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Older people who are wanting to support their own ability to age well may benefit from attending community-based group programs. However, many of these programs are designed and implemented by health professionals without direct input from older people, which may limit the opportunity to ensure such programs are authentically meeting the needs of this population group. A qualitative approach, using an interpretative phenomenological analysis (IPA), was undertaken with seven (six female and one male) participants, aged between 62 and 80 years to explore the experiences of participating in a pilot Ageing Well Program. Interviews were transcribed and analysed according to IPA principles. Three themes emerged from the analysis of the interview data: (1) The value of focusing on different aspects of ageing; (2) Learning new knowledge; and (3) Transferring skills to everyday life. Participants in the pilot of the Ageing Well Program highlighted that those aspects of the Program, such as the focus on adding value through targeting multiple aspects of ageing, as well as developing strategies to successfully learn, apply, and translate new knowledge into their everyday lives, were beneficial and supported engagement. However, future programs would benefit from the inclusion of clear and coherent written material to provide an aide in remembering the strategies and new information learnt during the Program. Findings support the importance and value of engaging with older people to assist with the development of community-based programs that are authentically designed to align with the expectations of older people, through a process of quality improvement. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is a commonly occurring, yet historically poorly understood, mental health concern among post-secondary students. The present study sought to identify the current knowledge needs of university stakeholders to inform training efforts around effective NSSI response and student support on university campuses. Participants were 1,762 university students, staff, and student-staff (77% female) from seven universities in Canada, the USA, New Zealand, and Australia. Participants completed an online survey about their attitudes and knowledge of both general mental health and NSSI. University stakeholders reported significantly greater stigma toward NSSI than mental illness in general. Student-staff reported greater perceived knowledge and comfort, and demonstrated greater knowledge of NSSI, than students and staff. Findings underscore the need for additional training and resources to reduce stigma and increase knowledge about NSSI on university campuses internationally. [ABSTRACT FROM AUTHOR]

The Australian multiple sclerosis (MS) community experienced two recent major crises, widespread bushfires and the COVID 19 pandemic. We aimed to understand the needs of persons with MS during times of crisis. A consumer-directed mixed-method study. We included an online survey, semi-structured interviews, and a workshop with persons with MS, carers, healthcare professionals, and disability advocates. Data were collected via: (1) 176 people completing online surveys to identify crisis concerns and communications, (2) 29 people completing online interviews on bushfire and pandemic impact, and (3) 13 people participating in a crises-priorities workshop. Descriptive data were calculated for survey response, and a general inductive analytical approach was taken with interview and workshop responses. The most significant concerns were bushfire smoke exposure and disease-modifying-medication and susceptibility to COVID-19 (66% and 63% mean concern score, respectively). Interviews indicated crises experiences from the bushfires, and the pandemic overlapped respective of changes in mood and symptom stability. For bushfires, a need for future preparations, and for the pandemic, the benefits of social restrictions, disclosing personal health information and increased care burden were important. Multiple crises challenged the MS community but offered lessons for healthcare in future crises. Continued progress in centralised crisis information, with considered use of telehealth and rural healthcare support, is needed. The MS community showed high concerns for the effect of toxic smoke from the 2019/2020 Australian bushfires and, separately, for the disease-modifying-medication and susceptibility to COVID-19. The MS community placed priority on a crisis management plan for individuals. Reduced social activity due to restrictions was beneficial for MS symptom self-awareness and may help overall fatigue management. Healthcare system preparation must prepare to alleviate increased carer workload at times of crisis. [ABSTRACT FROM AUTHOR]

The article focuses on the implementation of the National Dementia Education and Training Standards Framework (NDETSF) to enhance workforce development for dementia care in Australia. Topics discussed include the establishment and operation of the Specialist Dementia Care Program (SDCP), the creation of comprehensive training guidelines for staff using the NDETSF, and the importance of exercise for individuals living with dementia in improving their overall quality of life.

