Associations of locus of control, information processing style and anti-reflexivity with climate change scepticism in an Australian sample.

A proportion of the Australian public remains sceptical about the reality of climate change, its causes, impacts and the need for mitigatory action. To date, scepticism research largely focuses on factors highly resistant to change, particularly socio-demographic and value factors. This mixed-methods study investigated whether more malleable psychological factors: locus of control; information processing style; and anti-reflexivity, predicted climate change scepticism above and beyond socio-demographic and value factors. A sample of 390 participants (Mean age = 41.31, standard deviation = 18.72; 230 male) completed an electronic survey. Using hierarchical regression, trust in forces of anti-reflexivity and external locus of control predicted impact scepticism. Decreased trust in forces of reflexivity also predicted attribution and impact scepticism. Finally, external locus of control predicted response scepticism. Key qualitative themes identified were, trust in alternative science; mistrust of climate science; belief in natural cycles; predictions not becoming reality; and ulterior motives of interested parties.

To grieve or not to grieve (online)? Interactions with deceased Facebook friends.

Besides seeking social support, connecting with bereaved others, and maintaining relationships with the deceased, bereaved Facebook users may express their grief on Facebook to reduce their death anxiety. Notably, research has not yet explored the psychological outcomes of expressing grief on Facebook. This study undertook quantitative analysis of survey data from an initial community sample of 409 bereaved Facebook users (77.8% survey completion rate, n = 312; Mage = 34.46, SD = 12.38; 90% women) to ascertain whether expressions of grief on Facebook had negative psychological outcomes, and whether terror management theory (TMT) provided an appropriate lens for understanding Facebook grief expressions (FBGE). The aims of this study were three-fold: to clarify rates at which Facebook profiles of deceased users are deactivated, memorialized, unchanged, or managed; frequency and types of FBGE; and prevalence of/visitation to commemorative groups. Results-though insufficient to support TMT as an explanatory theoretical framework for FBGE-indicated that individuals who participated in FBGE reported higher anxiety and stress compared to bereaved individuals who did not express their grief on Facebook. Results provide a useful starting point for future research regarding online grieving behaviors and psychological wellbeing.

A systems approach to understanding the identification and treatment of sport-related concussion in community rugby union.

AIM: The aim of the present study was to utilise a systems thinking approach to explore the perceived responsibilities for identifying and treating concussion held by different actors across the community rugby system (e.g., players, coaches, parents, medics, referees, and management), as well as their role-specific concussion management strategies. METHODS: A systems approach was taken to assess what different stakeholders within rugby systems perceive their roles to be regarding concussion identification and treatment. Through an online survey, 118 members of the amateur (community) rugby union system were asked about their role-specific concussion management responsibilities and strategies. Respondents included players, parents, medics, coaches, club managers, administrators, and volunteers. RESULTS: The majority of respondents indicated that they were able to identify the symptoms of rugby-related concussion, however, only medics stated their responsibility to use formal concussion assessments (e.g., SCAT2). A smaller number of the respondents indicated that they were involved in treating concussion within their current role/s (majority of which were medics). CONCLUSIONS: This study illustrated that the current challenges in the identification and treatment of rugby-related concussion in community sport may be due to role/responsibility confusion and possible overreliance on field-side medics. These findings offer insight into the possible limitations of the current concussion management guidelines and may offer empirically based direction for future revisions.

Women's descriptions of childbirth trauma relating to care provider actions and interactions.

BACKGROUND: Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women's experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes. METHODS: As part of a large mixed methods study, 748 women completed an online survey and answered the question 'describe the birth trauma experience, and what you found traumatising'. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process. RESULTS: Four themes were identified in the data: 'prioritising the care provider's agenda'; 'disregarding embodied knowledge'; 'lies and threats'; and 'violation'. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women's own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider's clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault. CONCLUSION: Care provider actions and interactions can influence women's experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.

A knock to the system: A new sociotechnical systems approach to sport-related concussion.

Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.

Paternal mental health following perceived traumatic childbirth.

