Young women with diabetes: using internet communication to create stability during life transitions

Aims and objectives. The aim of the current study was to explore and describe the strategies young women with Type 1 diabetes used to manage transitions in their lives. This paper will describe one aspect of the findings of how women with Type 1 diabetes used the Internet to interact with other people with diabetes and create stability in their lives.

Background. Individuals living with diabetes develop a range of different strategies to create stability in their lives and enhance their well-being. Changing social and emotional conditions during life transitions have a major impact on diabetes management. Although the literature indicates that strategies enabling the individuals to cope with transitions are important, they remain under-researched.

Design. Using grounded theory, interviews were conducted with 20 women with Type 1 diabetes. Constant comparative data analysis was used to analyse the data and develop an understanding of how young women with Type 1 diabetes used the Internet to create stability in their lives.

Findings. The findings revealed that the women valued their autonomy and being in control of when and to whom they reveal their diabetic status, especially during life transitions and at times of uncertainty. However, during these times they also required health and social information and interacting with other people. One of the women's main strategies in managing transitions was to use Internet chat lines as a way of obtaining information and communicating with others. This strategy gave women a sense of autonomy, enabled them to maintain their anonymity and interact with other people on their own terms.

Conclusions. Having meaningful personal interactions, social support and being able to connect with others were fundamental to the women's well being. Most importantly, preserving autonomy and anonymity during such interactions were integral to the way the women with Type 1 diabetes managed life transitions.

Relevance to clinical practice. Health professionals need to explore and incorporate Internet communication process or anonymous help lines into their practice as a way to assist people manage their diabetes.

Mothering in the freelance film industry: case studies in the postproduction film industry in Melbourne, Australia

This paper examines the dynamic relationship between work and life through the experiences of three mothers seeking to realise careers in the freelance film industry in Melbourne, Australia. The women were part of a larger sample of postproduction workers who were surveyed on their responses to technological change in the postproduction freeelance film industry but were out of the industry having children during the first wave of technological change. The paper examines qualitative data from these women and later longitudinal data in order to understand the limits of equal opportunity in an uneven playing field.

Do MBA degrees matter? A study of boards of directors in Australia's top 200 companies

Pfeffer and Fong (2002) suggest that “business school enrolments have soared and business education has become a big business”. The Master of Business Administration (MBA) degree has often been held out to be useful in the career development of managers. The highest level that managers can aspire to, is to be a director of a large public company. This study investigates how many directors within the boards of Australia’s top 200 companies by market capitalization hold an MBA degree. We find that larger companies have proportionally more MBA holding directors than smaller companies. Interestingly we also find that proportionally more women hold MBAs than men; nearly one in five women directors hold an MBA within the top 200 companies dataset.

Which food-related behaviours are associated with healthier intakes of fruits and vegetables among women?

Objective To examine associations between shopping, food preparation, meal and eating behaviours and fruit and vegetable intake among women.
Design Cross-sectional survey.
Setting Community-based sample from metropolitan Melbourne, Australia.
Subjects A sample of 1136 women aged 18–65 years, randomly selected from the electoral roll.
Results Food-related behaviours reflecting organisation and forward-planning, as well as enjoyment of and high perceived value of meal shopping, preparation and consumption were associated with healthier intakes of fruits and vegetables. For example, women who more frequently planned meals before they went shopping, wrote a shopping list, enjoyed food shopping, planned in the morning what they will eat for dinner that night, planned what they will eat for lunch, reported they enjoy cooking, liked trying new recipes and who reported they sometimes prepare dishes ahead of time were more likely to consume two or more servings of vegetables daily. Conversely, women who frequently found cooking a chore, spent less than 15 minutes preparing dinner, decided on the night what they will eat for dinner, ate in a fast-food restaurant, ate takeaway meals from a fast-food restaurant, ate dinner and snacks while watching television and who frequently ate on the run were less likely to eat two or more servings of vegetables daily.
Conclusions Practical strategies based on these behavioural characteristics could be trialled in interventions aimed at promoting fruit and vegetable consumption among women.

