Academic literature on the topic 'Family – Western Australia – Psychological aspects'

IntroductionThe needs of refugees are of pivotal concern internationally. Relational trauma, in particular, is an area that is under-emphasised and under-researched. The strength to strength program (STS) was a rare, innovative relationship and family counselling service for recently-arrived refugees in Sydney, Australia during 2006–2014. The service model built on post-Milan systemic family therapy principles to include innovative cultural and trauma-informed aspects of care.ObjectivesWe were interested in the experiences of staff who delivered the program, and the ways in which more traditional, Western-informed modes of family therapy were transformed by the needs of refugee clients.AimsTo identify and describe transformations to the delivery of relationship and family counselling with refugees that enabled care, from the perspective of staff.MethodsA thematic analysis, guided by interpretive description, of individual interviews and focus groups with STS service staff (n = 20), including family therapists, bicultural workers and managers.ResultsKey themes pertaining to innovative aspects of the relationship and family counselling service provided by STS staff will be outlined and lessons for future service provision in this space considered.ConclusionsSTS is an example of staff-driven innovation to the therapeutic care of refugee families resettling in Western countries, taking into account the unique and complex set of cultural, practical and psychological needs. Important and timely lessons for future service delivery can be drawn from qualitative inquiry into the experiences of staff who deliver such programs, with refugee numbers continuing to increase internationally.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: There is a lack of interventional studies to support the psychosocial wellbeing of people with MND (PwMND) and their family carers. Moreover, their experiences with the models of care already provided by ALS/MND voluntary organisations have not been well investigated.Objectives: To report on a person-centered model of care, the MND Advisory Service, designed to support the needs of PwMND and their family carers, to explore their experiences with the service they received and to identify which aspects of this service were most needed and valued by the service users.Methods: Participants were recruited from the MND Association in Western Australia. PwMND and carers were invited to separately complete anonymous postal surveys (2015-17), using a mixed method design comprising quantitative and open-ended questions.Results: The average response rate across the 3 years was 38% (138 patients and 117 carers); 84-89% of both groups felt more supported and cared for as a result of the service and 79-82% felt they were able to make more informed decisions to manage their health and wellbeing. Ninety percent of both groups found the MND Advisory Service of high value practically and emotionally, especially the personal contact and time dedicated to the visit, with 86-88% stating that the service had met their expectations.Conclusions: Two unique features of this service, not provided by other services to the same extent, are the emotional benefit to both groups and the particular focus on the family carers’ needs. Until such person-centered models of care are properly investigated through the experiences of their users, erratic changes in care funding will pose a threat to their effective operation and even viability. The drive to find a cure should not detract from the fact that PwMND and their families still need to be supported physically and psychologically until then.

Background: Living with a cleft condition involves many years of multidisciplinary therapy, treatment, and surgical intervention. This complex process may have both physical and psychosocial long-term impacts. There is limited evidence of the psychosocial impact of cleft on individuals in Australia. Aim: To obtain an understanding of the adult patient perception of having a cleft and explore the impact of the condition on their lives. Design: Qualitative methodologies at one case study site in Western Australia. Population of Interest: Adults with a cleft lip and/or palate (CL/P) who had received treatment at Princess Margaret Hospital, the only treatment center for cleft in Western Australia. Methodology: Individual in-depth semi-structured qualitative interviews were conducted and recorded and transcribed for analysis. Results: Fifteen adults with a CL/P. Two main themes were identified: lived experience (with 3 subthemes: normality, support networks, and impacts in later life) and advice to others. The majority of participants reported social rejection and isolation, which occurred mostly at school and in some instances at home, but did not often last into adulthood. The greatest protective factor was the support of family and friends, which if missing during their childhood, was desired and appreciated in adulthood. Conclusion: Adults with CL/P may require psychosocial support from their cleft team including referral to clinicians in adult services. There is also the need for earlier psychological interventions and social programs to support those with appearance-related social difficulties.

Purpose The purpose of this study is to understand the destination image perceptions about Australia – a Western culture country – as held by the rapidly increasing, high spending, culturally dissimilar new segment of travellers, the Emiratis[1] from the United Arab Emirates (UAE). Design/methodology/approach A qualitative methodology was used to understand the cognitive, affective and conative images of Australia. A structured categorisation matrix was used to analyse the data so that only aspects fitting the matrix were selected. Findings Within the cognitive variable, Australia was found to be pleasant, family oriented, a fun place, laid back and the local people friendly. From an affective factor perspective, Australia was seen as being exciting, because of the variety of activities available for these tourists. Exciting was expressed by words like fantastic, amazing and extreme experience. In terms of the conative variable most of the Emirati tourists expressed strong feelings to go back to Australia and to even re-visit with friends. They also mentioned that they would recommend Australia to family and friends. Research limitations/implications A limitation of this study was that our sample comprised informants mainly from the Emirates of Abu Dhabi and Dubai, the two largest Emirates of the nation. The study offers destination marketing organisations’ (DMOs) insights into Emirati travellers’ perceptions about Australia, which would benefit destination marketing. Originality/value This study examines the under researched area of how Australia – with its liberal Western culture – could be better marketed to the growing numbers of culturally conservative, high spending Emirati outbound tourists from the officially Islamic UAE, and also more generally to the socio-culturally homogeneous Gulf Cooperation Council region that the UAE is part of. Whilst destination image is an intensively analysed topic within the realm of tourism research, and reportedly a powerful influence on destination choice, the extant literature on how Australia is perceived as a travel destination by Emiratis is scant. For DMO’s attempting to attract wealthy Emirati tourists into Australia, this research is valuable and timely, as several Emiratis are seeking newer travel destinations away from the Western hemisphere, where the general anti-Arab/Islamic sentiments are currently quite strong.

