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1.
Artigo em Inglês | MEDLINE | ID: mdl-38925867

RESUMO

BACKGROUND: Existing research has acknowledged a correlation between stress in pregnancy and poorer respiratory health in offspring. However, research focusing on stress caused by family and domestic violence in the prenatal period is missing. METHODS: A retrospective cohort study included children born 1987-2010 who were identified as being exposed to FDV in the prenatal period (n = 1477) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n = 41 996). Hospitalization for bronchiolitis was identified in HMDC. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval for bronchiolitis hospitalizations contact. RESULTS: Children exposed to FDV had a 70% (HR 1.70, 95% CI: 1.49-1.94) increased risk of hospitalization for bronchiolitis than non-exposed counterparts by age two. Children exposed to FDV had a longer average hospital stay for bronchiolitis than non-exposed children (4.0 days vs. 3.8 days, P < 0.001). CONCLUSIONS: Prenatal exposure to FDV is associated with bronchiolitis hospitalization in children <2 years. Along with other risk factors, clinicians should give consideration to maternal stress factors, including experiencing FDV as a potential contributor to bronchiolitis.

2.
Birth ; 50(3): 578-586, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36190166

RESUMO

OBJECTIVES: To compare the health of neonates born to women who experienced family and domestic violence (FDV) 12 months prior to birth, with the health of neonates born to women with an earlier history of FDV and women with no history of FDV. METHODS: A retrospective cohort of women who experienced FDV within 12 months of birth (antenatal FDV [AFDV]) (n = 1230) was identified using data from the Western Australia (WA) Police Force Incident Management System and WA Hospital Morbidity Data Collection. Two comparison cohorts were used, the first including women with a history of FDV (HFDV) 12-60 months prior to birth (n = 1549) and the second with no history of FDV (NFDV) recorded (n = 3690). Hospital, birth, mortality, and congenital anomaly data were used in generalized linear models to examine and compare neonatal health outcomes. RESULTS: Women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51, 95% CI: 1.18-1.94), low birth weight (1.74, 1.45-2.10), and preterm birth (1.48, 1.22-1.79) compared with neonates born to NFDV mother. Neonatal health outcomes in those born to AFDV women were not significantly different from those born to HFDV women. CONCLUSIONS: Antenatal and historical FDV were associated with poor neonatal health outcomes. Additional pregnancy and social support should be offered to women who have experienced FDV during or prior to pregnancy.


Assuntos
Violência Doméstica , Nascimento Prematuro , Recém-Nascido , Gravidez , Feminino , Humanos , Estudos Retrospectivos , Nascimento Prematuro/epidemiologia , Recém-Nascido de Baixo Peso , Avaliação de Resultados em Cuidados de Saúde
3.
Aust J Rural Health ; 31(5): 886-896, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37368437

RESUMO

INTRODUCTION: This study describes the experiences of eight mothers from the Wheatbelt region of Western Australia who shared their stories of travelling and/or temporarily relocating for birth. OBJECTIVE: The aim of this study was to describe rural and remote Western Australian mothers' experiences of travelling long distances and/or relocating to give birth. DESIGN: This study was based on Crotty's four elements of qualitative research. This study was underpinned by a constructivist epistemology, a feminist theoretical lens and a narrative approach using semistructured, story-based interviews. Participants narrated their stories of birthing away from home by telephone interview. FINDINGS: Five major themes were identified utilising thematic analysis. These were (1) feeling forgotten in the system, (2) accessibility and choice, (3) compounded social isolation, (4) doing it hard: financial and logistical challenges and (5) building strength: advocating for myself and baby. DISCUSSION: Mothers' stories were reflective of current and historical failures of rural maternal health policy, including widespread closures of rural birthing hospitals. Mothers described the logistical barriers they faced with little support and suggested multiple solutions that would improve their experiences. CONCLUSION: Mothers faced significant obstacles which impeded their access to equitable maternal healthcare. This study highlights the complexities of birthing as a rural mother and the need to address maternal health inequities between rural and metropolitan women.