OBJECTIVE: the objective behind the current study was to explore the experiences and perceptions of fathers after childbirth trauma, an area of minimal research. This is part two of a two-part series conducted in 2014 researching the mental health of fathers after experiencing a perceived traumatic childbirth. DESIGN: qualitative methodology using semi-structured interviews and reporting of qualitative questions administered in part one's online survey (Inglis, 2014). SETTING: interviews conducted face-to-face at an Australian University or on Skype. PARTICIPANTS: sixty-nine responded to the online qualitative questions and of these seven were interviewed. MEASUREMENTS: thematic analysis of verbal and written qualitative responses. FINDINGS: thematic analysis of qualitative survey data and interviews found a global theme 'standing on the sideline' which encompassed two major themes of witnessing trauma: unknown territory, and the aftermath: dealing with it, and respective subthemes. KEY CONCLUSIONS: according to the perceptions and experiences of the fathers, there was a significant lack of communication between birthing teams and fathers, and fathers experienced a sense of marginalisation before, during, and after the traumatic childbirth. The findings of this study suggest that these factors contributed to the perception of trauma in the current sample. Whilst many fathers reported the negative impact of the traumatic birth on themselves and their relationships, some reported post-traumatic growth from the experience and others identified friends and family as a valuable source of support. IMPLICATIONS FOR PRACTICE: improved communication between midwifery staff and fathers before, during and after childbirth may reduce the rates of paternal postpartum mental health difficulties and experiences of trauma.

Satisfaction of Basic Psychological Needs, Self-Determined Exercise Motivation, and Psychological Well-Being in Mothers Exercising in Group-Based Versus Individual-Based Contexts.

We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers' exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone.

Caregivers' support needs and factors promoting resiliency after brain injury.

AIM: This article explores the challenges, support needs and coping strategies of caregivers of people with an acquired brain injury (ABI). METHOD: Semi-structured interviews were conducted with caregivers (n = 20) to explore their support services received, access barriers, utility of services, needed supports, coping strategies and factors promoting life satisfaction. The team recorded, transcribed verbatim and inductively analysed all interviews. RESULTS: Through thematic data analysis, three central themes were revealed: (a) barriers impeding quality-of-life, (b) support needed to improve quality-of-life and (c) factors enabling quality-of-life. All perspectives from the participants involved are synthesized to provide a rich depiction of caregivers' support needs and coping strategies. CONCLUSIONS: Two specific findings of interest include a negative association between severity of brain injury and caregiver's desire to direct treatment, as well as a distinct service gap in assistance for caregivers who are caring for someone with violent/offending behaviours. This study recommends short- and long-term changes, given Australia's upcoming National Disability Insurance Scheme, to increase caregiver quality-of-life, which will ultimately affect the rehabilitation outcomes of persons with ABI.

Effect of an obesity pamphlet on parental perception and knowledge of excess weight in their children: results of a randomised controlled trial.

ISSUES ADDRESSED: This study examined the effectiveness of a brief educational intervention in increasing parental knowledge of childhood obesity risk factors and ability to correctly identify their child's weight status. METHODS: Eighty parents were randomly allocated to an experimental group given an obesity pamphlet or a control group given a stress management pamphlet. A survey measured parents' knowledge about risk factors, cause and consequences of childhood obesity, and perception of their child's weight. RESULTS: Parents with overweight or obese children increased their understanding of childhood obesity immediately after receiving the intervention, but did not differ significantly on perception of their child's weight. CONCLUSION: The experimental intervention increased knowledge of health risks associated with childhood obesity in parents of overweight or obese children. Parental perception of their child's weight status did not improve, suggesting that other factors have a role to play. SO WHAT? The obesity pamphlet may be a useful tool in a multifaceted approach targeting childhood obesity.

Executive functioning of 4 children with hyperphenylalaninemia from childhood to adolescence.

Hyperphenylalaninemia is a variant of phenylketonuria, and debate remains as to what, if any, active management of this condition is required to preserve cognitive function and psychological well-being. This study is the first to examine longitudinally the executive function (EF) in adolescents with hyperphenylalaninemia. Two sibling pairs with mild hyperphenylalaninemia underwent neuropsychological examination in early childhood and again in adolescence using EF tests that were highly sensitive to phenylalanine exposure. By early adolescence, none of the 4 children demonstrated EF impairment. The children demonstrated a typical developmental trajectory of EF from childhood to adolescence, given phenylalanine exposure consistent with their condition.