Self-harm remains a major health issue, particularly for adolescents. This qualitative study explored the reflections of adults who had self-harmed during adolescence. Foci included reasons for commencing and ceasing self-harm, as well as the perceived meaning of the self-harm and advice they would provide to adolescents currently engaging in self-harm. Participants included 185 adults aged 18 to 61 years, who had self-harmed at least once in adolescence. Participants responded to four qualitative questions that were part of a larger survey. Participants' responses were analyzed using either directed or conventional content analysis. Participants reported ambivalence about their self-harm with coexisting feelings of shame along with a recognition of the functions served by the behavior. The most frequently reported reasons for cessation included changes in personal relationships, frustration with shame, and receiving professional treatment. Most participants encouraged adolescents currently self-harming to seek help and to develop alternative coping mechanisms, although harm minimization also emerged as a theme. These findings are compared to international findings on reasons for initiation and cessation of self-harm as well as the advice for others. These insights may guide clinicians' understanding of motivations for adolescent self-harm and effective management of this behavior. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) often leads to reduced physical activity and exercise participation. Sedentary behaviour is associated with poor health, whereas exercise is effective in managing MS symptoms. This study assessed physical activity, exercise and sedentary sitting time, and identified associations with symptoms. Participants of the Australian MS Longitudinal Study completed surveys in 2016. We measured physical activity and sitting time via the International Physical Activity Questionnaire (short-form), and assessed participation in exercise (type and duration). Multivariable regression models assessed associations between physical activity, sitting time and exercise; and demographic characteristics and MS-related symptoms. Of the 1216 participants, 53.0% reported moderate-high physical activity levels (71.5% among those with no/mild disability). Median sitting time was 7 h/day. Most (78.4%) participated in aerobic exercise, while only 16.4% participated in strength training. Having a progressive MS onset, more severe symptoms (i.e., cognitive impairment, depression, fatigue, mobility impairment) and being male was indicative of lower physical activity levels and higher sitting time. Health promotion efforts should encourage physical activity and exercise, in particular strength training, among people with MS. People with more severe symptoms and progressive disease may require focused exercise promotion from healthcare professionals. Comprehensive MS management should include strategies to increase physical activity and exercise participation, with particular focus upon people with higher MS-symptom burden (i.e., depression, fatigue and mobility and cognitive impairment), men, and those with progressive onset MS. Efforts to promote physical activity guidelines for people with MS and address barriers to physical activity must be implemented in standard MS care, with a particular focus on adhering to strength training guidelines. Exercise type and duration varies among people with MS, and it would behove healthcare professionals and researchers to consider promoting activities which align with individuals preferences and abilities when promoting exercise. [ABSTRACT FROM AUTHOR]

