in which this group of IDUs neutralise risk through the use of these strategies. The findings illustrate how many of the psychological constructs surrounding the perception of risk which focus on individual behaviour are fundamentally simplistic and often unhelpful in understanding the behaviours of this group of people. It is concluded that some ‘risk’ behaviours are often functional and rational within the context of prohibitionist drug policies which create an environment in which the IDU often has little real agency to reduce the risks associated with their drug use.

Investigation of the interaction between risk types in the outsourcing of the information technology function

Describes a new theory of behaviour of risks in an information technology (IT) outsourcing exercise. A framework developed during the study allows practioners and managers to allay anxieties about managing uncertainty from risks that manifest when multiple parties interact over long periods of time in this environment.

Risk perception, risk communication and message framing : breast cancer and family history

Examines the relationships between risk perception, risk communication, and health protective behaviour in relation to breast cancer and family history. Qualitative research was conducted to develop a printed community resource. Theoretical and practical implications for health behaviour theory and risk communication are identified.

The seraphim profile of Australia's business angels : a survey of the identifying characteristics, behaviour patterns and investment criteria of informal venture capitalists in Australia

In Australia, as it is all over the world, finding and acquiring equity capital is one of the major problems facing entrepreneurs who are starting or growing entrepreneurial ventures. The informal venture capital market, made up of high net worth non-institutional private equity investors (or 'business Angels') provides risk capital directly to new and growing businesses and has been shown to be considerably more significant than institutional providers as a source of finance for entrepreneurial businesses. Building upon and comporting with Angel research undertaken overseas, this study generated and evaluated data resulting from an investigation of Australian business Angels which focused upon three primary research questions: (i) Who are Australia's Informal Venture Capitalists (Business Angels)? (ii) How do they behave? (iii) What are their investment criteria? Analysis of answers resulting from the in-depth survey of 36 carefully screened respondents produced a detailed portrait, summarised and depicted in twelve key graphs. Together, the graphs form a descriptive construct - the 'Seraphim Profile' - which articulates Australian business Angels' identifying characteristics, patterns of investment behaviour and investment criteria.

Diabetes risk reduction behaviours of rural postpartum women with a recent history of gestational diabetes

Introduction: For most women, gestational diabetes is temporary; however, an episode of gestational diabetes mellitus (GDM) confers an approximately seven-fold increased risk of developing type 2 diabetes mellitus. Objective: To examine readiness to adopt diabetes risk reduction behaviours and the prevalence of these behaviours among rural women with GDM during their last pregnancy.
Methods: The study design was a self-administered mailed questionnaire seeking information about demographics, stage of change, physical activity level and dietary fat intake. Setting: Regional outpatient context. Participants: Women with a single episode of GDM between 1 July 2001 and 31 December 2005 (n = 210). Main outcome measures: Stage of change for physical activity, weight loss and reducing dietary fat behaviour; meeting activity targets, body mass index (BMI) and dietary fat score.
Results: Eighty-four women returned completed questionnaires (40% response rate). Of the 77 women eligible (mean age 35 ± 3.8 years), 58% met recommended activity targets. Sixty-three percent of women were overweight or obese: mean BMI 29.6 kg/m2 (± 7.30). Women reported a high level of preparedness to engage in physical activity, weight loss and reduction of fat intake. Thirty-nine percent of women had not had any postpartum follow-up glucose screening. Women who remembered receiving diabetes prevention information were significantly more likely to meet physical activity targets (p<0.05).
Conclusions: Readiness to engage in behaviour change was high among this group of rural women for all three diabetes risk reduction behaviours measured. However, despite a high proportion of women meeting activity targets and reducing fat intake, the majority of women remained overweight or obese. Postpartum follow-up glucose testing needs to be improved and the impact of diabetes prevention information provided during pregnancy warrants further study.