A cross-sectional investigation of depressive, anxiety, and stress symptoms and health-behavior participation in Australian university students.

Transitioning to university involves a major life change that can have implications for physical and mental health. This study had three objectives: first, assess the mental health and health-behavior participation of Australian university students; second, evaluate clustering of health behaviors; and third, examine how mental health relates to health behaviors. University students (n = 751) enrolled at an Australian regional university completed an online survey containing the Depression, Anxiety, and Stress Scales and a health-behavior questionnaire. Over one-third of students reported mild or higher mental illness symptoms and most reported engaging in multiple unhealthy behaviors. Furthermore, mental health was associated with unhealthy behaviors. For males, depressive symptoms were associated with skipping breakfast and poor sleep quality. For females, depressive symptoms were associated with skipping breakfast, inadequate vigorous physical activity, and short or long sleep hours. Stress symptoms in females were associated with healthy sleep hours, but poor sleep quality. Future research may consider whether an intervention targeting one or two key health behaviors has utility in improving participation in other health behaviors and mental health.

Depression, anxiety, and stress in young adults with phenylketonuria: associations with biochemistry.

OBJECTIVE: Increasing concurrent phenylalanine to "off-diet" levels in adults with phenylketonuria (PKU) has been shown to lead to mood disturbances. However, the impact of controlled phenylalanine exposure across the developmental life span and mood stability remains questionable. The aim of this study was to investigate correlations between lifetime and concurrent phenylalanine (Phe) and tyrosine (Tyr) with levels of depression, anxiety, and stress in young adults maintaining a continuously treated diet for PKU. METHOD: Eight young adults (6 females, 2 males) aged 15 to 25 years (mean = 19.37, SD = 3.62) recruited through the Royal Children's Hospital Brisbane, with early and continuously treated PKU completed the Depression Anxiety Stress Scale, which was correlated with lifetime and concurrent measures of Phe, Tyr, and Phe-Tyr ratios. RESULTS: There was a strong significant correlation between lifetime Phe and levels of anxiety and stress (p < .01). Greater Phe-to-Tyr blood ratios were indicative of increased depression and anxiety levels (p < .01). CONCLUSIONS: An interaction between biochemical regulation and depression, anxiety, and stress levels was present in young adults with continuously treated PKU who were actively attempting to maintain dietary control. Strong associations were present with lifetime levels, suggesting a developmental impact of PKU-related biochemical exposure and the emergence of mood disturbances.

Continuing professional development in nursing in Australia: current awareness, practice and future directions.

Australian nurses and midwives are expected to compile a professional development portfolio during their annual registration process. This study aimed to ascertain the current understanding, practice and future continuing professional development (CPD) needs of nurses and midwives employed in a regional area of Queensland, Australia. Perceived barriers and incentives for CPD were also measured. 289 public and private hospital nurses and midwives responded to the survey. Results showed that participants understood the new requirements, valued ongoing learning, preferred education to occur within work hours, and considered their workplaces as accepting of change. Approximately two-thirds of participants believed CPD should be shared between them and their employers. Barriers to undertaking CPD included understaffing, and the concern that CPD would interfere with time outside work. Organisational support positively influenced attitudes to CPD. This study highlights the importance of supportive management in encouraging their workforce to embrace ongoing learning and change.

Qualitative analysis of factors affecting adherence to the phenylketonuria diet in adolescents.

PURPOSE/OBJECTIVE: Phenylketonuria (PKU) is an inborn error of metabolism that is primarily treated with a severely restricted, low-protein diet to prevent permanent neurological damage. Despite the recognition of the importance of strict dietary adherence in the prevention of intellectual impairment in individuals with PKU, apathy and attrition from diet, especially during adolescence, remain a threat to normal development in this population. This study's aim was to examine adolescents' perception of factors that encourage or inhibit their dietary adherence. DESIGN: This was a qualitative study, with the authors using thematic analysis to interpret the findings. SETTING: The study was conducted as part of a Metabolic Disorders Association conference. SAMPLE: Eight adolescents with PKU were recruited through convenience sampling. METHODS: A focus group was conducted with the adolescents to gather information about factors that encourage and discourage dietary adherence. FINDINGS: Thematic analysis revealed that the adolescents encountered problems explaining the nature and food requirements of their condition to other people. Friends, family, and wanting to maintain "normal" cognitive abilities were identified as factors that encouraged dietary adherence. CONCLUSION: Adolescents with PKU appear to share several barriers and incentives for maintaining the strict dietary regimen. IMPLICATIONS: Considering such perceptions may aid future interventions aiming to reduce diet attrition rates among adolescents.

