ORCID Profile
0000-0002-5393-7142
Current Organisations
Queensland University of Technology Faculty of Health
,
Queensland University of Technology
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Publisher: Elsevier BV
Date: 10-2007
Publisher: Wiley
Date: 27-02-2014
DOI: 10.1111/BIRT.12084
Abstract: Young motherhood is commonly associated with vulnerabilities, stereotyping of young women's behavior, and poor outcomes for them and their children. The objective was to understand how maternity care is experienced by this group in the transition to parenthood. Data from a large-scale 2010 survey of women's experience of maternity care were analyzed using qualitative methods with open text responses. Overall, 7,193 women responded to the survey: 237 were aged 20 years or less. Most (83%) of these young women provided open text responses. The main themes were: "being a consumer," "the quality of care," "needing support," and "pride in parenthood" whereas subthemes included "being young" and "how staff made me feel," "testimonials for staff," "not being left," and "it is all worthwhile." Many young women responding described a positive experience. For many first-time mothers this feeling marked a change in their identity. Nevertheless, staff perceptions and attitudes affected how they saw themselves and what they took away from their experience of maternity care. A key message for other women is offered, supporting and reinforcing their role as active and involved consumers who, in engaging with services, have to stand up for themselves and make their needs and wishes known.
Publisher: Informa UK Limited
Date: 28-05-2015
DOI: 10.1080/10810730.2015.1018587
Abstract: In this study, 3,531 Queensland women, who had recently given birth, completed a questionnaire that included questions about their participation in decision making during pregnancy, their ratings of client-centered care, and perceived quality of care. These data tested a version of the Linguistic Model of Patient Participation in Care, adapted to the maternity context. The authors investigated how age and education influenced women's perceptions of their participation and quality of care. Hierarchical multiple regressions revealed that women's perceived ability to make decisions, and the extent of client-centered communication with maternity care providers, were the most influential predictors of participation and perceived quality of care. Participation in care predicted perceived quality of care, but the influence of client-centered communication by a care provider and a woman's confidence in decision making were stronger predictors of perceived quality of care. Age and education level were not important predictors. These findings extend and support the use of Linguistic Model of Patient Participation in Care in the maternity context.
Publisher: Wiley
Date: 2003
DOI: 10.1002/NAU.10023
Abstract: The objectives of the current study were (1) to measure type and severity of urinary leakage and (2) to investigate the association between these factors and age-related life events and conditions in three groups of Australian women with a history of urinary leakage. Five hundred participants were randomly selected from women in the young (aged 18-22 in 1996), mid-age (45-50), and older (70-75) cohorts of the Australian Longitudinal Study of Women's Health (ALSWH) who had reported leaking urine in the 1996 baseline survey. Details about leaking urine (frequency, severity, situations) and associated factors (pregnancy, childbirth, body mass index [BMI]) were sought through self-report mailed follow-up surveys in 1999. Response rates were 50, 83, and 80% in the young, mid-age, and older women, respectively. Most women confirmed that they had leaked urine in the past month, and the majority of these were cases of "mixed" incontinence. Incontinence severity tended to increase with BMI for women of all ages, and increased severity scores were associated with having urine that burns or stings. Additional independent risk factors for increasing incontinence severity were heavy smoking in young women, past or present use of hormone replacement therapy in older women, and BMI and history of hysterectomy in mid-age women.
Publisher: Wiley
Date: 25-08-2023
DOI: 10.1111/BIRT.12762
Abstract: Woman‐centered maternity service delivery is endorsed by Australian federal health policy. Despite this, little evaluation of maternity care is conducted through the lens of women. We examined the responses of women birthing in Australia to the international Babies Born Better 2018 (Version 2) open‐response survey. An online international survey was distributed primarily by means of social media for women who had given birth in the last 5 years. In addition to closed‐ended questions to describe the s le, a series of open‐ended questions recorded women's experiences and satisfaction with their maternity care and place of birth. Of 1249 women who reported birthing their most recent baby in Australia and speaking English, 84% responded to at least one open‐ended evaluation question. We thematically analyzed the data to identify three related themes of safety, choice, and respect for women. Women's experiences of these were closely tied to their model of care those birthing at home with a private midwife more so reported positive experiences than those discussing obstetric care or, to a lesser extent, midwifery‐led care in a hospital. There was a strong preference and need for (1) access to affordable care with a known practitioner from early pregnancy to postpartum, and (2) in idualized care with the removal of restrictive hospital policies not aligned with woman‐centered practice. This is the first Australian national study of women's maternity experiences and evaluations. Consistent with previous state‐based research, women birthing in Australia continue to report maternity “care” that is physically and emotionally harmful. They also stated a need to address the psychosocial aspects of becoming a mother, in addition to the biological ones. Women and other birthing people must be at the center of defining quality maternity health service delivery, and services must be accountable for preventing and addressing harm, as defined by all birthing people.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
Publisher: Springer Science and Business Media LLC
Date: 26-04-2014
Publisher: Wiley
Date: 17-03-2018
DOI: 10.1007/S10897-018-0250-8
Abstract: Adequate knowledge is a vital component of informed decision-making however, we do not know what information women value when making decisions about noninvasive prenatal testing (NIPT). The current study aimed to identify women's information needs for decision-making about NIPT as a first-tier, non-contingent test with out-of-pocket expense and, in turn, inform best practice by specifying the information that should be prioritized when providing pre-test counseling to women in a time-limited scenario or space-limited decision support tool. We asked women (N = 242) in Australia to indicate the importance of knowing 24 information items when making a decision about NIPT and to choose two information items they would most value. Our findings suggest that women value having complete information when making decisions about NIPT. Information about the accuracy of NIPT and the pros and cons of NIPT compared to other screening and invasive tests were perceived to be most important. The findings of this study can be used to maximize the usefulness of time-limited discussions or space-limited decision support tools, but should not be routinely relied upon as a replacement for provision of full and tailored information when feasible.
