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Background: Despite the significant access and cost-saving potential of telehealth, the uptake of telehealth services in Australia has been sporadic. Understanding the factors that drive the uptake of home-telehealth services from the consumer perspective has received scant attention in the literature.Aim: The aim of this study was to explore how a comprehensive set of factors may influence the intention of older Australians to adopt home telehealth services.Methods: A survey of 306 Australians aged between 50 and 68 years was conducted to examine the influence of six categories of predictors on the intention of older Australians to adopt home telehealth: (a) demographics, (b) health status and usage, (c) mobility and ease of access to healthcare, (d) technology usage and anxiety with technology, (e) telehealth attitudes, and (f) personality traits.Results: Hierarchical regression analysis revealed that significant predictors were: trust in telehealth (β = 0.35); the technology acceptance model (β = 0.27); healthcare habits (β = -0.20); dissatisfaction with traditional healthcare (β = 0.19) and online behaviors (β = 0.09). The model explained 63% of the variance in intention to adopt home telehealth.Conclusion: This study is the first of its kind in Australia and provides valuable insight into the factors which impact consumer's intention to adopt telehealth services. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effectiveness of the Neighbors Helping Neighbors program. The study included surveys of 49 community-residing older adults and 26 community volunteers. Results showed that older adults perceived their quality of life to have improved after receiving social and environmental services; volunteers felt that their contributions to the program had made a significant difference in their community. This exploratory, descriptive study is only a beginning effort, but it holds great promise for suggesting ways to address the needs of the burgeoning aging population in our society. [ABSTRACT FROM AUTHOR]

As the nation struggles with the great increase in the numbers of older adults, many questions arise about how to provide housing and long-term care options that will ensure the quality of life of older adults. This study demonstrates that older adults and their families perceive quality of life more positively once moved from a nursing home to an assisted living facility using Medicaid funds. Results of this exploratory study are promising and suggest that having housing options available across the continuum of care with individualized case management offers older adults the hope for 'quality living.' [ABSTRACT FROM AUTHOR]

Background: The positive health and wellbeing effects of social support have been consistently demonstrated in the literature since the late 1970s. However, a better understanding of the effects of age and sex is required.Method: We examined the factor structure and reliability of Kessler's Perceived Social Support (KPSS) measure in a community-based sample that comprised younger and older adult cohorts from the Australian Twin Registry (ATR), totalling 11,389 males and females aged 18-95, of whom 887 were retested 25 months later.Results: Factor analysis consistently identified seven factors: support from spouse, twin, children, parents, relatives, friends and helping support. Internal reliability for the seven dimensions ranged from 0.87 to 0.71 and test-retest reliability ranged from 0.75 to 0.48. Perceived support was only marginally higher in females. Age dependencies were explored. Across the age range, there was a slight decline (more marked in females) in the perceived support from spouse, parent and friend, a slight increase in perceived relative and helping support for males but none for females, a substantial increase in the perceived support from children for males and females and a negligible decline in total KPSS for females against a negligible increase for males. The perceived support from twin remained constant. Females were more likely to have a confidant, although this declined with age whilst increasing with age for males.Conclusions: Total scores for perceived social support conflate heterogeneous patterns on sub-scales that differ markedly by age and sex. Our paper describes these relationships in detail in a very large Australian sample. [ABSTRACT FROM AUTHOR]

In recent years, the Australian university sector has undergone large-scale organizational change, including restructuring, downsizing and government funding cuts. At the same time, research from across the globe reports an alarming increase in the occupational stress experienced by university staff. We report on the first phase of a longitudinal investigation of occupational stress. A total of 22 focus groups were conducted with a representative sample of 178 academic and general staff from 15 Australian universities. The groups focused on understanding staff 's experience of occupational stress, and perceptions of the sources, consequences and moderators of stress. Both general and academic staff reported a dramatic increase in stress during the previous 5 years. As a group, academic staff reported higher levels of stress than general staff. Five major sources of stress were identified including: insufficient funding and resources; work overload; poor management practice; job insecurity; and insufficient recognition and reward. The majority of groups reported that job-related stress was having a deleterious impact on their professional work and personal welfare. Aspects of the work environment (support from co-workers and management, recognition and achievement, high morale, flexible working conditions), and personal coping strategies (stress management techniques, work/ non-work balance, tight role boundaries and lowering standards), were reported to help staff cope with stress. The findings provide a timely insight into the experience of stress within universities. [ABSTRACT FROM AUTHOR]