Domestic violence in refugee families in Australia : rethinking settlement policy and practice

It has been identified that immigrant and refugee women are particularly at risk in cases of domestic violence. This article reveals the qualitative research findings from a study into the significance of traumatic history, social and economic context, cultural differences and changed gender identities on the perceptions and experiences of domestic violence in refugee families. The study was undertaken with a sample of refugee men and women from Iraq, Ethiopia, Sudan, Serbia, Bosnia and Croatia. Compounding contextual factors concerning structurally based inequalities, culturally emerged challenges, social dissonance, psychological stress and patriarchal foundations are revealed. Informed by an intersectional framework that recognizes gender oppression as modified by intersections with other forms of inequality, the article argues the case for community-managed projects involving multi-level empowerment-based interventions to prevent domestic violence.

Depression, anxiety and stress in women following acute coronary syndrome: implications for secondary prevention

Objective
To document incidence of depression, anxiety, and stress in women more than 6 months following an acute coronary syndrome.

Design
Participants were identified from a coronary care unit database. The Depression Anxiety Stress Scales 21 (DASS 21) was sent to potential participants via postal survey.

Setting
A metropolitan teaching hospital in Melbourne, Australia.

Participants
The cohort of women was aged between 55 and 70 years. They had been admitted to hospital with a diagnosis of acute coronary syndrome (ACS) between 6 and 14 months prior to participating in this study.

Main outcome measures
Scores on Depression, Anxiety, and Stress Scale (DASS 21).

Results
Of the 117 posted questionnaires, 39 women with a mean age of 63 (S.D. 4.97) responded to the survey, representing a response rate of 33.3%. Most participants scored within normal levels of depression (66.7%), anxiety (60.5%), and stress (70.3%), however, mild to extremely severe levels of each construct (33.4%, 39.6%, and 29.7%, respectively) were found.

Conclusions
The reporting of elevated levels of depression, anxiety and stress in a subset of women more than 6 months following an ACS event underscores the importance of ongoing screening for risk factors impacting on psychological well-being and the inclusion of this information in education and counseling strategies in both the inpatient and outpatient settings. Based on these pilot data, consideration of a screening system in the immediate post discharge period for women at risk and an education or support service are recommended.

Overweight, obesity and metabolic syndrome in rural southeastern Australia

OBJECTIVE: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia.

DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004-2005. A stratified random sample of men and women aged 25-74 years was selected from the electoral roll. Data were collected by a self-administered questionnaire, physical measurements and laboratory tests.

MAIN OUTCOME MEASURES: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components.

RESULTS: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%-78.5%) in men and 64.1% (95% CI, 59.5%-68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%-76.7%) than men (61.9%; 95% CI, 57.0%-66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%-33.2%) based on BMI (> or = 30.0 kg/m(2)) and 44.7% (95% CI, 41.2%-48.1%) based on waist circumference (> or = 102 cm [men] and > or= 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%-31.6%) in men and 28.3% (95% CI, 24.0%-32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%-38.5%) and 30.1% (95% CI, 25.7%-34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age.

CONCLUSIONS: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population-wide action is required to tackle the problem.

Gendered (s)explorations among same-sex attracted young people in Australia

This paper seeks to import a more complex understanding of gendered subjectivity into discussions of young people and homosexuality, and is based on an Australian national survey (n=749) of same-sex attracted youth (SSAY) aged between 14 and 21. Results revealed significant gender differences with regard to patterns of sexual attraction, behaviour and identity labels among participants. For the young men in the study, there was more congruence between feelings of gender a-typicality, same-sex attractions and same-sex behaviours. Overall, young women displayed more fluidity with regard to their sexual feelings, behaviours and identities. Young women were more likely to be engaged in private explorations of lesbianism, concurrent with participation in heterosexual sex and relationships. Young women were also grappling with more limited and emotionally risky opportunities for sex with other girls who were already known to them as friends. The invisibility of lesbianism as an identity or practice led to confusion about what feelings meant for the future in the arena of lived experience. The paper concludes that more research is needed into the impact of gender on the development of young people's experiences of homosexuality, particularly the manner in which invisibility and lack of social acceptance of a full spectrum of sexual diversity may disadvantage young women's emotional health and well-being.