Publisher: Informa UK Limited
Date: 19-11-2020
Publisher: Springer Science and Business Media LLC
Date: 28-06-2021
DOI: 10.1186/S12884-021-03944-W
Abstract: Preference for caesarean birth is associated with higher fear and lower self-efficacy for vaginal birth. Vicarious experience is a strong factor influencing self-efficacy in nulligravid women, and is increasingly accessible via digital and general media. This study assessed the effect of exposure to different birth stories on nulligravid women’s childbirth preferences and the factors mediating these effects. Nulligravid women ( N = 426) were randomly allocated to one of four conditions exposing them to written birth stories. Stories varied by type of birth (vaginal/caesarean) and storyteller evaluation (positive/negative) in a 2 × 2 design. Childbirth preference, fear of labour and vaginal birth, and self-efficacy for vaginal birth were measured before and after exposure via a two-way between groups analysis of covariance. Hierarchical regression models were used to determine the mediating effects of change in childbirth fear and childbirth self-efficacy. Variations in type of birth and storyteller evaluation significantly influenced childbirth preferences ( F (1, 421) = 44.78, p 0.001). The effect of vaginal birth stories on preference was significantly mediated by fear of labour and vaginal birth and self-efficacy. Effects of exposure to caesarean birth stories were not explained by changes in fear or self-efficacy. Childbirth preferences in nulligravid women can be significantly influenced by vicarious experiences. For stories about vaginal birth, the influence of birth stories on women’s fear and self-efficacy expectancy are partly responsible for this influence. The findings highlight the importance of monitoring bias in vicarious experiences, and may inform novel strategies to promote healthy childbirth.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/892019
Abstract: Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care ( n = 13 ) versus Supported Care (in idualised exercise program with regular telephone support n = 15 ). Baseline characteristics (Mean ± SD) were: Age 33 ± 4 years Weight 80 ± 20 kg and Body Mass Index (BMI) 30.0 ± 9.7 kg/m 2 . The primary outcome, planned physical activity {Median (Range)}, increased by 60 (0–540) mins/week in the SC group versus 0 (0–580) mins/week in the UC group ( P = 0.234 ). Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.JSAMS.2008.10.003
Abstract: This is one of the first studies to explore known preventive behaviours for type 2 diabetes (T2DM) among women with recent gestational diabetes (GDM), and the first to do so in a representative population s le. The aim of this study was to describe the prevalence of health-enhancing physical activity (PA) and explore its association with psychosocial and sociodemographic factors, in postnatal women with recent GDM. Cross-sectional telephone surveys were conducted among Queensland women with a recent history (>or=6 months and <or=3 years since diagnosis) of GDM (N=331), which included measures on PA behaviour, social support and self-efficacy for regular PA. The prevalence of health-enhancing PA among women with recent GDM was 37.2%. In multivariate analysis, both social support (OR=1.06, 95% CI 1.03-1.09) and self-efficacy (OR=1.04, 95% CI 1.004-1.07) were significantly associated with health-enhancing PA. The findings from this study demonstrate the need for postnatal follow-up to increase PA levels in women with recent GDM as this may reduce the risk of developing type 2 diabetes (T2DM) in this at-risk population. Strategies that address social support and self-efficacy for PA may be effective in increasing health-enhancing PA among women with recent GDM.
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Springer Science and Business Media LLC
Date: 2007
DOI: 10.1186/AR2154
Publisher: Informa UK Limited
Date: 07-2001
Publisher: Informa UK Limited
Date: 09-2007
Publisher: BMJ
Date: 29-04-2015
Publisher: Informa UK Limited
Date: 08-08-2007
Publisher: Springer Science and Business Media LLC
Date: 07-02-2014
Publisher: BMJ
Date: 16-10-2008
Abstract: To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. A single group pre-post feasibility trial with 11 participants (3 male and 8 female aged 42-65 years) with elevated blood glucose. Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol) glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)) health-related quality of life stress and depressive symptoms. There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05, p<0.001), waist circumference (-2.80 cm, p<0.05), and systolic (-11.64 mm Hg, p<0.01) and diastolic blood pressure (-9.73 mm Hg, p<0.001), as well as in HbA1c (-0.32%, p<0.01), insulin resistance (-0.53, p<0.05), stress (-2.27, p<0.05), depressive symptoms (-3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.
Publisher: Informa UK Limited
Date: 02-2011
Publisher: Springer Science and Business Media LLC
Date: 26-10-2014
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1111/J.1753-6405.2008.00305.X
Abstract: To assess the test-retest reliability and validity of a modified self-administered version of the Active Australia physical activity survey. One hundred and fifty-nine mid-age women (54-59 years) completed a mailed physical activity questionnaire before recording daily pedometer step counts for seven consecutive days. A random subs le (n=44) also wore an accelerometer during this period. Participants then completed the physical activity questionnaire again. Spearman's rho and per cent agreement were used to assess test-retest reliability. Self-reported physical activity data (time 2) were compared with pedometer and accelerometer data using box plots and Spearman's correlations to assess validity. Median time between surveys was 13 days. Median frequency and duration of moderate and vigorous physical activity were the same at both surveys, but median walking frequency was slightly higher at time 2 than time 1. Reliability coefficients for frequency/time in each domain of physical activity ranged from 0.56-0.64 and per cent agreement scores ranged from 40% to 65% for the physical activity categories agreement was 76% for 'meeting guidelines'. Correlations (p) between self-reported physical activity and 1) weekly pedometer steps and 2) accelerometer data for duration of at least moderate intensity physical activity were 0.43 and 0.52 respectively. The measurement properties of this modified self-administered physical activity survey are similar to those reported for the original computer assisted telephone interview survey. This modified version of the Active Australia survey is suitable for use in self-administered format.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2013
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1016/J.MIDW.2012.06.003
Abstract: women who birth in private facilities in Australia are more likely to have a caesarean birth than women who birth in public facilities and these differences remain after accounting for sector differences in the demographic and health risk profiles of women. However, the extent to which women's preferences and/or freedom to choose their mode of birth further account for differences in the likelihood of caesarean birth between the sectors remains untested. women who birthed in Queensland, Australia during a two-week period in 2009 were mailed a self-report survey approximately 3 months after birth. Seven hundred and fifty-seven women provided cross-sectional retrospective data on where they birthed (public or private facility), mode of birth (vaginal or caesarean) and risk factors, along with their preferences and freedom to choose their mode of birth. A hierarchical logistic regression was conducted to determine the extent to which maternal risk and freedom to choose one's mode of birth explain sector differences in the likelihood of having a caesarean birth. while there was no sector difference in women's preference for mode of birth, women who birthed in private facilities had higher odds of feeling able to choose either a vaginal or caesarean birth, and feeling able to choose only a caesarean birth. Women had higher odds of having caesarean birth if they birthed in private facilities, even after accounting for significant risk factors such as age, body mass index, previous caesarean and use of assisted reproductive technology. However, there was no association between place of birth and odds of having a caesarean birth after also accounting for freedom to choose one's mode of birth. these findings call into question suggestions that the higher caesarean birth rate in the private sector in Australia is attributable to increased levels of obstetric risk among women birthing in the private sector or maternal preferences alone. Instead, the determinants of sector differences in the likelihood of caesarean births are complex and are linked to differences in the perceived choices for mode of birth between women birthing in the private and public systems.