Background: Somatoform disorders such as neurasthenia and chronic fatigue are characterized by a combination of prolonged fatigue and disabling neuropsychological and neuromuscular symptoms. However, the debate concerning the theoretical underpinnings of somatic disorders resembles the perennial dispute over the taxonomy of anxiety and depression. The objective of this study is to analyse the dimensional structure of items measuring anxiety, depression, phobic anxiety, somatic distress, and insomnia. It is anticipated that somatic distress should emerge as empirically distinct from measures of anxiety and depression, thereby lending support to proponents of the construct as independent of both anxiety and depression symptomatology.Methods: A 33-item self-report symptom inventory derived from the SCL-90 and DSSI/sAD scales was used to measure recently experienced psychiatric distress in the form of depression, anxiety, phobic anxiety, somatic distress, and insomnia. SCL and DSSI/sAD items were measured on a four-point distress scale from 1 'not-at-all' to 4 'unbearably'. The inventory was administered to a community-based sample of 3468 Australian twins between the ages of 18 and 28.Results: Factor analysis using Polychoric correlations and a Promax rotation criterion produced four factors: depression, phobic anxiety, somatic distress, and sleep disturbance.Conclusion: Results from the current factor analysis, together with the documented prevalence of somatic disorders, including evidence regarding the genetic and biological independence of somatic symptomatology, lend support to the argument that somatic symptoms, although correlated, are independent of anxiety and depression. [ABSTRACT FROM AUTHOR]

The past decade has witnessed a dramatic surge of research activity on trust in the workplace, coupled with a convergence amongst scholars on the central features that define trust. However research on the measurement of trust has lagged behind these developments resulting in the widespread use of measures that are incongruent with the defining features of trust. This paper describes the development and validation of the Behavioural Trust Inventory (BTI). The BTI measures the willingness to engage in trusting behaviour in interpersonal work relationships between leaders, members and peers. The development and validation of the BTI was supported by interviews, qualitative survey data, and cross-sectional and longitudinal quantitative data drawn from three samples; a pilot sample comprising 39 staff, a validation sample comprising 81 research and development project leaders and 234 team members, and a cross-validation sample of 67 managers and 214 of their direct reports. The BTI contributes to the literature by offering a validated, reliable and multidimensional measure of trust applicable to leader-member and peer relationships in work settings. [ABSTRACT FROM AUTHOR]

Objective To investigate whether diagnostic data from structured interviews, primary care and specialist care registries on major depressive disorder ( MDD), anxiety disorders ( AD) and alcohol use disorder ( AUD) identify the same individuals, yield comparable comorbidity estimates and reflect the same genetic influences. Methods Registry data from primary and specialist care were available for 11 727 twins and diagnostic interview data for 2271 of these. We used logistic regression analyses and biometric modelling to investigate the overlap between the data sources. Results Most individuals meeting diagnostic criteria at interview were not registered with a corresponding diagnosis. The rates of registration were higher for MDD (36% in primary care and 15% in specialist care) and AD (21% and 18%) than for AUD (3% and 7%). Comorbidity estimated as odds ratios, but not as polychoric correlations, was higher in the registries than in the interviews. Genetic influences on the disorders were highly correlated across data sources (median r = 0.81), bordering unity for MDD and AD. Conclusion Prevalence and comorbidity estimates differ between registries and population-based assessment. Nevertheless, diagnoses from health registries reflect the same genetic influences as common mental disorders assessed in the general population, indicating generalizability of aetiological factors across data sources. [ABSTRACT FROM AUTHOR]

The precise nature of how genetic and environmental risk factors influence changes in alcohol use (AU) over time has not yet been investigated. Therefore, the aim of the present study is to examine the nature of longitudinal changes in these risk factors to AU from mid-adolescence through young adulthood. Using a large sample of male twins, we compared five developmental models that each makes different predictions regarding the longitudinal changes in genetic and environmental risks for AU. The best-fitting model indicated that genetic influences were consistent with a gradual growth in the liability to AU, whereas unique environmental risk factors were consistent with an accumulation of risks across time. These results imply that two distinct processes influence adolescent AU between the ages of 15-25. Genetic effects influence baseline levels of AU and rates of change across time, while unique environmental effects are more cumulative. [ABSTRACT FROM AUTHOR]

