Women's perceptions of communication in pregnancy and childbirth: Influences on participation and satisfaction with care

In this study, 3531 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 centred care and perceived quality of care. These data tested a version of Street’s (2001) linguistic model of patient participation in care (LMOPPC), adapted to the maternity context. We 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-centred 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-centred 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 LMOPPC in the maternity context.

Weight-related risk perception among healthy and overweight pregnant women: A cross-sectional study

Objective The objective of this study was to evaluate weight-related risk perception in early pregnancy and to compare this perception between women commencing pregnancy healthy weight and overweight. Study design Pregnant women (n=664) aged 29±5 (mean±s.d.) years were recruited from a metropolitan teaching hospital in Australia. A self-administered questionnaire was completed at around 16 weeks of gestation. Height measured at baseline and self-reported pre-pregnancy weight were used to calculate body mass index. Cross-sectional analysis was conducted. Differences between groups were assessed using chi-squared tests for categorical variables and t-tests or Mann–Whitney U tests for continuous variables depending on distribution. Result Excess gestational weight gain (GWG) during pregnancy was more important in leading to health problems for women or their child compared with pre-pregnancy weight. Personal risk perception for complications was low for all women, although overweight women had slightly higher scores than healthy-weight women (2.4±1.0 vs 2.9±1.0; P<0.001). All women perceived their risk for complications to be below that of an average pregnant woman. Conclusion Women should be informed of the risk associated with their pre-pregnancy weight (in the case of maternal overweight) and excess GWG. If efforts to raise risk awareness are to result in preventative action, this information needs to be accompanied by advice and appropriate support on how to reduce risk.

Exploring cultural, social and psychosocial influences on women's drinking across age cohorts

This program of research used a mixed methods approach to explore the cultural, social and psychosocial factors that influence women's alcohol consumption. Results indicated that there were a number of common influencing factors across women of all ages but also a number of key influences and behaviours that were distinct for younger and older women. These findings emphasised the need for age-specific interventions that target these influences to reduce women's exposure to alcohol-related harm. This research is one of the first studies to examine alcohol consumption of both younger and older women.

Benefits and barriers to exercise in midlife women undertaking a web-based multi-modal lifestyle intervention for the primary prevention of chronic disease

Chronic diseases are a leading cause of death and disability, largely attributable to modifiable lifestyle risk factors. Many midlife Australian are getting insufficient physical activity for health and face a range of barriers to exercise. Results of this study provide evidence that benefits and barriers are an important predictor of exercise behaviour in midlife women and, that a 12 week nurse led health promotion program can effectively promote benefits and increase physical activity. This study provides evidence about benefits and barriers to exercise that will inform health promotion practice for chronic disease risk factor reduction in midlife women.

The characterisation of Ureaplasma species isolated from the Chorioamnion of women who deliver late Preterm

This thesis investigated, for the first time, the prevalence of Ureaplasma species infection within the placentae of women who delivered in the late preterm stages of pregnancy. The presence of these microorganisms was associated with either severe inflammation within the placenta or, for some women, there were no pregnancy complications and these women delivered at term. Ureaplasmas are able to vary their surface exposed lipoproteins and we demonstrated that different host immune responses were generated in vivo to different sized surface lipoproteins. This may explain why ureaplasma infections do not always result in adverse pregnancy and neonatal outcomes.

Medically-attended respiratory illnesses amongst pregnant women in Brisbane, Australia

There are limited community-based data on the burden of influenza and influenza-like illnesses during pregnancy to inform disease surveillance and control. We aimed to determine the incidence of medically-attended respiratory illnesses (MARI) in pregnant women and the proportion of women who are tested for respiratory pathogens at these visits. We conducted a nested retrospective cohort study of a non-random sample of women aged ≥18 years who had a live birth in maternity units in Brisbane, Queensland, from March 2012 to October 2014. The primary outcomes were self-reported doctor visits for MARI and laboratory investigations for respiratory pathogens. Descriptive analyses were performed. Among 1202 participants, 222 (18.5%, 95%CI 16.3%-20.7%) self-reported MARI during their pregnancy. Of those with an MARI, 20.3% (45/222) self-reported a laboratory test was performed. We were able to confirm with health service providers that 46.7% (21/45) of tests were undertaken, responses from providers were not received for the remainder. Whilst one in five women in this population reported a MARI in pregnancy, only 3.7% (45/1202) reported a clinical specimen had been arranged at the consultation and the ability to validate that self-report was problematic. As the focus on maternal immunisation increases, ascertainment of the aetiological agent causing MARI in this population will be required and efficient and reliable methods for obtaining those data at the community level need to be established.

