Environmental art and the production of publics : responding to environmental change

Environmental crises around the world have inspired an outpour of creative response. As the effects of climate change increasingly manifest, environmental! art is being politically and pedagogically mobilised for ameliorative strategies. The rubric that instrumentalist, techno-scientific approaches to environmental stress (and attendant social distress) cannot solely provide solutions to this challenge has found increasing acceptance. The concern of this paper, however, is the limited understanding of public art's capacity that is perpetuated bv certain trends in environmental art in which the work is charged with communicative responsibility,. Connected to the representational and instructive traditions of public art, this tendency is further informed by the influence of the 'information-deficit model' in environmental conmunication research: a concept that asserts a straightforward connection between information provision, indiyidual awareness and collective action on a concern. The idea that public art can function as a conduit for knowledge,.which in turn will inspire new moral positions and behaviours, absents the art work from the process of knowledge-making and the production of conditons that enable new practice. Arguing for a revised approach to the environmental possibilities of public art, this paper will propose that in thinking aboutl environmental transformation as essentially unrepresentable, a dfferent mode of public engagement with the issue is enabled.

Fighting with fire : how bushfire suppression can impact on fire fighters' health

Background: Each year bushfire threatens Australia’s rural, forest, and urban-rural areas. Australia’s rural fire fighters work to curtail this threat in hot, smoky conditions, often at risk to their physical health. General practitioners, especially in rural areas, can help preserve the health of fire fighters during the fire season by understanding the stressors they face on the fireground.

Objective: This article outlines how the key fireground stressors of work intensity and duration, heat (from the weather, the fire, and the fire fighter’s own exertion) and smoke impact on the health of fire fighters. Practical advice for GPs treating Australia’s rural fire fighters is also included.

Discussion: General practitioners can help preserve fire fighters' health during bushfire suppression in a number of ways, including: identifying fire fighters at risk of cardiac distress during physical labour and educating them about the early warning signs; advocating regular exercise; discouraging smoking; and promoting the benefits of maintaining fluid, carbohydrate, and electrolyte levels during a shift.

Pictorial cues and sexual desire : an experimental approach

The cognitive processing of sexual and non-sexual pictorial stimuli was examined to see whether picture rating and recognition tasks have potential utility as a means of assessing levels of sexual desire. Previous research has revealed slower responding to sexual compared to neutral semantic cues in persons with lower self-reported sexual desire. The present study investigated whether sexual pictorial cues evoked a similarly slower responding in people reporting low sexual desire compared to other individuals. A total of 136 participants completed two self-report measures of sexual desire (the Hurlbert Index of Sexual Desire and the Sexual Desire Inventory) before carrying out tasks involving affective ratings and recognition memory for pictorial stimuli. Participants were classified into relatively low, average, and higher groups on the basis of their scores on the desire measures. The stimuli were selected from the International Affective Picture System, and the tasks included (1) rating the valence, arousal, and sense of dominance or control for each picture, (2) recognition of previously seen images, and (3) a second rating of pictures viewed earlier. Level of sexual desire did not influence responding in the male participants. Female participants with lower sexual desire rated sexual images less pleasant and less arousing than the other participants, and completed picture recognition tasks more quickly. Sexual desire levels significantly influenced the interest ratings women gave to sexual pictures. We also found sexual content induced delays. These delays were not significantly different among desire groups. The variation in responding linked to levels of sexual desire in women suggests that more investigation of this methodology in a clinically diagnosed population might contribute to an understanding of low desire, and help design interventions addressing distress due to lack of sexual desire.

What can prevalence studies tell us about female sexual difficulty and dysfunction?

Introduction. Many recent studies have investigated the prevalence of female sexual difficulty/dysfunction.
Aim. Investigate female sexual difficulty/dysfunction using data from prevalence studies.
Methods. We reviewed published prevalence studies excluding those that had not included each category of sexual difficulty (desire, arousal, orgasm, and pain), were based on convenience sampling, or had a response rate <50% or a sample size <100.
Main Outcome Measures. For each study we used the prevalence of any sexual difficulty as the denominator and calculated the proportion of women reporting each type of difficulty. For each category of sexual difficulty we used the prevalence of that difficulty lasting 1 month or more as the denominator and calculated the proportion of difficulties lasting several months or more and 6 months or more.
Results. Only 11 of 1,248 studies identified met our inclusion criteria. These studies used different measures of sexual dysfunction, so generating a simple summary prevalence was not possible. However, we observed consistent patterns in the published data. Among women with any sexual difficulty, on average, 64% (range 16–75%) experienced desire difficulty, 35% (range 16– 48%) experienced orgasm difficulty, 31% (range 12–64%) experienced arousal difficulty, and 26% (range 7–58%) experienced sexual pain. Of the sexual difficulties that occurred for 1 month or more in the previous year, 62–89% persisted for at least several months and 25–28% persisted for 6 months or more. Two studies investigated distress. Only a proportion of women with sexual difficulty were distressed by it (21–67%).
Conclusions. Desire difficulty is the most common sexual difficulty experienced by women. While the majority of difficulties last for less than 6 months, up to a third persist for 6 months or more. Sexual difficulties do not always cause distress. Consequently, prevalence estimates will vary depending on the time frame specified by researchers and whether distress is included in these estimates.