Publisher: SAGE Publications
Date: 14-03-2013
Abstract: Recommendations for the introduction of solids and fluids to an infant’s diet have changed over the past decade. Since these changes, there has been minimal research to determine patterns in the introduction of foods and fluids to infants. This retrospective cohort study surveyed mothers who birthed in Queensland, Australia, from February 1 to May 31, 2010, around 4 months postpartum. Frequencies of foods and fluids given to infants at 4, 8, 13, and 17 weeks were described. Logistic regression determined associations between infant feeding practices, the introduction of other foods and fluids at 17 weeks, and sociodemographic characteristics. Response rate was 35.8%. At 17 weeks, 68% of infants were breastfed and 33% exclusively breastfed. Solids and water had been introduced in 8.6% and 35.0% of infants, respectively. The introduction of solids by 17 weeks was associated with younger maternal age and the infant being given water and infant formula at 4 weeks. The infant being given water at 17 weeks was associated with younger maternal age, the infant being given infant formula at 4 weeks, level of education, relative socioeconomic disadvantage, parity, and birth facility. Over the past decade, there has been a significant reduction in the proportion of infants in Australia who have been given solids by 17 weeks. Sociodemographic characteristics and formula feeding practices at 4 weeks were associated with the introduction of solids and water by 17 weeks. Further research should examine these barriers to improve compliance with current infant feeding recommendations.
Publisher: MDPI AG
Date: 20-12-2021
DOI: 10.3390/NU13124566
Abstract: In Pakistan, malnutrition is a chronic issue. Concerns regarding coexisting forms of malnutrition (CFM) in an in idual child are emerging, as children suffering from CFM have a 4 to 12-fold higher risk of death compared with healthy children. This study assessed the prevalence, trends, and socioeconomic determinants of various types of CFM using Pakistan Demographic and Health Survey (PDHS) datasets. Data from children aged 0–5 years old, with complete height and weight information, and valid anthropometry, from all regions of Pakistan (except residents of Azad Jammu Kashmir (AJK) and Federally Administered Tribal Areas (FATA), and non-de jure residents), were included. The prevalence of CFM was 30.6% in 2012–2013 and 21.5% in 2017–2018 PDHS. Both PDHSs reported a significantly higher prevalence of CFM in Sindh and Baluchistan compared with other regions of Pakistan. Improved socioeconomic status significantly reduced the odds of various types of CFM, except the coexistence of underweight with wasting. The high prevalence of CFM in Pakistan can be averted by multisectoral collaboration and by integrating nutrition-sensitive and nutrition-specific interventions.
Publisher: Elsevier BV
Date: 03-2013
Publisher: MDPI AG
Date: 10-01-2020
Abstract: Small-for-gestational-age (SGA) infants are fetuses that have not reached their genetically programmed growth potential. Low birth weight predisposes these infants to an increased risk of developing cardiovascular, metabolic and neurodevelopmental conditions in later life. However, our understanding of how this pathology occurs is currently incomplete. Previous research has focused on understanding the transcriptome, epigenome and bacterial signatures separately. However, we hypothesise that interactions between moderators of gene expression are critical to understanding fetal growth restriction. Through a review of the current literature, we identify that there is evidence of modulated expression/methylation of the placental genome and the presence of bacterial DNA in the placental tissue of SGA infants. We also identify that despite limited evidence of the interactions between the above results, there are promising suggestions of a relationship between bacterial signatures and placental function. This review aims to summarise the current literature concerning fetal growth from multiple avenues and propose a novel relationship between the placental transcriptome, methylome and bacterial signature that, if characterised, may be able to improve our current understanding of the placental response to stress and the aetiology of growth restriction.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2020
DOI: 10.1186/S12884-020-03149-7
Abstract: There is no available evidence for the prevalence of early labour admission to hospital or its association with rates of intervention and clinical outcomes in Australia. The objectives of this study were to: estimate the prevalence of early labour admission in one hospital in Australia compare rates of clinical intervention, length of hospital stay and clinical outcomes for women admitted in early ( 4 cm cervical dilatation) or active (≥4 cm) labour and determine the impact of recent recommendations to define early labour as 5 cm on the findings. We conducted a retrospective cohort study using medical record data from a random s le of 1223 women from live singleton births recorded between July 2013 and December 2015. Analyses included women who had spontaneous onset of labour at ≥37 weeks gestation whilst not a hospital inpatient, who had not scheduled a caesarean section before labour onset or delivered prior to hospital admission. Associations between timing of hospital admission in labour and clinical intervention, outcomes and hospital stay were assessed using logistic regression. Between 32.4% ( 4 cm) and 52.9% ( 5 cm) of eligible women ( N = 697) were admitted to hospital in early labour. After adjustment for potential confounders, women admitted in early labour ( 4 cm) were more likely to have their labour augmented by oxytocin (AOR = 3.57, 95% CI 2.39–5.34), an epidural (AOR = 2.27, 95% CI 1.51–3.41), a caesarean birth (AOR = 3.50, 95% CI 2.10–5.83), more vaginal examinations (AOR = 1.73, 95% CI = 1.53–1.95), and their baby admitted to special care nursery (AOR = 1.54, 95% CI = 1.01–2.35). Defining early labour as 5 cm cervical dilatation produced additional significant associations with artificial rupture of membranes (AOR = 1.41, 95% CI = 1.02–1.95), assisted vaginal birth (AOR = 1.96, 95% CI = 1.12–3.41) neonatal resuscitation (AOR = 1.73, 95% CI = 1.01–2.99) and longer maternal hospital stay (AOR = 1.21, 95% CI = 1.04–1.40). Findings provide preliminary evidence that a notable proportion of labouring women are admitted in early labour and are more likely to experience several medical procedures, neonatal resuscitation and admission to special care nursery, and longer hospital stay.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2022
DOI: 10.1186/S40337-022-00592-Z
Abstract: Currently, there is limited empirical validation of feminist-informed or in idualised interventions for the treatment of eating disorders. The aim of this study was to examine the effectiveness of a feminist-informed, in idually delivered counselling intervention for the treatment of eating disorders at a community-based eating disorder treatment service. Eighty in iduals aged between 17 and 64 years presenting to an outpatient eating disorder service were examined in a case series design at baseline, session 10, session 20 and end of treatment (session 30). Changes in eating disorder symptomology, depression, anxiety, stress, and mental health recovery over the course of treatment were examined in linear mixed model analyses. The treatment intervention was effective in reducing eating disorder symptomology and stress and improving mental health recovery after 10 sessions in a s le of 80 eating disorder participants engaged with the treatment service. Reductions in eating disorder symptomology and stress and improvements to mental health recovery were maintained at session 20 and session 30. The findings of this study provide preliminary support for feminist-informed and in idualised interventions for the treatment of eating disorders in community-based settings.
