Enablers and barriers to accessing mental health services for adults with high prevalence psychological disorders in South West Victoria

Knowing what services are available and how to access them can be challenging in rural areas. The aim of the South West Mental Health Mapping project was to identify the level, accessibility and effectiveness of mental health services for high prevalence psychological disorders amongst the adult population in the South West region of Victoria. This study includes data from a number of sources: regional records of the number and location of health professionals; a telephone survey of 1297 people in five Local Government Areas in the region; and a social network analysis of contact points. Additional qualitative interviews and surveys were conducted with 25 service recipients and 37 health professionals to identify issues from different perspective. This paper will focus on the social network analysis of the project. It highlights the relative prominence of each type of service provider within the overall network. The social network map shows the centrality of the General Practitioner and the wide range of agencies that become involved in supporting people with mental health issues. The discussion identifies primary contact points for people seeking help and places of referral. The main barrier acknowledged by people requiring assistance was lack of knowledge about where to go for help. Enablers included Medicare Better Access funded schemes. The findings show that there is a reasonable range of mental health professionals across the region, although there are challenges with recruitment and retention of staff. Even with available services, a major problem is communicating this information to potential consumers

The influence of Sport Education on student motivation in physical education

Background: Physical educators are faced with trying to provide motivating and enjoyable experiences in physical education. Sport Education is an instructional model that aims to provide positive motivational sport experiences by simulating the features of authentic sport. Research support for Sport Education is positive, however, the effects on student motivation and the motivational climate are not well understood.

Purpose: To investigate the influence of the Sport Education model on student motivation (intrinsic/extrinsic motivation, goal orientations, and perceived motivational climate) in secondary physical education.

Setting: Six classes were selected according to teacher and class availability in the sports of soccer, hockey, and football codes in a co-educational government school.

Participants: Participants were 115 (male = 97, female = 18) Year-8 students (aged 13-14 years), in a Sport Education condition (n = 41) and a Traditional condition (n = 74).

Measures: At pre- and post-test, all participants completed three questionnaires: the Intrinsic Motivation Inventory, the Task and Ego Orientation in Sport Questionnaire, and the Perceived Motivational Climate in Sport Questionnaire.

Intervention: Participants completed either a Sport Education condition or a Traditional condition for one double period (100 minutes) one day per week for 10 weeks (Sport Education condition) or for five weeks (Traditional condition). The Sport Education condition incorporated six distinctive features: seasons, affiliation, formal competition, record keeping, festivity, and a culminating event. The Traditional condition used whole-group instruction led by the teacher.

Research design: The study used a non-equivalent control group design with pre- and post-test procedures. The independent variable was teaching condition and the dependent variable was student motivation (assessed by intrinsic motivation, goal orientations, and motivational climate). The groups were already established and selected for convenience purposes.

Data collection and analysis: Participants completed pre-test measures and then participated in their pre-established classes. Post-test measures were completed in the last class in each condition. A reliability analysis on measures was conducted using Cronach's alphas. A pre-test manipulation check was performed to check for any initial differences in motivation. To compare the difference in changes between conditions on motivation, a series of 2 times 2 repeated measures analyses of variance were conducted. A comparison of the relationship between motivation measures was conducted using Pearson's product moment correlation coefficients.

Findings: There was a significant difference between the conditions on changes in perceived competence, task orientation, and mastery climate, with the Traditional condition decreasing significantly from pre- to post-test compared with the Sport Education condition. There were no significant differences on interest/enjoyment, effort/importance, pressure/tension, ego orientation, or performance climate. A mastery climate was positively related to task orientation and intrinsic motivation and a performance climate was related to ego orientation.

Conclusions: The Sport Education condition was more successful in maintaining high levels of intrinsic motivation, task orientation, and mastery climate than the Traditional condition. That is, the Traditional condition was associated with a decrease in adaptive aspects of motivation for students, whereas the Sport Education condition maintained existing levels of motivation.

On the communal analysis suspicion scoring for identity crime in streaming credit applications

This paper describes a rapid technique: communal analysis suspicion scoring (CASS), for generating numeric suspicion scores on streaming credit applications based on implicit links to each other, over both time and space. CASS includes pair-wise communal scoring of identifier attributes for applications, definition of categories of suspiciousness for application-pairs, the incorporation of temporal and spatial weights, and smoothed k-wise scoring of multiple linked application-pairs. Results on mining several hundred thousand real credit applications demonstrate that CASS reduces false alarm rates while maintaining reasonable hit rates. CASS is scalable for this large data sample, and can rapidly detect early symptoms of identity crime. In addition, new insights have been observed from the relationships between applications.