Assuntos
Serviços de Saúde Materna , Mães , Feminino , Humanos , Gravidez , Austrália , Acessibilidade aos Serviços de Saúde , Austrália Ocidental , Pesquisa Qualitativa
4.
BMC Womens Health ; 22(1): 261, 2022 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-35761231

RESUMO

BACKGROUND: Adolescent girls appear more vulnerable to experiencing mental health difficulties from social media use than boys. The presence of sexualized images online is thought to contribute, through increasing body dissatisfaction among adolescent girls. Sexual objectification through images may reinforce to adolescent girls that their value is based on their appearance. This study explored how sexualized images typically found on social media might influence adolescent girls' mental health, in positive and/or negative ways. METHODS: In-depth interviews were conducted with girls aged 14-17 years (n = 24) in Perth, Western Australia. Data were analyzed using thematic analysis. RESULTS: Participants identified body image as a major concern, reporting negative appearance comparisons when viewing images on social media. Appearance comparisons were perceived to exacerbate adolescent girls' appearance-based concerns. Comparisons also influenced adolescent girls' efforts to change their appearance and seek validation on social media. The importance of awareness and education from a younger age about social media and its influence on body image was emphasized, as was the need for strategies to promote positive body image and counteract negative body image. CONCLUSION: The findings of this study have important implications for professionals working with adolescent girls and for the development of health promotion programs addressing social media use and body image concerns.


Assuntos
Imagem Corporal , Mídias Sociais , Adolescente , Imagem Corporal/psicologia , Feminino , Humanos , Masculino , Homens , Comportamento Sexual/psicologia , Austrália Ocidental
5.
Health Promot J Austr ; 32(2): 238-247, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32153067

RESUMO

ISSUES ADDRESSED: To explore adolescents' experiences of access to and continued use of mental health services, and identify factors influencing their perceived satisfaction with their care. This paper focusses on the role of organisational and policy-level factors in the mental health system. METHOD: Qualitative semi-structured face-to-face interviews with 22 adolescents aged 14-18 years living in Perth, Western Australia. RESULTS: Adolescents identified key policy, systemic and service-based factors which influenced their access to and continued use of mental health services. These were strongly related to the processes of service intake, level of orientation towards person-centred care and adequacy of service resourcing and funding. Areas of concern for adolescents included, complex service intake procedures, suboptimal mental health service environments, lack of client-centred care and the quality of mental health support provided in school settings. CONCLUSIONS: Our research has identified a wide spectrum of factors influencing mental health service access and use amongst adolescents. The findings further support the growing national consensus for major reform to address the mental health needs of this age group. The current strengths within mental health services and the system identified by adolescents need to be supported and extended. SO WHAT?: Although there have been numerous recommendations on ways to improve mental health service access and ongoing engagement for Australian adolescents, a number of the major challenges faced by this high-risk population have shown little improvement. The findings of this research indicate the importance of now moving towards implementing meaningful plans for action.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Adolescente , Austrália , Acessibilidade aos Serviços de Saúde , Humanos , Austrália Ocidental
6.
J Immunol ; 200(4): 1457-1470, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29330323

RESUMO

T cells predominate the immune responses in the synovial fluid of patients with persistent Lyme arthritis; however, their role in Lyme disease remains poorly defined. Using a murine model of persistent Lyme arthritis, we observed that bystander activation of CD4+ and CD8+ T cells leads to arthritis-promoting IFN-γ, similar to the inflammatory environment seen in the synovial tissue of patients with posttreatment Lyme disease. TCR transgenic mice containing monoclonal specificity toward non-Borrelia epitopes confirmed that bystander T cell activation was responsible for disease development. The microbial pattern recognition receptor TLR2 was upregulated on T cells following infection, implicating it as marker of bystander T cell activation. In fact, T cell-intrinsic expression of TLR2 contributed to IFN-γ production and arthritis, providing a mechanism for microbial-induced bystander T cell activation during infection. The IL-10-deficient mouse reveals a novel TLR2-intrinsic role for T cells in Lyme arthritis, with potentially broad application to immune pathogenesis.


Assuntos
Interleucina-10/deficiência , Doença de Lyme/imunologia , Ativação Linfocitária/imunologia , Linfócitos T/imunologia , Receptor 2 Toll-Like/imunologia , Animais , Feminino , Interleucina-10/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos
7.
J Paediatr Child Health ; 56(3): 372-378, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31479558