Estimated alcohol-caused deaths in Australia, 1990-97

The purpose of the study was to provide updated estimates of alcohol-caused mortality rates in Australia between 1990 and 1997, making adjustments for changes in the prevalence of high-risk alcohol use estimated on the basis of per capita alcohol consumption (PCAC). Deaths wholly and partially attributable to high-risk alcohol consumption were extracted from the Australian Bureau of Statistics Mortality Datafile (1990-1997) and multiplied by specific aetiologicalfractions, which in turn were adjusted by changes in the prevalence of high-risk alcohol use estimated on the basis of annual changes in PCAC. The yearly trends in age-standardized rates of estimated alcohol-caused deaths were compared with those using (i) aetiological fractions unadjusted for changes in PCAC, and (ii) wholly alcohol-caused conditions only (thus requiring no application of aetiological fractions). The age-standardized rates of all alcohol-caused deaths among males aged 15 + years declined from 1990 (4.01110000) to 1993 (3.19/10000) and decreased far more slowly up to 1997 (3.15/10000)-16% overall. For females, these rates declined steadily from 1990 (1.75/10000) to 1997 (1.33/10000)-19% overall. Similar patterns in time trends were noted for estimated alcohol-caused death rates calculated as in (i) and (ii). However, the proportional decreases in rates (21.6%for males; 24. O%for females) would have been underestimated by 16% (males) and 19% (females) if the alcohol aetiological fractions had not been adjusted to take account of the estimated annual changes in the prevalence of high-risk drinking. The declines in estimated alcohol-caused death rates were more pronounced than the 9% decline in PCAC, and were due mainly to decreasing death rates for stroke (men and women), alcoholic liver cirrhosis and road injuries (men only). When aetiological fractions are used to measure temporal trends in estimated alcohol-caused death rates from official mortality statistics, they should account for annual changes in the prevalence of high-risk drinking. Such changes in prevalence can be deduced from yearly fluctuations in PCAC.

Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab)

Objective:
To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors.

Design:
AusDiab, a cross-sectional study conducted between May 1999 and December 2000, involved participants from 42 randomly selected districts throughout Australia.

Participants:
Of 20 347 eligible people aged > 25 years who completed a household interview, 11 247 attended the physical examination at local survey sites (response rate, 55%).

Main outcome measures:
Overweight and obesity defined by body mass index (BMI; kg/m2) and waist circumference (cm); sociodemographic factors (including smoking, physical activity and television viewing time).

Results:
The prevalence of overweight and obesity (BMI > 25.0 kg/m2; waist circumference > 80.0 cm [women] or > 94.0 cm [men]) in both sexes was almost 60%, defined by either BMI or waist circumference. The prevalence of obesity was 2.5 times higher than in 1980. Using waist circumference, the prevalence of obesity was higher in women than men (34.1% v 26.8%; P < 0.01). Lower educational status, higher television viewing time and lower physical activity time were each strongly associated with obesity, with television viewing time showing a stronger relationship than physical activity time.

Conclusions:
The prevalence of obesity in Australia has more than doubled in the past 20 years. Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity, and underline the potential benefits of reducing sedentary behaviour, as well as increasing physical activity, to curb the obesity epidemic.

Do socioeconomic gradients in women's health widen over time and with age?

A population-based study was conducted to investigate changes over time in women's well-being and health service use by socio-economic status and whether these varied by age. Data from 12,328 mid-age women (aged 45–50 years in 1996) and 10,430 older women (aged 70–75 years) from the Australian Longitudinal Study on Women's Health were analysed. The main outcome measures were changes in the eight dimensions of the Short Form General Health Survey (SF-36) adjusted for baseline scores, lifestyle and behavioural factors; health care utilisation at Survey 2; and rate of deaths (older cohort only). Cross-sectional analyses showed clear socioeconomic differentials in well-being for both cohorts. Differential changes in health across tertiles of socioeconomic status (SES) were more evident in the mid-age cohort than in the older cohort. For the mid-aged women in the low SES tertile, declines in physical functioning (adjusted mean change of –2.4, standard error (SE) 1.1) and general health perceptions (−1.5, SE 1.1) were larger than the high SES group (physical functioning –0.8 SE 1.1, general health perceptions –0.8 SE 1.2). In the older cohort, changes in SF-36 scores over time were similar for all SES groups but women in the high SES group had lower death rates than women in the low SES group (relative risk: 0.79, 95% confidence interval 0.64–0.98). Findings suggest that SES differentials in physical health seem to widen during women's mid-adult years but narrow in older age. Nevertheless, SES remains an important predictor of health, health service use and mortality in older Australian women.

Change in women's body mass index and waist circumference, 1997 to 2002: the Nepean study

Objective: To investigate character istics associated with body mass index (BMI) and waist circumference stability over a five-year period in women with school-age children.

Methods: Women with 7–8 year-old children from western Sydney, Australia, had anthropometric measures taken in 1996/97 (n====436) and five years later (n=327). Socio-demographic characteristics examined at baseline included age, socioeconomic status, smoking, and number of children.