Double blind: Supervising women as creative practice-led researchers

Many women creative practice-led researchers appear inhibited by a number of factors directly connected to their gender. This paper discusses these factors, including the culture of visual arts professional practice, the circumstances surrounding women postgraduate students, and unproductive self-theories about intelligence and creativity. A number of feminist strategies are discussed as potential interventions that may assist women creative practice-led researchers and their supervisors to reap more personal and professional rewards from their postgraduate research.

Women in politics in democratic transition: The case of Bhutan

This thesis is a study about women's participation in Bhutan's new democracy and exposes the patriarchy embedded in Bhutanese society which is reinforced through cultural practices and the legal framework. It reveals the public/private dichotomy, the low educational attainment of girls and the gendered division of labour which derails women's public life. It discloses a masculine driven party politics and the challenges of being a woman in the world of men. Nonetheless, the first trailblazing women parliamentarians demonstrated a principled, feminine, political leadership in a masculine environment. Semi-structured interviews, document review and participant observation methods were used to collect data.

Diabetes mellitus and the risk of depressive and anxiety disorders in Australian women: A longitudinal study

Background Longitudinal studies examining the risk of depressive and anxiety disorders associated with diabetes are limited. This study examined the association between diabetes and the risk of depressive and anxiety disorders in Australian women using longitudinal data. Methods Datawere froma sample of women who were part of anAustralian pregnancy and birth cohort study. Data comprised self-reported diabetes mellitus and the subsequent reporting of depressive and anxiety disorders. Mood disorders were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, obtained from participants using Composite International Diagnostic Interview (CIDI)-Auto (WHO WMH-CIDI CAPI, version 21.1.3). Multiple regression models with adjustment for important covariates were used. Results Women with diabetes had a higher lifetime prevalence of any depressive and/or anxiety disorder than women without diabetes. About 3 in 10 women with diabetes experienced a lifetime event of any depressive disorder, while 1 in 2 women with diabetes experienced a lifetime event of any anxiety disorder. In prospective analyses, diabetes was only significantly associated with a 30-day episode of any anxiety disorder (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.09–2.15). In the case of lifetime disorders, diabetes was significantly associated with any depressive disorder (OR 1.37, 95% CI 1.03–1.84), major depressive disorder (OR 1.36, 95% CI 1.01–1.85), and posttraumatic stress disorder (OR 1.42, 95% CI 1.01–2.02). Conclusions The findings suggest that the presence of diabetes is a significant risk factor for women experiencing current anxiety disorders. However, in the case of depression, the association with diabetes only held for women who had experienced past episodes, there was no association with current depression. This suggests that the evidence is not strong enough to support a direct effect of diabetes as a cause of mood disorders.

Physiological and biomechanical responses to walking underwater on a non-motorised treadmill: Effects of different exercise intensities and depths in middle-aged healthy women

Non-motorised underwater treadmills are commonly used in fitness activities. However, no studies have examined physiological and biomechanical responses of walking on non-motorised treadmills at different intensities and depths. Fifteen middle-aged healthy women underwent two underwater walking tests at two different depths, immersed either up to the xiphoid process (deep water) or the iliac crest (shallow water), at 100, 110, 120, 130 step-per-minute (spm). Oxygen consumption (VO2), heart rate (HR), blood lactate concentration, perceived exertion and step length were determined. Compared to deep water, walking in shallow water exhibited, at all intensities, significantly higher VO2 (+13.5%, on average) and HR (+8.1%, on average) responses. Water depth did not influence lactate concentration, whereas perceived exertion was higher in shallow compared to deep water, solely at 120 (+40%) and 130 (+39.4%) spm. Average step length was reduced as the intensity increased (from 100 to 130 spm), irrespective of water depth. Expressed as a percentage of maximum, average VO2 and HR were: 64–76% of peak VO2 and 71–90% of maximum HR, respectively at both water depths. Accordingly, this form of exercise can be included in the “vigorous” range of exercise intensity, at any of the step frequencies used in this study.

Physical activity in Latino men and women: Facilitators, barriers, and interventions

Latinos report less leisure time physical activity (PA) than non–Latino Whites and suffer disproportionately from diseases related to sedentary lifestyle, yet remain underserved and understudied. Gaining a better understanding of PA behavior in Latinos is critical to intervene on this significant public health issue. This article discusses the growing literature on the facilitators and barriers of PA in Latino men and women and reviews recent interventions to promote activity. Apart from acculturation influences, facilitators of PA in Latinos are similar to those of non–Latino Whites, with most research focusing on self-efficacy and social support. Barriers for Latinas, however, are more culturally distinct, such as a focus on caregiving and cultural standards for body shape. Barriers unique to Latino men largely have not been studied. Researchers have adopted a variety of approaches to increase PA, including using promotores and incorporating culturally appropriate activities, and have had mixed success. However, the community and randomized controlled trials almost exclusively included only women. Studies reviewed here suggest that interventions should target culturally specific barriers beyond language to successfully increase PA in Latinos and highlight a need for formative research and design of interventions for Latino men.

