ORCID Profile
0000-0001-7490-2478
Current Organisation
University of South Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.WOMBI.2018.03.003
Abstract: Exclusive breast milk provides complete nutrition for a baby's first six months of life. In Australia, breastfeeding initiation rates are high, however duration rates are low. Although numerous studies have explored the reasons behind low levels of breastfeeding, few have examined the experiences of women who maintain exclusive breastfeeding for the recommended six-month duration. This paper will present an in-depth, idiographic interpretation of first-time mothers' experience of exclusive breastfeeding for six months in Australia. Interpretative phenomenological analysis was used to explore how five new mothers understood their six-month exclusive breastfeeding journey. Face-to-face, semi-structured interviews were conducted retrospectively, transcribed in full, and analysed using the flexible seven-step approach of interpretative phenomenological analysis. Three higher-order themes were identified: (1) exclusive breastfeeding is a personal choice, (2) exclusive breastfeeding is harder than expected, and (3) everyone has something to say about breastfeeding. The mothers were not prepared for public debates around infant feeding methods, where mothers judge each other and give advice that supports their own goals, both of which create an unnecessary ide between mothers. Despite these issues, the findings highlight the personal and social meanings aligned with exclusive breastfeeding and point to the significance in fostering determination as a means to achieve exclusive breastfeeding goals. This qualitative reflection contributes a nuanced understanding of mothers' lived experience of exclusive breastfeeding, deepening our understanding and enabling appropriate strategies and support for the longevity of exclusive breastfeeding, as well as direction for continued research.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.NEPR.2015.08.014
Abstract: Many higher education institutions have adopted mentoring programs for students as a means of providing support, improve learning and enhance the student experience. The aim of this project was to improve midwifery students experience by offering a peer mentoring program to commencing students to assist with the transition to university life and the rigours of the midwifery program. This paper reports the evaluation of this specific mentoring program and the ongoing development and implementation of a sustainable program within an Australian University. A survey design was adopted to gather feedback from both mentees to evaluate if the peer mentoring program enhanced the first year midwifery student experience and ascertain how the program could be further developed. Fifty-five students engaged with the peer mentors and completed the questionnaire regarding the mentoring program. Specifically valuable was the positive impact that mentoring had on midwifery student confidence, managing the demands of the program and being motivated to keep going when the program requirements were challenging. The success of this program rested largely with mentoring students sharing their own experiences and providing reassurance that other students could also succeed.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.WOMBI.2017.06.017
Abstract: There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning. This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings. A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors. Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9) valid-data extraction loaded predominantly onto one factor and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n=83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student's practice performance and competence. The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.MIDW.2017.09.003
Abstract: to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth. ethnography. tertiary hospital in Australian city. sequential interviews were conducted with 16 women hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork. women were not given full disclosure of either practice and midwives tailored the information they gave according to the institutional policies rather than evidence. informed consent is an oft-cited human right in health care, yet in maternity care the micro-politics of how informed consent is gained is difficult to ascertain, leading to a situation whereby the concept of informed consent is more robust than the reality of practice an illusion of informed consent exists, yet information is often biased towards medicalised birth practices. as primary maternity care-givers, midwives have a role in providing unbiased information to women however it appears that hospital culture and policy affect the way that this information is presented. It is arguable whether women in such instances are giving true informed consent, and for this reason, the ethics of these hidden practices are questioned.
Publisher: Mark Allen Group
Date: 03-2009
DOI: 10.12968/BJOM.2009.17.3.40078
Abstract: The transition to parenthood is a major life event and may be one of the most acute changes experienced during a person's life. Nevertheless, many parents find themselves unprepared for their parenting role. It has been found that a positive experience throughout the period of transition to parenthood contributes to the parent's confidence and ability to master new roles, highlighting the need to develop innovative strategies which support parents through the transitional period. This article introduces one such strategy, a postnatal planner entitled ‘Coming ready or not!’ developed from an action research study designed to develop, implement, and evaluate strategies to improve postnatal education for parents. Using the antenatal period to address postnatal concerns must be considered.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.NEPR.2016.05.002
Abstract: Effective clinical supervision in midwifery programs leading to registration is essential to ensure that students can provide safe and competent woman centred care by the completion of their program. A number of different clinical supervision models exist in Australia and internationally, with varying levels of support and facilitation of student learning opportunities. In Australia, midwifery students must achieve specified learning outcomes and midwifery practice requirements to be eligible to register as a midwife. Identifying a best practice clinical supervision model for Australian midwifery students is therefore a priority for all key stakeholders, particularly education and maternity care providers. The aim of this literature review was to explore different types of clinical supervision models in order to develop and implement a best practice model in midwifery education programs.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2021
DOI: 10.1186/S12913-021-06373-9
