Breastfeeding beliefs and practices of African women living in Brisbane and Perth, Australia

The purpose of this study was to explore the experience of breastfeeding among refugee women from Liberia, Sierra Leone, Burundi and the Democratic Republic of Congo living in two major capital cities in Australia. Participants were recruited from their relevant community associations and via a snowballing technique. Thirty-one women took part in either individual interviews or facilitated group discussions to explore their experiences of breastfeeding in their home country and in Australia. Thematic analysis revealed four main themes: cultural breastfeeding beliefs and practices; stigma and shame around breastfeeding in public; ambivalence towards breastfeeding and breastfeeding support. Women who originated from these four African countries highlighted a significant desire for breastfeeding and an understanding that it was the best method for feeding their infants. Their breastfeeding practices in Australia were a combination of practices maintained from their countries of origin and those adopted according to Australian cultural norms. They exemplified the complexity of breastfeeding behaviour and the relationship between infant feeding with economic status and the perceived social norms of the host country. The results illustrate the need for policy makers and health professionals to take into consideration the environmental, social and cultural contexts of the women who are purportedly targeted for the promotion of breastfeeding.

Recruiting and engaging new mothers in nutrition research studies : lessons from the Australian NOURISH randomised controlled trial

Background: Despite important implications for the budgets, statistical power and generalisability of research findings, detailed reports of recruitment and retention in randomised controlled trials (RCTs) are rare. The NOURISH RCT evaluated a community-based intervention for first-time mothers that promoted protective infant feeding practices as a primary prevention strategy for childhood obesity. The aim of this paper is to provide a detailed description and evaluation of the recruitment and retention strategies used. Methods: A two stage recruitment process designed to provide a consecutive sampling framework was used. First time mothers delivering healthy term infants were initially approached in postnatal wards of the major maternity services in two Australian cities for consent to later contact (Stage 1). When infants were about four months old mothers were re-contacted by mail for enrolment (Stage 2), baseline measurements (Time 1) and subsequent random allocation to the intervention or control condition. Outcomes were assessed at infant ages 14 months (Time 2) and 24 months (Time 3). Results: At Stage 1, 86% of eligible mothers were approached and of these women, 76% consented to later contact. At Stage 2, 3% had become ineligible and 76% could be recontacted. Of the latter, 44% consented to full enrolment and were allocated. This represented 21% of mothers screened as eligible at Stage 1. Retention at Time 3 was 78%. Mothers who did not consent or discontinued the study were younger and less likely to have a university education. Conclusions: The consent and retention rates of our sample of first time mothers are comparable with or better than other similar studies. The recruitment strategy used allowed for detailed information from non-consenters to be collected; thus selection bias could be estimated. Recommendations for future studies include being able to contact participants via mobile phone (particular text messaging), offering home visits to reduce participant burden and considering the use of financial incentives to support participant retention.

Workable solutions : the intersubjective careers of women with families

This chapter considers to what degree the careers of women with young families, both in and out of paid employment, are lived as contingent, intersubjective projects pursued across time and space, in the social condition of growing biographical possibilities and uneven social/ideological change. Their resolutions of competing priorities by engaging in various permutations of home-work and paid work are termed ‘workable solutions’, with an intentional play on the double sense of ‘work’ – firstly as labour, thus being able to perform work, whether paid or not; secondly as in being able to make things work or function in the family unit’s best interests, however defined.

Well-being of refugees from Burma: a salutogenic perspective

A salutogenic approach explored themes of strength and well-being in life stories of Burmese refugees (N = 18) in Australia. Previous refugee studies have tended to focus on negative responses to traumatic events (e.g. posttraumatic stress disorder, depression). To widen the scope of refugee related research the focus of the current study was informed by a salutogenic perspective, exploring sources of strength that may facilitate well-being. Semi-structured narrative interviews explored: the participant's life before fleeing Burma, the journey of exile, and post-migration in Australia. Eight women and 10 men (Mage = 39 years) were interviewed and transcriptions analysis of narratives was conducted using Interpretative Phenomenological Analysis (IPA), with major themes being explicated. Super-ordinate themes pertaining to strength during times of hardship were identified and explicated as: support from interpersonal relationships, the pivotal role of values, a sense of future and agency, and reliance on spiritual or religious beliefs. Results indicate the existence of sources of strength that may contribute to human responses in times of hardship. Recognition and reflection of strengths may be incorporated into therapeutic and resettlement approaches for people from refugee backgrounds.