Publisher: Informa UK Limited
Date: 30-06-2010
DOI: 10.1080/03630242.2010.498756
Abstract: We evaluated the effectiveness of a woman-held pregnancy record ('The Pregnancy Pocketbook') on improving health behaviors important for maternal and infant health. The Pregnancy Pocketbook was developed as a woman-focused preventive approach to pregnancy health based on antenatal management guidelines, behavior-change evidence, and formative research with the target population and health service providers. The Pregnancy Pocketbook was evaluated using a quasi-experimental, two-group design one clinic cohort received the Pregnancy Pocketbook (n = 163) the other received Usual Care (n = 141). Smoking, fruit and vegetable intake, and physical activity were assessed at baseline (service-entry) and 12-weeks. Approximately two-thirds of women in the Pregnancy Pocketbook clinic recalled receiving the resource. A small, but significantly greater proportion of women at the Pregnancy Pocketbook site (7.6%) than the UC site (2.1%) quit smoking. No significant effect was observed of the Pregnancy Pocketbook on fruit and vegetable intake or physical activity. Few women completed sections that required health professional assistance. The Pregnancy Pocketbook produced small, but significant effects on smoking cessation, despite findings that indicate minimal interaction about the resource between health staff and the women in their care. A refocus of antenatal care toward primary prevention is required to provide essential health information and behavior change tools more consistently for improved maternal and infant health outcomes.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1111/J.1753-6405.2009.00380.X
Abstract: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district. Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007. Analyses were based on 262 pregnant women. The study s le was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy. There were low levels of adherence to health behaviour recommendations for pregnancy in this s le. There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.WOMBI.2015.08.002
Abstract: Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing c aigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing c aigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14055
Abstract: Objective Although home visiting in the early post partum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of post partum home visiting in the public and private sectors in Queensland. Methods Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1 February and 31 May 2010 at 4 months post partum (n = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Results Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable subpopulations in both sectors were more likely to be visited, whereas others were not. Conclusions Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed. What is known about the topic? A recent paper found that most women from the public sector in Victoria and South Australia receive an early post partum home visit from a midwife or nurse. Queensland only recently implemented a program to increase post partum home visiting but who receives visits is still unknown. What does this paper add? No previous study has investigated which women receive early post partum home visits in Queensland, nor home visiting rates within the private sector. This paper also examines whether specific subpopulations of vulnerable post partum women are receiving home visits so that patterns of inequity or unmet needs can be identified. What are the implications for practitioners? Home visiting by nurses or midwives in the post partum period in Queensland was less common than in other Australian states, and varies markedly between the public and private sector. These differences highlight inequities in community post partum care that need to be addressed if women are to receive the most cost-effective and clinically appropriate care and support in the post partum period.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13011
Abstract: Problem crying in the first few months of life is both common and complex, arising out of multiple interacting and co-evolving factors. Parents whose babies cry and fuss a lot receive conflicting advice as they seek help from multiple health providers and emergency departments, and may be admitted into tertiary residential services. Conflicting advice is costly, and arises out of discipline-specific interpretations of evidence. An integrated, interdisciplinary primary care intervention (‘The Possums Approach’) for cry-fuss problems in the first months of life was developed from available peer-reviewed evidence. This study reports on preliminary evaluation of delivery of the intervention. A total of 20 mothers who had crying babies under 16 weeks of age (average age 6.15 weeks) completed questionnaires, including the Crying Patterns Questionnaire and the Edinburgh Postnatal Depression Scale, before and 3−4 weeks after their first consultation with trained primary care practitioners. Preliminary evaluation is promising. The Crying Patterns Questionnaire showed a significant decrease in crying and fussing duration, by 1 h in the evening (P = 0.001) and 30 min at night (P = 0.009). The median total amount of crying and fussing in a 24-h period was reduced from 6.12 to 3 h. The Edinburgh Postnatal Depression Scale showed a significant improvement in depressive symptoms, with the median score decreasing from 11 to 6 (P = 0.005). These findings are corroborated by an analysis of results for the subset of 16 participants whose babies were under 12 weeks of age (average age 4.71 weeks). These preliminary results demonstrate significantly decreased infant crying in the evening and during the night and improved maternal mood, validating an innovative interdisciplinary clinical intervention for cry-fuss problems in the first few months of life. This intervention, delivered by trained health professionals, has the potential to mitigate the costly problem of health professionals giving discipline-specific and conflicting advice post-birth.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.MIDW.2015.04.005
Abstract: currently, care providers and policy-makers internationally are working to promote normal birth. In Australia, such initiatives are being implemented without any evidence of the prevalence or determinants of normal birth as a multidimensional construct. This study aimed to better understand the determinants of normal birth (defined as without induction of labour, epidural/spinal/general anaesthesia, forceps/vacuum, caesarean birth, or episiotomy) using secondary analyses of data from a population survey of women in Queensland, Australia. women who birthed in Queensland during a two-week period in 2009 were mailed a survey approximately three months after birth. Women (n=772) provided retrospective data on their pregnancy, labour and birth preferences and experiences, socio-demographic characteristics, and reproductive history. A series of logistic regressions were conducted to determine factors associated with having labour, having a vaginal birth, and having a normal birth. overall, 81.9% of women had labour, 66.4% had a vaginal birth, and 29.6% had a normal birth. After adjusting for other significant factors, women had significantly higher odds of having labour if they birthed in a public hospital and had a pre-existing preference for a vaginal birth. Of women who had labour, 80.8% had a vaginal birth. Women who had labour had significantly higher odds of having a vaginal birth if they attended antenatal classes, did not have continuous fetal monitoring, felt able to 'take their time' in labour, and had a pre-existing preference for a vaginal birth. Of women who had a vaginal birth, 44.7% had a normal birth. Women who had a vaginal birth had significantly higher odds of having a normal birth if they birthed in a public hospital, birthed outside regular business hours, had mobility in labour, did not have continuous fetal monitoring, and were non-supine during birth. these findings provide a strong foundation on which to base resources aimed at increasing informed decision-making for maternity care consumers, providers, and policy-makers alike. Research to evaluate the impact of modifying key clinical practices (e.g., supporting women׳s mobility during labour, facilitating non-supine positioning during birth) on the likelihood of a normal birth is an important next step.
Publisher: Informa UK Limited
Date: 20-03-2015
DOI: 10.1080/03630242.2015.1022690
Abstract: Information in the popular media tends to be biased toward promoting the benefits of medicalized birth for low-risk pregnancies. We aimed to assess the effect of communicating the benefits of non-medicalized birth in magazine articles on women's birth intentions and to identify the mechanisms by which social communication messages affected women's intentions for birth. A convenience s le of 180 nulliparous Australian women aged 18-35 years were randomly exposed to a magazine article endorsing non-medicalized birth (using either celebrity or non-celebrity endorsement) or organic eating (control) throughout June-July 2011. Magazine articles that endorsed non-medicalized birth targeted perceived risk of birth, expectations for labor and birth, and attitudes toward birth. These variables and intention for birth were assessed by self-report before and after exposure. Exposure to a magazine article that endorsed non-medicalized birth significantly reduced women's intentions for a medicalized birth, regardless of whether the endorsement was by celebrities or non-celebrities. Changes in perceived risk of birth mediated the effect of magazine article exposure on women's intentions for a medicalized birth. Persuasive communication that endorses non-medicalized birth could be delivered at the population level and may reduce women's intentions for a medicalized birth.