RESUMO

AIM: To describe neurodevelopmental outcomes among a cohort of Western Australian infants exposed to maternal methamphetamine use during pregnancy and to determine whether the Ages and Stages Questionnaire is a reliable screening tool for this population. METHODS: Methamphetamine-using women were approached for participation when referred to the state-wide perinatal specialist drug and alcohol service for pregnancy care. Drug use during pregnancy was self-reported in each trimester using a standardised questionnaire. Ages and Stages Questionnaires were completed by infant care givers at 4 and 12 months, and development was formally assessed at 12 months using the Griffiths Mental Development Scales. Griffiths results for term-born infants in our cohort were compared to a Western Australian historical cohort of 443 healthy 1-2-year-olds. RESULTS: A total of 112 methamphetamine-using pregnant women participated in the study, who gave birth to 110 live-born infants. Ages and Stages Questionnaires were completed for 89 (81%) and 78 (71%) of the infants at 4 and 12 months, respectively. The Ages and Stages assessment identified 30 infants (33.7%) as having a potential developmental delay at 4 months and 29 infants (38.7%) as having a potential developmental delay at 12 months. Griffiths assessments were performed on 64 (58%) of the infants, with a mean general quotient of 92.7. This was significantly lower in term-born babies compared to the historical cohort (who had a median general quotient of 113.0). There was a weak correlation between 12-month Ages and Stages scores and Griffiths general quotients (r = 0.322) and no correlation between 4-month Ages and Stages Questionnaire scores and later Griffiths results. CONCLUSIONS: Infants born to women reporting methamphetamine use during pregnancy are at increased risk of developmental delay and may warrant enhanced developmental follow-up. However, they are a challenging group to follow due to complex psychosocial factors. Ages and Stages Questionnaires at 4 and 12 months were not helpful in screening for infants who had a developmental delay at 12 months.


Assuntos
Metanfetamina , Efeitos Tardios da Exposição Pré-Natal , Austrália , Desenvolvimento Infantil , Pré-Escolar , Estudos de Coortes , Deficiências do Desenvolvimento/induzido quimicamente , Deficiências do Desenvolvimento/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Psicometria
8.
J Immunol ; 199(10): 3525-3534, 2017 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-28986440

RESUMO

Previously, using a forward genetic approach, we identified differential expression of type I IFN as a positional candidate for an expression quantitative trait locus underlying Borrelia burgdorferi arthritis-associated locus 1 (Bbaa1). In this study, we show that mAb blockade revealed a unique role for IFN-ß in Lyme arthritis development in B6.C3-Bbaa1 mice. Genetic control of IFN-ß expression was also identified in bone marrow-derived macrophages stimulated with B. burgdorferi, and it was responsible for feed-forward amplification of IFN-stimulated genes. Reciprocal radiation chimeras between B6.C3-Bbaa1 and C57BL/6 mice revealed that arthritis is initiated by radiation-sensitive cells, but orchestrated by radiation-resistant components of joint tissue. Advanced congenic lines were developed to reduce the physical size of the Bbaa1 interval, and confirmed the contribution of type I IFN genes to Lyme arthritis. RNA sequencing of resident CD45- joint cells from advanced interval-specific recombinant congenic lines identified myostatin as uniquely upregulated in association with Bbaa1 arthritis development, and myostatin expression was linked to IFN-ß production. Inhibition of myostatin in vivo suppressed Lyme arthritis in the reduced interval Bbaa1 congenic mice, formally implicating myostatin as a novel downstream mediator of the joint-specific inflammatory response to B. burgdorferi.


Assuntos
Borrelia burgdorferi/imunologia , Inflamação/imunologia , Interferon beta/metabolismo , Doença de Lyme/imunologia , Macrófagos/imunologia , Miostatina/metabolismo , Animais , Células Cultivadas , Regulação da Expressão Gênica , Loci Gênicos/genética , Inflamação/genética , Doença de Lyme/genética , Camundongos , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Miostatina/genética , Quimera por Radiação , Regulação para Cima
9.
Med Teach ; 41(1): 24-27, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29171333

RESUMO

Service learning is an educational methodology that facilitates transformation of students' knowledge, attitudes and attitudes around holistic care through work with community organizations. To implement academically, defensible service learning requires faculty endorsement, consideration of course credit, an enthusiastic champion able to negotiate agreements with organizations, organizations' identification of their own projects so they are willing to both fund and supervise them, curricular underpinning that imparts the project skills necessary for success, embedding at a time when students' clinical identity is being formed, small packets of curriculum elements delivered "just in time" as students engage with their project, flexible online platform/s, assessment that is organically related to the project, providing cross cultural up-skilling, and focused on the students' responsibility for their own product. The result is a learning experience that is engaging for medical students, links the university to the community, and encourages altruism which is otherwise reported to decline through medical school.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Educação de Graduação em Medicina/organização & administração , Saúde Pública/educação , Atitude , Currículo , Humanos , Desenvolvimento de Programas , Estudantes de Medicina
10.
Aust Occup Ther J ; 66(1): 52-60, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30298929

