Adaptive and maladaptive coping strategies predict posttrauma outcomes in ambulance personnel

Attending potentially dangerous and traumatic incidents is inherent in the role of emergency workers, yet there is a paucity of literature aimed at examining variables that impact on the outcomes of such exposure. Coping has been implicated in adjusting to trauma in other contexts, and this study explored the effectiveness of coping strategies in relation to positive and negative posttrauma outcomes in the emergency services environment. One hundred twenty-five paramedics completed a survey battery including the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), the Impact of Events Scale–Revised (IES-R; Weiss & Marmar, 1997), and the Revised-COPE (Zuckerman & Gagne, 2003). Results from the regression analysis demonstrated that specific coping strategies were differentially associated with positive and negative posttrauma outcomes. The research contributes to a more comprehensive understanding regarding the effectiveness of coping strategies employed by paramedics in managing trauma, with implications for their psychological well-being as well as the training and support services available.

Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma

Purpose: To examine the relationship between visual impairment and functional status in a community-dwelling sample of older adults with glaucoma. Methods: This study included 74 community-dwelling older adults with open-angle glaucoma (aged 74 ± 6 years). Assessment of central vision included high-contrast visual acuity and Pelli-Robson contrast sensitivity. Binocular integrated visual fields were derived from merged monocular Humphrey Field Analyser visual field plots. Functional status outcome measures included physical performance tests (6-min walk test, timed up and go test and lower limb strength), a physical activity questionnaire (Physical Activity Scale for the Elderly) and an overall functional status score. Correlation and linear regression analyses, adjusting for age and gender, examined the association between visual impairment and functional status outcomes. Results: Greater levels of visual impairment were significantly associated with lower levels of functional status among community-dwelling older adults with glaucoma, independent of age and gender. Specifically, lower levels of visual function were associated with slower timed up and go performance, weaker lower limb strength, lower self-reported physical activity, and lower overall functional status scores. Of the components of vision examined, the inferior visual field and contrast factors were the strongest predictors of these functional outcomes, whereas the superior visual field factor was not related to functional status. Conclusions: Greater visual impairment, particularly in the inferior visual field and loss of contrast sensitivity, was associated with poorer functional status among older adults with glaucoma. The findings of this study highlight the potential links between visual impairment and the onset of functional decline. Interventions which promote physical activity among older adults with glaucoma may assist in preventing functional decline, frailty and falls, and improve overall health and well-being.

Addressing sustainable living using a collaborative approach and multi-disciplinary techniques

In order to achieve meaningful reductions in individual ecological footprints, individuals must dramatically alter their day to day behaviours. Effective interventions will need to be evidence based and there is a necessity for the rapid transfer or communication of information from the point of research, into policy and practice. A number of health disciplines, including psychology and public health, share a common mission to promote health and well-being and it is becoming clear that the most practical pathway to achieving this mission is through interdisciplinary collaboration. This paper argues that an interdisciplinary collaborative approach will facilitate research that results in the rapid transfer of findings into policy and practice. The application of this approach is described in relation to the Green Living project which explored the psycho-social predictors of environmentally friendly behaviour. Following a qualitative pilot study, and in consultation with an expert panel comprising academics, industry professionals and government representatives, a self-administered mail survey was distributed to a random sample of 3000 residents of Brisbane and Moreton Bay (Queensland, Australia). The Green Living survey explored specific beliefs which included attitudes, norms, perceived control, intention and behaviour, as well as a number of other constructs such as environmental concern and altruism. This research has two beneficial outcomes. First, it will inform a practical model for predicting sustainable living behaviours and a number of local councils have already expressed an interest in making use of the results as part of their ongoing community engagement programs. Second, it provides an example of how a collaborative interdisciplinary project can provide a more comprehensive approach to research than can be accomplished by a single disciplinary project.

Gender influences on the work-related stress-coping process

The increasing incidence of occupational stress is recognized as a global phenomenon that is having a detrimental impact on both individuals and organizations. This study aims to identify whether men and women adopt different stress and coping processes when subjected to stress in a work context. A total of 258 workers of various professions (males = 106, females = 152) participated in the study. Results indicated that men and women differ in their stress and coping processes, forming two very distinct groups and adopting specific process models when encountering a stressful situation at work. Limitations and implications from this study are discussed.

