Source monitoring for pictures: an exploration of factors which affect performance

Research Doctorate - Doctor of Philosophy (PhD)Source memory refers to memory for details about how information was acquired, as opposed to memory for the information itself. While participants’ memory for some forms of source information has been extensively researched, performance on external source monitoring tasks for visual stimuli has been less frequently examined. As such, the factors that affect performance on visual source monitoring tasks are not as well understood. There were five key aims of this thesis. A novel visual source monitoring task designed to overcome some of the limitations of other visual source monitoring tasks reported in the literature was used to firstly investigate the effect of age on source monitoring. Secondly, the effect of source cue type on source monitoring performance was examined. As a result of poor levels of performance for both children and adults on one of the experimental conditions on the source monitoring task, several experimental manipulations were used to determine whether performance could be improved. Examining the effects of task-based factors such as the provision of elaborative encoding instructions, the provision of intentional encoding instructions, and varying the intrinsic versus extrinsic nature of the stimuli was the third aim of this thesis. The fourth aim was to investigate whether factors based on individual differences, such as anticipation of a source memory task and self-initiated strategy use also improved source monitoring performance. Finally, the relationship between performance on working memory and binding tasks, and source monitoring performance was explored. An underlying theme in the results across the five experiments reported in this thesis was that task manipulations or self-initiated actions that served to increase or facilitate the binding between the item and the source information led to improvements in source monitoring accuracy. This thesis has highlighted the importance of effective binding of visually presented item and source information in order to achieve accurate source monitoring performance

Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity ('SNAP') health risk factors

Objective: There is a growing body of literature examining the clustering of health risk behaviours, but little consensus about which risk factors can be expected to cluster for which sub groups of people. This systematic review aimed to examine the international literature on the clustering of smoking, poor nutrition, excess alcohol and physical inactivity (SNAP) health behaviours among adults, including associated socio-demographic variables. Method: A literature search was conducted in May 2014. Studies examining at least two SNAP risk factors, and using a cluster or factor analysis technique, or comparing observed to expected prevalence of risk factor combinations, were included. Results: Fifty-six relevant studies were identified. A majority of studies (81%) reported a 'healthy' cluster characterised by the absence of any SNAP risk factors. More than half of the studies reported a clustering of alcohol with smoking, and half reported clustering of all four SNAP risk factors. The methodological quality of included studies was generally weak to moderate. Males and those with greater social disadvantage showed riskier patterns of behaviours; younger age was less clearly associated with riskier behaviours. Conclusion: Clustering patterns reported here reinforce the need for health promotion interventions to target multiple behaviours, and for such efforts to be specifically designed and accessible for males and those who are socially disadvantaged

A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: What do we choose in the absence of evidence?

Background: There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. Methods. A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. Results: A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's <.0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Conclusions: Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based. © 2013 Paul et al.; licensee BioMed Central Ltd

Agreement between a single-item measure of anxiety and depression and the Hospital Anxiety and Depression Scale: A cross-sectional study.

Anxiety and depression can be heightened among individuals living with chronic diseases. Identifying these individuals is necessary for ensuring they are provided with adequate support. Traditional tools such as clinical interviews or symptom checklists are not always feasible to implement in practice. Robust single-item questions may be a useful alternative. This study aimed to measure agreement, sensitivity, specificity, positive predictive value and negative predictive value of a single-item question about anxiety and depression compared to the widely used Hospital Anxiety and Depression Scale (HADS). A cross-sectional survey of 2,811 people with cancer attending 19 treatment centres in Australia. Patients were approached in the waiting room prior to an outpatient clinic appointment and invited to complete a pen and paper survey. Participants completed the HADS as well as 2 single-items asking if they have felt anxious or depressed in the last week. The single-items for anxiety and depression each demonstrated moderate levels of sensitivity (0.78 for anxiety; 0.63 for depression) and specificity (0.75 for anxiety; 0.84 for depression) against the relevant HADS subscale. Positive predictive values were moderate (0.53 for anxiety and 0.52 for depression) while negative predictive values were high for both single-item questions (0.90 for anxiety and 0.89 for depression). The single-item measures of anxiety and depression may be useful to rule out individuals who do not require further psychological assessment or intervention for anxiety and depression. Further research is needed to explore whether these findings generalise to other chronic diseases

A narrative review of the potential for self- tanning products to substitute for solaria use among people seeking a tanned appearance

