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Many motives for undertaking a counter-urban move appear to be associated with a search for a sense of 'home', such as moving for a sense of community, for affordable or larger housing, perceptions of a 'safer' area for children, or moving to a childhood hometown. However, rarely is counter-urban migration directly linked to the concept of home. In this paper, I make the direct link between counter-urban moves and the search for a sense of home using biographies of four (4) counter-urban movers to the Sunshine Coast, Australia. The participants each moved to the area in a search for a sense of home related to four key themes: housing, family, stability and familiarity, however they varied in their pre-move experiences and expectations of how the Sunshine Coast would improve their sense of home. These differences impacted their post-move experiences, as those participants with prior familiarity with the Sunshine Coast felt a greater sense of home post-move. This paper provides an important conceptual link between the search for a sense of home and counterurbanisation, to add further critical insight into motivations and experiences of counter-urban migrants, and the perceptions of a sense of home being better achieved outside of major cities.. [ABSTRACT FROM AUTHOR]

Healthcare professionals' advice on lifestyle behaviours is a key factor in improving a nation's health. Although allied health professionals have been well placed to provide such advice as part of patient care, little is known about the characteristics of allied health practitioners who discuss lifestyle topics with patients. This paper focused upon an overlooked avenue for lifestyle advice regarding an allied health profession – osteopathy. A workforce survey including questions about four lifestyle topics (including diet/nutrition, smoking/drugs/alcohol, physical activity/fitness, and stress management) was distributed to a nationally representative sample of Australian registered osteopaths in 2016. Separate multivariate logistic regression and Poisson regression models were developed to determine the most important predictors of the discussion of lifestyle factors. Amongst the 992 participating osteopaths, 89%, 49%, 38%, and 18% often discussed physical activity/fitness, stress management, diet/nutrition, and smoking/drugs/alcohol with their patients, respectively. Approximately 30% of participating osteopaths discussed at least three lifestyle topics with patients. Varied predictors were identified for discussing each lifestyle topic. Osteopaths who often discuss diet/nutrition in patient management plans were more likely to often discuss smoking/drugs/alcohol (OR = 14.13), physical activity/fitness (OR = 2.71), and/or stress management (OR = 1.69). In conclusion, lifestyle factors are often discussed with patients as part of osteopathy treatments in the Australian healthcare context. Osteopaths are well positioned to initiate discussions regarding patient lifestyles, and such discussions may be an effective contribution to health promotion. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to explore the perceptions, attitudes and beliefs of middle‐aged Australians around their health, lifestyle risks and chronic disease. Background: Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. Design: A qualitative descriptive study using semi‐structured interviews. Reporting was guided by the COREQ checklist. Methods: Thirty‐four participants aged 40–65 years were recruited across South Eastern New South Wales, Australia, using convenience sampling. Semi‐structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. Results: Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles; denial; an impetus for change; and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. Conclusions: Understanding the perceptions of health of middle‐aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. Relevance to Clinical Practice: These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person‐centred health promotion and chronic disease prevention strategies in this age group. [ABSTRACT FROM AUTHOR]

Lifestyle risk factors are antecedents to many chronic conditions and are largely modifiable. Health professional support is often sought to reduce lifestyle risk. The ongoing relationship general practice nurses typically have with patients situates them ideally to provide this support. This paper explores the barriers and facilitators to lifestyle risk communication by registered nurses (RNs) in Australian general practice. Fifteen general practice RNs from south-eastern Australia participated in semistructured interviews. Verbatim transcriptions of the audio-recorded interviews were analysed using thematic analysis. Six themes emerged in terms of perceived barriers and facilitators: educational preparation and confidence; organisational and funding arrangements; lifestyle risk prioritisation; organisational support; autonomous roles; and supporting patients' needs. Although communication about lifestyle risk factors is within the general practice nurses' scope of practice, concerted efforts fostering interdisciplinary collaboration, the prioritisation of time, funding and educational opportunities would better support this role, at the same time optimising chronic disease management and patient outcomes. General practice nurses undertake chronic disease management and discuss lifestyle risk reduction with patients. However, a concerted approach is required to support this practice. Prioritising time, funding, education, collaborative relationships and optimising the capacity for general practice nurses to work to their full scope of practice are necessary to support communication related to lifestyle risk reduction. [ABSTRACT FROM AUTHOR]