Relationship between hypoactive sexual desire disorder and aging

Objective: Explore the association between Hypoactive Sexual Desire Disorder (HSDD) and aging. The American Foundation of Urologic Disease and the American Psychiatric Association stipulate that HSDD is only diagnosed when both low sexual desire and sexually related personal distress are present.
Design : Community-based, cross-sectional study.
Setting : Europe (UK, Germany, France, Italy) and the USA.
Patient(s) Women aged 20-70 in sexual relationships participating in the Women’s International Study of Health and Sexuality (n=1998 Europe, n=1591 USA).
Intervention(s) : No interventions were administered.
Main Outcome Measures : Self-administered questionnaire that included two validated instruments: Profile of Female Sexual Function© measured sexual desire; Personal Distress Scale© measured sexual distress. Women with low desire and distress were considered to have HSDD.
Results : The proportion of European women with low desire increased from 11% amongst women aged 20-29 years to 53% amongst women aged 60-70 years. The proportion of American women with low desire displayed a trend towards an increase with age. In the 20-29 year age group 65% of European women and 67% of American women with low sexual desire were distressed by it. This decreased to 22% and 37%, respectively, in the 60-70 year age group. In Europe and the USA the prevalence of HSDD in the population did not change significantly with age (6-13% in Europe, 12-19% in the USA).
Conclusions: The proportion of women with low desire increased with age while the proportion of women distressed about their low desire decreased with age. Consequently, the prevalence of HSDD remained essentially constant with age. This may explain why no association between HSDD and age is often reported in the literature.

What is the "true" prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact?

Introduction. A wide range of prevalence estimates of female sexual dysfunctions (FSD) have been reported.
Aim. Compare instruments used to assess FSD to determine if differences between instruments contribute to variation in reported prevalence.
Main Outcome Measures. Sexual Function Questionnaire combined with Female Sexual Distress Scale (SFQ-FSDS) was our gold standard, validated instrument for assessing FSD. Alternatives were SFQ alone and two sets of simple questions adapted from Laumann et al. 1994.
Methods. A postal survey was administered to a random sample of 356 Australian women aged 20 to 70 years.
Results. When assessed by SFQ-FSDS, prevalence estimates (95% confidence intervals) of hypoactive sexual desire disorder, sexual arousal disorder (lubrication), orgasmic disorder, and dyspareunia were 16% (12% to 20%), 7% (5% to 11%), 8% (6% to 12%), and 1% (0.5% to 3%), respectively. Prevalence estimates varied across alternative instruments for these disorders: 32% to 58%, 16% to 32%, 16% to 33%, and 3% to 23%, respectively. Compared with SFQ-FSDS alternative instruments produced higher estimates of desire, arousal and orgasm disorders and displayed a range of sensitivities (0.25 to 1.0), specificities (0.48 to 0.99), positive predictive values (0.01 to 0.56), and negative predictive values (0.95 to 1.0) across the disorders investigated. Kappa statistics comparing SFQ-FSDS and alternative instruments ranged from 0 to 0.71 but were predominantly 0.44 or less. Changing recall from previous month to 1 month or more in the previous year produced higher estimates for all disorders investigated. Including sexual distress produced lower estimates for desire, arousal, and orgasm disorders.
Conclusions. Prevalence estimates of FSD varied substantially across instruments. Relatively low positive predictive values and kappa statistics combined with a broad range of sensitivities and specificities indicated that different instruments identified different subgroups. Consequently, the instruments researchers choose when assessing FSD may affect prevalence estimates and risk factors they report.