Beyeria cockertonii Halford & R.J.F.Hend. and Beyeria villosa Halford & R.J.F.Hend. (Euphorbiaceae) are two short-range endemic monoecious congeners from southern Western Australia. We sought to determine whether life-history characteristics were responsible for their limited distribution and to identify aspects of their ecology that might render them vulnerable to current threatening processes. We investigated reproductive phenology in relation to climate, pollinator activity and synchronicity of male and female flowering. In addition seed dispersal, regeneration, demography and seed viability were examined and ex situ germination experiments conducted to determine seed-dormancy mechanisms. Flowering in the conservation-listed B. cockertonii was significantly correlated with temperature, whereas fruit set was correlated with pollinator abundance and movement; male and female flowering showed limited synchrony. The presence of soil-stored seeds lacking a caruncle at sites absent of adult plants of either species suggests that seed may be ant-dispersed (myrmecochory). Fresh seeds of B. cockertonii were significantly more viable than those of its more common congener, B. villosa (72 vs 0.5%, P < 0.001). Fresh B. cockertonii seeds would not germinate with an intact caruncle; caruncle removal elicited germination of 64% and 60% (10°C and 15°C, respectively). Aqueous smoke further stimulated germination to 72% and 83% germination (10°C and 15°C, respectively), providing a link between fire and germination. Beyeria villosa was affected by high levels of pre-dispersal predation (up to 70%) and seed abortion (88%) and appeared to have lower reproductive fitness than B. cockertonii. Life-history strategies did not explain the greater abundance and wider distribution of B. villosa than those of the conservation-listed B cockertonii, nor was the greater rarity of B. cockertonii fully explained by habitat specificity, with both species being restricted to ultra-mafic volcanic rock associated with Achaean greenstone. However, an apparent dependence of B. cockertonii on a specific insect pollinator from the family Miridae may render this species vulnerable to threatening processes.

Background: There is an international drive towards increasing provision of community-led models of social and practical support for people living with advanced illness. Aim: This feasibility project aims to develop, implement and evaluate a model of community volunteers, identified as Compassionate Communities Connectors, to support people living with advanced life limiting illnesses/palliative care needs. The aims also include the development and evaluation of a training programme for volunteers and assessment of the feasibility, acceptability and preliminary effectiveness of this model of care. Methods: The approach seeks to map and mobilise people’s personal networks of care through the Connectors enlisting Caring Helpers (community volunteers). Up to 10 Connectors will be trained to work with at least 30 families selected by the palliative care service as requiring support. The primary outcome is the effect of the intervention on social connectedness. Secondary outcomes are the intervention’s effect on unplanned hospital utilisation, caregiver support needs, advance care plans and satisfaction with intervention for patients/carers, volunteers and service providers. Conclusion: It is expected that this intervention will enhance patient, carer and family social, psychological and practical support and reduce the need for dying people to be admitted to a hospital.

ABSTRACTBackground: Previous research has found an association between post-stroke depressive symptoms and premorbid personality. This study sought to investigate further the relationship between premorbid personality and a number of common post-stroke behavioral and psychological symptoms in a three-month follow-up study.Methods: This prospective study was conducted between May 2003 and January 2005 in a Perth metropolitan teaching hospital. The pre-stroke personality of stroke survivors was assessed by interviewing a close family member (informant) within four weeks of the index stroke using the NEO Personality Inventory-Revised. Three months after the stroke, patients were followed up and assessed with the Cambridge Cognitive examination and Hospital Anxiety and Depression Scale, and their informants completed the Neuropsychiatric Inventory-carer distress version (NPI) and instrumental activities of daily living scale.Results: Depressive symptoms were the most commonly reported post-stroke symptom (45.1%). Spearman's correlations showed that high neuroticism was positively correlated with NPI total scores (ρ = 0.37, p = 0.007), NPI total distress scores (ρ = 0.47, p = 0.001), and specifically with agitation and irritability NPI composite scores. Agreeableness was inversely correlated with agitation (ρ = −0.40, p = 0.004) and irritability (ρ = −0.37, p = 0.007) composite scores.Conclusions: Premorbid personality traits of high neuroticism and low agreeableness are associated with the presence of post-stroke agitation, irritability, and carer distress. This knowledge may contribute to the development of strategies designed to identify patients and families who require more intense supervision and support during post-stroke rehabilitation.