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Vietnamese in Australia have become a strong community with a unique culture and lifestyle. A lot of research about the community has been conducted by Australian and other researchers under sociological, cultural, and anthropological views. Based on the publications relating to the Vietnamese lifestyle, this paper discusses some issues related to the ways of living, the preservation of community culture and the sharing of cultural values in families. There are three main parts in this paper: the arrival of Vietnamese in Australia, Vietnamese lifestyle in Australia as shown in international publications, and discussion. [ABSTRACT FROM AUTHOR]

Life cycle energy analysis (LCEA) is used to assign energy values to product flows in each phase of an activity’s life cycle. In the case of a residential building, this usually comprises energy embodied in the manufacture of building materials, energy used in the building’s operation, and in periodic maintenance. In order to place these amounts of energy in a national context, the energy embodied in other goods and services consumed by householders also needs to be considered. This paper uses LCEA to demonstrate the need for considering not only the life cycle energy of the building but also the life cycle energy attributable to activities being undertaken by actual users of the building. The life cycle energy of an Australian residential building as well as common activities of households are analysed and simulated over a 30 year period using a worked example of a two bedroom, brick-veneer, semi-detached unit. The importance of considering the energy embodied in the initial construction of a residential building as well as the consumption of goods and services by householders is demonstrated as having long-term implications. In order to encourage sustainable living practices it is suggested that architects more closely consider the activities of householders when designing residential buildings, especially in temperate climates. The paper concludes by identifying future areas of research for LCEA in the residential sector. Les études de cycle de vie antérieures à: la construction ont tendance à omettre les phases situées après la démolition. Si le recyclage n'a pas été prévu, il n'est donc pas possible d'en évaluer les bénéfices. Une étude paramétrique portant sur une maison individuelle fait le point sur les économies d'énergie potentielles après la démolition rendues possibles par la réutilisation des divers mateacute;riaux de construction. Les résultats indiquent qu'il est peut être plus important de concevoir un bâtiment en vue de son recyclage que d'employer des matériaux exigeant peu d'énergie lors de la fabrication, ce qui fait que la mise au point d'un recyclage efficace dépend de sa prise en compte et de son intégration lors de la phase de conception; de cette façon la réutilisation et l'adaptation des éléments de base existants sont des composantes importantes de ce recyclage. [ABSTRACT FROM AUTHOR]

Objectives: In this paper, we report maintenance of behavior change in a nutrition and physical activity intervention for cancer survivors at 12-months follow-up. Methods: The ENRICH (Exercise and Nutrition Routine Improving Cancer Health) program was an 8-week face-to-face program for cancer survivors and caregivers, focused on healthy eating, healthy weight, resistance training, and a walking program. Randomized controlled trial participants completed a survey and 7-days of pedometry at baseline, 8-weeks, and 20-weeks. Intervention participants completed 12-month measures. Maintenance was assessed by examining change between 20-weeks and 12-months for cancer survivors. Results: Sixty cancer survivors in the intervention group completed baseline data collection, and 29 (48%) completed 12-month assessments. Initial improvements in step counts, weight, and body mass index were maintained from 20-weeks to 12-months. Vegetable consumption declined significantly (difference -30g/day; p = .04). Moderate-to-vigorous physical activity increased significantly (difference 55 minutes/week; p = .05). Conclusions: Physical activity and weight improvements were maintained over 12-months indicating the potential for a multiple health behavior intervention to help cancer survivors sustain improvements to lifestyle behaviors. Additional support is warranted to assist cancer survivors to make and maintain dietary changes. [ABSTRACT FROM AUTHOR]