Abstract: The sustainability of Australian rural maternity services is under threat due to current workforce shortages. In July 2019, a new midwifery caseload model of care was implemented in rural South Australia to provide midwifery continuity of care and promote a sustainable workforce in the area. The model is unique as it brings together five birthing sites connecting midwives, doctors, nurses and community teams. A critical precursor to successful implementation requires those working in the model be ready to adopt to the change. We surveyed clinicians at the five sites transitioning to the new model of care in order to assess their organizational readiness to implement change. A descriptive study assessing readiness for change was measured using the Organizational Readiness for Implementing Change scale (ORIC). The 12 item Likert scale measures a participant’s commitment to change and change efficacy. All clinicians working within the model of care (midwives, nurses and doctors) were invited to complete an e-survey. Overall, 55% (56/102) of clinicians participating in the model responded. The mean ORIC score was 41.5 (range 12–60) suggesting collectively, midwives, nurses and doctors began the new model of care with a sense of readiness for change. Participants were most likely to agree on the change efficacy statements, “People who work here feel confident that the organization can get people invested in implementing this change and the change commitment statements “People who work here are determined to implement this change”, “People who work here want to implement this change”, and “People who work here are committed to implementing this change. Results of the ORIC survey indicate that clinicians transitioning to the new model of care were willing to embrace change and commit to the new model. The process of organizational change in health care settings is challenging and a continuous process. If readiness for change is high, organizational members invest more in the change effort and exhibit greater persistence to overcome barriers and setbacks. This is the first reported use of the instrument amongst midwives and nurses in Australia and should be considered for use in other national and international clinical implementation studies.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.NEPR.2018.07.010
Abstract: Clinical placement is a core feature of Australian midwifery education programs, with clinical supervision acknowledged as a key component for student success. The aim of this study was to evaluate the clinical facilitation models in South Australia, specifically the quality of clinical supervision to facilitate learning, and key stakeholder satisfaction. A mixed method evaluation research design was used to compare three models of clinical facilitation for midwifery students undertaking clinical placement across five venues. Midwifery students (n = 174), across two universities completed an anonymous e-survey utilising the validated Clinical Placement Experience Questionnaire. Midwives (n = 149) across five venues completed an anonymous purpose-designed questionnaire on their experience providing clinical supervision to midwifery students and Clinical Facilitators (n = 8) representing three facilitation models completed a self-report e-diary for two weeks and engaged in a focus group. Few differences were identified between the quality of student support and learning opportunities. Students in all models were well orientated and prepared for the clinical environment. Clinical Facilitators were supportive, educative and valuable for the students to achieve their learning objectives. One significant difference was that facilitators employed in the 'Shared' model were more able to provide support to midwives supervising students and maintain good liaison with the universities.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.NEPR.2019.102635
Abstract: Undergraduate midwifery programs across Australia have embedded simulation into their curriculum although there is limited but emerging evidence to support the use of simulation as an effective teaching strategy. The purpose of this study was to evaluate the impact that a simulated learning activity (insertion and management of a neonatal nasogastric tube), had on midwifery students' knowledge, confidence and skills post-simulation, and on completion of a clinical placement. A descriptive explorative study was undertaken in two phases. Phase 1: Midwifery students (n = 60) completed a purpose-designed questionnaire to assess their knowledge, confidence and skills, pre and post simulation. Phase 2: Students (n = 46) repeated the questionnaire to reassess their knowledge, confidence and skills after the completion of a neonatal nursery placement. The findings demonstrate that simulation is an effective learning strategy in an undergraduate midwifery program. Students' knowledge, confidence and skills increased significantly post-simulation activity (p0.001). A further increase in these areas was noted post-placement. Key aspects that contributed to student learning included the demonstrators' level of knowledge, expertise and currency of practice, as well as the role the student assumes in the simulation activity.
Publisher: JMIR Publications Inc.
Date: 10-06-2021
DOI: 10.2196/29770
Abstract: The postnatal period can be a challenging time for women, with mothers experiencing a range of emotions. As a woman transitions to motherhood, she adjusts to a new sense of self and forms a new relationship with her infant. Becoming a mother is a complex cognitive and social process that is unique for each woman and is influenced and shaped by culture. The emerging mother-infant relationship is a significant factor in maternal well-being and infant development, with the bond between the mother and her baby being critical to the development of secure attachment. It has been recognized that the strength of this relationship is the main predictor of how well a child will do throughout life. There has been a global focus on the importance of the first 1000 days, with Australia identifying this as a national priority. Midwives are ideally placed to support mothers during the development of the mother-infant relationship, providing care through the early postnatal period, which has been identified as a sensitive period for the development of the mother-infant relationship. The aim of this study is to explore how midwives can support the emerging mother-infant relationship in the context of cultural ersity and develop an appropriate co-designed intervention in the early postnatal period. This study will use a mixed method approach, specifically the exploratory sequential design (intervention development variant). This study will be undertaken in 3 phases: 1 qualitative phase, which is followed by 2 quantitative phases. Phase 1 will include a scoping review to explore interventions that have influenced the development of the mother-infant relationship, and then, interviews will be undertaken with women exploring their early experiences of motherhood, followed by 3 co-design workshops. The workshops will engage with multilevel stakeholder representatives where, through partnership and participation, they will propose and develop an intervention to support the emerging mother-infant relationship. Phase 2 will develop and pilot 2 purpose-designed evaluation surveys to evaluate the co-designed intervention from the perspective of both mothers and midwives. Phase 3 will implement and evaluate the co-designed intervention using pre- and postmeasures and feedback from the purpose-designed surveys. Phase 1 has commenced and is expected to be completed by August 2021. Phase 2 is expected to be completed by September 2021, with phase 3 commencing in October 2021. The study will be completed by March 2023. The results of this study will be shared with a variety of audiences and will contribute to the body of knowledge on the mother-infant relationship, potentially improving the understanding of this relationship for women and midwives. This may result in improved strategies for care, with mothers benefiting from enhanced experience and satisfaction during the early postnatal period.
Publisher: SAGE Publications
Date: 04-2007
Abstract: In this study, a novel method for manufacturing composite tubes utilizing the Quickstep TM process has been developed. Tubes manufactured from `quick-cure' Toray G83C prepreg have demonstrated highly repeatable axial crush behavior with an average specific energy absorption (SEA) of 86 kJ/kg. The cure cycle is optimized by comparing the results from compression, dynamic mechanical thermal analysis (DMTA), differential scanning calorimetry (DSC), and porosity testing. The tube lay-up is optimized using compression and porosity test results. The effect of changes in fiber-orientation on SEA is also investigated. Process development has resulted in a robust manufacturing method capable of producing fully cured, high performance composite tubes with a cure cycle of 7 min. This corresponds to a 95% reduction in time compared to an equivalent autoclave cycle.