The mediating effects of the time structure on the relationships between time management behaviour, job satisfaction and psychological wellbeing

This article examined the relationship between time structure and Macan's process model of time management. This study proposed that time structure—‘appraisal of effective time usage’—would be a more parsimonious mediator than perceived control over time in the relationship between time management behaviours and outcome variables, such as job satisfaction and psychological well-being. Alternative structure models were compared using a sample of 111 university students. Model 1 tested Macan's process model of time management with perceived control over time as the mediator. Model 2 replaced perceived control over time by the construct of time structure. Model 3 examined the possibility of perceived control over time and time structure as being parallel mediators of the relationships between time management and outcomes. Results of this study showed that Model 1 and Model 2 fitted the data equally well. On the other hand, the mediated effects were small and partial in both models. This pattern of results calls for reassessment of the process model.

Methodology for evaluating the landscape character of Malaysian heritage urban river corridors

The effects of rapid development have increased pressures on these places exacerbated by the competition between two key industry sectors, commercial base and tourism development. This, in supplement with urbanisation and industrialisation, has posted a high demand for the uses of these spaces. The political scenario and lack of adaptation on ecological principles and public participations in its design approach have sparked stiff environmental, historical and cultural constraint towards its landscape character as well as the ecological system. Therefore, a holistic approach towards improving the landscape design process is extremely necessary to protect human well being, cultural, environmental and historical values of these places. Limited research also has been carried out to overcome this situation. This further has created an urgent need to explore better ways to improve the landscape design process of Malaysian heritage urban river corridor developments that encompass the needs and aspirations of the Malaysian multi-ethnic society without making any drastic changes to the landscape character of the rivers. This paper presents a methodology to develop an advanced Landscape Character Assessment (aLCA) framework for evaluating the landscape character of the places, derived from the perception of two keys yet oppositional stakeholders: urban design team and special interest public. The triangulation of subjectivist paradigm methodologies: the psychophysical approach; the psychological approach; and, the phenomenological approach will be employed. The outcome will be used to improve the present landscape design process for future development of these places. Unless a range of perspectives can be brought to bear on enhancing the form and function of their future development and management, urban river corridors in the Malaysian context will continue to decline.

Communicating friendships : a case study of women in an Australian 'seachange' town

This thesis proposes =friendworks‘ as an important sub-group of social networks, comprised of networks of friends. It investigates friendworks of a particular group of adult Australian women as a way of understanding neglected aspects of social networking practices. Friendworks are contextualised to highlight two main themes of interest: population mobility and communication practices. The impact of relocation on individuals, local communities and the wider society is explored through a case study of female friendworks in a seachange community. Research findings point to the importance of friendworks in building and cohering social and emotional support, well-being, belonging and senses of place and community. Different types of communication methods were used by research participants for mediating different kinds of social ties within the friendworks considered here. Communication patterns were influenced by geographical proximity to friends, and the type of social support required of them (emotional, instrumental or companionship). Most findings were consistent with broader social patterns of communication. For example, face-to-face interactions were the dominant and most favoured communication method between local friends, regardless of whether they were weak or strong ties. The fixed-telephone and the internet were commonly in use to maintain old and geographically distant social ties, while mobile phones were used the least among friends in comparison with other communication methods. The key finding of this thesis is that friendworks are an extremely important solid network in contemporary society, providing mooring relations in a mobile world. Paradoxically, however, for women in this study, the mobile phone, which is popularly perceived as a flexible, multi-purpose communication technology for people on the move, was the least versatile of all technologies for maintaining friendworks. The cost of services was the main inhibitor here. The internet was found to be the most versatile communication technology and was used to support various types of social ties: strong, weak, local and distant. This thesis also highlights the value of the concept of friendworks as well as networks for communication research and policy investigating individuals‘ motivations and practices.

Maximum recovery after knee replacement - the MARKER study rationale and protocol