There is extensive evidence that health promotion routinely benefits those who are already most socioeconomically advantaged. While the government's healthy ageing policy recognizes that improving health outcomes will require a range of strategies involving different target groups, recommendations focus on the issues and needs of the comfortable majority. This paper examines the scope and relevance of health promotion for one disadvantaged minority with extensive health needs: homeless older men. In an ethnographic study of older men (⩾ 50 years of age) living alone in the inner city (Sydney), 32 men were identified as homeless and are the focus of this paper. Face to face semi-structured interviews were used to record the men's accounts of their everyday lives, including their health and use of services. The conditions in which these men were living were observed and recorded, and the researchers were aware of health and other services available in the geographic area. All informants were living on or below the poverty line. They reported a range of health conditions, for which many accessed available mainstream and specialist health services. Some obstacles to accessing services were noted. Information relevant to widely endorsed prescriptions for ‘healthy ageing’ also emerged. These included physical activity (especially walking), healthy eating, social activity and adopting healthy lifestyle habits. Findings highlight the extent to which these men lack the basic requirements for healthy ageing, notably adequate incomes and housing. At the same time, within the constraints of the lifestyle they lead, they are motivated to maintain their health and independence. While there are limits to what can be achieved for such people at a local level of service delivery, it is possible to identify feasible health promotion goals and service strategies. [ABSTRACT FROM AUTHOR]

Background: Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses' overall health and the presence of chronic disease; to describe nurses' health-related behaviours and to compare them to those of the general population, with both groups matched by age and gender. Methods: Cross-sectional descriptive paper-based survey of nurses from two Sydney metropolitan hospitals using established instruments and questions and measurements taken with standardised methods. Results: This nursing sample (n = 381) had a mean age of 39.9 (SD 11.7, range 20-67) years, Most (n = 315; 82.7 %) were female, worked full-time (80.0 %), and were shift workers (93.0 %). The majority (94.0 %) indicated good, very good or excellent health, despite 42.8 % indicating they had chronic disease. The most common risk factors for chronic disease were inadequate vegetable (92.6 %) and fruit intake (80.1 %), overweight and obesity (44.0 %) and risky alcohol intake (34.7 %); health screening behaviours were not ideal. Aside from overweight and obesity, these risk factors were more prevalent in nurses than the equivalent group of the New South Wales population, particularly for risky alcohol intake which was much more common in female nurses and most marked in those aged under 35 years. However, 80 % met the guidelines for physical activity, more than the equivalent group of the New South Wales population. Conclusion: There are early ‘warning signs' concerning the health status of nurses. Despite perceiving current good health, support is required for nurses to prevent future chronic disease, particularly in the areas of nutrition and alcohol intake. With these concerns, the nursing workforce ageing and demands for care increasing, it is now time to implement health enhancing strategies for nurses. [ABSTRACT FROM AUTHOR]

This paper examines health and safety issues for small farms in Australia. It provides evidence that small area farmers face similar hazards to that of larger operations. The results also indicate that further work is required to assist these producers in understanding both their legal obligations in respect to health and safety, plus the types of effective control actions they can take to reduce risk. Small area farmers received little information on health and safety, but for those that did, the usual means was through word of mouth or pathways outside the typical communication networks of larger farms. There is significant scope to work with and improve the dissemination of health and safety information for small area farmers and to transfer this information into practical skills to reduce health and safety risks. [ABSTRACT FROM AUTHOR]

In the context of rising chronic diseases amongst Indigenous peoples, there are calls for the adoption of more healthy “lifestyles.” In this context, this paper explores thoughts about physical activity from 21 Indigenous families through the voices of women and girls living in remote rural communities in the Torres Strait and Northern Peninsula Area, Australia. Speaking back to physical activity as a lifestyle “choice,” three consistent themes emerged: shame, gendered positioning, and welfarism. In conclusion, the perspectives of Torres Strait islanders and Northern Peninsula Area communities suggest that there are deeply embedded ways of thinking about the body, familial obligations, and the provision of and access to being active that are not consistent with Western health policies predicated upon individuals shouldering responsibility for “taking exercise.” [ABSTRACT FROM PUBLISHER]