Publisher: BMJ
Date: 02-04-2008
Publisher: Elsevier BV
Date: 10-2003
DOI: 10.1111/J.1467-842X.2003.TB00827.X
Abstract: To develop a physical activity directory (PAD) for Brisbane people over the age of 50 years for distribution by two methods (given or requested), and to determine its effectiveness in raising awareness and encouraging older people to participate in local physical activity options. Baseline demographic data and stage of change was collected from 224 participants who received the directory. Participants were interviewed by telephone six weeks later to determine their use of the directory on a number of dimensions. Most participants interviewed at follow-up remembered reading the directory. Participants who requested the directory were significantly more likely than those who were given it to: be contemplators, read the directory, plan to ring a number, plan to attend a class, and to share the directory with others. Participants who were contemplators were significantly more likely to have participated in physical activity of their own and rang a number from the directory. The directory increased over half the participants' awareness of local physical activity options, yet only 7% reported ringing a number and 15% reported doing their own physical activity. The directory was more effective in raising awareness about physical activity options than encouraging people to participate in physical activity, and participants with short-term plans to be more active were more likely to have used the directory. The directory, even when linked with other services, raises awareness about physical activity options, but has minimal short-term influence on participation.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.PEC.2017.09.015
Abstract: This study investigated how health care provider communication of risk information, and women's role in decision-making, influenced women's preferences for mode of birth after a previous caesarean birth. Women (N = 669) were randomised to one of eight conditions in a 2 (selectivity of risk information) × 2 (format of risk information) × 2 (role in decision making) experimental design. After exposure to a hypothetical decision scenario that varied information communicated by an obstetrician to a pregnant woman with a previous caesarean birth across the three factors, women were asked to decide their preferred hypothetical childbirth preference. Women provided with selective information (incomplete/biased toward repeat caesarean) and relative risk formats (ratio of incidence being compared e.g. 2.5 times higher), perceived lower risk for caesarean and were significantly more likely to prefer repeat caesarean birth than those provided with non-selective information (complete/unbiased) and absolute risk formats (incidence rate e.g. 0.01 per 100). Role in decision-making did not significantly influence childbirth preferences CONCLUSIONS: Modifiable aspects of healthcare provider communication may influence women's decision-making about childbirth preferences PRACTICE IMPLICATIONS: Optimised communication about risks of all options may have an impact on over-use of repeat CS.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2012
DOI: 10.1038/EJCN.2012.84
Abstract: To describe the diet quality of a national s le of Australian women with a recent history of gestational diabetes mellitus (GDM) and determine factors associated with adherence to national dietary recommendations. A postpartum lifestyle survey with 1499 Australian women diagnosed with GDM ≤3 years previously. Diet quality was measured using the Australian recommended food score (ARFS) and weighted by demographic and diabetes management characteristics. Multinominal logistic regression analysis was used to determine the association between diet quality and demographic characteristics, health seeking behaviours and diabetes-related risk factors. Mean (±s.d.) ARFS was 30.9±8.1 from a possible maximum score of 74. Subscale component scores demonstrated that the nuts/legumes, grains and fruits were the most poorly scored. Factors associated with being in the highest compared with the lowest ARFS quintile included age (odds ratio (OR) 5-year increase=1.40 95% (confidence interval) CI:1.16-1.68), tertiary education (OR=2.19 95% CI:1.52-3.17), speaking only English (OR=1.92 95% CI:1.19-3.08), being sufficiently physically active (OR=2.11 95% CI:1.46-3.05), returning for postpartum blood glucose testing (OR=1.75 95% CI:1.23-2.50) and receiving risk reduction advice from a health professional (OR=1.80 95% CI:1.24-2.60). Despite an increased risk of type 2 diabetes, women in this study had an overall poor diet quality as measured by the ARFS. Women with GDM should be targeted for interventions aimed at achieving a postpartum diet consistent with the guidelines for chronic disease prevention. Encouraging women to return for follow-up and providing risk reduction advice may be positive initial steps to improve diet quality, but additional strategies need to be identified.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.MIDW.2013.06.018
Abstract: young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15-20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. in the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. this study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2012
DOI: 10.1007/S11136-012-0311-7
Abstract: The aim was to assess the effects of a Tai Chi-based program on health-related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical-care control group (N = 21). The Tai Chi group involved 3 × 1.5 h supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. There were significant improvements in favor of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95% CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2022
DOI: 10.1186/S12889-022-13098-9
Abstract: Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an in idual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in in iduals were included. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for prevalence and longitudinal studies. The search retrieved 14,207 articles, of which 24 were included in this review. The prevalence of CFM varied by geographical area and specific types. In children under 5 years, the coexistence of stunting with overweight/obesity ranged from 0.8% in the United States to over 10% in Ukraine and Syria, while the prevalence of coexisting wasting with stunting ranged from 0.1% in most of the South American countries to 9.2% in Niger. A decrease in CFM prevalence was observed in all countries, except Indonesia. Studies in China and Indonesia showed a positive association between rurality of residence and coexisting stunting with overweight/obesity. Evidence for other risk and protective factors for CFM is too minimal or conflicting to be conclusive. Evidence regarding the prevalence, determinants and trends for CFM is scarce. Apart from the coexistence of stunting with overweight/obesity, the determinants of other types of CFM are unclear. CFM in any form results in an increased risk of health adversities which can be different from comparable standalone forms, thus, there is an urgent need to explore the determinants and distribution of different types of CFM.
Publisher: Springer Science and Business Media LLC
Date: 23-10-2003
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1016/S1440-2440(01)80046-3
Abstract: Leaking urine is frequently mentioned (anecdotally) by women as a barrier to physical activity. The aim of this paper was to use results from the Australian Longitudinal Study on Women's Health (ALSWH) to explore the prevalence of leaking urine in Australian women, and to ascertain whether leaking urine might be a barrier to participation for women. More than 41,000 women participated in the baseline surveys of the ALSWH in 1996. More than one third of the mid-age (45-50 years) and older (70-75) women and 13% of the young women (18-23) reported leaking urine. There was a cross-sectional association between leaking urine and physical activity, such that women with more frequent urinary leakage were also more likely to report low levels of physical activity. More than one thousand of those who reported leaking urine at baseline participated in a follow-up study in 1999. Of these, more than 40% of the mid-age women (who were aged 48-53 in 1999), and one in seven of the younger (21-26 years) and older (73-79 years) women reported leaking urine during sport or exercise. More than one third of the mid-age women and more than one quarter of the older women, but only 7% of the younger women said they avoided sporting activities because of leaking urine. The data are highly suggestive that leaking urine may be a barrier to physical activity, especially among mid-age women. As current estimates suggest that fewer than half of all Australian women are adequately active for health benefit, health professionals could be more proactive in raising this issue with women and offering help through non-invasive strategies such as pelvic floor muscle exercises.