Skin cancers including melanoma and non-melanoma skin cancers are a high-cost and largely preventable form of cancer. While limiting exposure to solar ultraviolet (UV) light via outdoor activities is a focus of public health efforts, indoor UV exposure via solaria or ‘tanning booths’ has also become a cause for concern. In recent decades the availability of less harmful non-UV self-tanning products such as sprays and lotions has increased. This review explores (i) the available data regarding the prevalence and behavioural factors associated with use of solaria and self-tanning products and (ii) data that may shed light on the likelihood of solaria users substituting self-tanning products as a less harmful alternative to solaria exposure. While there are insufficient data on which to draw a firm conclusion about the potential for substitution, it appears unlikely that most solaria users would readily substitute self-tanning products in place of solaria exposure. Public health advocates may need to consider whether a robust research study of the cost-effectiveness of encouraging substitutional use of self-tanners is desirable, or whether efforts to severely restrict access to solaria may be a better approach

Medical oncology outpatients’ preferences and experiences with advanced care planning: a cross-sectional study

Abstract Background Medical oncology outpatients are a group for whom advance care planning (ACP) activities are particularly relevant. Patient views can help prioritise areas for improving end of life communication. The study aimed to determine in a sample of medical oncology outpatients: (1) the perceived importance of participating in ACP activities; (2) the proportion of patients who have ever participated in ACP activities; and (3) the proportion of patients who had not yet participated in ACP activities who were willing to do so in next month. Methods Adult medical oncology outpatients in two Australian cancer treatment centres were consecutively approached to complete a pen-and-paper survey. Items explored perceived importance, previous participation, and willingness to participate across key ACP activities including: discussing wishes with their family or doctor; recording wishes in a written document; appointing a substitute decision maker (SDM); and discussing life-expectancy. Results 185 participants completed the survey (51% consent rate). Most patients agreed it was important to: discuss end of life wishes with family (85%) and doctors (70%) and formally record wishes (73%). Few had discussed end of life wishes with a doctor (11%), recorded their wishes (15%); chosen a SDM (28%); discussed life expectancy (30%); or discussed end of life wishes with family (30%). Among those who had not participated in ACP, most were willing to discuss life expectancy (66%); discuss end of life wishes with family (57%) and a doctor (55%); and formally record wishes (56%) in the next month. Fewer wanted to appoint a SDM (40%). Conclusion Although medical oncology outpatients perceive ACP activities are important, rates of uptake are relatively low. The willingness of many patients to engage in ACP activities suggests a gap in current ACP practice. Efforts should focus on ensuring patients and families have clarity about the legal and other ramifications of ACP activities, and better education and training of health care providers in initiating conversations about end of life issues

Does a retrospective seven-day alcohol diary reflect usual alcohol intake for a predominantly disadvantaged Australian Aboriginal population?

Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and ‘usual’ drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop (n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities

A rapid review describing the scalability of early childhood education and care-based programs targeting children’s social and emotional learning

Objectives: To describe: i) how scalability domains (i.e., factors that influence a program's ability to expand to reach a larger population) are assessed and reported within randomised controlled trials (RCTs) of programs to improve child social and emotional learning in early childhood education and care (ECEC) settings; and ii) relative impact of scaled-up programs. Methods: We undertook a rapid review in November 2023 to identify RCTs of universal programs delivered in ECECs which were effective on at least one child social, emotional, and learning outcome. This formed a sample of pre-scale RCTs where additional intervention characteristics and reporting of seven scalability domains were extracted according to the Intervention Scalability Assessment Tool. To identify scale-up evaluations, we searched for related publications of the pre-scale RCTs. For directly comparable outcomes, we calculated the relative effect size between pre-scale and scaled-up programs. Results: Twenty-two RCTs were included. Scalability domains were variably reported with only one study reporting on all assessed domains. Almost all programs were delivered by an external facilitator together with child educators, and none concurrently targeted physical health behaviours, such as physical activity and nutrition. We identified one formal evaluation of a scaled-up trial. Compared to the pre-scale trial, the scaled-up trial had a reduced effect on behavioural difficulties and an increased effect on prosocial behaviour. Conclusions: More comprehensive reporting of scalability domains and formal evaluations of scaled-up social and emotional learning programs in ECEC are needed to ensure the intended outcomes to child health and wellbeing are achieved

Additional file 1: of Ready, set, go: a cross-sectional survey to understand priorities and preferences for multiple health behaviour change in a highly disadvantaged group

Table S1. Includes details of the measures used to assess risk factors in the health risk survey, as well as the cut-offs used to define risk status. (DOCX 16 kb