Background: Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems. Methods: The Crossroads II study was a large-scale cross-sectional study undertaken in the Goulburn Valley region of Victoria, Australia in 2016–18. Data were collected from randomly selected households across four rural and regional towns and then screening clinics from individuals from these households. The main outcome measures were self-reported mental health problems of psychological distress assessed by the Kessler 10 and depression assessed by Patient Health Questionnaire-9. Unadjusted odd ratios and 95% confidence intervals of factors associated with the two mental health problems were calculated using simple logistic regression with multiple logistic regression using hierarchical modelling to adjust for the potential confounders. Results: Of the 741 adult participants (55.6% females), 67.4% were aged ≥ 55 years. Based on the questionnaires, 16.2% and 13.6% had threshold-level psychological distress and depression, respectively. Of those with threshold-level K-10 scores, 19.0% and 10.5% had seen a psychologist or a psychiatrist respectively while 24.2% and 9.5% of those experiencing depression had seen a psychologist or a psychiatrist, respectively in the past year. Factors such as being unmarried, current smoker, obesity, were significantly associated with a higher prevalence of mental health problems whereas physical activity, and community participation reduced the risk of mental health problems. Compared to rural towns, the regional town had higher risk of depression which was non-significant after adjusting for community participation and health conditions. Conclusions: The high prevalence of psychological distress and depression in this rural population was consistent with other rural studies. Personal and lifestyle factors were more relevant to mental health problems than degree of rurality in Victoria. Targeted lifestyle interventions could assist in reducing mental illness risk and preventing further distress. [ABSTRACT FROM AUTHOR]

Background: Approximately 1 in 20 men are sub-fertile or infertile yet the aetiologies of male infertility remain largely unexplained. It is suggested that lifestyle choices and environmental factors contribute but research is limited. In particular, no study has evaluated early life exposures and subsequent male infertility. To address this knowledge gap, this study aims to characterise a cohort of men with idiopathic infertility and compare their general health, lifestyle choices and environmental exposures from teenage years onwards to men without reproductive abnormalities. Methods: Two groups of men (N = 500 cases; N = 500 controls), matched for age and socio-economic status, will be recruited from fertility clinics around Australia between June 2021 and June 2024. Men will be eligible if they are between 18 and 50 years, with a female partner less than 42 years, and have identified idiopathic male infertility (case) or are part of a couple with diagnosed female factor infertility but with no indication of compromised male fertility (control). Participants will complete an in-depth survey on general health, lifestyle and environmental exposures, reporting from teenage years onwards. An online medical data capture form will be used to gather fertility assessment information from participant medical records. Biological specimens of saliva (all study participants), blood and urine (optional) will be collected and stored for future genetic and epigenetic analysis. Differences in outcome measures between cases and controls will be determined using appropriate between groups comparisons. The relationship between explanatory variables and infertility will be analysed using multilevel modelling to account for clustering within fertility clinics. Discussion: This study addresses an important gap in research on the aetiology of male infertility and will provide a comprehensive profile of the lifestyle and environmental risk factors for male infertility, leading to provision of up-to-date health advice for male teenagers and adults about optimising their fertility. Plain language summary: Approximately 1 in 20 men are sub-fertile or infertile yet very little is known about the causes of male infertility. Research has suggested that lifestyle choices and environmental factors contribute to infertility, but more needs to be done to identify and verify the full suite of associations. We will recruit up to 1000 Australian male partners within couples who are seeking help from fertility clinics to get pregnant. They will be asked about their general health, lifestyle and environmental exposures at home or work over their lifespan. We will compare findings between men who are sub- or infertile with men who are not. Any differences will help us understand what factors may be associated with risk of infertility in men. This study will provide important information to clinicians and to inform public policy that will lead to prevention and improved treatment strategies for infertile men. The data gathered from this study will enable future research including the genetic and epigenetic basis of male infertility. [ABSTRACT FROM AUTHOR]