Results: Over five years, less than half of the women maintained a stable BMI (38.8%) or waist circumference (31.5%), with the majority gaining in both indicators of adiposity. BMI and socio-demographic characteristics were not predictive of BMI or waist circumference stability or decrease.

Conclusions and Implications: Total and abdominal adiposity increased in these Australian women who have children. The results support the need to develop effective weight gain prevention initiatives.

Weight and place: a multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia

Objective: To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI.

Methods: We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (<$400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI.

Results: There were significant variations in BMI between CCDs for women, even after adjustment for individual and area SES (P=0.012); significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m² (95% CI: 0.48–1.68 kg/m²) for women, and of 0.93 kg/m² (95% CI: 0.32–1.55 kg/m²) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m² (95% CI: 0.09–1.26 kg/m²) for women, and 0.43 kg/m² for men (95% CI: -0.16–1.01).

Conclusion: These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.

Consumption of 'extra' foods (energy-dense, nutrient poor) among children aged 16-24 months from western Sydney, Australia

Objective: This study evaluates the contribution of energy-dense, nutrient-poor ‘extra’ foods to the diets of 16–24-month-old children from western Sydney, Australia.

Design:   An analysis of cross-sectional data collected on participants in the Childhood Asthma Prevention Study (CAPS), a randomised trial investigating the primary prevention of asthma from birth to 5 years. We collected 3-day weighed food records, calculated nutrient intakes, classified recorded foods into major food groups, and further classified foods as either ‘core’ or ‘extras’ according to the Australian Guide to Healthy Eating.

Setting:  Pregnant women, whose unborn child was at risk of developing asthma because of a family history, were recruited from all six hospitals in western Sydney, Australia. Data for this study were collected in clinic visits and at participants’ homes at the 18-month assessment.

Participants: Four hundred and twenty-nine children participating in the CAPS study; 80% of the total cohort.

Results:  The mean consumption of ‘extra’ foods was xs223C150 g day− 1 and contributed 25–30% of the total energy, fat, carbohydrate and sodium to the diets of the study children. ‘Extra’ foods also contributed around 20% of fibre, 10% of protein and zinc, and about 5% of calcium. Children in the highest quintile of ‘extra’ foods intake had a slightly higher but not significantly different intake of energy from those in the lowest quintile. However, significant differences were evident for the percentage of energy provided by carbohydrate and sugars (higher) and protein and saturated fat (lower). The intake of most micronutrients was also significantly lower among children in the highest quintile of consumption. The intake of ‘extra’ foods was inversely associated with the intake of core foods.

Conclusions:  The high percentage of energy contributed by ‘extra’ foods and their negative association with nutrient density emphasise the need for dietary guidance for parents of children aged 1–2 years. These preliminary data on commonly consumed ‘extra’ foods and portion sizes may inform age-specific dietary assessment methods.

Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory

Background: A strong association between persistent infection with oncogenic types of human papillomavirus (HPV) and cervical cancer is well established. Small numbers of international studies examining adolescent HPV infection and the risk factors associated are published, but there is currently no evidence on the prevalence and risk factors for HPV in an Australian, sexually active female adolescent population. Methods: To provide prevalence and risk factors for HPV in a female sexually active, senior high school population in the Australian Capital Territory (ACT), a convenience sample of 161, 16–19-year-old females attending a senior high school was evaluated. The sample formed part of a larger sample recruited for a study of sexually transmitted infections and blood-borne viruses in senior high school students. A clinical record was used to collect information about sexual and other risk behaviours, while self-collected vaginal swabs were tested for HPV DNA detection and genotyping using polymerase chain reaction. Results: The prevalence of HPV DNA in this sample overall was 11.2%, with multiple genotypes in 38%. No statistically significant associations were found between HPV DNA and the number of male partners, age of coitarche, time since first sexually active, condom use, smoking or alcohol intake. Conclusions: This is the first Australian study that has examined the prevalence and risk factors for genital HPV in this demographic group. The prevalence of HPV infection is slightly lower than reported in similar age groups overseas and is lower than other Australian studies in older women and those attending sexual health centres. Of HPV-positive young women, high-risk genotypes were found in over half, with more than one-third of HPV existing as multiple genotypes. Large community-based prevalence studies are needed to guide the development of recommendations for the vaccination of young women against HPV and to support other health promotion initiatives.