Publisher: University of South Australia
Date: 2021
Publisher: MDPI AG
Date: 04-2019
DOI: 10.3390/MA12071069
Abstract: Here we report on how residence time influences the evolution of the structure and properties through each stage of the carbon fibre manufacturing process. The chemical structural transformations and density variations in stabilized fibres were monitored by Fourier Transform Infrared Spectroscopy and density column studies. The microstructural evolution and property variation in subsequent carbon fibres were studied by X-ray diffraction and monofilament tensile testing methods, which indicated that the fibres thermally stabilized at longer residence times showed higher degrees of structural conversion and attained higher densities. Overall, the density of stabilized fibres was maintained in the optimal range of 1.33 to 1.37 g/cm3. Interestingly, carbon fibres manufactured from higher density stabilized fibres possessed lower apparent crystallite size (1.599 nm). Moreover, the tensile strength of carbon fibres obtained from stabilized fibres at the high end of the observed range (density: 1.37 g/cm3) was at least 20% higher than the carbon fibres manufactured from low density (1.33 g/cm3) stabilized fibres. Conversely, the tensile modulus of carbon fibres produced from low density stabilized fibres was at least 17 GPa higher than those from high density stabilized fibres. Finally, it was shown that there is potential to customize the required properties of resultant carbon fibres suiting specific applications via careful control of residence time during the stabilization stage.
Publisher: Springer International Publishing
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 14-03-2023
DOI: 10.1186/S40359-023-01092-8
Abstract: The mother-infant relationship is complex and dynamic, informing the psychological development of the infant through bonding and attachment. Positive early interactions influence the quality of this relationship. Midwives are well placed to support the developing relationship between the mother and baby, yet there has been limited research exploring the role of the midwife in this context. To explore interventions that have been provided by the midwife which support the development of the maternal-fetal or mother-infant relationship amongst a low-risk population from pregnancy, and up to six weeks postnatal. The review also sought to understand the types of interventions developed, format and delivery, outcomes measured and if cultural considerations had been incorporated. A scoping review of the research literature was undertaken using the Joanna Briggs Institute framework. Five online databases were searched for relevant articles published in English from 2000 to 2021. Sixteen articles met the inclusion criteria. Three themes emerged: (1) viewing the fetus as separate from the mother, (2) focused activities on the maternal-infant relationship and (3) targeted educational interventions. Providing focused activities and targeted education during the pre and postnatal periods support the development of the mother-infant relationship. Significantly, there was insufficient research that considered the influence of culture in supporting the mother-infant relationship. Further research is required to develop interventions that include a erse s le to ensure culturally appropriate activities can be integrated into care during pregnancy and/or the postnatal period provided by midwives.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.WOMBI.2017.01.002
Abstract: Given the significant benefits of breastfeeding, the World Health Organization (WHO) recommend exclusive breastfeeding for six months. Despite numerous strategies aimed at increasing the percentage of babies who are exclusively breastfed, Australia currently has one of the lowest six-month exclusive breastfeeding rates in the developed world. Notably, most research focuses on the early postnatal period (birth-two months) yet the largest decline in exclusive breastfeeding rates is observed between two and six months. This study aimed to understand what enabled a first-time mother to continue exclusively breastfeeding between two and six months in Australia. The qualitative approach known as interpretative phenomenological analysis (IPA) was used to explore how the new mother understood her exclusive breastfeeding journey. Data was collected retrospectively through a face-to-face, semi-structured interview, then transcribed in full and analyzed using IPA's approach to data analysis. Three main themes were identified as self-determination to achieve exclusive breastfeeding, the influence of social norms in Australian culture, and the impact social supports have on maintaining exclusive breastfeeding. For this mother, her self-determination to exclusively breastfeed, along with positive social support, outweighed the impact of perceived social norms and negative pressure from significant others to stop exclusive breastfeeding. This qualitative reflection contributes to an understanding of the in idual in the breastfeeding journey, uncovering nuances around exclusive breastfeeding that may be helpful in providing support for mothers and direction for further research.
Publisher: JMIR Publications Inc.