Background: Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. Objectives: The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. Design: The study involved 1657 pregnant women from the Australian Longitudinal Study on Women's Health, who completed surveys from 2006 to 2012 (aged 28–39 years). Methods: Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0–<33.3 MET.min/week), (2) Low (33.3–<500 MET.min/week), (3) Moderate (500–<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). Results: There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). Conclusion: Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking is associated with worse cognition and decreased cortical volume and thickness in healthy cohorts. Chronic cigarette smoking is prevalent in schizophrenia spectrum disorders (SSD), but the effects of smoking status on the brain and cognition in SSD are not clear. This study aimed to understand whether cognitive performance and brain morphology differed between smoking and non-smoking individuals with SSD compared to healthy controls. Methods: Data were obtained from the Australian Schizophrenia Research Bank. Cognitive functioning was measured in 299 controls and 455 SSD patients. Cortical volume, thickness and surface area data were analysed from T1-weighted structural scans obtained in a subset of the sample (n = 82 controls, n = 201 SSD). Associations between smoking status (cigarette smoker/non-smoker), cognition and brain morphology were tested using analyses of covariance, including diagnosis as a moderator. Results: No smoking by diagnosis interactions were evident, and no significant differences were revealed between smokers and non-smokers across any of the variables measured, with the exception of a significantly thinner left posterior cingulate in smokers compared to non-smokers. Several main effects of smoking in the cognitive, volume and thickness analyses were initially significant but did not survive false discovery rate (FDR) correction. Conclusions: Despite the general absence of significant FDR-corrected findings, trend-level effects suggest the possibility that subtle smoking-related effects exist but were not uncovered due to low statistical power. An investigation of this topic is encouraged to confirm and expand on our findings. [ABSTRACT FROM AUTHOR]

Searching for and selling real estate in Australia and worldwide changed this century with the proliferation of web and mobile platforms for real estate, now often known as Realtech. These platforms offer enticing images of homes as commodities, emphasizing desirable lifestyles and opportunities for renovation and capital gains. In comparison with previous advertising media, real estate platforms powerfully mediate spatiality, mobilizing attraction images that intensify the experience of house hunting. Maps and floorplans, photos and videos, drone shots and 3D walkthroughs, algorithms and interaction design present buyers with complex but not unified impressions of space and place. This article provides a critical history of these changes in the cultural field of real estate in Australia with the rise of the platforms Domain and realestate.com.au. It connects these sociotechnical and industrial changes with the influence of neo-liberal ideology and the framing of homes as commodities. Through a textual, visual, spatial and content analysis of online real estate advertising in three contrasting suburbs in Sydney, Australia, it observes the intensification of three dominant strategies for promoting real estate: the lifestyle image, the opportunity image, and the attraction image. It shows how these images vary across geography, class and subculture. [ABSTRACT FROM AUTHOR]

Over the last two decades there has been a steady decline in youth migration to Australian rural communities. Generally, inland agricultural communities are the most seriously impacted by this trend. Coupled with high rates of youth out-migration, many rural communities face difficulties in attracting young people to fill skilled job vacancies and apprentice positions. Declining youth in-migration also has social consequences, effectively reducing the capacity of rural communities to replenish their skill base and social networks. This research identifies how urban-based youth perceive rural lifestyles and employment opportunities and how this is linked to their willingness to move to rural areas. The study reveals that young people attach undesirable aesthetic values to the physical environment of inland rural communities and perceive them as socially isolating and as having minimal opportunities for career advancement. However, the perceptions of those who live, or had lived, in rural areas are far more positive than those who have had little experience in rural communities. Accordingly, those who had previously lived in inland regions were far more likely to move to rural areas than those who had limited lived experience of rural communities. Overall, the research found that perceptions of lifestyle and employment opportunities were important influences on young people's willingness to move to rural communities. [ABSTRACT FROM AUTHOR]