Depressive symptoms in adolescents with early and continuously treated phenylketonuria: associations with phenylalanine and tyrosine levels.

BACKGROUND: Previous research has suggested an increased risk for individuals with phenylketonuria (PKU) of developing depression and other mood disorders. As PKU can disrupt neurotransmitter synthesis via biochemical mechanisms, depressive symptoms are hypothesised to result from neurotransmitter dysregulation. Whilst adherence (or return) to the phenylalanine-restricted diet may resolve or improve symptoms of depression, data to demonstrate a direct relationship between biochemistry and mood in this population are lacking. METHODS: Thirteen adolescents with early and continuously treated PKU and eight sibling controls were compared in their total reported depressive symptoms. A general executive function assessment was also undertaken in the PKU group. Correlations between depressive symptoms and biochemical markers were examined within the PKU group only. RESULTS: Correlational analyses within the PKU group demonstrated strong and significant associations between depressive symptoms and long term exposure to either a high phenylalanine:tyrosine ratio, or low tyrosine. Increasing symptoms of depression were also found to be associated with poorer executive function in the PKU sample. However, both groups of adolescents scored within the normal range in symptoms of depression (p>0.05). CONCLUSIONS: Significant associations were observed between biochemical markers indicating poorer dietary control and increasing depressive symptoms in a sample of adolescents with early and continuously treated PKU, although symptoms of depression remained within the normal range. An association between depressive symptoms and poorer EF was also demonstrated. Further research is needed to establish whether the depressive symptoms observed in this young population represent an emerging (subclinical) risk for major depressive disorder as they age.

Tyrosine monitoring in children with early and continuously treated phenylketonuria: results of an international practice survey.

Investigations into the biochemical markers associated with executive function (EF) impairment in children with early and continuously treated phenylketonuria (ECT-PKU) remain largely phenylalanine-only focused, despite experimental data showing that a high phenylalanine:tyrosine (phe:tyr) ratio is more strongly associated with EF deficit than phe alone. A high phe:tyr ratio is hypothesized to lead to a reduction in dopamine synthesis within the brain, which in turn results in the development of EF impairment. This paper provides a snapshot of current practice in the monitoring and/or treatment of tyrosine levels in children with PKU, across 12 countries from Australasia, North America and Europe. Tyrosine monitoring in this population has increased over the last 5 years, with over 80% of clinics surveyed reporting routine monitoring of tyrosine levels in infancy alongside phe levels. Twenty-five percent of clinics surveyed reported actively treating/managing tyrosine levels (with supplemental tyrosine above that contained in PKU formulas) to ensure tyrosine levels remain within normal ranges. Anecdotally, supplemental tyrosine has been reported to ameliorate symptoms of both attention deficit hyperactivity disorder and depression in this population. EF assessment of children with ECT-PKU was likewise highly variable, with 50% of clinics surveyed reporting routine assessments of intellectual function. However when function was assessed, test instruments chosen tended towards global measures of IQ prior to school entry, rather than specific assessment of EF development. Further investigation of the role of tyrosine and its relationship with phe and EF development is needed to establish whether routine tyrosine monitoring and increased supplementation is recommended.

A preliminary investigation of the role of the phenylalanine:tyrosine ratio in children with early and continuously treated phenylketonuria: toward identification of "safe" levels.

Children with early and continuously treated phenylketonuria (ECT-PKU) remain at risk of developing executive function (EF) deficits. There is some evidence that a high phenylalanine to tyrosine ratio (phe:tyr) is more strongly associated with impaired EF development than high phenylalanine alone. This study examined EF in a sample of 11 adolescents against concurrent and historical levels of phenylalanine, phe:tyr, and tyrosine. Lifetime measures of phe:tyr were more strongly associated with EF than phenylalanine-only measures. Children with a lifetime phe:tyr less than 6 demonstrated normal EF, whereas children who had a lifetime phe:tyr above 6, on average, demonstrated clinically impaired EF.