Publisher: Informa UK Limited
Date: 10-2005
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.AMEPRE.2011.04.007
Abstract: Previous studies have shown that qi-gong, a form of mind-body movement therapy, may be beneficial for people with type 2 diabetes however, no controlled studies have been conducted to examine the predictors and mediators of qi-gong effects on indicators of diabetes control. This study examined the effects of qi-gong on diabetes control and identified the predictors and mediators of these effects. RCT. The study included forty-one participants (16 men and 25 women aged 41-71 years) with elevated blood glucose levels. Participants were randomized to qi-gong intervention or a usual medical care control group. Physical and hematologic measures were assessed at baseline and after 12 weeks. The outcomes were indicators of diabetes control (HbA1c, insulin resistance, fasting blood glucose and insulin, and 2-hour blood glucose and insulin) and potential mediators of these (body weight, waist circumference, and leg strength). Data were collected in 2006 and analyzed in 2007 to 2009. Linear regression analyses showed significant between-group differences in favor of the intervention group in weight (p<0.01) waist circumference (p<0.01) leg strength (p<0.01) HbA1c (p<0.05) insulin resistance (p<0.01) and fasting blood insulin (p<0.01) at 12 weeks. Logistic regression analyses showed that the qi-gong intervention was a significant predictor of reduced weight (odds for decreasing by -2 kg=11.14, p<0.01) waist circumference (by -5 cm=22.50, p<0.01) insulin resistance (by -0.2 unit=3.75, p<0.05) and improved leg strength (odds for increasing by 4 stands in 30 seconds=7.00, p<0.01). The effect of the qi-gong intervention on improved insulin resistance was mediated by reduced weight. The qi-gong intervention was associated with improvements in weight, waist circumference, leg strength, and insulin resistance. The mediation analyses highlight the importance of weight reduction in the control of diabetes. TRIAL REGISTRATION #: Australian New Zealand Clinical Trials Registry: ACTRN12607000528459.
Publisher: Public Library of Science (PLoS)
Date: 12-07-2022
DOI: 10.1371/JOURNAL.PONE.0271105
Abstract: We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide s le of women who had recently given birth in Queensland (response rate = 30.4%). Logistic regression was used to estimate the odds of outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates. Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. There were minimal differences for women in GP Shared Care. Women in Public Midwifery Continuity Care were less likely to have a scheduled caesarean and more likely to have an unassisted vaginal birth, experience freedom of mobility during labour and informed consent processes for inducing labour, vaginal examinations, fetal monitoring and receiving Syntocinon to birth their placenta, and report highest quality interpersonal care. They had fewer vaginal examinations, lower odds of perineal trauma requiring sutures and anxiety after birth, shorter postpartum hospital stays, and higher odds of a home postpartum care visit. Women in Private Obstetric Care were more likely to have their labour induced, a scheduled caesarean birth, experience informed consent processes for caesarean, and report highest quality interpersonal care, but less likely to experience unassisted vaginal birth and informed consent for Syntocinon to birth their placenta. There is an urgent need to communicate variations between maternity models across the range of outcome and experiential measures that are important to women build more rigorous comparative evidence for Private Midwifery Care and prioritise experiential and out-of-pocket cost comparisons in further research to enable woman-centred informed decision-making.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.WOMBI.2018.08.170
Abstract: Communication with maternity care providers is one of the strongest predictors of the perceived quality of maternity care. There is evidence that older mothers experience better communication than younger mothers, but no evidence for why this occurs. To identify differences between younger (<35 years) and older (35+ years) mother's perceived quality of communication and any apparent age-related differences. We analysed cross-sectional data from 2504 first-time mothers in the Having a Baby in Queensland Survey 2012. Binary logistic regression assessed associations between maternal age and perceived optimal communication (information, participation, and connection) from care providers during women's most recent pregnancy and birth. Multivariable logistic regression modelling determined the effect of potential confounders (model of care, mode of birth, maternal age, and risk perceptions) on associations between age and communication quality. After adjustment for confounders, older mothers were more likely to report experiencing optimal information (e.g., not receiving conflicting information) and connection with caregivers (e.g., comfortable asking questions) in both pregnancy and birth. There were no age-related differences in the perception of participation. Model of care and mode of birth were more influential than maternal age in predicting communication perceptions. Women who used midwifery or private obstetric models and had unassisted vaginal births were more likely to perceive optimal communication. Given the benefits of communication on maternity care, redressing these age-related differences should be a focus of future communication training for care providers to ensure that women receive optimal communication, regardless of their age.
Publisher: BMJ
Date: 06-2010
Publisher: Springer Science and Business Media LLC
Date: 16-05-2016
DOI: 10.1007/S40615-015-0118-7
Abstract: Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically erse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Springer Science and Business Media LLC
Date: 16-10-2021
Publisher: Wiley
Date: 27-06-2012
Publisher: Springer Science and Business Media LLC
Date: 27-11-2014
DOI: 10.1007/S10995-013-1398-3
Abstract: This study investigated the effect of any health professional contact and the types of contact new mothers received in the first 10 days post-discharge on breastfeeding rates at 3 months. This cross-sectional retrospective self-report survey was distributed to women who birthed in Queensland, Australia between 1st February and 31st May 2010 at 4-5 months postpartum. Data were collected on pregnancy, birth, postpartum care and infant feeding. Logistic regression was used to assess the relationship between health professional contact and breastfeeding at 3 months. Data were analysed by birthing facility sector because of significant differences between sectors in health professional contact. The study cohort consisted of 6,852 women. Women in the public sector were more likely to be visited at home than women birthing in the private sector. Any health professional contact (AOR 1.65 99 % CI 0.98-2.76 public sector, AOR 0.78 99 % CI 0.59-1.03 private sector) and home visits (AOR 1.50 99 % CI 0.89-2.54 public sector, AOR 0.80 99 % CI 0.46-1.39 private sector) were not associated with breastfeeding at 3 months in either sector. A telephone call (AOR 2.07 99 % CI 1.06-4.03) or visit to a general practitioner (GP) (AOR 1.83 99 % CI 1.04-3.21) increased the odds of breastfeeding in public sector women. Health professional contact or home visiting in the first 10 days post-discharge did not have a significant impact on breastfeeding rates at 3 months. Post-discharge telephone contact for all women and opportunities for self-initiated clinic visits for women assessed to be at higher risk of ceasing breastfeeding may be the most effective care.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.WOMBI.2014.02.002
Abstract: Women born outside Australia make up more than a fifth of the Queensland birthing population and like migrants in other parts of the world face the challenges of cultural dislocation and possible language barriers. Recognising that labour and birth are major life events the aim was to investigate the experiences of these women in comparison to native-born English speaking women. Secondary analysis of data from a population based survey of women who had recently birthed in Queensland. Self-reported clinical outcomes and quality of interpersonal care of 481 women born outside Australia who spoke a language other than English at home were compared with those of 5569 Australian born women speaking only English. After adjustment for demographic factors and type of birthing facility, women born in another country were less likely to be induced, but more likely to have constant electronic fetal monitoring (EFM), to give birth lying on their back or side, and to have an episiotomy. Most women felt that they were treated as an in idual and with kindness and respect. However, women born outside Australia were less likely to report being looked after 'very well' during labour and birth and to be more critical of some aspects of care. In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care.
