ORCID Profile
0000-0003-4144-0718
Current Organisations
University of Sydney
,
World Health Organization
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Publisher: Springer Science and Business Media LLC
Date: 13-01-2017
Publisher: Elsevier BV
Date: 06-2020
DOI: 10.1016/J.PEC.2019.12.014
Abstract: To refine communication strategies to assist clinician conversations with vaccine hesitant and declining parents as part of the Sharing Knowledge About Immunisation (SKAI) package. We recorded and analysed consultations held in two Specialist Immunisation Clinics in tertiary hospitals in Australia between consenting clinicians and parents. We undertook content analysis that was both iterative and informed by the Calgary Cambridge Model of health communication and motivational interviewing. We found common strengths and opportunities in clinician's communication styles. Strengths included: rapport building communicating care for both the parent and child exhibiting depth of vaccination-specific communication skill and content knowledge. Opportunities for strengthening communication practices included: eliciting parents' concerns to saturation early in the consultation structuring the consultation to prioritise and address parents' concerns recognising and responding to parents' motivation to vaccinate effectively closing consultations. This study has synthesised clinical communication strategies from expert vaccination communicators using well-established communication frameworks to advance a unique approach to the challenging task of addressing vaccine hesitancy and refusal. The clinic observations helped us to create a structured consultation guide that can enhance and provide greater structure to a clinician's existing communication skills.
Publisher: MDPI AG
Date: 02-09-2020
Publisher: Springer Science and Business Media LLC
Date: 16-11-2010
Publisher: Springer Science and Business Media LLC
Date: 13-07-2016
Publisher: Cambridge University Press (CUP)
Date: 16-06-2020
DOI: 10.1017/S1368980020000555
Abstract: This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors. A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes. Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis. Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella , remain significant identifiable causes of infant morbidity and mortality. Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.VACCINE.2017.10.077
Abstract: The SKAI (Sharing Knowledge About Immunisation) project aims to develop effective communication tools to support primary health care providers' consultations with parents who may be hesitant about vaccinating their children. This study explored parents' communication needs using a qualitative design. Parents of at least one child less than five years old were recruited from two major cities and a regional town known for high prevalence of vaccine objection. Focus groups of parents who held similar vaccination attitudes and intentions were convened to discuss experiences of vaccination consultations and explore their communication needs, including preferences. Draft written communication support tools were used to stimulate discussion and gauge acceptability of the tools. Important differences in communication needs between group types emerged. The least hesitant parent groups reported feeling reassured upon reading resources designed to address commonly observed concerns about vaccination. As hesitancy of the group members increased, so did their accounts of the volume and detail of information they required. Trust appeared to be related to apparent or perceived transparency. More hesitant groups displayed increased sensitivity and resistance to persuasive language forms.
Publisher: BMJ
Date: 29-06-2012
Abstract: This study compares the formula milk advertisements that appeared in parenting magazines published in two countries that have enacted measures to restrict the advertising of infant formula products in response to the international code with two that have not. Content analysis was used to compare the type and frequency of formula milk advertisements that appeared in parenting magazines collected from the USA, Canada, the UK and Australia during 2007, and to examine whether there was a relationship between these frequencies and advertising regulations. Advertisements that promoted formula products or brands occurred in all of the magazines s led but the type of product advertised differed. Follow-on formula advertisements occurred more frequently in titles from the UK, where infant formula advertising is prohibited (RR 3.82, 95% CI 2.65 to 5.50, p<0.0001) than they did in titles from the USA/Canada where infant and/or follow-on formula advertising is permitted. Toddler milk advertisements appeared more frequently in titles from Australia, where infant and follow-on formula advertising is prohibited, than they did in titles from countries where direct-to-consumer infant and/or follow-on formula advertising is permitted. Rate ratios were as follows: UK only 0.03 (95% CI 0.01 to 0.11, p<0.0001) USA/Canada only 0.02 (95% CI 0.01 to 0.06, p<0.0001). Bans on the advertising of infant formula products do not prevent companies from advertising (follow-on or toddler formula). These products are presented in ways that encourage consumers to associate the claims made in them with a group of products (a product line) that includes infant formula.
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2018-023044
Abstract: Very-low birthweight (VLBW, g) infants comprise about 1%–1.4% of all births in high-income countries. Every year, about 3000 VLBW babies in Australia and New Zealand receive intensive care. Many die or else survive with severe brain injury, retinopathy, late-onset sepsis or necrotising enterocolitis (NEC), each of which carries substantial risk of disability. This trial tests whether adding bovine lactoferrin (bLF) to feeds in VLBW infants improves (1) survival to hospital discharge free from brain injury, late-onset sepsis, NEC and treated retinopathy of prematurity (primary composite end point) (2) each component of the primary composite end point and (3) time to reach full enteral feeds, number of blood transfusions, chronic lung disease and length of hospital stay. It includes a cost-effectiveness analysis of bLF in improving survival free from major morbidity, and evaluates the effect of bLF on survival and developmental outcomes at 24 to 36 months corrected gestational age. This is a multicentre, two-arm, randomised trial comparing the treatment group receiving bLF added to breast milk or formula milk daily (up to 250 mg/kg/day bLF) versus the control group receiving no bLF supplementation. The intervention is administered until 34 completed weeks corrected gestation or for 2 weeks, whichever is longer, or until discharge home, if earlier. The target s le size of 1500 participants yields 85% power, at the two-sided 5% level significance, to detect a difference in proportions meeting the primary outcome assuming the true probability is 74% in controls and 80.5% in the bLF group. This protocol was approved by Northern Sydney Local Human Research Ethics Committee in January 2017 (Version 2.0, Reference 1003-118M) and other relevant ethics committees. The findings of the trial will be disseminated through peer-reviewed journals and conference presentations. ACTRN12611000247976 Pre-results.