Background/objectives: Associations between patterns of food intake and health in people with multiple sclerosis (MS) are of increasing global interest; however, Australian data are lacking. This study aimed to assess the dietary habits and associations with health outcomes of Australians with MS.Subjects/methods: This cross-sectional study used 2016 survey data from the Australian MS Longitudinal Study, including the Dietary Habits Questionnaire, Hospital Anxiety and Depression Scale, Assessment of Quality of Life, Fatigue Severity Scale, Patient-Determined Disease Steps Scale and 13 MS symptoms scales. Regression models were constructed using directed acyclic graphs.Results: Almost all (94.3%) of the 1490 participants reported making an effort to eating healthy with 21.2% following one or more specific diets, although often not strictly. Overall, 7.9% reported not eating meat, 8.1% reported not consuming dairy, and 4.0% consumed neither food group. A healthier diet score was associated with better mental, physical and total quality of life, and lower depression, and pain scores, and fewer cognition, vision and bowel symptoms. Higher reported fibre, fruit, vegetable and healthy fat scores were positively associated with most health outcomes.Conclusions: Healthier overall diet scores and higher fibre, fruit and vegetable scores were associated with better health outcomes in this sample of Australians adults with MS. However, the proportion of participants avoiding dairy and meat, or adhering to a specific MS diet was much lower than previously reported. Prospective dietary studies are needed to further understand whether dietary change is feasible and affects health outcomes over time. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is an inflammatory, neurodegenerative disease of the central nervous system which results in disability over time and reduced quality of life. To increase the sensitivity of the EQ-5D-5L for psychosocial health, four bolt-on items from the AQoL-8D were used to create the nine-item EQ-5D-5L-Psychosocial. We aimed to externally validate the EQ-5D-5L-Psychosocial in a large cohort of people with MS (pwMS) and explore the discriminatory power of the new instrument with EQ-5D-5L/AQoL-8D., Methods: A large representative sample from the Australian MS Longitudinal Study completed the AQoL-8D and EQ-5D-5L (including EQ VAS) and both instruments health state utilities (HSUs) were scored using Australian tariffs. Sociodemographic/clinical data were also collected. External validity of EQ-5D-5L-Psychosocial scoring algorithm was assessed with mean absolute errors (MAE) and Spearman's correlation coefficient. Discriminatory sensitivity was assessed with an examination of ceiling/floor effects, and disability severity classifications., Results: Among 1683 participants (mean age: 58.6 years; 80% female), over half (55%) had moderate or severe disability. MAE (0.063) and the distribution of the prediction error were similar to the original development study. Mean (± standard deviation) HSUs were EQ-5D-5L: 0.58 ± 0.32, EQ-5D-5L-Psychosocial 0.62 ± 0.29, and AQoL-8D: 0.63 ± 0.20. N = 157 (10%) scored perfect health (i.e. HSU = 1.0) on the EQ-5D-5L, but reported a mean HSU of 0.90 on the alternative instruments. The Sleep bolt-on dimension was particularly important for pwMS., Conclusions: The EQ-5D-5L-Psychosocial is more sensitive than the EQ-5D-5L in pwMS whose HSUs approach those reflecting full health. When respondent burden is taken into account, the EQ-5D-5L-Psychosocial is preferential to the AQoL-8D. We suggest a larger confirmatory study comparing all prevalent multi-attribute utility instruments for pwMS., (© 2022. The Author(s).)

Aim: The aim of this research is to synthesize findings from primary studies (quantitative and qualitative) that investigated the global mental health experiences of single mothers to provide a deeper understanding to better care and respond to the support needs of single mothers., Design: Hayvaert et al.'s mixed methods research synthesis approach., Data Sources: The search process in the following databases, CINAHL, PsycINFO, and Scopus resulted in eight high-quality studies (5 qualitative and 3 quantitative) published between June 2016 and July 2021., Review Methods: Descriptive statistics and instrument scores were provided in summary form. Themes were analysed using Krippendorff's content analysis. A joint display was provided to reveal a complementary relationship between two different data sets., Results: A total of 348 single mothers participated. Amongst the pooled sample, women identified as: Japanese (n = 174), Israeli (n = 147), Black African (n = 18), African American (n = 9), Native American (n = 5), Burundian-Australian (n = 8), UK British (n = 12), Asian (n = 3), South Korean (n = 7), Indian (n = 2), Malaysian (n = 44), Hispanic/Latina (n = 1) and Eastern European (n = 3). Four themes were identified: (1) Learning to let go of the past, (2) It takes a whole village: Importance of social support, (3) Seeking a self-reliant life: Challenges with balancing career & childcare and (4) Finding strength within: Personal growth. Only one intervention utilizing creative group counselling was found to significantly decrease depression (p = .008), anxiety (p = .005), and stress (p = .012) whilst increasing self-compassion (p = .013)., Conclusion: It is important for clinicians who care for single mothers, particularly if they recently immigrated, are multiparous, and an ethnic minority to encourage engagement in peer-initiated counselling and obtain mental health care as necessary., Impact: This study identified and addressed the mental health issues that single mothers face worldwide. This is also the first mixed methods research synthesis to report single mothers' ethnicity in nursing and midwifery literature. Thus, findings from this mixed methods research synthesis can help nurses worldwide build culturally-concordant programs in their respective community organizations and partners (e.g. community health centres, mother-child enrichment clubs), inform health policies, and promote safer spaces for many single mothers, particularly for those who will immigrate to the Global North (i.e. UK, US, Canada) and become an ethnic minority., (© 2022 John Wiley & Sons Ltd.)