The impact of study design on prevalence estimates of female sexual dysfunction

Introduction, objectives Despite increasing research, the true prevalence of Female Sexual Dysfunction (FSD) remains a contentious issue. Previous research suggests that aspects of study design affect the reported prevalence of FSD. We compare commonly used instruments for assessing FSD. Methods A random sample of 240 Australian women aged 20-70 participated in this population based, cross-sectional study. A questionnaire mailed to women across Australia included four instruments for assessing FSD. The Sexual Function Questionnaire combined with the Female Sexual Distress Scale (SFQ-FSDS) was employed as a standard, validated instrument. Alternative instruments were the SFQ alone and two modified versions of a set of questions originally developed by Laumann et al. Results When assessed by the SFQ-FSDS, prevalence estimates (and 95% confidence intervals) of Hypoactive Sexual Desire Disorder, Female Sexual Arousal Disorder (genital subtype), Female Orgasmic Disorder, and Dysparunia were 16%(11-20%), 8%(4-11%), 9%(6-13%), 2%(0.1-3%) respectively. The prevalence estimates of these same disorders obtained using alternative instruments were 32-55%, 17-35%, 17-33% and 3-25% respectively. The sensitivity of alternative instruments varied widely (0 to 1.0). Specificities ranged from 0.51 to 0.99. Positive predictive values ranged from 0 to 0.57. Negative predictive values were all above 0.90. Changing the time span for recalling sexual experiences in an instrument altered the prevalence estimates, sensitivity and specificity. 32% of women with low desire, 31% with low genital arousal, 36% with orgasm difficulty and 57% with sexual pain were sexually distressed. Conclusion Over a third of women who were classified as suffering FSD by alternative instruments did not have FSD when assessed by SFQ-FSDS. Alternative instruments produced substantially higher prevalence estimates of FSD and identified different groups of women. Consequently, the instruments researchers choose to assess FSD may affect both the prevalence estimates and risk factors they report.

Police stress : the role of psychological contract and perceptions of fairness

Purpose – The overall purpose of this paper is to examine the extent to which breaches in psychological contracts and perceptions of organizational fairness account for variations in job stress experienced by operational police officers (as measured by psychological distress and employee performance), after controlling for the variance associated with more established job stressors (i.e. job demands, job control and social support).

Design/methodology/approach – This study is based on data collected through a self-report survey involving operational members of a large Australian police force (n=582).

Findings – Results of hierarchical multiple regression analyses indicate that vast majority of explained variance in psychological distress and extra-role performance is attributed to the additive effects of demand, control, and support. Furthermore, only one of the social exchange dimensions (interpersonal fairness) is predictive of either target variable.

Research limitations/implications – The limitations that need to be taken into account are the cross-sectional nature of the study design and the focus on a single police service.

Practical implications – Despite the generally weak support for the social exchange variables, there are signs that dimensions of justice (particularly interpersonal justice) should be included in future police-stress investigations. The results also suggest that job characteristics such as job demand, job control and social support should be taken into account when developing strategies to prevent and/or reduce chronic job stress in policing services.

Originality/value – This is one of the first studies to examine the relationships between psychological contract breach, perceptions of fairness and police stress.

Exploring optimistic and pessimistic attributions in depression-specific mood

Cognitive theories of depression include maladaptive thinking styles as depressive vulnerabilities. The hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) particularly implicates stable and global attributions for negative events as influences upon depression. Positive event attributions are considered less influential, yet they have shown equal predictiveness to negative event attributions for depression-specific mood. Previous research has provided equivocal results largely because of cross-sectional design and modest psychometric properties of the measures. The present research aimed to: create a new instrument to measure optimistic and pessimistic attributions; test the relatedness of attributions for positive and negative events; and, clarify relationships of the scales with optimism and mood. Three studies were undertaken, all of which used structural equation modeling. Two cross-sectional studies, using 342 and 332 community participants respectively, developed and validated the Questionnaire of Explanatory Style (QES). A final longitudinal study with 250 community participants tested the predictive validity of the QES. Overall, six scales were developed, three of which were optimistic and three of which were negative. The scales were acceptable to community samples and had adequate psychometric properties. The optimistic scales were attributions for positive events and the negative scales were attributions for negative events rather than pessimistic scales. Cross-sectional results indicated that only one of the negative scales weakly directly predicted depression-specific mood, but all predicted general psychological distress. By contrast, the optimistic scales were more directly predictive of depression-specific mood, particularly the Positive Disposition scale. Longitudinal results indicated that two of the optimistic scales were the most important QES predictors of depression-specific mood two months later. The optimistic scale Positive Disposition appears most central to the prediction of both concurrent and subsequent depression-specific mood. The scale content represents explanations for positive events that are internal and stable characteristics. These may be construed as personal competencies to bring about positive outcomes. This scale is closely allied to measures of optimism. Findings affirm the importance of optimistic attributions to the understanding of depression-specific mood and provide a productive focus for therapeutic intervention and future research.