Publisher: Wiley
Date: 14-12-2015
DOI: 10.1111/BIRT.12212
Abstract: Access to information on the features and outcomes associated with the various models of maternity care available in Australia is vital for women's informed decision-making. This study sought to identify women's preferences for information access and decision-making involvement, as well as their priority information needs, for model of care decision-making. A convenience s le of adult women of childbearing age in Queensland, Australia were recruited to complete an online survey assessing their model of care decision support needs. Knowledge on models of care and socio-demographic characteristics were also assessed. Altogether, 641 women provided usable survey data. Of these women, 26.7 percent had heard of all available models of care before starting the survey. Most women wanted access to information on models of care (90.4%) and an active role in decision-making (99.0%). Nine priority information needs were identified: cost, access to choice of mode of birth and care provider, after hours provider contact, continuity of carer in labor/birth, mobility during labor, discussion of the pros/cons of medical procedures, rates of skin-to-skin contact after birth, and availability at a preferred birth location. This information encompassed the priority needs of women across age, birth history, and insurance status subgroups. This study demonstrates Australian women's unmet needs for information that supports them to effectively compare available options for model of maternity care. Findings provide clear direction on what information should be prioritized and ideal channels for information access to support quality decision-making in practice.
Publisher: Springer Science and Business Media LLC
Date: 06-2003
DOI: 10.1207/S15327558IJBM1002_04
Abstract: In the 1996 baseline surveys of the Australian Longitudinal Study of Women's Health (ALSWH), 36.1% of mid-age women (45-50) and 35% of older women (70-75) reported leaking urine. This study aimed to investigate (a) the range of self-management strategies used to deal with urinary incontinence (UI) (b) the reasons why many women who report leaking urine do not seek help for UI and (c) the types of health professionals consulted and treatment provided, and perceptions of satisfaction with these, among a s le of women in each age group who reported leaking urine "often" at baseline. Five hundred participants were randomly selected from women in each of the mid-age and older cohorts of the ALSWH who had reported leaking urine "often" in a previous survey. Details about UI (frequency, severity, and situations), self-management behaviors and help-seeking for UI, types of health professional consulted, recommended treatment for the problem, and satisfaction with the service provided by health care professionals and the outcomes of recommended treatments were sought through a self-report mailed follow-up survey. Most respondents had leaked urine in the last month (94% and 91% of mid-age and older women, respectively), and 72.2% and 73.1% of mid-aged and older women, respectively, had sought help or advice about their UI. In both age groups, the likelihood of having sought help significantly increased with severity of incontinence. The most common reasons for not seeking help were that the women felt they could manage the problem themselves or they did not consider it to be a problem. Many women in both cohorts had employed avoidance techniques in an attempt to prevent leaking urine, including reducing their liquid consumption, going to the toilet "just in case," and rushing to the toilet the minute they felt the need to.
Publisher: The Sax Institute
Date: 2005
DOI: 10.1071/NB05039
Publisher: Oxford University Press (OUP)
Date: 06-2009
DOI: 10.1007/S12160-009-9099-2
Abstract: The impact of life events on physical activity (PA) is little understood. The purpose of this study is to examine relationships between specific life events and changes in PA in three cohorts of Australian women. Young (N = 7,173 age 22-27 years), mid-age (N = 8,762 51-56 years), and older (N = 6,660 73-78 years) participants in the Australian Longitudinal Study on Women's Health completed surveys on two occasions, 3 years apart. About one third of the young and mid-age women and one quarter of the older women were "active" at both times. Decreasing PA was associated with marriage and childbirth in young women and with declining health in older women. Increasing PA was associated with retirement and death of spouse in the mid-age women. Stressful events such as orce, harassment at work, and violence were also associated with changing PA. There were significant associations between age-specific life events and PA changes. Understanding these relationships could inform interventions for preventing declines in activity at specific life stages.
Publisher: SAGE Publications
Date: 2005
DOI: 10.4278/0890-1171-19.3.159
Abstract: To determine whether Australia's Walk to Work Day media c aign resulted in behavioral change among targeted groups. Pre- and postc aign telephone surveys of a cohort of adults aged 18 to 65 years (n = 1100, 55% response rate) were randomly s led from Australian major metropolitan areas. Tests for dependent s les were applied (McNemar χ 2 or paired t-test). Among participants who did not usually actively commute to work was a significant decrease in “car only” use and an increase in walking combined with public transport. Among those who were employed was a significant increase in total time walking (+16 min/wk t [780] = 2.04, p .05) and in other moderate physical activity (+l20 min/wk t [1087] = 4.76, p .005), resulting in a significant decrease in the proportion who were “inactive” (χ 2 (1) = 6.1, p .05). Although nonexperimental, the Walk to Work Day initiative elicited short-term changes in targeted behaviors among target groups. Reinforcement by integrating worksite health promotion strategies may be required for sustained effects.
Publisher: Springer Science and Business Media LLC
Date: 18-06-2018
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1016/J.EJOGRB.2016.12.032
Abstract: To describe and examine the EXIT (EXperiences of Induction Tool), and report on the experience of women undergoing PGE2 vaginal gel IOL, who were participants in a randomized controlled trial comparing early amniotomy with repeat-PGE2. Following an evening dose of PGE2 vaginal gel, 245 women with live singleton term pregnancies were randomized to amniotomy or repeat-PGE2. Women's experience of IOL was a secondary outcome measure, assessed using the self-report EXIT administered by phone at 7-9days post-partum. The 10-item EXIT assessed women's experiences in multiple domains using a 5-point agreement scale. Principal components analysis with orthogonal varimax rotation was undertaken to examine the scale structure. Internal consistency, face, content, construct and discriminant validity were also assessed. The final 3-component solution comprised 8 of the 10 EXIT items, explained 76.1% of the variance and had a good fit to model (p<0.001). The three resulting components were representative of women's experience of the time taken to give birth, discomfort with IOL, and subsequent contractions. The items loading to each component showed good internal consistency for time taken to give birth (α=0.88), discomfort with IOL (α=0.78), and experience of subsequent contractions (α=0.87). Women in the repeat-PGE2 group reported a less favorable experience with the time taken to give birth (mean (SD): 3.5 (1.4) vs 3.9 (1.2) p=0.04) and more discomfort with IOL (2.9 (1.1) vs 2.5 (1.0) p=0.04) compared to women in the amniotomy group. At the in idual item level, women in the amniotomy group responded more positive about the time taken to have their baby (median (IQR): 4 (3-5) vs 3 (2-5) p<0.01) and less negative to the question about the number of vaginal examinations (2 (1-3) vs 2 (1-4) p=0.05). The EXIT shows promise as an instrument for assessing women's experience of IOL. Women undergoing PGE2 vaginal gel IOL reports a more positive experience with an early amniotomy rather than with repeat-PGE2.