Publisher: Oxford University Press (OUP)
Date: 06-11-2013
DOI: 10.1007/S12160-012-9424-Z
Abstract: There is limited evidence for effective obesity treatment programs that engage men. This study evaluated the efficacy of two gender-tailored weight loss interventions for men, which required no face-to-face contact. This was a three-arm, randomized controlled trial: (1) Resources (n = 54), gender-tailored weight loss materials (DVD, handbooks, pedometer, tape measure) (2) Online (n = 53), Resources materials plus study website and e-feedback and (3) Wait-list control (n = 52). The interventions lasted 3 months and were grounded in Social Cognitive Theory. At 6 months, significantly greater weight loss was observed for the Online (-4.7 kg 95 % CI -6.1, -3.2) and Resources (-3.7 kg 95 % CI -4.9, -2.5) groups compared to the control (-0.5 kg 95 % CI -1.4, 0.4). Additionally, both intervention groups significantly improved body mass index, percent body fat, waist circumference, blood pressure, physical activity, quality of life, alcohol risk, and portion size, compared to controls. Men achieved significant weight loss after receiving novel, minimal-contact, gender-tailored programs, which were designed for widespread dissemination.
Publisher: Wiley
Date: 14-10-2017
DOI: 10.1111/MCN.12383
Publisher: Springer Science and Business Media LLC
Date: 04-05-2022
DOI: 10.1007/S13668-022-00414-3
Abstract: Globally, too few children are breastfed as recommended. Commercial promotion of breast-milk substitutes (BMS) is one factor undermining breastfeeding globally. Although the International Code of Marketing of BMS prohibits all forms of marketing, promotion has been observed in digital environments. We aimed to understand the scope and impact of digital marketing for the promotion of BMS. BMS are promoted strategically and in an integrated fashion across multiple digital channels (social media, manufacturer websites, online retailers, blogs, mobile apps and digital streaming services). Traditional marketing strategies like gifts, discounts and coupons are also disseminated digitally. Data mining, real-time direct-to-consumer advertising and partnering with peer-group social media influencers are additional avenues. Exposure to digital marketing is common. Research on the impact of digital marketing is scarce, but its negative impact on breastfeeding intention and initiation has been documented. Case reports from marketing industry press corroborate academic evidence by highlighting the benefits of digital marketing to BMS companies in recruiting new users and increasing sales. To protect and promote breastfeeding, coordinated global action and strengthened national measures will be needed to implement, monitor and enforce the International Code in a digital context. Further action could include voluntary restrictions on BMS marketing by social media platforms and greater use of government-led data and health privacy regulation.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Wiley
Date: 13-12-2008
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Wiley
Date: 11-10-2017
DOI: 10.1111/MCN.12388
Publisher: Elsevier BV
Date: 08-2006
Publisher: MDPI AG
Date: 02-06-2021
Abstract: Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. Methods: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study s le comprised all women who had a live birth in the 24 months preceding the survey. ‘Delayed’ initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as “vaginal birth at a facility (VBF)”, “caesarean section birth (CSB) “, and “vaginal birth at home (VBH)”. We used respondent-level s ling weights to account for in idual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. Results: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births however, there was no direct association with each country’s national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from −28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. Discussion: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth.
Publisher: Wiley
Date: 24-05-2012
DOI: 10.1111/J.1465-3362.2011.00319.X
Abstract: Alcohol energy drinks (AEDs) are a recent entry to the ready-to-drink market, but there is an absence of research into the reasons young people consume these products and their consumption-related experiences. The aim of the current study was to investigate university students' perceptions of, and experiences with, pre-mixed AEDs. Four focus groups with undergraduate university students in a large regional city in New South Wales with transcripts coded for key themes. Participants reported a number of benefits of AED consumption, many of which were similar to other ready-to-drinks, such as taste and image. However, the primary benefits of AEDs related to their capacity to wake the drinker up at the beginning of the evening and facilitate partying and drinking over a longer period. Many of the participants reported experiencing or observing negative effects from drinking AEDs, some quite severe, but this did not appear to act as a deterrent to their consumption. Given the popularity and perceived benefits of AEDs-and evidence from previous research that their consumption is associated with increases in intoxication levels, risky behaviours and harmful alcohol-related consequences-there is a need to consider a range of strategies to reduce harmful consumption of AEDs. While educational interventions may be of benefit, there is also a role for regulation of the packaging and marketing of a product that is associated with substantial harms.
Publisher: SAGE Publications
Date: 02-2012
DOI: 10.1016/J.AUSMJ.2011.10.011
Abstract: The Marketing in Australia of Infant Formula: Manufacturers’ and Importers’ Agreement prevents manufacturers and importers from advertising infant formula. However, toddler milks, which share brand identities with infant formula, are advertised freely and recent research suggests consumers fail to distinguish between advertising for infant formula and for toddler milk. This study examined whether Australian parents recalled having seen advertisements for ‘formula’. Most respondents (66.8%) reported seeing an advertisement for infant formula, with those who had only seen non-retail advertising more than twice as likely to believe that they had seen such an advertisement as those who had only seen retail advertising. This suggests that toddler milk advertisements are functioning as defacto infant formula advertisements in Australia.
Location: Australia
Start Date: 2016
End Date: 2017
Funder: University of Sydney
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