Objectives: The aim of this study was to assess the relationship between background and sociodemographic variables, attitudes toward controversial aspects of human sexuality and sex knowledge among medical and nursing students. Method: The study design was a questionnaire-based survey of medical and nursing students in Western Australia. Participants were first-through fifth-year medical students at the University of Western Australia and first-through third-year undergraduate nursing students at Edith Cowan University. Outcome measures were students' attitudes toward controversial aspects of human sexuality expressed on a five-point Likert scale and a modified version of the Kinsey Institute/Roper Organization National Sex Knowledge Test. Results: A significant relationship was found between certain background and sociodemographic variables, sexual attitudes and sex knowledge. The background variable most strongly related to both attitudes and knowledge was frequency of attendance at religious services of any religious denomination during the past month, with those attending three or more times more likely to express negative attitudes and have lower sex knowledge scores. Lower sex knowledge was related to negative attitudes toward gay/lesbian/bisexual behaviour, masturbation, premarital sex and contraception. Other important background and sociodemographic variables related to negative attitudes were: never having experienced sexual intercourse; right-wing political orientation; lower family income; gender and ethnicity. Conclusions: Negative attitudes toward controversial aspects of human sexuality and lower sex knowledge scores among medical and nursing students can be predicted on the basis of background and sociodemographic variables. Education aimed at increasing sex knowledge and modifying negative attitudes may increase students' ability to function more effectively as sexual history takers and sex counsellors.

Purpose The purpose of this paper is to contribute to the extant literature of family firms and corporate social responsibility (CSR), examining the case of West’n Fresh, a regional Western Australian family firm. Moreover, in adopting stakeholder theory (ST) the firm’s involvement in and resulting benefits from CSR are investigated. Design/methodology/approach In-depth telephone and face-to-face interviews with three members of the firm, including one of its two owners, were further complemented through onsite observations and secondary data from the firm’s website and media reports. Findings Entrepreneurial CSR emerges as a critical element in the family firm’s business philosophy, whereby through innovative practices the ownership is able to create a balance between the firm’s financial objectives and socially responsible initiatives. In particular, the development of food products creates business opportunities while at the same time addresses the needs of different consumer groups, in particular, aged care individuals. These findings have alignments with the four theses of ST; for instance, the recognition of various stakeholder groups by the firm’s ownership, and the initiatives to improve their quality of life clearly suggest associations with normative thesis. Originality/value Although the field of family entrepreneurship has grown significantly, many under-researched aspects of this discipline remain. For instance, family business research, including on CSR conducted in Western Australia, a state with a very strong economic significance, and with multiple links to the outside world is very limited.

It is a commonly held belief among mental health care providers that patients from the Western Pacific region with major depressive disorder (MDD) and anxiety disorders disproportionately present with somatic symptoms as opposed to emotional symptoms. Cultural norms, such as the stigma associated with psychiatric disorders, may lead members of this population to ignore the emotional aspects of these disorders or deny the presence of psychological symptoms. Empirical support is provided by the lower prevalence of these disorders in some Western Pacific nations in relation to the rest of the world. For example, MDD rates in India (9%), Japan (2%), China (2% to 4%), Malaysia (8%) and Australia (3%) are generally lower than rates in the United States (16%) and worldwide (10%). These discrepancies may be the result of missed diagnoses. Misdiagnosis is related to the increased somatization of MDD symptoms in these populations. As defined by the WHO, the Western Pacific region consists of 37 countries with a total population of 1.8 billion people (1.3 billion in China alone) with diverse cultural backgrounds and demographic profiles, which makes the issue of cultural effects on MDD diagnosis more complex.Patients with MDD or anxiety disorders worldwide often present with somatic symptoms, which frequently accompany psychological symptoms. For example, in a recent report of pooled data from Canada, scores on the Somatic Symptoms Inventory, the 17-item Hamilton Rating Scale for Depression (HAM-D17), and the Hamilton Rating Scale for Anxiety (HAM-A) were used to evaluate the association between somatic symptoms and MDD. Of the 2,191 patients randomly enrolled in the study, 78% reported moderate-to-severe fatigue and weakness. Painful physical symptoms commonly occur in patients with anxiety disorders as well. In a European study, painful physical symptoms were reported by 28% of those without anxiety disorders and 45% of those with anxiety disorders.

The Western Australian (WA) mining industry directly employs approximately 56,000 people. Almost half work Fly-in/Fly-out commute arrangements (FIFO, e.g. employees living in a city are flown to a remote worksite where they live and work during their work roster) and approximately half work more than 50 hours per week, on average. There are many anecdotal claims that FIFO has negative impacts on WA mining employees, leading to an elevated risk of high stress levels, depression, binge drinking, recreational drug use and relationship break-ups. Previous studies found FIFO can be stressful, and have negative impacts on WA employees 'and partners' lifestyles and relationships. This project investigated the long-term (Study One) and short-term (Study Two) impacts of FIFO and extended working hours on a representative sample of WA FIFO mining employees and partners. In Study One, a total of 222 FIFO and Daily Commute (DC) mining employees and partners completed an anonymous questionnaire investigating long-term impacts on work satisfaction, lifestyle, relationships and health. A subgroup of 32 Study One FIFO employees and partners also participated in Study Two; a detailed study of the short-term impacts of FIFO and extended working hours and how these impacts fluctuate in intensity during the mining roster. Study Two participants completed a diary and provided saliva samples each day throughout a complete mining roster. The main findings of the study were that FIFO and extended working hours had negative impacts on employees work satisfaction and FIFO was frequently reported to be disruptive to employees 'and partners' lifestyle, in the long-term. However, FIFO and extended working hours did not lead to poor quality relationships, high stress levels or poor health, on average in the long-term; there were generally no significant differences in these characteristics between FIFO and DC employees, or between the FIFO sample and the wider community. There were minor differences between FIFO and DC employees in long-term health characteristics, and Study One employees had similar, or in some cases poorer health outcomes than other community samples.