Date: 19-04-2021
Abstract: he postnatal period can be a challenging time for women, with mothers experiencing a range of emotions. As a woman transitions to motherhood, she adjusts to a new sense of self and forms a new relationship with her infant. Becoming a mother is a complex cognitive and social process that is unique for each woman and is influenced and shaped by culture. The emerging mother-infant relationship is a significant factor in maternal well-being and infant development, with the bond between the mother and her baby being critical to the development of secure attachment. It has been recognized that the strength of this relationship is the main predictor of how well a child will do throughout life. There has been a global focus on the importance of the first 1000 days, with Australia identifying this as a national priority. Midwives are ideally placed to support mothers during the development of the mother-infant relationship, providing care through the early postnatal period, which has been identified as a i sensitive period /i for the development of the mother-infant relationship. he aim of this study is to explore how midwives can support the emerging mother-infant relationship in the context of cultural ersity and develop an appropriate co-designed intervention in the early postnatal period. his study will use a mixed method approach, specifically the exploratory sequential design (intervention development variant). This study will be undertaken in 3 phases: 1 qualitative phase, which is followed by 2 quantitative phases. Phase 1 will include a scoping review to explore interventions that have influenced the development of the mother-infant relationship, and then, interviews will be undertaken with women exploring their early experiences of motherhood, followed by 3 co-design workshops. The workshops will engage with multilevel stakeholder representatives where, through partnership and participation, they will propose and develop an intervention to support the emerging mother-infant relationship. Phase 2 will develop and pilot 2 purpose-designed evaluation surveys to evaluate the co-designed intervention from the perspective of both mothers and midwives. Phase 3 will implement and evaluate the co-designed intervention using pre- and postmeasures and feedback from the purpose-designed surveys. hase 1 has commenced and is expected to be completed by August 2021. Phase 2 is expected to be completed by September 2021, with phase 3 commencing in October 2021. The study will be completed by March 2023. he results of this study will be shared with a variety of audiences and will contribute to the body of knowledge on the mother-infant relationship, potentially improving the understanding of this relationship for women and midwives. This may result in improved strategies for care, with mothers benefiting from enhanced experience and satisfaction during the early postnatal period.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.WOMBI.2012.10.001
Abstract: Nausea and vomiting in pregnancy (NVP) is a normal, commonly experienced affliction of early pregnancy. Despite this, its impact on women's lives is not necessarily minimal. For some women, the implications of NVP are substantial with multi-faceted effects, hindering their ability to maintain usual life activities, and particularly their ability to work. In an effort to understand the effect of NVP, several researchers have developed NVP measurement tools, which enable an understanding of NVP's effect on quality of life (QOL). This paper seeks to provide a review of the literature to explore the impact of NVP on women's quality of life, particularly their ability to maintain social and professional commitments. Medline, CINAHL, PsychINFO, Ebsco, Science Direct, Health Source, Academic Search Premiere, Cochrane databases were extensively searched using Boolean operators with various combinations of relevant terms: nausea, vomiting, pregnancy, emesis, quality of life, QOL, NVPQOL, PUQE, SF-12, SF-36 and limited to those published from 1999 onwards. Papers were scrutinised to include those discussing the impact of normal NVP on women's lives, particularly their QOL with careful exclusion of those addressing hyperemesis gravidarum (HG). NVP has a significant effect on women's QOL and therefore their ability to maintain day-to-day activities as well as work capacity. This has implications for the woman, her partner, her family and her employers. It is important that all maternity care workers consider the impact of NVP on the woman's QOL and that care is given not to minimise this experience. Further research is warranted which considers ways in which women can best manage this experience in relation to social and professional commitments. Given the authors were able to identify only one Australian study in this area, published in 2000 and utilising non-NVP specific QOL measurement tools, there exists scope for additional local studies using NVP-specific QOL tools to determine the impact of QOL for Australian women and therefore Australian society.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.WOMBI.2021.09.006
Abstract: Australian midwives are considering leaving the profession. Moral distress may be a contributing factor, yet there is limited research regarding the influence of moral distress on midwifery practice. Moral distress was first used to describe the psychological harm incurred following actions or inactions that oppose an in iduals' moral values. Current research concerning moral distress in midwifery is varied and often focuses only on one aspect of practice. To explore Australian midwives experience and consequences of moral distress. Semi-structured interviews were used to understand the experiences of moral distress of 14 Australian midwives. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis and NVIVO12©. Three key themes were identified: experiencing moral compromise experiencing moral constraints, dilemmas and uncertainties and professional and personal consequences. Describing hierarchical and oppressive health services, midwives indicated they were unable to adequately advocate for themselves, their profession, and the women in their care. It is evident that some midwives experience significant and often ongoing moral compromise as a catalyst to moral distress. A difference in outcomes between early career midwives and those with more than five years experiences suggests the cumulative nature of moral distress is a significant concern. A possible trajectory across moral frustration, moral distress, and moral injury with repeated exposure to morally compromising situations could explain this finding. This study affirms the presence of moral distress in Australian midwives and identified the cumulative effect of moral compromise on the degree of moral distress experienced.
Publisher: Royal Society of Chemistry (RSC)
Date: 2017
DOI: 10.1039/C7TA01022B
Abstract: This study quantitatively defines the temperature induced chemical transformations and evolution of radial heterogeneity during the stabilisation of carbon fibre precursors.
Publisher: American Chemical Society (ACS)
Date: 07-03-2018
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.WOMBI.2016.10.009
Abstract: Vaginal birth is a safe mode of birth for most women who have had a prior caesarean with a transverse incision. Despite the evidence, most Taiwanese women who have had a previous caesarean are rarely offered the opportunity to consider any possibility other than a repeat caesarean. This study explored factors affecting Taiwanese women's decisionmaking regarding vaginal birth after cesarean. Ajzen's Theory of Planned Behaviour provided the theoretical framework to underpin the study, which adopted an interpretive descriptive methodology. Sequential semi-structured interviews were conducted with 29 women who had a previous caesarean and were pregnant between 34 and 38 weeks gestation, ten women who attempted vaginal birth in the third to fifth day postpartum, and 25 women in the fourth week postpartum. Boyatzis' method of thematic analysis was used to identify themes and codes. This paper reports the findings of the prenatal interviews with 29 participants. The major factor influencing women's decision-making was to avoid negative outcomes for themselves and their babies. Three thematic codes describe influences on the women's decisions: 'past experience of childbirth', 'anticipating the next experience of normal birth' and 'contemplation on the process of childbirth'. Women who have had a previous caesarean section are prepared to have a vaginal birth but are not always supported to carry out this decision. Changing the models of antenatal care is recommended as a strategy to overcome this difficulty therefore empowering women to make a meaningful choice about VBAC after a CS.