Background: Young adults gain more weight annually than other adults and may be destined for future obesity. Effective interventions are needed, and social support may be a key element for success. The present study explores how best to leverage social media to support young adults with their health goals in a healthy lifestyle programme. Method: Young adults aged 18–25 years were recruited from the community to a series of four focus groups led by an experienced facilitator who used a discussion guide developed a priori. The discussion explored their opinions regarding which social media platforms were appropriate for providing social support, the types of support that were relevant (family and friends versus strangers) and factors that would encourage peer‐to‐peer communication in a healthy lifestyle intervention. Sessions were audio‐taped, transcribed and analysed using the qualitative software, nvivo, version 11 (QSR International Pty Ltd., Melbourne, VIC, Australia). Themes were generated using an inductive approach informed by the Theory of Social Identity and Social Influence Model of Consumer Participation. Results: Thirty‐three people (12 male) participated. Facebook was the most popular platform for facilitating social support as a result of its private group capabilities and already being embedded into their daily routines. The preference was to be grouped with strangers who shared similar goals in smaller groups of participants. The discussions highlighted the integral role of a credible and relatable health coach to serve as a mentor, mediator and role model. Conclusions: The learnings from this research will be applied to optimise engagement within social media support groups in lifestyle interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine differences in eating and physical activity behaviours among ethnic groups in Queensland, Australia, and differences in those behaviours due to the duration of residency in Australia.Design: Cross-sectional study using baseline data collected for the Living Well Multicultural-Lifestyle Modification Program between October 2014 and June 2017.Setting: Culturally and linguistically diverse communities (CALD), including Afghani, Somali, Burmese, Pacific and South Sea Islander, Sri Lankan, Sudanese and Vietnamese, living in Queensland, Australia.Participants: People were recruited if they were ≥18 years old and living in the targeted CALD communities.Results: Burmese/Vietnamese, on average, had better eating scores in line with Australian dietary guidelines, compared with Afghani/Arabic-speaking (difference = 2·05 points, 95 % CI 1·39, 2·72), Somali/Sudanese (difference = 1·53 points, 95 % CI 0·79, 2·28) and Pacific Islander (difference = 1·46 points, 95 % CI 0·79, 2·13). Association between ethnicity and meeting the physical activity guideline was not significant. Those who stayed in Australia longer than a year were less likely to meet the physical activity guideline than those staying <1 year (OR = 0·51, 95 % CI 0·31, 0·84). There was no significant association between duration of residency in Australia and eating scores.Conclusions: Eating behaviours were significantly different among the ethnic groups in Queensland with Burmese/Vietnamese and Sri Lankan/Bhutanese having the healthiest diets. All ethnic groups were less likely to meet the physical activity guideline compared with the general Australian population. People with duration of residency of at least 1 year in Australia were less likely to meet the physical activity guideline compared with those who had shorter stays. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer in women worldwide. Weight gain after breast cancer is associated with poorer health outcomes. The aim of this study was to describe how Australian breast cancer survivors are currently managing their weight.Methods: Online cross-sectional survey open to any woman living in Australia who self-identified as having breast cancer, between November 2017 and January 2018.Results: We received 309 responses. Most respondents described their diet as good/excellent and reported moderate-high levels of weight self-efficacy. Despite this, the proportion of overweight/obesity increased from 47% at time of diagnosis to 67% at time of survey. More than three quarters of respondents did not receive any advice on weight gain prevention at the time of diagnosis. 39% of women reported being less active after cancer diagnosis, and and few weight loss interventions were perceived to be effective. Facilitators were structured exercise programs, prescribed diets, and accountability to someone else, while commonly cited barriers were lack of motivation/willpower, fatigue, and difficulty maintaining weight. Women who cited fatigue as a barrier were almost twice as likely to be doing low levels of physical activity (PA) or no PA than women who did not cite fatigue as a barrier.Conclusions: We report high levels of concern about weight gain after BC and significant gaps in service provision around weight gain prevention and weight management. Women with BC should be provided with support for weight gain prevention in the early survivorship phase, which should include structured PA and dietary changes in combination with behavioural change and social support. Weight gain prevention or weight loss programs should address barriers such as fatigue. More research is required on the effectiveness of diet and exercise interventions in BC survivors, particularly with regard to weight gain prevention. [ABSTRACT FROM AUTHOR]

Background: Explanatory evaluation of interventions for prevention of weight gain is required beyond changes in weight, to determine for whom the intervention works and the underlying mechanisms of change. It was hypothesised that participant characteristics moderate intervention effect on weight change and improved eating and physical activity behaviours during the 3-month program mediate the relationship between intervention and weight. Methods: In our randomised controlled trial, young adults at risk of weight gain (P = 250) were assigned either n to an intervention group that received a 3-month mHealth (TXT2BFiT) program with 6-month maintenance or to a control group. Data were collected via online self-report surveys. Hypothesised moderators and mediators of the intervention effect on weight were independently assessed in PROCESS macro models for 3 and 9-month weight change. Results: Males (P = 0.01), mid-20s age group (P = 0.04), and higher income earners (P = 0.02) moderated intervention effects on weight change at 3-months and males only at 9-months (P = 0.02). Weight change at 3 (-1.12 kg) and P 9-months (-1.38 kg) remained significant when 3-month nutrition and physical activity behaviours were specified as mediators (P<0.01 and = 0.01 respectively). Indirect paths explained 39 % (0.72/1.85 kg) and 40 % (0.92/2.3 kg) of total effect on weight change at 3 and 9-months respectively. Increased vegetable intake by intervention group at 3-months accounted for 19 and 17 % and decreased sugar-sweetened beverages accounted for 8 and 13 % of indirect weight change effects at 3 and 9-months respectively. Conclusions: TXT2BFiT was effective for both young men and women. Small sustained behavioural changes, including increased vegetable intake and decreased sugar-sweetened beverages consumption significantly mediated the intervention's effects on weight change. Improved eating behaviours and increased physical activity accounted for approximately 40 % of the weight change. Trial registration: The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000924853). [ABSTRACT FROM AUTHOR]