Objective: The aim of this study was to explore the experience of participation in sport and exercise for individuals with multiple sclerosis (MS) with minimal disability. The objectives were to gain an understanding of key factors that influence participation in sport and exercise and to determine support required by individuals with MS to participate in their choice of sport and exercise for as long as possible. Methods: A qualitative, descriptive study utilizing three focus groups was conducted. Data were analysed thematically aided by NVivo software. Participants were individuals with MS who had an Expanded Disability Status Scale score of 0–4, indicating full ambulation. All participants were living in northern Queensland, Australia. Results: Sixteen individuals participated; 63% of whom regularly participated in sport or exercise. All participants viewed sport and exercise positively and identified inherent benefits of exercise. Five key themes emerged to describe the experience of participating in sport and exercise: "personally engaging with exercise," "influencing barriers and enablers of exercise," "sustaining independence," "integrating exercise into lifestyle," and "getting the balance right." Most participants felt that advice and guidance from health professionals about the optimum mode and dose (how much and how often) of exercise was lacking. Conclusions: Participation in sport and exercise was valued by individuals with MS with minimal disability for sustaining independence and an active lifestyle. Personalized exercise advice from health professionals was the key support identified by participants to assist them to maintain an active lifestyle for as long as possible. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is particularly prevalent during adolescence and emerging adulthood. The salience of shame during these developmental periods suggests that shame may be inherently linked to NSSI, and at least partially explain the high rates of NSSI observed among youth. In this article, a theoretical developmental model relating shame and NSSI is proposed, and results from a preliminary test of a sub-set of cross-sectional relationships in this model is presented. In the model tested, it was hypothesized that adverse caregiving experiences in prior development (i.e., childhood to late adolescence) like parental invalidation and child maltreatment, established predictors of NSSI, would be linked to proximal episodes of NSSI (i.e., past year) through current shame-proneness (i.e., experiencing shame in a trait-like manner) and internalizing shame-coping (i.e., responding to shame through attacking one's self and withdrawing). It was also hypothesized that some key proximal predictors of NSSI during youth development, such as low body esteem, increased loneliness and heightened psychological distress, would be linked to proximal NSSI via shame-proneness and internalizing shame-coping. Using structural equation modelling, it was observed that data, obtained via self-reports completed by 573 emerging adults (age in years: M = 20.7, SD= 2.20, 69.1% female, NSSI history: n = 220, where most recent NSSI episode was within a year of study participation) recruited throughout Australia between June 2013 and June 2014, fit the hypothesized model well. Tests of indirect effects indicated that current shame-proneness and internalizing shame-coping significantly linked perceived parental invalidation and prior experiences of child maltreatment to proximal NSSI, though this relationship was, unexpectedly, an inverse one in relation to child maltreatment. Current shame-proneness was also linked to proximal NSSI via internalizing shame-coping, current loneliness, and current psychological distress, but not through current body esteem. Finally, proximal self-evaluations of body esteem, loneliness and increased psychological distress were linked to recent NSSI through internalizing shame-coping. The theory and findings presented in this article contribute to a deeper developmental understanding of NSSI among youth, highlight crucial pathways between adverse caregiving experiences and NSSI, and illuminate important shame-based mechanisms that potentially warrant clinical attention for at-risk individuals. Future research directions and clinical recommendations are discussed. [ABSTRACT FROM AUTHOR]

