Diagnosing postpartum depression in mothers and fathers : Whatever happened to anxiety?

Although anxiety disorders are documented in the literature for new mothers (but less so for fathers), rates of postpartum caseness tend to include only those with depression when diagnostic interviews or self-report measures validated on such interviews are used. This methodology therefore underestimates the true percentage of women and men who experience significant psychological difficulties postpartum. This has implications for assessment, treatment and screening for postnatal mood disorders. Two studies were conducted on a total of 408 women and 356 men expecting their first child. They were recruited antenatally, and interviewed at 6 weeks postpartum using the Diagnostic Interview Schedule. DSM-IV criteria were applied to determine the presence since birth of depression (major or minor), panic disorder, acute adjustment disorder with anxiety (meeting the criteria for generalised anxiety disorder except for the duration criterion), and phobia. The inclusion of diagnostic assessment for panic disorder and acute adjustment disorder with anxiety increased the rates of caseness by between 57 and 100% for mothers, and 31-130% for fathers, over the rates for major or minor depression. Inclusion of assessment for phobia further increased the rates of disorder in both samples.

The Alcohol Helplessness Scale and its prediction of depression among problem drinkers

Event-specific scales commonly have greater power than generalized scales in prediction of specific disorders and in testing mediator models for predicting such disorders. Therefore, in a preliminary study, a 6-item Alcohol Helplessness Scale was constructed and found to be reliable for a sample of 98 problem drinkers. Hierarchical multiple regression and its derivative path analysis were used to test whether helplessness and self-efficacy moderate or mediate the link between alcohol dependence and depression, A test of a moderation model was not supported, whereas a test of a mediation model was supported. Helplessness and self-efficacy both significantly and independently mediated between alcohol dependence and depression. Nevertheless, a significant direct effect of alcohol dependence on depression also remained.

Film Festivals

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Stakeholder impact analysis of infrastructure project management in developing countries : a study of perception of project managers in state-owned engineering firms in Vietnam

Construction projects can involve a diverse range of stakeholders and the success of the project depends very much on fulfilling their needs and expectations. It is important, therefore, to identify and recognize project stakeholders and develop a rigorous stakeholder management process. However, limited research has investigated the impact of stakeholders on construction projects in developing countries. A stakeholder impact analysis (SIA), based on an approach developed by Olander (2007), was adopted to investigate the stakeholders' impact on state-owned civil engineering projects in Vietnam. This involved the analysis of a questionnaire survey of 57 project managers to determine the relative importance of different stakeholders. The results show the client to have the highest level of impact on the projects, followed by project managers and the senior management of state-owned engineering firms. The SIA also provides suggestions to project managers in developing and evaluating the stakeholder management process.

Patterns of reporting to child protection services in Canada by healthcare and nonhealthcare professionals

Background: All Canadian jurisdictions require certain professionals to report suspected or observed child maltreatment. This study examined the types of maltreatment, level of harm and child functioning issues, controlling for family socioeconomic status, age and gender of the child reported by healthcare and non-healthcare professionals. Methods: We conducted chi-square analyses and logistic regression on a national child welfare sample from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) and compared the differences in professional reporting with its previous cycle (CIS-1998) using Bonferroni-corrected confidence intervals. Results: Our analysis of CIS-2003 data revealed that the majority of substantiated child maltreatment is reported to service agencies by non-healthcare professionals (57%), followed by non-professionals (33%) and healthcare professionals (10%). The number of professional reports increased 2.5 times between CIS-1998 and CIS-2003, while non-professionals’ increased 1.7 times. Of the total investigations, professional reports represented 59% in CIS-1998 and 67% in CIS-2003 (p<0.001). Compared to non-healthcare professionals, healthcare professionals more often reported younger children, children who experienced neglect and emotional maltreatment and those assessed as suffering harm and child functioning issues, but less often exposure to domestic violence. Conclusion: The results indicate that healthcare professionals played an important role in identifying children in need of protection considering harm and other child functioning issues. The authors discuss the reasons why underreporting is likely to remain an issue.

Relationship over time between psychological distress and physical activity in colorectal cancer survivors

Purpose Increased physical activity in colorectal cancer patients is related to improved recurrence free and overall survival. Psychological distress after cancer may place patients at risk of reduced physical activity; but paradoxically also act as a motivator for positive lifestyle change. The relationship between psychological distress and physical activity after cancer over time has not been described. Methods A prospective survey of 1966 (57% response) colorectal cancer survivors assessed the psychological distress variables of anxiety, depression, somatisation, cancer threat appraisal as predictors of physical activity five, 12, 24 and 36 months post-diagnosis 978 respondents had valid data for all time points. Results Higher somatisation was associated with greater physical inactivity (Relative risk ratio (RRR) =1.12; 95% CI=[1.1, 1.2]) and insufficient physical activity (RRR=1.05; [0.90, 1.0]). Respondents with a more positive appraisal of their cancer were significantly (p=0.031) less likely to be inactive (RRR=0.95; [0.90, 1.0]) or insufficiently active (RRR=0.96). Fatigued and obese respondents and current smokers were more inactive. Respondents whose somatisation increased between two time periods were less likely to increase their physical activity over the same period (p<0.001). Respondents with higher anxiety at one time period were less likely to have increased their activity at the next assessment (p=0.004). There was no association between depression and physical activity. Conclusions Cancer survivors who experience somatisation and anxiety are at greater risk of physical inactivity. The lack of a clear relationship between higher psychological distress and increasing physical activity argues against distress as a motivator to exercise in these patients.