Publisher: MDPI AG
Date: 12-10-2022
DOI: 10.3390/NU14204242
Abstract: Breastmilk is the only recommended source of nutrition for infants below six months of age. However, a significant proportion of children are either on supplemental breastfeeding (SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids (SSF) before six months of age. There is good evidence that exclusive breastfeeding (EBF) in infants below six months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition (CFMs) has not yet been explored. This study examined the association of different feeding indicators (continuation of breastfeeding, predominant feeding, and SSF) and feeding practices (EBF, SBF, and complete weaning) with CFM in infants aged below six months in Pakistan. National and regional datasets for Pakistan from the last ten years were retrieved from the Demographic Health Surveys (DHS) and UNICEF data repositories. In Pakistan, 34.5% of infants have some form of malnutrition. Among malnourished infants, 44.7% (~15.4% of the total s le) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF (65.4%) or weaned infants (13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting, and underweight with both wasting and stunting by 1.96 (1.12–3.47) and 2.25 (1.16–4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protected infants in Pakistan from various types of CFM during the first six months of life.
Publisher: Wiley
Date: 06-11-2007
Publisher: Springer Science and Business Media LLC
Date: 10-08-2023
DOI: 10.1007/S10389-023-02054-5
Abstract: This study aimed to explore the relationship between different complementary feeding (CF) indicators and coexisting forms of malnutrition (CFM) in Pakistan. This study involves secondary data analysis of eight national and regional datasets of Pakistan, which were retrieved from the Demographic Health Survey (DHS) and UNICEF. From these datasets, data of children aged between 6 to 23.9 months was analysed after excluding incomplete and/or invalid data related to their feeding practices and anthropometry. Thus, data of 30,097 Pakistani children between the ages of 6 to 23.9 months was analysed in this study using Jamovi software. The prevalence of CFM in this s le of children was 28.1%. Cereals and dairy were chiefly used for CF. With the exception of continuation of breastfeeding and coadministration of breastmilk with solid/semi-solid/soft food, adherence to all other CF indicators (minimum dietary ersity, minimum meal frequency, iron & folate consumption, egg & flesh food consumption, zero vegetable & fruit consumption) were associated with reduced odds of various forms of CFM. Nutritional adversities in children may be prevented by improving the dietary ersity, meal frequency, protein consumption, iron & folic acid (IFA) use, and food fortification.
Publisher: Mary Ann Liebert Inc
Date: 05-2007
Abstract: To review the evidence relating to the effectiveness of qigong in the management of diabetes. We performed a systematic literature review of qigong intervention studies published in English or Chinese since 1980, retrieved from English-language databases and Chinese journals. Qigong intervention studies conducted with adults with diabetes, which reported both preintervention and postintervention measures of fasting blood glucose and/or hemoglobin A(1c)(HbA(1c)) were included. S le characteristics, intervention frequency/duration, and metabolic outcomes were reviewed. Sixty-nine intervention studies were located. Of these, only 11 met the criteria for inclusion. There were consistent and statistically significant positive associations between participation in qigong and fasting and 2-hour oral glucose tolerance test results, blood glucose, and triglycerides and total cholesterol. Effects on insulin and HbA(1c) were inconsistent. There was no evidence of any effect of qigong on weight. Most of the studies were of short duration, involved small s les, and did not include a control group. Although qigong has beneficial effects on some of the metabolic risk factors for type 2 diabetes, methodologic limitations make it difficult to draw firm conclusions about the benefits reported. Randomized controlled trials are required to confirm the potential beneficial effects of qigong on the management of type 2 diabetes.
Publisher: BMJ
Date: 29-04-2015
Publisher: Elsevier BV
Date: 08-2002
DOI: 10.1016/S0749-3797(02)00484-1
Abstract: Women with children are less likely to engage in adequate physical activity (PA) than women without children. This study aimed to evaluate the efficacy of two strategies for promoting increased PA among mothers of preschool-aged children, and to explore the mediators of any resulting change in PA behavior. Controlled intervention trial incorporating repeated data collection from 554 women, randomized to one of three experimental conditions. Intervention Group 1 served as a control, while women in Groups 2 and 3 were given print information about overcoming PA barriers. Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children. The primary strategies included increasing partner support, social advocacy, and capacity building, and were implemented through collaboration among participants, researchers, and community organizations. Adequate physical activity (PA), self-efficacy (SE) and partner support (PS). Following the intervention, women in Group 3 were significantly more likely to meet guidelines for PA than controls (odds ratio [OR]=1.71, confidence interval [CI]=1.05-2.77)] after controlling for age and PA at baseline. After controlling for baseline PA, residualized change in SE (OR=1.86, CI=1.17-2.94) and PS (OR=2.29, CI=1.46-3.58) significantly predicted meeting guidelines. After controlling for residual change in PS and SE, the significant intervention effect was attenuated (Group 3 OR=1.40, CI=0.76-2.36), indicating that partner support and self-efficacy may be mediators of physical activity behavior change. The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA among mothers of young children.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.YPMED.2008.03.014
Abstract: To identify predictors for initiating and maintaining active commuting (AC) to work following the 2003 Australia's Walk to Work Day (WTWD) c aign. Pre- and post-c aign telephone surveys of a cohort of working age (18-65 years) adults (n=1100, 55% response rate). Two dependent c aign outcomes were assessed: initiating or maintaining AC (i.e., walk/cycle and public transport) on a single day (WTWD), and increasing or maintaining health-enhancing active commuting (HEAC) level (> or = 30 min/day) in a usual week following WTWD c aign. A significant population-level increase in HEAC (3.9%) was observed (McNemar's chi(2)=6.53, p=0.01) with 136 (19.0%) achieving HEAC at post c aign. High confidence in incorporating walking into commute, being active pre-c aign and younger age (<46years) were positively associated with both outcomes. The utility of AC for avoiding parking hassles (AOR=2.1, 95% CI: 1.2-3.6), for less expense (AOR=1.8, 95% CI: 1.1-3.1), for increasing one's health (AOR=2.5, 95% CI: 1.1-5.6) and for clean air (AOR=2.2, 95% CI: 1.0-4.4) predicted HEAC outcome whereas avoiding the stress of driving (AOR=2.6, 95% CI: 1.4-5.0) and the hassle of parking predicted the single-day AC. Transportation interventions targeting parking and costs could be further enhanced by emphasizing health benefits of AC. AC was less likely to occur among inactive employees.
Publisher: Springer Science and Business Media LLC
Date: 18-09-2010
Location: Australia
Start Date: 2010
End Date: 2011
Funder: National Health and Medical Research Council
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