Objective: Self-compassion has been framed as a healthy alternative to self-esteem, as it is nonevaluative. However, rather than being alternatives, it may be that the two constructs develop in a mutually reinforcing way. The present study tested this possibility among adolescents.Method: A large adolescent sample (N = 2,809; 49.8% female) reported levels of trait self-esteem and self-compassion annually for 4 years. Autoregressive cross-lagged structural equation models were used to estimate the reciprocal longitudinal relations between the two constructs.Results: Self-esteem consistently predicted changes in self-compassion across the 4 years of the study, but not vice versa.Conclusions: Self-esteem appears to be an important antecedent of the development of self-compassion, perhaps because the capacity to extend compassion toward the self depends on one's appraisals of worthiness. These findings add important insights to our theoretical understanding of the development of self-compassion. [ABSTRACT FROM AUTHOR]

Background: There is emerging evidence that early maladaptive schemas (EMS) may be a cognitive vulnerability factor in nonsuicidal self-injury (NSSI). The current study sought to examine the relationship between EMS and NSSI history, and whether this is moderated by gender, in a community youth sample., Method: Participants were 403 Australian secondary and university students aged between 16 and 25 years, who completed a survey of NSSI history, EMS, and general emotional distress., Results: Logistic regression analysis indicated that being female, depression, and EMS scores were useful for differentiating between youth reporting NSSI history and those who did not. High levels of Defectiveness/Shame and Abandonment/Instability schema scores, and low levels of Emotional Inhibition schema scores, were associated with NSSI history. Gender did not moderate the relationships between these EMS scores and NSSI history., Conclusions: Present results suggest that aspects of the schema domain of Disconnection and Rejection are important for identifying NSSI history beyond young people's emotional distress. This provides researchers and clinicians with an opportunity to better target key EMS, especially beliefs about self-defectiveness and feelings of shame, that may be driving the regulatory function of self-injury among youth., (© 2021 Wiley Periodicals LLC.)

Lower levels of Intimate Relationship Quality (IRQ) have been found in those with Multiple Sclerosis (MS) compared to the general population. This study examined an MS sample to see whether IRQ was positively associated with self-concept, whether IRQ was positively associated with MS illness acceptance and whether IRQ was predicted by self-concept and illness acceptance. In this cross-sectional study, 115 participants with MS who were in an intimate relationship completed an online survey advertised on MS related websites. The survey assessed demographic variables, MS illness variables and levels of IRQ, self-concept and illness acceptance. Results revealed that IRQ was significantly positively associated with self-concept and with illness acceptance. Multiple hierarchical linear regression analysis revealed that, after controlling for illness duration and level of disability, self-concept significantly predicted IRQ but illness acceptance did not significantly predict IRQ. This study addressed several gaps and methodological flaws in the literature and was the first known to assess predictors of IRQ in those with MS. The results suggest that self-concept could be a potential target for individual and couple psychological interventions to improve IRQ and contribute to improved outcomes for those with MS. [ABSTRACT FROM AUTHOR]

Monitoring physical activity is important to better individualise health and fitness benefits. This study assessed the concurrent validity of a smartphone global positioning system (GPS) 'app' and a sport-specific GPS device with a similar sampling rate, to measure physical activity components of speed and distance, compared to a higher sampling sport-specific GPS device. Thirty-eight (21 female, 17 male) participants, mean age of 24.68, s = 6.46 years, completed two 2.400 km trials around an all-weather athletics track wearing GPSports ProTM (PRO), GPSports WiSpiTM (WISPI) and an iPhoneTM with a Motion X GPSTM 'app' (MOTIONX). Statistical agreement, assessed using t-tests and Bland-Altman plots, indicated an (mean; 95% LOA) underestimation of 2% for average speed (0.126 km.h-1; -0.389 to 0.642; p < .001), 1.7% for maximal speed (0.442 km.h-1; -2.676 to 3.561; p = .018) and 1.9% for distance (0.045 km; -0.140 to 0.232; p < .001) by MOTIONX compared to that measured by PRO. In contrast, compared to PRO, WISPI overestimated average speed (0.232 km.h-1; -0.376 to 0.088; p < .001) and distance (0.083 km; -0.129 to -0.038; p < .001) by 3.5% whilst underestimating maximal speed by 2.5% (0.474 km.h-1; -1.152 to 2.099; p < .001). Despite the statistically significant difference, the MOTIONX measures intensity of physical activity, with a similar error as WISPI, to an acceptable level for population-based monitoring in unimpeded open-air environments. This presents a low-cost, minimal burden opportunity to remotely monitor physical activity participation to improve the prescription of exercise as medicine. [ABSTRACT FROM AUTHOR]