Raising the profile of depression in the workplace

The prevalence of depression in the Australian workforce is unknown. Epidemiological surveys (e.g., the National Health Survey and National Survey of Mental Health and Wellbeing) do not routinely include a depression scale and within the mental health field, few studies focus on depression and employment groups specifically. Although the inclusion of a direct measure of depression in  national surveys is preferable, the prevalence of depression may be inferred from short screening scales of general mental health. In this paper, scores on the  General Health Questionnaire (GHQ-12) and the Kessler psychological distress scale (K10) for a sample of employed persons were mapped onto the CES-D (Iowa) measure of depression. The results of this study indicate that the  recommended GHQ-12 cut-off point is appropriate for estimating work-related depression prevalence. However, the cut-off point on the K10 (the short-scale  currently used in Australian national surveys) may need to be substantially  reduced if scores on the K10 are to be used to identify workers at risk of  depression. The routine inclusion of a direct depression measure in national  surveys is recommended, particularly considering the number of employed persons in Australia and large proportion of the sample classified as depressed in this study.

Severely compromised quality of life in women and those of lower socioeconomic status waiting for joint replacement surgery

Objective
To determine health-related quality of life (HRQOL), psychological distress, physical function, and self efficacy in persons waiting for lower-limb joint replacement surgery.

Methods
A total of 214 patients on a waiting list for unilateral primary total knee or hip replacement at a large Australian public teaching hospital completed questionnaires after entry to the list. HRQOL and psychological distress were compared with available population norms.

Results
Average HRQOL was extremely poor (mean ± SD 0.39 ± 0.24) and much lower (>2 SD) than the population norm. Near death-equivalent HRQOL or worse than death-equivalent HRQOL were reported by 15% of participants. High or very high psychological distress was up to 5 times more prevalent in the waiting list sample (relative risk 5.4 for participants ages 75 years and older; 95% confidence interval 3.3, 9.0). Women had significantly lower HRQOL, self efficacy, and physical function scores than men. After adjusting for age and sex, significant socioeconomic disparities were also found. Participants who received the lowest income had the poorest HRQOL; those with the least education or the lowest income had the highest psychological distress. Low self efficacy was moderately associated with poor HRQOL (r = 0.49, P < 0.001) and more strongly associated with high psychological distress (r = -0.55, P < 0.001).

Conclusion
Patients waiting for joint replacement have very poor HRQOL and high psychological distress, especially women and those from lower socioeconomic backgrounds. Lengthy waiting lists mean patients can experience extended and potentially avoidable morbidity. Interventions to address psychological distress and self efficacy could reduce this burden and should target women and lower socioeconomic groups.

Psychological impact of DAFNE training in adults with Type 1 diabetes

This thesis investigated the psychological impact of an education intervention, Dose Adjustment for Normal Eating (DAFNE), in adults with type 1 diabetes. The results demonstrated that the education programme improved participants' subjective wellbeing, self-efficacy and reduced diabetes-related distress compared to a comparison group that engaged in usual care. The portfolio examined the use of mindfulness-based strategies, in particular Acceptance and Commitment Therapy (ACT) in four case studies which illustrated that the impact of the therapy is directly related to the the willingness of the client to engage in the practices.

Depression and anxiety in patients with cancer and their families

This thesis identified aspects of family relationships and the patients' illness that were associated with depression and anxiety in patients and their relatives after a cancer diagnosis and during treatment. It also tested the ability of a measure of family relationships to identify psychological distress in these families.

The relationship between primary and secondary control and eating behaviour

Two studies were conducted investigating Australian women's management of their life goals. Although engagement with goals was generally positive for psychological well-being, the propensity to disengage from appearance-related goals was beneficial for body image and protective against disordered eating, suggesting strategies for promoting goal disengagement in women with eating disordered behaviour. The portfolio presents four case studies reviewing empirical research demonstrating the efficacy of adjuvant psychological therapy in relieving psychological distress in cancer patients.

Internet child pornography : an examination of attachment and intimacy deficits

This study found that Internet child pornographers (ICP) reported significantly less optimal attachment than non-offenders, matched child and matched adult sexual offenders. ICP also reported a more negative view of self than non-offenders and the matched sexual offender groups. Finally, the ICP group reported more social avoidance and distress than non-offenders. The portfolio explores the influence of treatment readiness on the best practice principles when working with violent offenders in relation to their assessment, and subsequent treatment recommendations. The importance of treatment readiness and its utility in relation to these principles is highlighted in four case studies.