The on-road difficulties of older drivers and their relationship with self-reported motor vehicle crashes

OBJECTIVES: To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes. DESIGN: Prospective cohort study. SETTING: On-road driving assessment. PARTICIPANTS: Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll. MEASUREMENTS: Performance on a standardized measure of driving performance. RESULTS: Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes; every instructor intervention almost doubled prospective crash risk. CONCLUSION: These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.

‘Capitalism’ as False Consciousness

The assertion on which this paper is based is that Capitalism has been superseded by Corporatism. I put forward an argument as to why Marxist scholars can and should abandon the idea that Capitalism still exists based on Marx’s approach to understanding political economy. Further, I argue that Marx’s method can be deployed to better understand and change the corporatist system in which we are currently living first by understanding what it means to be “labour” in a system governed by complex structures of debt.

Prevalence and determinants of sunburn in Queensland

Issue addressed: Australia records the highest incidence of skin cancer in the world. In response to this public education campaigns have incorporated messages about reducing sun exposure and avoiding sunburn. This study sought to describe the prevalence of and factors associated with sunburn in Queensland residents. Methods: The Queensland Cancer Risk Study was a population-based, cross-sectional survey of 9,298 respondents conducted via computer-assisted telephone interview during 2004. Sunburn prevalence and its association with sociodemographics and skin cancer risk variables were examined. Results: More than two-thirds (70.4%) of respondents reported at least one episode of sunburn in the past 12 months, and one in ten respondents reported at least one episode of sever sunburn in the past 12 months. Experiences of sunburn on two or more occasions were reported more frequently by males than females (57.6% versus 46.5%, p < 0.001), and by nearly two-thirds (65.8%) of those aged 20-39 years compared to 48.0% of 40-59 year olds, and 26.7% of 60-75 year olds (p < 0.001). Episodes of sunburn were strongly associated with being male (OR=2.20 95%CI 1.84-2.63) and being aged 20 to 39 years compared to 60 to 75 years (OR=9.79, 95%CI=7.66-12.50). Conclusions: Sunburn remains highly prevalent among Queensland residents particularly among men and in the younger age groups. So what? More effective strategies and methods may be required to extend the influence of health promotion campaigns.

Microbial risk from rainwater tanks in South East Queensland

Quantitative Microbial Risk Assessment (QMRA) analysis was used to quantify the risk of infection associated with the exposure to pathogens from potable and non-potable uses of roof-harvested rainwater in South East Queensland (SEQ). A total of 84 rainwater samples were analysed for the presence of faecal indicators (using culture based methods) and zoonotic bacterial and protozoan pathogens using binary and quantitative PCR (qPCR). The concentrations of Salmonella invA, and Giardia lamblia β-giradin genes ranged from 65-380 genomic units/1000 mL and 9-57 genomic units/1000 mL of water, respectively. After converting gene copies to cell/cyst number, the risk of infection from G. lamblia and Salmonella spp. associated with the use of rainwater for bi-weekly garden hosing was calculated to be below the threshold value of 1 extra infection per 10,000 persons per year. However, the estimated risk of infection from drinking the rainwater daily was 44-250 (for G. lamblia) and 85-520 (for Salmonella spp.) infections per 10,000 persons per year. Since this health risk seems higher than that expected from the reported incidences of gastroenteritis, the assumptions used to estimate these infection risks are critically discussed. Nevertheless, it would seem prudent to disinfect rainwater for potable use.

Making connections : creative industries networks in outer suburban locations

The role of networks and their contribution to sustaining and developing creative industries is well documented (Wittel 2001; Kong 2005; Pratt 2007). This article argues that although networks operate across geographical boundaries, particularly through the use of communication technologies, the majority of studies have focussed on the ways in which networks operate in a) specific inner-urban metropolitan regions or b) specific industries. Such studies are informed by the geographical mindset of creative city proponents such as Florida (2002) and Landry (2000) in which inner-urban precincts are seen as the prime location for creative industries activity, business development and opportunity. But what of those creative industries situated beyond the inner city? Evidence in Australia suggests there is increasing creative industries activity beyond the inner city, in outer-suburban and ex-urban areas (Gibson & Brennan-Horley 2006). This article identifies characteristics of creative industries networks in outer-suburban locations in Melbourne and Brisbane. It argues that supporting and sustaining creative industries networks in these locations may require different strategies than those applied to inner-city networks. The article thus contributes to the growing understanding of the cultural economic geography of creative industries.