High levels of depressive and anxiety symptoms have been reported by individuals with multiple sclerosis (MS). This study examined the associations between resilience, self-efficacy and coping and depressive and anxiety symptoms and whether resilience, self-efficacy and coping were predictors of depressive and anxiety symptoms in patients newly diagnosed with MS. A sample of 129 individuals newly diagnosed with MS participated in this cross-sectional study and completed an online questionnaire assessing resilience, self-efficacy, coping and depressive and anxiety symptoms. Results revealed that depressive and anxiety symptoms were significantly associated with problem-focused, emotion-focused and avoidance coping strategies, resilience and self-efficacy. Anxiety symptoms were also significantly associated with employment status and level of disability. Results from hierarchical multiple regression revealed that the resilience subscale of personal competence, the avoidance coping style of substance use and emotion-focused coping styles of venting predicted depressive symptoms and uniquely accounted for 63.8% of the variance in the depression score,F(18, 124) = 10.36,p = .000. Level of disability and employment status accounted for 13.2% of the anxiety score and avoidance coping style of denial and emotion-focused coping style of humour accounted for 36.4% of the variance in the anxiety symptom score,F(15, 112) = 6.37,p = .000. Our findings suggest that resilience and avoidance and emotion-focused coping strategies are predictive of depressive symptoms and anxiety symptoms in those newly diagnosed with MS. Resilience and coping styles may be another target for interventions aimed at managing depressive and anxiety symptoms in those newly diagnosed with MS. [ABSTRACT FROM PUBLISHER]

Objectives. A critical question in the activity engagement literature is whether physical exercise alters the trajectory of age-related cognitive decline (differential preservation) or is associated with enhanced baseline cognitive ability (preserved differentiation). Further, investigations considering that these relations may differ across young, middle, and older adulthood are rare. Method. We evaluated data from the PATH Through Life Project, where participants aged 20–24, 40–44, and 60–64 years at baseline (n = 6,869) completed physical activity (PA; mild, moderate, and vigorous) and cognitive measurements thrice over 8 years. Results. Multilevel models accounting for employment status, sex, education, health, and mental and social activity showed that between-person differences in PA participation positively predicted baseline performance on fluid cognitive ability (perceptual speed, short-term memory, working memory, and episodic memory). These effects were similar across age groups, but strongest for the youngest cohort, for whom there was also evidence of covariation between within-person change in PA and cognitive score. PA was not associated with change in cognition over time. Discussion. Results support preserved differentiation, where physically active adults have higher initial cognitive ability, and the advantage is maintained over time. PA appears to be unique in showing differences across young, middle, and older adulthood in predicting cognition. [ABSTRACT FROM PUBLISHER]