Publisher: Elsevier BV
Date: 02-2017
Publisher: Elsevier BV
Date: 06-2016
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.WOMBI.2017.09.010
Abstract: Listening to women as part of their antenatal care has been recognized as valuable in understanding the woman's needs. Conversations as part of routine antenatal interactions offer ideal opportunities for women to express themselves and for midwives to learn about the woman's issues and concerns. The antenatal visit and the convention of antenatal consultations for midwives have not been well explored or defined and much of what takes place replicate medical consultative processes. As a consequence, there is little to assist midwives construct woman-centred care consultations for their routine antenatal care practice. This study showed how some practices were better in promoting the woman's voice and woman-centred care in the hospital setting. Contemporary focused ethnography using both interview and observations, explored how midwives from six different public antenatal clinics in South Australia organized their antenatal care consultations with pregnant women. Thematic analysis of the data provided insights into professional interpretation of woman-centred practice. How midwives interacted with women during routine antenatal care events demonstrated that some practices in a hospital setting could either support or undermine a woman-centred philosophy. In idual midwives adopted practices according to their own perceptions of actions and behaviors that were considered to be in accordance with the philosophy of woman-centred care. Information arising from this study has shown ways midwives may arrange antenatal care consultations to maximize women's participation.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.MIDW.2019.102589
Abstract: Shared decision making in pregnancy, labour, and birth is vital to woman-centred care and despite strong evidence for the effectiveness of shared decision making in pregnancy care, practical uptake has been slow. This scoping review aimed to identify and describe effective and appropriate shared decision aids designed to be provided to women in the antenatal period to assist them in making informed decisions for both pregnancy and birth. Two questions guided the enquiry: (i) what shared decision aids for pregnancy and perinatal care are of appropriate quality and feasibility for application in Australia? (ii) which of these decision aids have been shown to be effective and appropriate for Aboriginal and Torres Strait Islander peoples, culturally erse women, or those with low literacy? The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) was used to conduct the review. Five key databases and selected grey literature sources were examined. English language evidence from Australia, Europe, Canada, United Kingdom, New Zealand, and United States of America produced from 2009 was eligible for inclusion, checked against apriori inclusion criteria, and assessed for quality and usability using the International Patient Decision Aid Standards. From a total of 5,209 search results, 35 sources of evidence reporting on 27 decision aids were included following title/abstract and full-text review. Most of the decision aids concerned decisions around birth (52%, n = 14) or antenatal screening 37% (n = 10). The quality of the decision aids was moderate to high, with most communicating risks, benefits, and choice pathways via a mix of Likert-style scales, quizzes, and pictures or graphs. Use of decision aids resulted in significant reductions in decisional conflict and increased knowledge. The format of decision aids appeared to have no effect on these outcomes, indicating that paper-based are as effective as video- or audio-based decision aids. Eleven decision aids were suitable for low literacy or low health literacy women, and six were either developed for culturally erse groups or have been translated into other languages. No decision aids found were specific to Aboriginal and Torres Strait Islander peoples. The 27 decision aids are readily adoptable into westernised healthcare settings and can be used by midwives or multidisciplinary teams in conjunction with women. Decision aids are designed to support women, and families to arrive at informed choices and supplement the decision-making process rather than to replace consumer-healthcare professional interaction. If given before an appointment, high quality decision aids can increase a woman's familiarity with medical terminology, options for care, and an insight into personal values, thereby decreasing decisional conflict and increasing knowledge.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.WOMBI.2022.03.004
Abstract: The ongoing closure of regional maternity services in Australia has significant consequences for women and communities. In South Australia, a regional midwifery model of care servicing five birthing sites was piloted with the aim of bringing sustainable birthing services to the area. An independent evaluation was undertaken. This paper reports on women's experiences and birth outcomes. To evaluate the effectiveness, acceptability, continuity of care and birth outcomes of women utilising the new midwifery model of care. An anonymous questionnaire incorporating validated surveys and key questions from the Quality Maternal and Newborn Care (QMNC) Framework was used to assess care across the antenatal, intrapartum and postnatal period. Selected key labour and birth outcome indicators as reported by the sites to government perinatal data collections were included. The response rate was 52.6% (205/390). Women were overwhelmingly positive about the care they received during pregnancy, birth and the postnatal period. About half of women had caseload midwives as their main antenatal care provider the other half experienced shared care with local general practitioners and caseload midwives. Most women (81.4%) had a known midwife at their birth. Women averaged 4 post-natal home visits with their midwife and 77.5% were breastfeeding at 6-8 weeks. Ninety-five percent of women would seek this model again and recommend it to a friend. Maternity indicators demonstrated a lower induction rate compared to state averages, a high primiparous normal birth rate (73.8%) and good clinical outcomes. This innovative model of care was embraced by women in regional SA and labour and birth outcomes were good as compared with state-wide indicators.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.NEPR.2014.09.006
Abstract: Assertiveness can be defined as an interpersonal behaviour that promotes the fact all people in a relationship are equally important. All health professionals including midwives must work with and care for people. At times this will include facilitating interactions that require skilful negotiation and assertiveness. Yet embedding assertiveness education into undergraduate midwifery curricula has not been widely adopted. This paper explores one method of delivering assertiveness training in an undergraduate midwifery course and provides comment on the effectiveness of this strategy in developing assertiveness skills in a cohort of undergraduate midwifery students. We used an assertiveness survey which was administered immediately before and 3-4 months after an assertiveness training workshop. All students (n = 55) attending the training day were invited to participate. Of these 41 (77% response) chose to participate in the pre intervention survey and 32 participated (9 students lost to follow-up) in the follow up survey. There was an overall improvement in self-perceived assertiveness scores following the assertiveness training workshop. These findings provide encouraging evidence that educational institutions that offer specific and targeted assertiveness education will be rewarded with more assertive graduates.