Background There is little scientific evidence to support the usual practice of providing outpatient rehabilitation to patients undergoing total knee replacement surgery (TKR) immediately after discharge from the orthopaedic ward. It is hypothesised that the lack of clinical benefit is due to the low exercise intensity tolerated at this time, with patients still recovering from the effects of major orthopaedic surgery. The aim of the proposed clinical trial is to investigate the clinical and cost effectiveness of a novel rehabilitation strategy, consisting of an initial home exercise programme followed, approximately six weeks later, by higher intensity outpatient exercise classes. Methods/Design In this multicentre randomised controlled trial, 600 patients undergoing primary TKR will be recruited at the orthopaedic pre-admission clinic of 10 large public and private hospitals in Australia. There will be no change to the medical or rehabilitative care usually provided while the participant is admitted to the orthopaedic ward. After TKR, but prior to discharge from the orthopaedic ward, participants will be randomised to either the novel rehabilitation strategy or usual rehabilitative care as provided by the hospital or recommended by the orthopaedic surgeon. Outcomes assessments will be conducted at baseline (pre-admission clinic) and at 6 weeks, 6 months and 12 months following randomisation. The primary outcomes will be self-reported knee pain and physical function. Secondary outcomes include quality of life and objective measures of physical performance. Health economic data (health sector and community service utilisation, loss of productivity) will be recorded prospectively by participants in a patient diary. This patient cohort will also be followed-up annually for five years for knee pain, physical function and the need or actual incidence of further joint replacement surgery. Discussion The results of this pragmatic clinical trial can be directly implemented into clinical practice. If beneficial, the novel rehabilitation strategy of utilising outpatient exercise classes during a later rehabilitation phase would provide a feasible and potentially cost-effective intervention to optimise the physical well-being of the large number of people undergoing TKR.

The psychological impact of industrial strikes: Does involvement in union activity during strikes make a difference?

The current study investigated the psychological impact of a United Steelworkers of America strike on the steelworkers involved, and the relationship between psychological well-being and individuals' levels of involvement in union activity during the strike. Three hundred and fifty-one steelworkers (302 `strikers' and 49 `non-strikers') completed surveys measuring a range of demographic and psychological well-being variables. Strikers, compared to non-strikers, reported higher levels of depression, anxiety, and irritation, and lower levels of mental health. For strikers, engaging in higher levels of union activity during the strike was associated with better psychological well-being. Jahoda's theory of deprivation during unemployment is used as the lens through which to explain some of the results, supporting the view that latent benefits associated with work are important for psychological well-being. A range of practical implications are offered for unions and their members.

Gifted young adolescents : voices of self

Despite the challenges that giftedness can add to self-formation during early adolescence, gifted young adolescents seldom are asked about their lives outside of counselling and educational contexts. The study considers the complexities that face gifted young adolescents in the process of self-discovery and self-representation, thereby building a case for seeking their own viewpoints. A guiding assumption for the study was that gifted young adolescents may respond positively to the opportunity to share their own perspectives and their own versions of “who they are”. The theoretical underpinnings for this study drew from Dialogical Self Theory. The study resides within an interactive view of self as a dynamic construction rather than a static state, where “who we are” is formed in everyday exchanges with self and others. Self-making as a process among gifted young adolescents is presented as an interactive network of “I” voices interpreted to reflect internal and external dialogue. In this way, self is understood within dialogical concepts of voices as multiple expressions. The study invited twelve gifted young adolescents to write freely about themselves over a six month period in an email journal project. Participants were recruited online and by word-of-mouth and they were able to negotiate their own levels of involvement. Access to the lives of individual young adolescents was sought in an out-of-school setting using narrative methods of personal writing in the form of journals sent as emails to the researcher. The role of the researcher was to act as a supportive listener who responded to participant-led emails and thereby facilitated the process of authoring that occurred across the data-gathering phase. The listening process involved responses that were affirming and designed to build trust. Data in the form of email texts were analysed using a close listening method that uncovered patterns of voices that were explicitly or subtly expressed by participants. The interpretation of voices highlighted the tensions and contradictions involved in the process of participants forming a “self” that emerged as multiple “I” voices. There were three key findings of the study. First, the gifted young adolescent participants each constructed a self around four key voices of Author, Achiever, Resistor/Co-operator and Self-Innovator. These voices were dialogical selfconstructions that showed multiplicity as a normal way of being. Second, the selfmaking processes of the gifted young adolescent participants were guided by a hierarchy of voices that were directed through self-awareness. Third, authoring in association with a responsive adult listener emerged as a dialogic space for promoting self-awareness and a language of self-expression among gifted young adolescents. The findings of the study contribute to knowledge about gifted young adolescents by presenting their own versions of “who” they are, perspectives that might differ from mainstream perceptions. Participants were shown to have highly diverse, complex and individual expressions that have implications for how well they are understood and supported by others. The use of email journals helped to create a synergy for self-disclosure and a safe space for self-expression where participants’ abilities to be themselves were encouraged. Increased self-awareness and selfknowledge among gifted young adolescents is vital to their self-formation and their management of self and others’ expectations. This study makes an original contribution to the field of self-study by highlighting the processes and complexities of young adolescents’ self-constructions. Through the innovative use of narrative methods and an inter-disciplinary approach, the voices of gifted young adolescents were privileged. At a practical level, the study can inform educators, policy-makers, parents and all those who seek to contribute to the well-being of gifted young adolescents.