Objective: This pilot study aimed to establish the appropriateness of the Model of Juggling Occupations in exploring the complex experience of role balance amongst working women with family responsibilities living in Perth, Australia. Methods: In meeting this aim, an evaluation was conducted of a case study design, where data were collected through a questionnaire, time diary, and interview. Results: Overall role balance varied over time and across participants. Positive indicators of role balance occurred frequently in the questionnaires and time diaries, despite the interviews revealing a predominance of negative evaluations of role balance. Between-role balance was achieved through compatible role overlap, buffering, and renewal. An exploration of within-role balance factors demonstrated that occupational participation, values, interests, personal causation, and habits were related to role balance. Conclusions: This pilot study concluded that the Model of Juggling Occupations is an appropriate conceptual framework to explore the complex and dynamic experience of role balance amongst working women with family responsibilities. It was also confirmed that the case study design, including the questionnaire, time diary, and interview methods, is suitable for researching role balance from this perspective. [ABSTRACT FROM AUTHOR]

Physiotherapists may have an impact on obesity prevention and treatment by providing nutrition and physical activity advice to overweight or obese clients; yet little is known about physiotherapists' beliefs and practices related to client weight management. The aim of this pilot study was to determine the practices, beliefs, attitudes and knowledge of physiotherapists regarding the provision of weight management advice to overweight or obese clients. Physiotherapists ( n = 65) working in multiple practice settings completed a self-administered questionnaire. Logistic regression determined factors associated with the provision of dietary and physical activity advice for weight management. The majority of physiotherapists ( n = 53 [81.5%]) believed providing weight management advice was within their scope of practice, yet only a minority had received training during their professional entry level education ( n = 13 [20%]) or through professional development ( n = 7 [11%]). Most physiotherapists ( n = 55 [84.6%]) provided physical activity advice for weight management, but a minority ( n = 27 [41.5%]) provided dietary advice. Having received training in weight management during their professional entry level education was associated with providing dietary advice (Odds ratio 8.8, 95% confidence interval 2.0-38.9, p = 0.004). Training in weight management may increase the likelihood of physiotherapists providing dietary advice, improving physiotherapists' management of obesity. [ABSTRACT FROM AUTHOR]

Background Nutrition education for cardiovascular disease (CVD) management is not effective for all population groups. There is little understanding of the factors that hinder patients from adhering to dietary recommendations. Methods 37 interviews were conducted with people living with CVD in Adelaide, Australia. Recruitment occurred via General Practitioner (GP) clinics and hospital cardiac rehabilitation programs. Participants were either receiving preventive treatment or active treatment for established CVD. Results The volume and contradictory nature of dietary information were the most prominent barriers to making changes identified in interviews, especially by order participants. Conclusion Patients will seek out, or come into contact with information which contradicts advice from their GPs. The volume of information may lead them to resort to old and familiar habits. GPs play a valuable role in highlighting key take-home messages and reliable external sources of information. The findings have implications for GP practice given that lifestyle changes are a cost- and clinically-effective means of managing CVD. [ABSTRACT FROM AUTHOR]