Publisher: Royal Society of Chemistry (RSC)
Date: 2016
DOI: 10.1039/C6TA06842A
Abstract: Carbon fibre composites are lightweight, high performance materials with outstanding mechanical properties.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.WOMBI.2015.01.012
Abstract: Approximately 30% of Australian women use epidural analgesia for pain relief in labour, and its use is increasing. While epidural analgesia is considered a safe option from an anaesthetic point of view, its use transfers a labouring woman out of the category of 'normal' labour and increases her risk of intervention. Judicious use of epidural may be beneficial in particular situations, but its current common use needs to be assessed more closely. This has not yet been explored in the Australian context. To examine personal, social, institutional and cultural influences on women in their decision to use epidural analgesia in labour. Examining this one event in depth illuminates other birth practices, which can also be analysed according to how they fit within prevailing cultural beliefs about birth. Ethnography, underpinned by a critical medical anthropology methodology. These findings describe the influence of risk culture on labour ward practice specifically, the policies and practices surrounding the use of epidural analgesia are contrasted with those on the use of water. Engaging with current risk theory, we identify the role of power in conceptualisations of risk, which are commonly perpetuated by authority rather than evidence. As we move towards a risk-driven society, it is vital to identify both the conception and the consequences of promulgations of risk. The construction of waterbirth as a 'risky' practice had the effect of limiting midwifery practice and women's choices, despite evidence that points to the epidural as the more 'dangerous' option.
Publisher: SAGE Publications
Date: 2016
Abstract: In this article, we discuss the use of critical medical anthropology (CMA) as a theoretical framework for research in the maternity care setting. With reference to the doctoral research of the first author, we argue for the relevance of using CMA for research into the maternity care setting, particularly as it relates to midwifery. We then give an overview of an existing analytic model within CMA that we adapted for looking specifically at childbirth practices and which was then used in both analyzing the data and structuring the thesis. There is often no clear guide to the analysis or writing up of data in ethnographic research we therefore offer this Critical analytic model of childbirth practices for other researchers conducting ethnographic research into childbirth or maternity care.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 03-2016
Publisher: Springer Science and Business Media LLC
Date: 03-01-2017
Publisher: Elsevier BV
Date: 04-2014
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.WOMBI.2014.08.005
Abstract: To register as a midwife in Australia, students must complete minimum requirements of clinical experiences throughout their programme. This includes following women through their childbirth journey in order to gain continuity of care experience. Research suggests that women and students find the continuity of care experience (COCE) valuable. Nevertheless, students cite difficulty in achieving these experiences. Aim This project sought to explore the challenges and identify supportive strategies for midwifery students undertaking the COCE. This project adopted an action research approach incorporating the four stages of planning, action, observation and reflection. This paper specifically reports the findings from the planning stage in which a focus group with education providers, facilitator and students was conducted and a survey with students (n=69) was undertaken. Key themes were identified through thematic analysis and a number of actions were proposed. Three main themes, 'access', 'boundaries' and 'confidence' were identified as challenges for students undertaking the COCE. Students raised concern regarding lack of access to women for COCE. They identified a need to establish clear professional and personal boundaries in managing the COCE. Students also highlighted the significance of confidence on the success of their experience. Throughout the study students identified strategies that could assist in the COCE. There is a need for clarity and support around the COCE for all stakeholders. Placing the COCE within a Service Learning model is one response that ensures that this experience is understood as being symbiotic for women and students and enables supportive actions to be developed and implemented.
Publisher: MDPI AG
Date: 08-01-2021
Abstract: Our objective was to describe the development and validation of a survey investigating barriers to weight loss, perception of diabetes risk, and views of diet strategies following gestational diabetes (GDM). The survey underwent three stages of development: generation of items, expert evaluation, and pilot testing. A content validation index (CVI) was calculated from expert responses regarding item relevance, coherence, clarity, and response options. Experts also responded to the domain fit of questions linked to the Theoretical Domains Framework (TDF). Pilot responders answered the survey and responded to review questions. Six experts in the field of nutrition, midwifery, psychology, or other health or medical research completed the expert review stage of the survey. In the pilot test, there were 20 responders who were women with previous GDM and who were living in Australia. The overall CVI from the expert review was 0.91. All questions except one received an I-CVI of .78 for relevance (n = 35). Fourteen of the 27 items linked to the TDF received an agreement ratio of .0. Twenty-seven of the 31 pilot questions were completed by ≥90% of responders. Pilot review questions revealed an agreement percentage of ≥86% (n = 12) regarding the survey’s ease to complete, understand, importance, length, and interest level. The final survey tool consists of 30 items and achieved content validation through expert evaluation and pilot testing.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.WOMBI.2009.02.003
Abstract: The reduction of time available to midwives during the hospital postnatal stay suggests that there is a need to review postnatal care. Innovative strategies are required which give attention to specific family needs and assist in the transition to parenthood. Nevertheless, new ideas and changes are not always readily accepted in midwifery practice. To enhance the provision of postnatal care to parents in the early postnatal period given time constraints for parents' hospital stay. Action research was employed to explore the educational experiences of parents in the postnatal period. An action research group (ARG) was established, comprising predominantly of midwives. Based on data collected from parents through questionnaires, focus groups and interviews, three actions were developed and implemented on a postnatal ward. The actions were evaluated by 122 parents through self-report questionnaires. Midwives working on the postnatal ward and midwives involved in the ARG provided feedback regarding the actions through separate focus group discussions. The parents who participated in the study and, the midwives involved in the ARG, were positive about the actions and perceived them to be beneficial in preparing parents for parenthood. Many of the ward midwives, however, were negative about the actions and questioned their benefit for midwifery practice. The negativity of the ward midwives regarding the innovations implemented in the study contrasted strikingly with the positive responses from both parents and the action research midwives. Two themes emerged which may explain the response of midwives to the actions, notably, a lack of ownership of the actions and the problematic nature of the current culture of the postnatal-care environment. It appears that the provision of hospital postnatal care has been influenced by an underlying culture in midwifery practice, which in turn, has impeded the change required to enhance postnatal care.