Mental health reflects an array of causal influences that span biological, psychological, and social circumstances, with resultant underlying causal pathways to poor mental health outcomes in childhood that are complex. Key features of this complexity are reciprocal interactions between person and environment that take place over time. The core of this thesis seeks to attend to the complexity of development to move the field of developmental health forward toward greater explanation, and more successful prediction and prevention. The focal point of the thesis is the psychosocial determinants of childhood mental health, the resource domain of the developing child, and the interplay between characteristics of the individual child, the family, and the community. The eventual goal is to better understand why and how socioeconomic circumstances impact on developmental health. One component of this thesis focuses on the expansion of extant developmental theory. The other component focuses on the development of an analytic strategy that more appropriately reflects the intricacies of this theoretical expansion. In the process, data are analysed, principally as a heuristic strategy, to illustrate the analytical approach needed to support the theoretical framework. The specification of a bioecological conceptual framework suitable to guide research and policy in developmental health is the first principal objective of the thesis. A critical examination of the resource framework proposed by Brooks-Gunn, Brown, Duncan, and Anderson Moore (1995) reveals it to be centred on family and community resources, but otherwise silent with respect to the physical and psychological resources of the child. The quintessential point of this thesis is that theory in developmental health must be able to account for the contribution individuals make to their own development. A modified resource framework is proposed that acknowledges financial, physical, human, and social capital, within the domains of the individual child, the family, and the community. The second principal objective of the thesis, the development of analytical methods that focus on the individual child and the complexity of data generated by this theoretical approach, is then introduced. Theory and method are thus integrated when comprehensive measures of characteristics in multiple domains across developmental periods are modeled using longitudinal data from the Western Australian Pregnancy Cohort (Raine) Study (Newnham, Evans, Michael, Stanley, & Landau, 1993). The mothers of 2,860 children were enrolled at 18 weeks in pregnancy and the children have been followed at birth, one, two, three, five, and eight years of age. Eighty-nine per cent (2,537 /2,860) of families were available for follow-up at eight and 74 per cent (2,126/2,860) of families responded. Extensive demographic, psychological, and developmental data were available for the children and their families and a limited amount of data were available for the communities in which they reside. A measure of mental health morbidity, the Child Behaviour Checklist (Achenbach, 1991), was available for the children at two, five, and eight years of age. In the first instance, dichotomous summary variables are derived for the demographic, psychological, and developmental variables of interest. Variables are then selected for inclusion in one of several explanatory models. To create a mathematical representation of resource characteristics, the information for each child is concatenated as a series of binary strings. Frequency tabulation is then used to aggregate the data and odds ratios are calculated to determine the degree of risk associated with each string of code, or pattern of factors relative to a nominated mental health outcome. The results provided a scaffold from which this theoretical and analytical approach is compared and contrasted with the reviewed literature. Two principal themes of investigation are pursued. The first theme to be examined is the interplay between characteristics of the child, family, and community and the contribution children make to their own development. The specific approach models the interaction between selected characteristics of the child, family and community in each of four developmentally significant time periods. The theoretical position adopted in the present study suggests that the effect of any personal or contextual factor on later development, if a relationship does truly exist, is most likely to be differential. That is, it is a combination of influences that determines developmental outcomes for children, not any single factor acting independently. The modelling process demonstrates that, for the children involved, personal and contextual factors impact mental health differentially depending on various other individual, family and/or community characteristics. The modelling process identifies patterns of factors that impact relatively small, but significant, numbers of children because the models focus on the effect for individual children rather than the effect for the group. For example, one model suggests that the effect of intra-uterine growth restriction for the group as a whole may be minimal, but the impact for some children could be critical depending on the combination of family and community influences, such as the mothers level of education, the family’s experience of significant life stress, and residence in a relatively disadvantaged community. The second theme to be examined is the possibility that the accumulation of resource deficits or risk characteristics, over time, amplifies the likelihood of mental health problems in childhood. The approach models selected characteristics of the child in each of the four periods of development collectively, and it also models selected characteristics spanning each of the four time periods discretely. The results suggest that latency, pathway, and recency effects may operate simultaneously, and that timing and accumulated burden may both be important determinants of risk. For example, with regard to children whose family experienced life stress, these three effects operated in a systematic way to increase the degree of risk of a mental health problem. In summary, the aggregation of data at the individual level is a productive approach in seeking to explain population level social phenomena. While seemingly paradoxical, the identification of the joint, interactive effects between individual, family, and community characteristics, better allows for the quantification of family and community characteristics operating through multiple causal pathways.