An examination of the relationships between lifestyle factors and mental health among Australian midlife and older women

Background It is well known that lifestyle factors including overweight/obesity, physical inactivity, smoking and alcohol use are largely related with morbidity and mortality of chronic diseases including diabetes and cardiovascular diseases. The effect of lifestyle factors on people’s mental health who have a chronic disease is less defined in the research. The World Health Organisation has defined health as “a state of complete physical, mental and social well-being”. It is important, therefore to develop an understanding of the relationships between lifestyle and mental health as this may have implications for maximising the efficacy of health promotion in people with chronic diseases. Objectives The overall aim of the research was to examine the relationships between lifestyle factors and mental health among Australian midlife and older women. Methodology The current research measured four lifestyle factors including weight status, physical activity, smoking and alcohol use. Three interconnecting studies were undertaken to develop a comprehensive understanding of the relationships between lifestyle factors and mental health. Study 1 investigated the longitudinal effect of lifestyle factors on mental health by using midlife and older women randomly selected from the community. Study 2 adopted a cross-sectional design, and compared the effect of lifestyle factors on mental health between midlife and older women with and without diabetes. Study 3 examined the mediating effect of self-efficacy in the relationships between lifestyle factors and mental health among midlife and older women with diabetes. A questionnaire survey was chosen as the means to gather information, and multiple linear regression analysis was conducted as the primary statistical approach. Results The research showed that the four lifestyle factors including weight status, physical activity, smoking and alcohol use did impact on mental health among Australian midlife and older women. First, women with a higher BMI had lower levels of mental health than women with normal weight, but as women age, the mental health of women who were overweight and obese becomes better than that of women with normal weight. Second, women who were physically active had higher levels of mental health than those who were not. Third, smoking adversely impacted on women’s mental health. Finally, those who were past-drinkers had less anxiety symptoms than women who were non-drinkers as they age. Women with diabetes appeared to have lower levels of mental health compared to women without. However, the disparities of mental health between two groups were confounded by low levels of physical activity and co-morbidities. This finding underlines the effect of physical activity on women’s mental health, and highlights the potential of reducing the gap of mental health by promoting physical activity. In addition, self-efficacy was shown to be the mediator of the relationships between BMI, physical activity and depression, suggesting that enhancing people’s self-efficacy may be useful for mental health improvement. Conclusions In conclusion, Australian midlife and older women who live with a healthier lifestyle have higher levels of mental health. It is suggested that strategies aiming to improve people’s mental health may be more effective if they focus on enhancing people’s self-efficacy levels. This study has implications to both health education and policy development. It indicates that health professionals may need to consider clients’ mental health as an integrated part of lifestyle changing process. Furthermore, given that lifestyle factors impact on both physical and mental health, lifestyle modification should continue to be the focus of policy development.

Start playing with your food : fun food experiences with mobile social media

Healthy and sustainable food is gaining more attention from consumers, industry, and researchers. Yet many approaches to date are limited to information dissemination, advertisement or education. We have embarked on a three year collaborative research project (2011 – 2013) to explore urban food practices – eating, cooking, growing food – to support the well-being of people and the environment. Our overall goal is to employ a user-centred interaction design research approach to inform the development of entertaining, real-time, mobile and networked applications, engaging playful feedback to build motivation. Our aspiration for this study is to deliver usable and useful mobile and situated interaction prototypes that employ individual and group strategies to foster food cultures that provide new pathways to produce, share and enjoy food that is green, healthy, and fun.

‘I can’t get no satisfaction’...or can I? A study of satisfaction with financial planning and client wellbeing

This paper reports findings from an ongoing collaborative research project with the Financial Services Council (FSC), which contributed funding and facilitated the survey of financial planners’ clients through FSC member organisations. The article draws on the report to the FSC that was prepared by the QUT researchers, reporting findings on the initial exploratory stage of the project.1 The lyric in the title of this paper has become a catchcry for consumers dissatisfied with a range of financial services and products, and, as recent Federal Government inquiries have revealed, there is some truth to the claim. But as financial planning undergoes a series of reforms, including increased professionalism (FPA 2009) and improved quality of advice (Australian Government 2011), there are good reasons to explore the conditions under which clients report satisfaction with their financial planners; not least because the provision of effective financial planning and advice, delivered in accordance with, or transcending, the rules and norms of industry best-practice has the potential to benefit clients, not just financially, but across a number of life domains. In this paper, we report findings from an exploratory study investigating whether financial planning and advice contribute to client well-being, beyond effects on financial well-being. While anecdotal evidence supports psychological benefits such as a sense of security, little research has explored these links in any systematic or theoretically driven way. However, theory and research from cognate disciplines, such as psychology, indicate clear links between planning, goal setting and well-being that are likely to arise in the financial planning domain. Surveyed clients were asked to indicate their satisfaction with their financial advisers, the planning process and the advice they received. Clients responded to items designed to reflect key areas for financial planners in the shift towards increased professionalism, improved disclosure and greater client focus (e.g. FPA 2009). Clients also reflected on their financial situations before and after seeing their advisers, and considered the impact of their financial situations on a number of life areas including family relationships, mental health and well-being, and overall life satisfaction.