The heritability of attention-deficit/hyperactivity disorder (ADHD) is higher for children than adults. This may be due to increasing importance of environment in symptom variation, measurement inaccuracy when two raters report behavior of a twin-pair, a contrast effect resulting from parental comparison of siblings and/or dimensionality of measures. We examine rater contrast and sex effects in ADHD subtypes using a dimensional scale and compare the aetiology of self, versus maternal-report. Data were collected using the Strengths and Weaknesses of ADHD and Normal Behaviour Scale (SWAN): maternal-report for 3,223 twins and siblings (mean age 21.2, SD = 6.3) and self-report for 1,617 twins and siblings (mean age 25.5, SD = 3.2). Contrast effects and magnitude of genetic and environmental contributions to variance of ADHD phenotypes (inattention, hyperactivity-impulsivity, combined behaviours) were examined using structural equation modeling. Contrast effects were evident for maternal-report hyperactivity-impulsivity ( b = −0.04) and self-report inattention (−0.09) and combined ADHD (−0.08). Dominant genetic effects were shared by raters for inattention, hyperactivity-impulsivity and combined ADHD. Broad-sense heritability was equal across sex for maternal-report inattention, hyperactivity-impulsivity and combined ADHD (0.72, 0.83, 0.80). Heritability for corresponding subtypes in self-reported data were best represented by sex (0.46, 0.30, 0.39 for males; 0.69, 0.41, 0.65 for females). Heritability difference between maternal and self-report ADHD was due to greater variance of male specific environment in self-report data. Self-reported ADHD differed across sex by magnitude of specific environment and genetic effects. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of the angiotensin converting enzyme inhibitor perindopril on six minute walking distance and quality of life in very old patients with left ventricular systolic dysfunction.Design: Prospective, double blind placebo controlled trial.Setting: Medicine for the elderly day hospital.Patients: 66 patients (average age 81) with left ventricular systolic dysfunction identified by echocardiography.Interventions: 10 weeks of treatment with titrated doses of perindopril or placebo.Main Outcome Measures: Six minute walking distance 10 weeks following treatment, quality of life measurements including the Minnesota living with heart failure questionnaire and the 36 item short form health survey.Results: In patients with left ventricular systolic dysfunction, six minute walking distance was significantly increased in the treatment group (37.1 m) compared with the placebo group (-0.3 m, p < 0.001). The medication was well tolerated and there were no significant adverse events.Conclusions: Six minute walking distance is improved considerably by treatment with perindopril in older patients with heart failure caused by left ventricular systolic dysfunction. [ABSTRACT FROM AUTHOR]

Presents an abstract of the study 'Crossmodal Links in Attention and Inhibition of Return Between Audition, Vision, and Touch,' submitted to the Fifteenth International Australasian Winter Conference on Brain Research in Queenstown, New Zealand in August to September 1997.

Objectives: To determine if RJR Nabisco's cartoon-theme advertising is more effective in promoting Camel cigarettes to children or to adults. To determine if children see, remember, and are influenced by cigarette advertising.Design: Use of four standard marketing measures to compare the effects of Camel's Old Joe cartoon advertising on children and adults.Subjects: High school students, grades 9 through 12, from five regions of the United States, and adults, aged 21 years and over, from Massachusetts.Outcome Measures: Recognition of Camel's Old Joe cartoon character, product and brand name recall, brand preference, appeal of advertising themes.Results: Children were more likely to report prior exposure to the Old Joe cartoon character (97.7% vs 72.2%; P less than .0001). Children were better able to identify the type of product being advertised (97.5% vs 67.0%; P less than .0001) and the the Camel cigarette brand name (93.6% vs 57.7%; P less than .0001). Children also found the Camel cigarette advertisements more appealing (P less than .0001). Camel's share of the illegal children's cigarette market segment has increased from 0.5% to 32.8%, representing sales estimated at $476 million per year.Conclusion: Old Joe Camel cartoon advertisements are far more successful at marketing Camel cigarettes to children than to adults. This finding is consistent with tobacco industry documents that indicate that a major function of tobacco advertising is to promote and maintain tobacco addiction among children. [ABSTRACT FROM AUTHOR]

Psychological stress is associated with increased oxidative stress, a pro-inflammatory state, increased rates of infection, and cardiovascular disease. Cardiovascular disease is also associated with increased stress, homocysteine and Creative protein (CRP) levels. Occupational stress, and psychological strain were measured and correlated with homocysteine, CRP, salivary IgA and oxidative stress in 43 university employees to test stress induced oxidative damage. The research questions were: Does psychological strain increase the innate/inflammatory response as indicated by increased CRP; decrease acquired immunity as indicated by decreased Immunoglobulin A (IgA); increase the pro-oxidant state as indicated by decreased lymphocytic 5'-ectonucleotidase (NT) and Vitamin C stores; and increase cardiovascular disease (CVD) risk parameters as indicated by increased homocysteine and CRP? The study confirmed that certain psychological stress parameters are associated with pro-oxidant/pro-inflammatory states as evidenced by either decreased NT levels and/or increased CRP concentrations. Conversely, positive or low stress parameters indicating good life skill mechanisms were associated with increased NT and decreased CRP — indications of a low pro-oxidant state. Homocysteine was associated with increased anger (anger suppression/'anger-IN' and anger-experience/'AX/EX Score'), psychological parameters known to be associated with cardiovascular disease, as is mildly elevated CRP and homocysteine. We conclude that psychological well being and stress can influence biochemical parameters respectively in both positive and negative ways in relation to immunity and cardiovascular disease processes. Psychological stress parameters can influence biochemical changes in a healthy population, which are indicative of increased CVD risk and problems associated with a decreased acquired immunity. [ABSTRACT FROM AUTHOR]