Background In rural and remote Australia, cardiovascular mortality and morbidity rates are higher than metropolitan rates. This study analysed cardiovascular and other chronic disease risk factors and related health behaviours by occupational status, to determine whether agricultural workers have higher cardiovascular disease (CVD) risk than other rural workers. Methods Cross-sectional surveys in three rural regions of South Eastern Australia (2004-2006). A stratified random sample of 1001 men and women aged 25-74 from electoral rolls were categorised by occupation into agricultural workers (men = 214, women = 79), technicians (men = 123), managers (men = 148, women = 272) and 'home duties (women = 165). Data were collected from self-administered questionnaire, physical measurements and laboratory tests. Cardiovascular disease (CVD) and coronary heart disease (CHD) risk were assessed by Framingham 5 years risk calculation. Results Amongst men, agricultural workers had higher occupational physical activity levels, healthier more traditional diet, lower alcohol consumption, lower fasting plasma glucose, the lowest proportion of daily smokers and lower age-adjusted 5 year CVD and CHD risk scores. Amongst women, managers were younger with higher HDL cholesterol, lower systolic blood pressure, less hypertension, lower waist circumference, less self-reported diabetes and better 5 year CVD and CHD risk scores. Agricultural workers did not have higher cardiovascular disease risk than other occupational groups. Conclusions Previous studies have suggested that farmers have higher risks of cardiovascular disease but this is because the risk has been compared with non-rural populations. In this study, the comparison has been made with other rural occupations. Cardiovascular risk reduction programs are justified for all. Programs tailored only for agricultural workers are unwarranted. [ABSTRACT FROM AUTHOR]

The aims of this study were to examine: (1) the association between sociodemographic and lifestyle factors and sleep quality in a population-based cohort of Australian women and (2) possible influence of reproductive status and mental and physical health factors on these associations. Data on 3,655 women (mean age = 46.6 years, range 34.3-67.4) were obtained from the Mater Hospital University of Queensland Study of Pregnancy for this cross-sectional study. Self-rated sleep quality was assessed using the Pittsburgh Sleep Quality Index. For the purpose of this study, two cutoff points (scores 5 and 10) were used to divide women into three categories: normal (65.2 %), moderately poor (26.4 %), and very poor sleep quality (8.5 %). Other covariates were measured at 21-year follow-up as well. After adjusting for reproductive status, mental and physical health, there were significant associations between moderately poor sleep quality and education and between very poor sleep quality and unemployment, both measures of socioeconomic status. In addition, work-related exertion was associated with increased rates of moderately poor sleep quality, whereas those women undertaking moderate exercise were less likely to experience very poor sleep quality. Independent associations between sociodemographic factors and exercise with moderately poor and very poor sleep quality were identified. These findings demonstrate the dynamic nature of the association between exercise/exertion, socioeconomic status, and sleep quality and highlight the importance of taking these into consideration when dealing with issues of poor sleep quality in women. [ABSTRACT FROM AUTHOR]

Signifi cant transformations of the health care services sector over the past three decades have seen an increasing reliance on the private provision of health care services mediated through private health insurance. In countries such as Australia and the UK, private health insurance is promoted as providing a greater choice for individuals and easing the burden on the public system. While these claims, the policy contexts and the decision-making processes of individual consumers have attracted some sociological attention, little has been said about the role of private insurers. In this article we present a comparative analysis of the websites of private health insurers in Australia and the UK. Our analysis highlights adoption by private health insurers of neoliberal discourses of choice and individual responsibility, partnership and healthy lifestyles. In these respects, similarities between the discourses over-ride national differences which might otherwise be expected given their contrasting health care traditions and contexts. [ABSTRACT FROM AUTHOR]

The work-life balance is a pressing social issue in Australia but one on which geographers have been relatively silent. Predictions of ‘a leisure society’ have not been fulfilled. Instead, work has come to dominate life in Australia and in many other advanced western societies. The reasons for this are explored. Materialism is at the heart of the work-life imbalance. There is, however, evidence of a changing work ethic and the emergence of leisure-orientated lifestyles, albeit with ‘leisure’ interpreted as ‘freedom to’ undertake gratifying activity rather than simply ‘freedom from’ obligatory commitments. Despite the supposed homogenising influence of globalisation and the internet, place will become increasingly important in a leisure-orientated lifestyle-led future. [ABSTRACT FROM AUTHOR]

Background: Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS. Methods: Ten women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison. Results: Women in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children's meal preferences. Conclusions: Women with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS. [ABSTRACT FROM AUTHOR]