Identification and characterisation of novel genes involved in skeletal muscle hypertrophy

There is mounting evidence in support of the view that skeletal muscle hypertrophy results from the complex and coordinated interaction of numerous signalling pathways. Well characterised components integral to skeletal muscle adaptation include the transcriptional activity of the members of the myogenic regulatory factors, numerous secreted peptide growth factors, and the regenerative potential of satellite cells. Whilst studies investigating isolated components or pathways have enhanced our current understanding of skeletal muscle hypertrophy, our knowledge of how all of these components react in concert to a common stimulus remains limited. The broad aim of this thesis was to identify and characterise novel genes involved in skeletal muscle hypertrophy. We have created a customised human skeletal muscle specific microarray which contains ∼11,000 cDNA clones derived from a normalised human skeletal muscle cDNA library as well as 270 genes with known functional roles in human skeletal muscle. The first aspect of this thesis describes the production of the microarray and evaluates the robustness and reproducibility of this analytical technique. Study one aimed to use this microarray in the identification of genes that are differentially expressed during the forced differentiation of human rhabdomyosarcoma cells, an in vitro model of skeletal muscle development. Firstly using this unique model of aberrant myogenic differentiation we aimed to identify genes with previously unidentified roles in myogenesis. Secondly, the data from this study permitted the examination of the performance of the microarray in detecting differential gene expression in a biological system. We identified several new genes with potential roles in the myogenic arrest of rhabdomyosarcoma and further characterised the expression of muscle specific genes in rhabdomyosarcoma differentiation. In study two, the molecular responses of cell cycle regulators, muscle regulatory factors, and atrophy related genes were mapped in response to a single bout of resistance exercise in human skeletal muscle. We demonstrated an increased expression of MyoD, myogenin and p21, whilst the expression of myostatin was decreased. The results of this study contribute to the existing body of knowledge on the molecular regulation skeletal muscle to a hypertrophic stimulus. In study three, the muscle samples collected in study two were analysed using the human skeletal muscle specific microarray for the identification of novel genes with potential roles in the hypertrophic process. The analysis uncovered four interesting genes (TXNIP, MLP, ASB5, FLJ 38973) that have not previously been examined in human skeletal muscle in response to resistance exercise. The functions of these genes and their potential roles in skeletal muscle are discussed. In study four, the four genes identified in study three were examined in human primary skeletal muscle cell cultures during myogenic differentiation. Human primary skeletal muscle cells were derived from the vastus lateralis muscle of 8 healthy volunteers (6 males and 2 females). Cell cultures were differentiated using serum withdrawal and serum withdrawal combined with IGF-1 supplementation. Markers of the cell proliferation, cell cycle arrest and myogenic differentiation were examined to assess the effectiveness of the differentiation stimulus. Additionally, the expressions of TXNIP, MLP, ASB5 and FLJ 38973 measured in an attempt to characterise further their roles in skeletal muscle. The expression of TXNIP changed markedly in response to both differentiation stimuli, whilst the expression of the remaining genes were not altered. Therefore it was suggested that expression of these genes might be responsive to the mechanical strain or contraction induced by the resistance exercise. In order to examine whether these novel genes responded specifically to resistance type exercise, their expression was examined following a single bout of endurance exercise. The expression of TXNIP, MLP, and FLJ 38973 remained unchanged whilst ASB5 increased 30 min following the cessation of the exercise.

Preventing weight and muscle concerns among preadolescents

The high level of weight and shape concerns amongst preadolescent children has prompted interest in the development of prevention programs for this age group. In the 1990s weight and shape concerns were considered primarily an adolescent phenomenon. However, prevention programs which have been designed with adolescent and adult populations have been found to show limited success. Some researchers have argued that programs which target preadolescent children are more likely to be effective than programs that target adolescents, as by adolescence many attitudes and behaviours have become entrenched so they may be more difficult to modify. On the other hand, children's weight and shape concerns are believed to be more malleable and amenable to change. To date there have been limited controlled studies implementing prevention programs designed to reduce weight and shape concerns with preadolescent populations. The new study conducted as part of this thesis involves the development and implementation of the ‘Everybody’ s Different, Nobody Else Is Me’ preadolescent prevention program. The program was designed to address some of the methodological biases of past research and incorporate three risk factors, social comparisons, negative affect, and self-esteem, to reduce and/or prevent the development of weight and muscle concerns among children. These three risk factors have been found to be associated with weight and shape concerns of adolescents and adults, and there is also increasing evidence that they are important factors among children. Research also suggests that social comparisons, negative affect, and self-esteem are interrelated, which highlights the importance of targeting the variables in one program. The new five session prevention initiative was implemented with 156 grade four children. Both the treatment and control conditions consisted of 78 children. Preliminary evidence from the new prevention initiative indicated that the program reduced muscle bulk and exercise (ie. An over-emphasis on exercise to lose weight rather than health promotion), and negative affect in the long term as assessed by the six month follow-up. At the six month follow-up, children in both the treatment and control conditions reported reduced negative affect, dieting, and muscle bulk and exercise scores and increased positive affect. Consistent with short term follow-up results, boys reported greater muscle bulk and exercise scores than girls at the six month follow-up. Girls, in both conditions, were also found to report greater positive affect than boys. These findings are discussed in relation to past research, and suggestions for future prevention initiatives are highlighted.

Optimising care for people with chronic disease : foreword

Chronic disease self-management emerged as an organised, formal entity in Australia in the 1980s, when a specific group-based program was introduced from the United States. This program, the Stanford Arthritis Self-Management Course, was promulgated in Australia and other countries by its creator, Professor Kate Lorig of Stanford University. The program showed much early promise, particularly with its dissemination and uptake by an enthusiastic non-government sector. Over subsequent years it has matured, and many other programs endeavouring to support patients to engage in self-management have been developed. In some ways, chronic disease self-management has become mainstream.1-3