[Truncated abstract] Background: Genetic epidemiology draws on the mechanisms of heredity and the reproductive characteristics of populations to formulate methods to investigate the role of genetic factors and their interaction with the environment in disease aetiology. Asthma and atopy are complex genetic disorders and are among the most common diseases to affect the developed world. Twin studies provide an elegant means of disentangling genetic and environmental contributions to the aetiology of conditions that have a significant impact on the health of the general population in ways that cannot be achieved by any other study design, by comparing disease frequency in monozygotic (MZ) or identical twins, who share 100% of their genes with that in dizygotic (DZ) or non-identical twins who share, on average, 50% of their genes. Twin-family studies allow the complete partitioning of phenotypic variation into components representing additive genetic, dominance, shared environment and non-shared environment. ... For twin family data, the best fitting model was the one which included additive genetic effects and either genetic dominance or shared sibling environment, and that shared family environment was not important. With respect to asthma in WA twin families, there are no reasons to conclude that the EEA is not valid. Conclusions: The WA Twin Register is the first population-based register of childhood multiples to be established in Australia, and the WATCH study is one of only a few population-based twin-family studies in the world. Families who participated in the WATCH study were no different from non-participants with respect to social class and there was no difference in the prevalence of DDA in WATCH study twins and either their singleton siblings or the general population of WA children. Results from the GEE models replicate those found in numerous studies from many different countries. The BUGS models developed have been shown to produce consistent results with both simulated and real data sets and offer alternative methods of analyzing twin and twin-family data. By including an extra term in the partitioning of the variance to account for the environment effect of being a MZ twin, a numerical value is calculated for the difference in MZ and DZ correlation with respect to the phenotype examined, which allows the validity of the EEA to be directly assessed.

Doctor of Philosophy
This study explores the health beliefs and preventive health behaviours of older Hong Kong Chinese people resident in Australia. Participation in physical activity was used as the case study. There were two frameworks used to shape the research. Because of their perceived influence on the health beliefs and practices of Hong Kong Chinese people, the traditional Chinese philosophies of Confucianism, Taoism, and Buddhism provided the philosophical framework. The Theory of Planned Behaviour provided a theoretical framework for understanding the target group's preventive health behaviour. Data was collected by means of in-depth interviews, participant observation and case study. Twenty-two informants were interviewed, their transcripts analysed, summarised and typologised, identifying six states of physical activity participation. Findings demonstrated that this target group possessed a holistic view of health, with food taking a special role in preventive care and self-treatment at times of illness. The Cantonese terms used to denote “physical activity” caused confusion among the target group. Most interpreted it as meaning deliberate planned body movement, strength-enhancing activities or exercise, although some did see it as including mundane daily activities and chores. Lack of time, no interest and laziness were reported as the main reasons for low participation in deliberate planned physical activity. Cultural, social and environmental determinants were the intrinsic and extrinsic factors influencing attitudes toward physical activity, as well as perceived social supports and perceived control over physical activity participation barriers. To a large extent, these interactive determinants of health were rooted in the three traditional Chinese philosophies mentioned above. The thesis concludes by arguing that rather than simply advocating activities designed for other populations, health promotion strategies and education need to create links to the traditions of this target group and also clarify their conception of physical activity.

Australia is experiencing widespread ecosystem degradation, including dryland salinity, erosion and vegetation loss. Approximately 1 million hectares (5.5%) of the south-west agricultural zone of Western Australia is affected by dryland salinity and is predicted to rise to 5.4 million hectares by 2050. Such degradation is associated with many environmental outcomes that may impact on human health, including a decrease in primary productivity, an increase in the number of invasive species, a decrease in the number of large trees, overall decrease in biodiversity, and an increase in dust production. The resulting degradation affects not only farm production but also farm values. This study examines the effects of such severe and widespread environmental degradation on the physical and mental health of residents. Western Australia has an extensive medical record database which links individual health records for all hospital admissions, cancer cases, births and deaths. For the 15 diseases examined in this project, the study area of the south west of Western Australia (excluding the capital city of Perth) contained 1,570,985 morbidity records and 27,627 mortality records for the 15 diseases examined in a population of approximately 460,000. Environmental data were obtained from the Western Australian Department of Agriculture?s soil and landscape mapping database. A spatial Bayesian framework was used to examine associations between these disease and environmental variables. The Bayesian model detected the confounding variables of socio-economic status and proportion of the population identified as Aboriginal or Torres Strait Islander. With the inclusion of these confounders in the model, associations were found between environmental degradation (including dryland salinity) and several diseases with known environmentally-mediated triggers, including asthma, ischaemic heart disease, suicide and depression. However, once records of individuals who had been diagnosed with coexistent depression were removed from the analysis, the effect of dryland salinity was no longer statistically detectable for asthma, ischaemic heart disease or suicide, although the effects of socio-economic status and size of the Aboriginal population remained. The spatial component of this study showed an association between land degradation and human health. These results indicated that such processes are driving the degree of psychological ill-health in these populations, although it remains uncertain whether this 4 is secondary to overall coexisting rural poverty or some other environmental mechanism. To further investigate this complex issue an instrument designed to measure mental health problems in rural communities was developed. Components of the survey included possible triggers for mental health, including environmental factors. The interview was administered in a pilot study through a telephone survey of a small number of farmers in South-Western Australia. Using logistic regression a significant association between the mental health of male farmers and dryland salinity was detected. However, the sample size of the survey was too small to detect any statistically significant associations between dryland salinity and the mental health of women. The results of this study indicate that dryland salinity, as with other examples of ecosystem degradation, is associated with an increased burden of human disease.