Publisher: SAGE Publications
Date: 19-09-2021
DOI: 10.1177/09697330211023983
Abstract: Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting in eight articles for review. Data were analysed using NVivo12©. Three core attributes were identified: moral actions and inactions, conflicting needs and negative feelings/emotions. The antecedents of clinical situations, moral awareness, uncertainty and constraint were identified. Consequences of moral distress include adverse personal professional and organisational outcomes. A model case depicting these aspects is presented. A midwifery focused definition of moral distress is offered as ‘a psychological suffering following clinical situations of moral uncertainty and/or constraint, which result in an experience of personal powerlessness where the midwife perceives an inability to preserve all competing moral commitments’. This concept analysis affirms the presence of moral distress in midwifery practice and provides evidence to move towards a consistent definition of moral distress.
Publisher: MDPI AG
Date: 08-12-2020
Abstract: Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM) however, weight loss remains challenging in this population. In order to explore perceptions of T2DM risk, barriers to weight loss, and views of diet strategies in women with previous GDM, a cross-sectional online survey of n = 429 women in Australia aged ≥18 years with previous GDM was conducted. Opinions of intermittent energy restriction (IER) were of interest. Seventy-five percent of responders (n = 322) had overweight or obesity, and 34% (n = 144) believed they had a high risk of developing T2DM. Within the Theoretical Domains Framework, barriers to weight loss were prominently related to Environmental Context and Resources, Beliefs about Capabilities, and Behavioural Regulation. Exercising was the most tried method of weight loss over other diet strategies (71%, n = 234) and weight loss support by a dietician was appealing as in idual appointments (65%, n = 242) or an online program (54%, n = 200). Most women (73%, n = 284) had heard of IER (the “5:2 diet”), but only 12% (n = 34) had tried it. Open comments (n = 100) revealed mixed views of IER. Women in Australia with previous GDM were found to lack a self-perceived high risk of developing T2DM and expressed barriers to weight loss related to their family environment, beliefs about their capabilities and behavioural regulation. IER is appealing for some women with previous GDM however, views vary.
Publisher: Informing Science Institute
Date: 2016
DOI: 10.28945/3486
Abstract: Selecting the most appropriate methodology for research as a doctoral student is one of the most important yet difficult decisions. Not only should the methodology suit the research question, it is important that it resonates with the philosophy of one’s discipline and produces needed results that will contribute to knowledge. Interpretative phenomenological analysis (IPA) is an approach to qualitative enquiry. IPA seeks to explore how in iduals make sense of their major life experiences and is committed to the detailed study of each particular case before moving to broader claims. In the field of midwifery, midwives work with women throughout pregnancy, childbirth and the early postnatal period, offering in idualized care based on the unique needs of each woman. IPA aligns with this women-centered philosophy as it offers a methodological approach that considers the in idual in a local context. By capturing context specific situations, IPA allows broad-based knowledge to be contextualized within a social and cultural context, producing relevant findings. Thus the access to IPA studies will enable midwives to better care for women and their families through understanding the experiences and perceptions of those in their scope of practice. This paper presents the theoretical framework leading to practical guidelines on how to con-duct a doctoral-level IPA study, as experienced by the first author. It also addresses the advantages and challenges around utilizing IPA, illustrated through ex les from the doc-toral student’s study on the journey of exclusive breastfeeding in Australia.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.WOMBI.2017.09.005
Abstract: It's more than just luck: A qualitative exploration of breastfeeding in rural Australia PROBLEM: Despite significant public health benefits, breastfeeding for six months continues to be challenging for women. In the Mid North of South Australia, healthcare professionals were concerned that breastfeeding rates were lower than the national average and that a collaborative approach was needed to promote breastfeeding. To explore the experiences of women and health professional in the Mid North, to inform interventions to improve breastfeeding longevity. Two focus groups were conducted to examine breastfeeding experience in the region. Focus group one included nine mothers who had breastfed more than six months and focus group two consisted of ten health professionals from the Mid North. Thematic analysis was used to analyse the data. Two overarching themes were identified 'breastfeeding: It's more than just luck' represented the voices of the mothers and 'breastfeeding: It's everybody's business' captured the discussion between the health professionals. Women described themselves as lucky while acknowledging that their own persistence, as well as positive support was vital. Health professionals identified education and support as key foci, and a need for a holistic approach to improve breastfeeding rates. Breastfeeding should be understood as a relationship, in which broadly applied solutions do not necessarily influence longevity, particularly in rural communities. Strategies should also reflect a realistic picture of breastfeeding and safeguard against idealistic expectation of the experience. A holistic approach to improve breastfeeding rates is imperative. One of the most promising antidotes to the breastfeeding dilemma is the provision of midwifery continuity of care.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Springer Publishing Company
Date: 2014
Abstract: The World Health Organization (WHO) recommends that every woman should have a skilled birth attendant (SBA) attend her birth however, until this ideal is met, traditional birth attendants (TBA) continue to provide care to women, particularly in rural areas of countries such as Cambodia. The lack of congruence between an ideal and reality has caused difficulty for policy makers and governments. In 2007, The 2h Project, an Australian-based, nongovernment organization in partnership with a local Cambodian organization, “Smile of World,” commenced the “Safe Arrivals” project, providing annual training for SBAs and TBAs in the rural provinces of Cambodia. Following implementation of this project, feedback was collected through a questionnaire undertaken by interviews with participants. This was part of a quality assurance process to further develop training in line with WHO recommendations and to consider the cultural context and respond to local knowledge. Over a 2-year period, 240 birth attendants were interviewed regarding their role and practice. Specifically, through the responses to the questionnaires, several cultural practices were identified that have informed training focus and resource development. More broadly, it was evident that TBAs remain a valuable resource for women, acknowledging their social and cultural role in childbirth.