Shifting global powers and international law : challenges and opportunities [Challenges of Globalisation series]

This book examines the influence of emerging economies on international legal rules, institutions and processes. It describes recent and predicted changes in economic, political and cultural powers, flowing from the growth of emerging economies such as China, India, Brazil, South Africa and Russia, and analyses the influence of these changes on various legal frameworks and norms. Its contributors come from a variety of fields of expertise, including international law, politics, environmental law, human rights, economics and finance. The book begins by providing a broad analysis of the nature of the shifting global dynamic in its historical and contemporary contexts, including analysis of the rise of China as a major economic and political power and the end of the period of United States domination in international affairs. It illustrates the impact of these changes on states’ domestic policies and priorities, as they adapt to a new international dynamic. The authors then offer a range of perspectives on the impact of these changes as they relate to specific regimes and issues, including climate change regulation, collective security, indigenous rights, the rights of women and girls, environmental protection and foreign aid and development. The book provides a fresh and comprehensive analysis of an issue with extensive implications for international law and politics.

Academic wage structure by gender : the roles of peer review, performance, and market forces

We focus on understanding the role of productivity in determining wage structure differences between men and women in academia. The data arise from a pay-equity study carried out in a single Midwestern U.S. university over the 1996–7 academic year. Econometric results confirm that external market forces exert influence over both male and female salary. But peer review ratings play a significant role in male but not female earnings determination, with similar results for objective measures of research, teaching and service.

Diabetes health program development for Aboriginal and Torres Strait Islander women

According to Australian Health (2008), the area of endocrine, nutritional and metabolic disorders (mainly diabetes) yields the highest cause of death for Indigenous Australian women at 10.1%. Indigenous Brisbane North women’s results reiterate this with slightly higher percentages and are a cause for concern and action due to the noted levels of undiagnosed/unaware Indigenous Brisbane North women with abnormal blood glucose levels, whom participated in the research. A sub-sample of the group (N=17) were piloted to test the feasibility of method of eliciting health information on Indigenous Women within this community. This pilot study revealed the following health information regarding this group of women. 41.2% of Indigenous Brisbane North women were found to have blood glucose levels that were outside normal ranges, however only 29.4% had been diagnosed with diabetes and or endocrine abnormalities. These findings highlight that 11.8% of participants have signs indicating that they may have undiagnosed diabetes or/and pre diabetes juxtaposed to unacceptable endocrine levels compatible with health and wellness. The percentages of Indigenous Brisbane North Women whom have indicated that they have a diagnosis of diabetes have been compared to both National Indigenous peoples percentages and the national percentages for the wider Australian community (all Australians). The rate of diabetes within this population is 9 times that of the wider Australian community and 5 times that of the wider Australian Indigenous community. Data was collected from Indigenous participants on arrival and the attendance numbers of 112 women was recorded for comparison with other current health prevention wellness programs being delivered. Data was also collected through the use of specially designed culturally safe questionnaires undertaken in conjunction with health checks and health service information given to participants.

Understanding Indigenous Australian women’s social and emotional wellbeing and wellness through yarning

This paper explores Indigenous Australian women’s understanding of wellness, through the lens of social and emotional wellbeing. The authors use a “yarning” approach to explore how wellness is important to Indigenous women who live in North Brisbane (Australia). They discuss the benefits of yarning and its strength as a methodology for conducting research and building activism within Indigenous Australian communities. They argue that, for Indigenous Australian women, wellness is linked to a sense of wholeness and strongly related to the feeling of connection that women get from meeting together and having time for women’s business. They describe the way that their research project developed into a community summit focused on Indigenous women’s wellness.

Facilitating lifestyle changes to manage menopausal symptoms in women with breast cancer : delivering the Pink Women’s Wellness Program

Women diagnosed as having breast cancer may experience difficulties with posttreatment effects such as menopausal symptoms. The aims of this pilot study were to (1) evaluate the impact of a multimodal lifestyle program on reducing menopausal symptoms in women with breast cancer and (2) examine the impact of the program on health-related quality of life (HRQoL) and adherence to lifestyle recommendations.

Walk@Work : an automated intervention to increase walking in university employees not achieving 10,000 daily steps

This study assessed the workday step counts of lower active (<10,000 daily steps) university employees using an automated, web-based walking intervention (Walk@Work). METHODS: Academic and administrative staff (n=390; 45.6±10.8years; BMI 27.2±5.5kg/m2; 290 women) at five campuses (Australia [x2], Canada, Northern Ireland and the United States), were given a pedometer, access to the website program (2010-11) and tasked with increasing workday walking by 1000 daily steps above baseline, every two weeks, over a six week period. Step count changes at four weeks post intervention were evaluated relative to campus and baseline walking. RESULTS: Across the sample, step counts significantly increased from baseline to post-intervention (1477 daily steps; p=0.001). Variations in increases were evident between campuses (largest difference of 870 daily steps; p=0.04) and for baseline activity status. Those least active at baseline (<5000 daily steps; n=125) increased step counts the most (1837 daily steps; p=0.001), whereas those most active (7500-9999 daily steps; n=79) increased the least (929 daily steps; p=0.001). CONCLUSIONS: Walk@Work increased workday walking by 25% in this sample overall. Increases occurred through an automated program, at campuses in different countries, and were most evident for those most in need of intervention.