The use of quality-of-life as an outcome measure provides detailed information about the effectiveness of medical treatments than morbidity or mortality rates alone. The use of quality-of-life data in the clinical setting can inform patients regarding treatment options, treatment benefits and costs. In competing health care markets, outcome measurement is regarded as important as it is concerned with the impact of health care practice and affects health policy decisions. Doessel (1978) conducted the first Australian study on the cost-effectiveness analysis of renal replacement therapies. The study was based on Klarman, Francis & Rosenthal's (1968) the study, where the output was measured in terms of the number of life years gained from kidney transplantation, and a twenty-five percent weight was allocated in an attempt to capture quality-of-life from kidney transplantation. Doessel (1978) used two sources of data: Australian data (Disney 1974) and European data (Gurland et al. 1973; Shiel et al. 1974). The study measured life years gained, and agreed with the Klarman et al. (1974) findings that transplantation is the most effective way to increase life expectancy of persons with chronic renal disease (Butler & Doessel 1989). The outputs of the alternative treatments were not reported in monetary terms; the study focused on life years gained as the output measure. Hence the importance of this current study, which includes a cost-effectiveness analysis for cadaver liver, and living kidney transplantation for end-stage liver and kidney disease patients. Calls to respect patient autonomy and to produce patient-centered outcomes have recently brought the patient’s point of view back into the center of clinical medicine (Sullivan 2003). Survival rates indicate one measure of outcome however they do not reflect patients’ perceptions of health benefit or experiences. Noting that patients’ psychosocial effect on functioning is of more concern to them than their physical Thesis Preamble iii ability, that more accurate knowledge of patients’ conditions be measured prior to transplantation (Tarter et al. 1991). Recently researchers advocated investigating transplant patients' states of health to assess the social benefit of these expensive health care services from their perspective (Joralemon & Fujinaga 1997). The current study's mixed method, bridges the gaps in treatment outcome measurements, as the mixed method applied (Creswell 1994; Sim & Sharp 1998) prospectively measured quality-oflife, determined health utility, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The study reported the living donors experience of the donation process, described their needs; expressed using a new psychosocial model supporting future living kidney donor's during the donation process.

Children in upper primary school who have not made progress along the Swimming and Water Safety Continuum may be at a greater risk in an aquatic environment because they have not developed the swimming competency, endurance and skills needed for survival in threatening aquatic situations. Three groups representing different socio-economic and geographical areas were selected to explore the relationships between psycho-social factors and the development of swimming ability among year seven students. Two groups from lower socio-economic areas were chosen. The first group was directly on the coast with easy access to the beach, while the second group was inland in the foothills of Perth. As higher socio-economic areas in Perth are generally not far from the coast only one group from a higher socio-economic coastal area was chosen. The participants were 540 year seven students, 282 of whom were males and 258 of whom were females. The primary variable of interest was the current swimming stage of year seven participants, and the differences between genders and/or locality groups. The primary research questions investigated differences between locality groups and/or genders for; a) perceived athletic competence and global self-worth, b) perceived swimming competency, confidence in deep water and importance placed on learning to swim well. c) perceived social support for sport and swimming activities and d) attendance at Interm, Vacswim and other swimming programs and aquatic venue experience. Relationships between swimming stage and the above variables were analysed. The secondary research questions investigated the most frequent reasons given by the students for not attending or discontinuing participation inVacswim, and whether there were differences between locality groups or genders. Findings indicated that the lower socio-economic groups had a significantly lower swimming stage and lower perceived self-worth than the higher socioeconomic group. Students from the lower socio-economic inland area had the lowest mean swimming stage as well as lower perceived social support for sport and swimming than either of the other two groups in the study. The two lower socioeconomic groups also attended less swimming instruction and placed less emphasis on the importance of learning to swim well than the higher socio-economic group. Despite these findings, the lower socio-economic groups did not view themselves as any less able in terms of athletic and swimming competence. However, as the two lower socio-economic groups have not progressed along the Swimming and Water Safety Continuum to the 'desirable standards' of the RLSSA (1999), these groups could be viewed as at-risk in an aquatic environment. At the same time, there was evidence that attendance at Interm along with attendance at another swimming program enabled participants to reach the 'desirable standards' of the RLSSA (1999). Girls generally had a higher swimming stage than boys in the lower socio-economic areas, attended year seven Interm and Vacswim more than boys, reported more social support for sport and swimming, and placed more emphasis on the importance of learning to swim well than boys. While many of these relationships between swimming stage and psycho-social factors have been intuitively accepted within the swimming teaching industry, we now have a better understanding of the strength and direction of these relationships.