Publisher: E.U. European Publishing
Date: 29-11-2019
DOI: 10.18332/EJM/114226
Publisher: Bentham Science Publishers Ltd.
Date: 19-12-2022
DOI: 10.2174/18743501-V15-E221020-2022-39
Abstract: It is well-recognized that early parenting significantly influences the health and well-being of children. However, many parents struggle with the daily demands of being a parent and feel overwhelmed and exhausted psychologically and physically. Encouraging self-care practices is essential for parents, and self-compassion may be a potential strategy to utilize. The review aims to assess the influence and impact of providing self-compassion education for parents and families when caring for their children. This systematic review utilized Joanna Briggs Institute (JBI) methodology. A three-stage search approach was undertaken that included seven electronic databases, registries and websites. These databases are Medline, Embase, PsycINFO, Emcare, Cochrane library, Scopus, and ProQuest. The included studies were appraised using the standardized critical appraisal instruments for evidence of effectiveness developed by JBI. Ten studies met the inclusion criteria. Overall, the studies confirmed improved psychological well-being, and higher levels of self-compassion, kindness towards oneself and others, and mindfulness were reported. In addition, there were improvements in psychological well-being, decreased parental distress and perceived distress, lower levels of anxiety, and avoidance of negative experiences. The findings provide evidence to guide further research on developing, designing, facilitating, and evaluating self-compassion education programs and workshops for parents and families. This systematic review title is registered at the International Prospective Register of Systematic Reviews: CRD42021225021.
Publisher: MDPI AG
Date: 23-09-2021
DOI: 10.3390/PH14100954
Abstract: Host cell invasion by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mediated by the interaction of the viral spike protein (S) with human angiotensin-converting enzyme 2 (ACE2) through the receptor-binding domain (RBD). In this work, computational and experimental techniques were combined to screen antimalarial compounds from different chemical classes, with the aim of identifying small molecules interfering with the RBD-ACE2 interaction and, consequently, with cell invasion. Docking studies showed that the compounds interfere with the same region of the RBD, but different interaction patterns were noted for ACE2. Virtual screening indicated pyronaridine as the most promising RBD and ACE2 ligand, and molecular dynamics simulations confirmed the stability of the predicted complex with the RBD. Bio-layer interferometry showed that artemisone and methylene blue have a strong binding affinity for RBD (KD = 0.363 and 0.226 μM). Pyronaridine also binds RBD and ACE2 in vitro (KD = 56.8 and 51.3 μM). Overall, these three compounds inhibit the binding of RBD to ACE2 in the μM range, supporting the in silico data.
Publisher: Queensland University of Technology
Date: 15-03-2021
DOI: 10.5204/SSJ.1802
Abstract: Transition pedagogy has had a major impact on the first year experience for higher education students in Australia. Similarly, there has been a significant focus on transitioning students from their final year of study to employment. Considerably fewer studies have sought to understand the “middle child” the years in between the first and final year of study. Staff at a metropolitan Australian university noticed an increase in students struggling with university life after the first year of their program, with students purposefully withdrawing from courses or their program entirely. This article reports on focus groups held with staff and feedback via a student survey. Findings suggest the challenges faced by students in second year are multi-faceted, and curriculum and delivery should be intentionally designed to support students through a series of transitions throughout the university journey.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 03-2021
Publisher: JMIR Publications Inc.
Date: 23-09-2021
Abstract: im and objective: To undertake a systematic review to assess the influence and impact of providing self-compassion education or training for parents and/or families when caring for their children. Review methods: This systematic review will utilize the Joanna Briggs Institute (JBI) systematic review methodology. A three-stage comprehensive search of at least five electronic databases including Medline, Embase, PsychoInfo, Emcare and Cochrane library, as well as grey literature, will be conducted. Two independent reviewers will review the title and abstract of each paper to determine inclusion all included papers will be appraised using the standardized critical appraisal instruments for evidence of effectiveness developed by JBI. This review will consider studies that include parents, mothers, fathers, family/families or expectant parents. Studies investigating education and/or training will be included, i.e., programs, workshops, seminars or sessions provided by all health care professionals/health and social workers/counsellors, psychologists, nurses, midwives, meditation practitioners, and mindfulness trainers. In addition, this review will consider studies that evaluate or measure any type of self-compassion education or training, i.e., programs, workshops, seminars, sessions targeted for parents, mothers, fathers, family/families or expectant parents. Self-compassion education and/or training may be provided face-to-face, one-to-one, group work, webinar, digital or online, programs, workshops, parental education classes or simulation classes, seminars, sessions. This review will include any randomized controlled trials, quasi-experimental studies, cohort studies and case-controlled studies, before and after studies, and mixed-method studies. Studies will only be considered if they include the following outcome measures: measuring self-compassion (self-kindness, common humanity, mindfulness), fear of compassion and any outcome for health and wellbeing of parents/families, and these will be reported in a column in the summary table of all included studies. The review outcomes will be reported on both continuous and dichotomous scales, where possible findings will be pooled for reporting using JBI tools. Implication: The findings of this systematic review will guide further research on developing, designing, facilitating and evaluating self-compassion education and training programs, workshops, sessions for parents and families. PROSPERO registration: This systematic review title is registered at the International Prospective Register of Systematic Reviews: CRD42021225021
Publisher: Elsevier BV
Date: 05-2017
No related grants have been discovered for Lois McKellar.