Supportive-expressive group therapy for women with metastatic breast cancer: Improving access for Australian women through use of teleconference

While supportive-expressive group therapy (SEGT) has been found to be effective in significantly reducing distress associated with life-threatening illness, the challenge in Australia is to develop a means of providing supportive interventions to rural women who may be isolated both by the experience of illness and by geographical location. In this study an adaptation of SEGT was provided to women with metastatic breast cancer (n =21), who attended face-to-face or by telephone conference call. Participants showed significant gains on standardised measures of well-being, including a reduction in negative affect and an increase in positive affect, over a 12-month period. A reduction in intrusive and avoidant stress symptoms was also observed over 12 months; however, this difference was not significant. These outcomes suggest that SEGT, delivered in an innovative way within a community setting, may be an effective means of moderating the adverse effects of a diagnosis of metastatic breast cancer while improving access to supportive care for rural women. These results are considered exploratory, as the study did not include a matched control group.

An exercise intervention for women undergoing chemotherapy for ovarian cancer : feasibility and preliminary outcomes

Exercise interventions during adjuvant cancer treatment have been shown to increase functional capacity, relieve fatigue and distress and in one recent study, assist chemotherapy completion. These studies have been limited to breast, prostate or mixed cancer groups and it is not yet known if a similar intervention is even feasible among women diagnosed with ovarian cancer. Women undergoing treatment for ovarian cancer commonly have extensive pelvic surgery followed by high intensity chemotherapy. It is hypothesized that women with ovarian cancer may benefit most from a customised exercise intervention during chemotherapy treatment. This could reduce the number and severity of chemotherapy-related side-effects and optimize treatment adherence. Hence, the aim of the research was to assess feasibility and acceptability of a walking intervention in women with ovarian cancer whilst undergoing chemotherapy, as well as pre-post intervention changes in a range of physical and psychological outcomes. Newly diagnosed women with ovarian cancer were recruited from the Royal Brisbane and Women’s Hospital (RBWH), to participate in a walking program throughout chemotherapy. The study used a one group pre- post-intervention test design. Baseline (conducted following surgery but prior to the first or second chemotherapy cycles) and follow-up (conducted three weeks after the last chemotherapy dose was received) assessments were performed. To accommodate changes in side-effects associated with treatment, specific weekly walking targets with respect to frequency, intensity and duration, were individualised for each participant. To assess feasibility, adherence and compliance with prescribed walking sessions, withdrawals and adverse events were recorded. Physical and psychological outcomes assessed included functional capacity, body composition, anxiety and depression, symptoms experienced during treatment and quality of life. Chemotherapy completion data was also documented and self-reported program helpfulness was assessed using a questionnaire post intervention. Forty-two women were invited to participate. Nine women were recruited, all of whom completed the program. There were no adverse events associated with participating in the intervention and all women reported that the walking program was helpful during their neo-adjuvant or adjuvant chemotherapy treatment. Adherence and compliance to the walking prescription was high. On average, women achieved at least two of their three individual weekly prescription targets 83% of the time (range 42% to 94%). Positive changes were found in functional capacity and quality of life, in addition to reductions in the number and intensity of treatment-associated symptoms over the course of the intervention period. Functional capacity increased for all nine women from baseline to follow-up assessment, with improvements ranging from 10% to 51%. Quality of life improvements were also noted, especially in the physical well-being scale (baseline: median 18; follow-up: median 23). Treatment symptoms reduced in presence and severity, specifically, in constipation, pain and fatigue, post intervention. These positive yet preliminary results suggest that a walking intervention for women receiving chemotherapy for ovarian cancer is safe, feasible and acceptable. Importantly, women perceived the program to be helpful and rewarding, despite being conducted during a time typically associated with elevated distress and treatment symptoms that are often severe enough to alter or cease chemotherapy prescription.