[Truncated abstract] Background: A review of the literature indicated there was a need for more long-term randomised controlled studies on the effects of BRCA counselling/testing on high risk women, including improved strategies for risk communication. Reviews have also shown women are confused about the significance of inconclusive or non informative results with a need for more research in this area. Aims: The general aim of this study was to evaluate the impact of breast cancer genetic counselling on psychological distress levels, perception of risk, genetic knowledge and understanding of BRCA testing/test results in a cohort of 207 women from high risk breast cancer families who were referred for genetic counselling in Perth during the period 1997 to 2001. Short- and long-term impact of BRCA genetic counselling/testing was determined in women with and without cancer in a randomised controlled trial as part of which women were randomised to either receive immediate versus delayed genetic counselling. This included family communication patterns before BRCA testing, anticipated outcomes of testing on oneself and family including intentions for result disclosure. Comprehension of index and predictive BRCA testing with possible results was assessed both in the short- and the long-term and understanding of individual or family BRCA test results was evaluated at long-term. The effect of genetic counselling on breast cancer risk perception in unaffected women was evaluated. This study considered a theoretical framework of educational learning theories to provide a basis for risk communication with possible relevance for future research. ... Only 25% of the original study population (52/207) reported BRCA results and women's understanding of results is concerning. Key findings were: 1. The majority of affected women received an inconclusive result. 2. Out of twelve unaffected women who reported results, seven were inconclusive which are not congruent with predictive testing. This implies that these women did not understand their test result. 3. A minority of untested relatives did not know whether a family mutation had or had not been found in their tested family member or what their actual test result was. This implies either a lack of disclosure or that woman did not understand the rationale for and significance of testing for a family mutation. 4. Three relatives did not understand a positive result was a mutation. Conclusion: The implication of this research for breast cancer counselling and testing services is that women who wait for counselling are no worse off in terms of short- or long-term general psychological distress than women who receive the intervention early. There is a suggestion that unaffected women without the disease found counselling more advantageous than affected women. The meaning of BRCA results as reported by women is concerning particularly women's understanding of negative and inconclusive results and further research is needed in this area. Too much information presented at counselling may affect women's comprehension of risk, BRCA testing and future test results and further research is required to evaluate the effects of information overload.

Thesis (MA)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: Violence against women, commonly known as women abuse, is currently evolving into a serious social problem. In South Africa thousands of women are victims of violence inflicted by their intimate partners. Although violence against women is a serious violation of human rights, it is often not recognised as such. Violence against women in intimate relationships often results in women experiencing serious physical, psychological and reproductive health problems. When living or trapped in abusive relationships, women are exposed to injuries, ailments and diseases, wounds, chronic pain, infertility and internal bleeding. In spite of the fact that governments, including the South Africa government, have committed themselves to addressing women abuse through legislation, large numbers of women still experience extraordinary high levels of violence. However, many women neglect to report incidents of violence. Many women remain in such relationships, legislation aimed at protecting their rights not withstanding. The aim of this study was to explore why women neglect to report incidents of violence and to explore women's experiences of violence. Seven coloured women between the ages of 21 and 38 years and living in a small rural town in the Western Cape participated in the study. In-depth interviews were used to obtain information from these women. The extent of the problem of women abuse worldwide and in South Africa is illustrated by research conducted internationally as well as locally. Radical feminism is used as a theoretical framework to interpret the causes of women abuse, the 'acceptance' of women abuse by the community and society and the reasons why women choose not to report incidents of abuse. The analysis and the interpretation of the data is done against the background of social practices embedded in the patriarchal structuring of society. It was found that women's experiences and lives are predominantly structured in terms of their sex and that women comply with expectations set by their intimate partners, family and friends. In order to maintain their relationships, secure a household income and to protect their children against poverty, women remain silent about the abuse they suffer. The study also found that women's responses to abuse relate to the sources and options available to them.
AFRIKAANSE OPSOMMING: Geweld teen vroue wat algemeen bekend staan as vrouernishandeling, is tans besig om in 'n ernstige sosiale probleem te ontwikkel. Binne die Suid-Afrikaanse konteks is duisende vroue die slagoffers van geweld binne intieme verhoudings. Alhoewel vrouernishandeling 'n ernstige skending van menseregte is, word dit nie altyd as sodanig erken nie. Mishandeling binne intieme verhoudings lê dikwels ten grondslag van vroue se fisiese, sielkundige en reproduktiewe gesondheidsprobleme. Vroue wat vasgevang is in sulke verhoudings word blootgestel aan beserings, kwale en siektes, wonde, kroniese pyn, onvrugbaarheid en interne bloeding. Ten spyte van die feit dat verskeie lande se regenngs, insluitende Suid-Afrika, hulself verbind het tot 'n stryd teen vrouernishandeling met behulp van wetgewing, ervaar groot getalle vroue wêreldwyd nog steeds buitengewone vlakke van geweld. Baie vroue versuim egter om insidente van mishandeling te rapporteer. Baie vroue bly in intieme verhoudings ten spyte daarvan dat wetgewing wat gerig is op die beskerming van hul regte in plek is. Die doel van hierdie studie was dus om vas te stel waarom vroue versuim om insidente van mishandeling te rapporteer en om insig te verkry in die ervaringswêreld van mishandelde vroue. Sewe Kleurling vroue tussen die ouderdomme van 21 en 38 jaar en woonagtig in 'n klein plattelandse dorpie in die Wes-Kaap het aan die studie deelgeneem. 'n Kwalitatiewe benadering is gevolg en data is met behulp van in-diepte onderhoude ingesamel. Die omvang van vrouernishandeling wêreldwyd en binne die Suid-Afrikaanse konteks word geïllustreer aan die hand van internasionale en plaaslike navorsing oor die verskynsel. Radikale feminisme word as teoretiese vertrekpunt geneem in die interpretasie van die oorsake van vroumishandeling, die 'aanvaarding' van die verskynsel deur die gemeenskap en samelewing en die redes waarom vroue nie insidente van geweld rapporteer nie. Die analise en interpretasie van data is gedoen teen die agtergrond van sosiale praktyke binne die konteks van patriargale strukturering van die samelewing. Die studie bevind dat vroue se ervarings grootliks gestruktureer word in terme van hul geslag en dat hulle hul gedrag in ooreenstemming bring met die verwagtings van hul intieme maats, vriende en familie. Ten einde hulle verhoudings in stand te hou, 'n huishoudelike inkomste te verseker en hul kinders teen armoede te beskerm, besluit vroue om 'n stilswye rondom hul mishandeling te handhaaf. Die studie toon dat vroue se response verband hou met die bronne en opsies wat tot hul beskikking is.