Background To frame interventions, it is useful to understand context- and time-specific correlates of children's physical activity. To do this, we need accurate assessment of these correlates. There are currently no measures that assess correlates at all levels of the social ecological model, contain items that are specifically worded for the lunchtime and/or after-school time periods, and assess correlates that have been conceptualised and defined by children. The aim of this study was to develop and evaluate the psychometric properties of the lunchtime and after-school Youth Physical Activity Survey for Specific Settings (Y-PASS) questionnaires. Methods The Y-PASS questionnaire was administered to 264 South Australian children (146 boys, 118 girls; mean age = 11.7 ± 0.93 years). Factorial structure and internal consistency of the intrapersonal, sociocultural and physical environmental/policy lunchtime and after-school subscales were examined through an exploratory factor analysis. The test-retest reliability of the Y-PASS subscales was assessed over a one-week period on a subsample of children (lunchtime Y-PASS: n = 12 boys, 12 girls, mean age of 11.6 ± 0.8 years; after-school YPASS: n = 9 boys, 13 girls; mean age = 11.4 ± 0.9 years). Results For the lunchtime Y-PASS, three factors were identified under each of the intrapersonal, sociocultural and physical environmental/policy subscales. For the after-school Y-PASS, six factors were identified in the intrapersonal subscale, four factors in the sociocultural subscale and seven factors in the physical environmental/policy subscale. Following item reduction, all subscales demonstrated acceptable internal consistency (Cronbach alpha = 0.78 - 0.85), except for the lunchtime sociocultural subscale (Cronbach alpha = 0.55). The factors and items demonstrated fair to very high test-retest reliability (ICC = 0.26 - 0.93). Conclusion The preliminary reliability and factorial structure evidence suggests the Y-PASS correlate questionnaires are robust tools for measuring correlates of context-specific physical activity in children. The multi-dimensional factor structure provides justification for exploring physical activity correlates from a social ecological perspective and demonstrates the importance of developing items that are context specific. Further development and refinement of the Y-PASS questionnaires is recommended, including a confirmatory factor analysis and exploring the inclusion of additional items. [ABSTRACT FROM AUTHOR]

Objective: Compulsive internet use (CIU) has been linked to decrements in mental health and well-being. However, relatively little is known about how CIU relates to evaluations of the self, and in particular, whether CIU is antecedent to or is a consequence of negative evaluations of one's social worth (self-esteem) and general efficacy (hope). To examine this, we explored the longitudinal relations between CIU and the development of self-esteem and hope among adolescents over a four-year period., Method: Two thousand eight hundred and nine adolescents completed measures yearly from Grade 8 (M Age = 13.7) to Grade 11. Autoregressive cross-lagged structural equation models were used to test whether CIU influenced or was influenced by self-esteem and hope., Results: We found consistent support for a CIU-as-antecedent model. CIU preceded reductions in trait hope, and small reductions in self-esteem. In contrast, we did not find evidence for a CIU-as-consequence model: low self-esteem and hope did not predict increases in CIU over time., Conclusions: Our findings suggest that CIU has negative consequences for young people's feelings of goal-efficacy, and that interventions that address the compulsive use of the internet are likely to strengthen hope and self-esteem among young people., (© 2018 Wiley Periodicals, Inc.)

Background: Due to early detection and advances in treatment, the number of women surviving breast cancer is increasing. Whilst there are many positive aspects of improved survival, breast cancer survival is associated with many long-term health and psychosocial sequelae. Engaging in regular physical activity post-diagnosis can reduce this burden. Despite this evidence, the majority of breast cancer survivors do not engage in regular physical activity. The challenge is to provide breast cancer survivors with appealing and effective physical activity support in a sustainable and cost-effective way. This article describes the protocol for the Move More for Life Study, which aims to assess the relative efficacy of two promising theory-based, print interventions designed to promote regular physical activity amongst breast cancer survivors. Method and design: Breast cancer survivors were recruited from across Australia. Participants will be randomised into one of three groups: (1) A tailored-print intervention group, (2) a targeted-print intervention group, or (3) a standard recommendation control group. Participants in the tailored-print intervention group will receive 3 tailored newsletters in the mail over a three month period. Participants in the targeted-print group will receive a previously developed physical activity guidebook designed specifically for breast cancer survivors immediately after baseline. Participants in the standard recommendation control will receive a brochure detailing the physical activity guidelines for Australian adults. All participants will be assessed at baseline, and at 4 and 10 months post-baseline. Intervention efficacy for changing the primary outcomes (mins/wk aerobic physical activity; sessions/exercises per week resistance physical activity) and secondary outcomes (steps per day, health-related quality life, compliance with physical activity guidelines, fatigue) will be assessed. Mediation and moderation analyses will also be conducted. Discussion: Given the growing number of cancer survivors, distance-based behaviour change programs addressing physical activity have the potential to make a significant public health impact. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12611001061921 [ABSTRACT FROM AUTHOR]