ActiGraph GT3X determined variations in “free-living” standing, lying, and sitting duration among sedentary adults

Background Overweight and obesity has become a serious public health problem in many parts of the world. Studies suggest that making small changes in daily activity levels such as “breaking-up” sedentary time (i.e., standing) may help mitigate the health risks of sedentary behavior. The aim of the present study was to examine time spent in standing (determined by count threshold), lying, and sitting postures (determined by inclinometer function) via the ActiGraph GT3X among sedentary adults with differing weight status based on body mass index (BMI) categories. Methods Participants included 22 sedentary adults (14 men, 8 women; mean age 26.5 ± 4.1 years). All subjects completed the self-report International Physical Activity Questionnaire to determine time spent sitting over the previous 7 days. Participants were included if they spent seven or more hours sitting per day. Postures were determined with the ActiGraph GT3X inclinometer function. Participants were instructed to wear the accelerometer for 7 consecutive days (24 h a day). BMI was categorized as: 18.5 to <25 kg/m2 as normal, 25 to <30 kg/m2 as overweight, and ≥30 kg/m2 as obese. Results Participants in the normal weight (n = 10) and overweight (n = 6) groups spent significantly more time standing (after adjustment for moderate-to-vigorous intensity physical activity and wear-time) (6.7 h and 7.3 h respectively) and less time sitting (7.1 h and 6.9 h respectively) than those in obese (n = 6) categories (5.5 h and 8.0 h respectively) after adjustment for wear-time (p < 0.001). There were no significant differences in standing and sitting time between normal weight and overweight groups (p = 0.051 and p = 0.670 respectively). Differences were not significant among groups for lying time (p = 0.55). Conclusion This study described postural allocations standing, lying, and sitting among normal weight, overweight, and obese sedentary adults. The results provide additional evidence for the use of increasing standing time in obesity prevention strategies.

Modulation of LPS-induced chorioamnionitis by ureaplasma parvum in sheep chorioamnionitis in sheep

ABSTRACT Objective: Ureaplasma parvum colonization in the setting of polymicrobial flora is common in women with chorioamnionitis, and is a risk factor for preterm delivery and neonatal morbidity. We hypothesized that ureaplasma colonization of amniotic fluid will modulate chorioamnionitis induced by E.coli lipopolysaccharide (LPS). Methods: Sheep received intra-amniotic (IA) injections of media (control) or live ureaplasma either 7 or 70d before delivery. Another group received IA LPS 2d before delivery. To test for interactions, U.parvum exposed animals were challenged with IA LPS, and delivered 2d later. All animals were delivered preterm at 125±1 day gestation. Results: Both IA ureaplasmas and LPS induced leukocyte infiltration of chorioamnion. LPS greatly increased the expression of pro-inflammatory cytokines and myeloperoxidase in leukocytes, while ureaplasmas alone caused modest responses. Interestingly, 7d but not 70d ureaplasma exposure significantly downregulated LPS induced pro-inflammatory cytokines and myeloperoxidase expression in the chorioamnion. Conclusion: U.parvum can suppress LPS induced experimental chorioamnionitis.

The relationship between anti-mullerian hormone in women receiving fertility assessments and age at menopause in subfertile women : evidence from large population studies

Context: Anti-Müllerian hormone (AMH) concentration reflects ovarian aging and is argued to be a useful predictor of age at menopause (AMP). It is hypothesized that AMH falling below a critical threshold corresponds to follicle depletion, which results in menopause. With this threshold, theoretical predictions of AMP can be made. Comparisons of such predictions with observed AMP from population studies support the role for AMH as a forecaster of menopause. Objective: The objective of the study was to investigate whether previous relationships between AMH and AMP are valid using a much larger data set. Setting: AMH was measured in 27 563 women attending fertility clinics. Study Design: From these data a model of age-related AMH change was constructed using a robust regression analysis. Data on AMP from subfertile women were obtained from the population-based Prospect-European Prospective Investigation into Cancer and Nutrition (Prospect- EPIC) cohort (n � 2249). By constructing a probability distribution of age at which AMH falls below a critical threshold and fitting this to Prospect-EPIC menopausal age data using maximum likelihood, such a threshold was estimated. Main Outcome: The main outcome was conformity between observed and predicted AMP. Results: To get a distribution of AMH-predicted AMP that fit the Prospect-EPIC data, we found the critical AMH threshold should vary among women in such a way that women with low age-specific AMH would have lower thresholds, whereas women with high age-specific AMH would have higher thresholds (mean 0.075 ng/mL; interquartile range 0.038–0.15 ng/mL). Such a varying AMH threshold for menopause is a novel and biologically plausible finding. AMH became undetectable (�0.2 ng/mL) approximately 5 years before the occurrence of menopause, in line with a previous report. Conclusions: The conformity of the observed and predicted distributions of AMP supports the hypothesis that declining population averages of AMH are associated with menopause, making AMH an excellent candidate biomarker for AMP prediction. Further research will help establish the accuracy of AMH levels to predict AMP within individuals.