This research study looked at the cultural value preferences in Western management practice for African manager and non-manager employees exemplified by Nigerian cement industries. The study specifically focused on management practice of leadership, motivation, recruitment and promotion around which their cultural values, the meaning of their work-world and their coping strategies are structured. From management and culture theory perspectives, managerial practices are affected both by Western factors, such as education, money, challenging tasks, and by traditional factors, such as family, ethnicity, social connections etc. The theoretical bases for this study drew largely from three streams of literature. The first theoretical base for the study relates to traditional African environment of management, especially the cultural perspectives. The second drew largely from the theoretical discourse on culture, management and organisation perspectives. The mainstream schools of management discourse on management theories and models as proposed by Western management theorists represent the third stream. As a methodology, the study used a quantitative questionnaire survey and qualitative open-ended interviews to collect data on the manager and non-manager employees in the organisations. The quantitative questionnaires and open-ended interviews centered national dimensions of cultures and on these Western and traditional factors of: leadership styles, motivation, dedication, satisfaction, ethnicity, family and social connections. The survey confirms that the dimension of national cultures of Nigeria as measured by the work-values and desires of the employees population are somehow different from those obtained by Hofstede’s study for the West African Region. Nigeria is still more collectivistic, although at least Nigeria has become relatively more individualist since Hofstede’s study. Over the years between Hofstede’ IBM study and the present study, there has been no change in the difference in Power Distance. Power Distance is much higher in Nigeria, like elsewhere in Africa, and this is unlikely to change for the foreseeable future. The large Power Distance in Nigeria means that the ideal manager is benevolent paternalistic. On recruitment and promotion, one major point made is that the traditional factors are generally felt by the respondents as influencing employees’ recruitment and promotion more than the modern (intrinsic) factors. The employees however, generally felt that the modern (intrinsic) factors should or ought to have greater influence. Building on the premises that every society is unique and its trajectory is shaped by its unique historical events, cultural norms and values, it can be argued that since the history of Western management concept in Africa is short, Africa then has a unique opportunity to develop its own unique management values based on its unique traditions. However, the increasing globalisation of market economies suggests that management values in Nigeria in particular and Africa in general can hardly be realised without proactively contributing to the Western management concepts in its unique ways. As the intensity of interaction between Western management practices and African traditional values increases, we can anticipate the increase in the importance of a new form of management concepts and practices in various African countries. Based on others and this study, the study proposes a “management heterogeneity” concept that reflects this new and unique perspective. Management heterogeneity perspective endorses the view that the practice of leadership, motivation, recruitment and promotion are developed differently in different cultural societies and organisations. But it adopts a pragmatic position on the mounting social and economic challenges now facing African organisations and argues further that management techniques, skills and behaviours practiced in different cultures and organisations can be brought together in a positive synergistic blend to address the needs of a given society and organisation and improve its ability to deliver effective and relevant values to its actors. It is the ability to judiciously select and combine the Western and traditional values and practices into new practices that fit the managerial requirements of a given group of organisational members that provides management its competitive edge in a culturally dynamic management environment.

ABSTRACT Background: Mothers experienced enormous physical and emotional changes, especially during childbirth. Birth support role of husbands reassured both husband and wife about labor and birth. This study aimed to review the first-time advisory experience of husbands during labor time of primigravida wife. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selection; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The search included ScienceDirect, Wiley Online Library, ProQuest, and grey literature through Google Scholar search engine databases. The inclusion criteria were English/ Indonesian-language and full-text articles in peer-reviewed journals published between 2009 and 2019. A total of 543,111 articles were obtained by the searched database. After the review process, six articles were eligible for this review. The data were reported by the PRISMA flow chart. Results: Six articles from developed countries (Australia, Sweden, Singapore, Israel, and England) met the inclusion criteria with qualitative and quantitative (cross-sectional) studies. Three main aspects discussed were support, challenges, and psychological conditions of experience of husbands during labor time of pregnancy. Support of husbands was identified as physical and moral. Challenges faced by husbands included lack of preparedness, knowledge, and encouragement from health care professionals. Psychological conditions of satisfaction and concern were found in husbands’ transition to fatherhood. Conclusion: Responsibility, emotion, experience, and barrier of husbands are related to maternal health problems. Better involvement of fathers will be able to enhance better quality of relationships and family health through understanding, experience, and assistance, especially in the childbirth process. Keywords: advisory, husbands, experience, labor, pregnancy Correspondence: Nuristy Brillian Ainindyahsari Winarna. Universitas ‘Aisyiyah Yogyakarta. Jl. Siliwangi (Ring Road Barat) No 63 Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta, 55292. Email: nuristybrillian02@gmail.com. Mobile: +6285338800207. DOI: https://doi.org/10.26911/the7thicph.03.66