There's a dinosaur in my armoire: A creative exploration of women's dress choice

This project explores social negotiation, that sees dress used to style a personal and appropriate public image in everyday situations. The research seeks to identify and gain insight into the external influences and internal motivations of a small group of Australian women.

Awareness and knowledge of Human Papillomavirus (HPV) among ethnically diverse women varying in generation status

Although Human papillomavirus (HPV) is a common sexually transmitted infection, there is limited knowledge of HPV with ethnic/racial minorities experiencing the greatest disparities. This cross-sectional study used the most recent available data from the California Health Interview Survey to assess disparities in awareness and knowledge of HPV among ethnically/racially diverse women varying in generation status (N = 19,928). Generation status emerged as a significant predictor of HPV awareness across ethnic/racial groups, with 1st generation Asian-Americans and 1st and 2nd generation Latinas reporting the least awareness when compared to same-generation White counterparts. Also, generation status was a significant predictor of HPV knowledge, but only for Asian-Americans. Regardless of ethnicity/race, 1st generation women reported lowest HPV knowledge when compared to 2nd and 3rd generation women. These findings underscore the importance of looking at differences within and across ethnic/racial groups to identify subgroups at greatest risk for poor health outcomes. In particular, we found generation status to be an important yet often overlooked factor in the identification of health disparities.

Effects of compression on lymphoedema during resistance exercise in women with breast cancer-related lymphoedema: A randomised, cross-over trial

Background The use of compression garments during exercise is recommended for women with breast cancer-related lymphoedema, but the evidence behind this clinical recommendation is unclear. The aim of this randomised, cross-over trial was to compare the acute effects of wearing versus not wearing compression during a single bout of moderate-load resistance exercise on lymphoedema status and its associated symptoms in women with breast cancer-related lymphoedema. Methods Twenty-five women with clinically diagnosed, stable unilateral breast cancer-related lymphoedema completed two resistance exercise sessions, one with compression and one without, in a randomised order separated by a 14 day wash-out period. The resistance exercise session consisted of six upper-body exercises, with each exercise performed for three sets at a moderate-load (10-12 repetition maximum). Primary outcome was lymphoedema, assessed using bioimpedance spectroscopy (L-Dex score). Secondary outcomes were lymphoedema as assessed by arm circumferences (percent inter-limb difference and sum-of-circumferences), and symptom severity for pain, heaviness and tightness, measured using visual analogue scales. Measurements were taken pre-, immediately post- and 24 hours post-exercise. Results There was no difference in lymphoedema status (i.e., L-Dex scores) pre- and post-exercise sessions or between the compression and non-compression condition [Mean (SD) for compression pre-, immediately post- and 24 hours post-exercise: 17.7 (21.5), 12.7 (16.2) and 14.1 (16.7), respectively; no compression: 15.3 (18.3), 15.3 (17.8), and 13.4 (16.1), respectively]. Circumference values and symptom severity were stable across time and treatment condition. Conclusions An acute bout of moderate-load, upper-body resistance exercise performed in the absence of compression does not exacerbate lymphoedema in women with breast cancer-related lymphoedema.

Paper and electronic antenatal records: What do women and health care providers tell us about their use?

The antenatal paper hand-held record (PHR) has been used extensively in general practice (GP) shared-care management of pregnant women, but recently the antenatal electronic health record (EHR) was introduced. This study aimed to examine the experiences of women and health care providers who use the PHR and the EHR, and find out the relative role of these records in the integration of care. Purposive homogenous samples of women and health care providers were interviewed as users of the PHR in phase 1 and the EHR in phase 2 of the study. Qualitative data were collected via interview with women and GPs and focus groups held with hospital health care providers. Interviews were coded manually and analysed using qualitative content analysis. Fifteen women participated in phase 1 and 12 in phase 2. Seventeen GPs participated in phase 1 and 15 in phase 2. Five focus groups with hospital health care providers were conducted in each phase. Results were categorised into four themes: 1. Record purpose; 2. Perception of the record; 3. Content of the record, and; 4. Sharing information in the record. Both women and health care providers were familiar with the PHR, but identified that some information was missing or not utilised well, and reported underuse of the EHR. The study identified continued widespread use of the PHR and several issues concerning the use of the EHR. An improvement in the strategic implementation of the EHR is suggested as a mechanism to facilitate its wider adoption.