RESUMO

BACKGROUND/AIM: There is anecdotal recognition within the profession that novice occupational therapists who perform well at interview do not necessarily make the best practising clinicians. Further anecdotal evidence suggests that it is difficult to tell (at interview) which occupational therapists will follow which path and whether further training can achieve excellence in existing staff. What is it that makes the difference? What attributes do those truly 'excellent' clinicians have that makes them better than others? METHOD: A two-round Delphi survey was utilised and 18 expert occupational therapists were purposively recruited from Perth's three adult tertiary hospitals. Panellists rated and ranked sixteen possible attributes that could comprise excellence in an acute practice occupational therapist. RESULTS: The final order of importance (from most to least) of the 16 possible attributes of excellence was determined. Communication, Self-management and Critical Thinking were found to be the three most important attributes, whereas Humility was considered the least important attribute. All attribute rankings achieved at least a low level of consensus. CONCLUSION: We now have a much clearer picture of what excellence looks like in the acute practice setting, giving managers a new understanding. There is now the possibility of integrating this information into both the recruitment of new staff and the professional development of existing staff. In this way we can move forward to a future that includes the active development of occupational therapy excellence in ways that were not possible before these results were available.


Assuntos
Terapeutas Ocupacionais/normas , Terapia Ocupacional/normas , Adulto , Austrália , Competência Clínica , Tomada de Decisão Clínica , Comunicação , Técnica Delphi , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel Profissional
11.
Community Ment Health J ; 53(3): 306-315, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27401164

RESUMO

This qualitative study assessed the experiences of assertive community treatment (ACT) team members regarding the integration of physical and mental health self-management for persons with serious mental illness. Three focus groups elicited information from participants concerning barriers, strategies, and recommendations. Findings from inductive analyses revealed six overarching themes: (1) collaboration with primary care, (2) improvements in engagement, (3) team-focused roles, (4) education and training, (5) recommendations for system level barriers, and (6) systems collaboration. Participant recommendations suggest that ACT teams are well positioned to integrate mental and physical health treatment, but further research is needed to support integrated care.


Assuntos
Serviços Comunitários de Saúde Mental , Prestação Integrada de Cuidados de Saúde , Saúde Mental , Equipe de Assistência ao Paciente , Adulto , Comportamento Cooperativo , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Atenção Primária à Saúde , Pesquisa Qualitativa , Autocuidado
12.
Health Promot J Austr ; 28(2): 110-117, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27498710

RESUMO

Issue addressed The study aim was to investigate the relationships between social capital measures and playgroup participation in a local residential area for parents with children of playgroup age (1-4 years) compared with non-participation and participation in a playgroup outside the local residential area. Research indicates playgroup participation has benefits for families, however, less is known about the potential local community social capital for parents who participate in playgroups. Methods Data were collected through a cross-sectional survey from March 2013 to January 2014 in Perth, Western Australia. The data from a group of parents (n=405) who had at least one child aged between 1 and 4 years were analysed using multivariable regression. Reported playgroup participation (local, outside the area or non-participation) in the previous 12 months was investigated for associations with three measures (Neighbourhood Cohesion Index, Social Capital and Citizenship Survey and local reciprocity) that capture attributes of social capital. Results Participation in playgroup locally was generally associated with higher levels of social capital than both participation in playgroup outside the local area and non-participation. Mothers with two or more children fared better for social capital measures than mothers with one child. Conclusions Participation in a locally placed playgroup may provide an important opportunity for families with children of playgroup age (1-4 years) to build social capital in their local community. So what? Playgroups in a family's local area have the potential to foster locally placed social capital through community interaction, social networks and cohesion, which are important for mental health promotion in communities.


Assuntos
Participação da Comunidade , Jogos e Brinquedos , Capital Social , Apoio Social , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Grupo Associado , Austrália Ocidental
13.
BMC Womens Health ; 16: 13, 2016 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-26957314

RESUMO

BACKGROUND: Domestic Violence (DV) remains a significant global health problem for women in contemporary society. Existing literature on midlife women's experiences of domestic violence is limited and focuses on health implications. Leaving a violent relationship is a dynamic process that often requires multiple attempts and separations prior to final termination. The aim of this study was to explore the process of leaving a violent relationship for midlife women. METHODS: This qualitative study involved fifteen women aged between 40-55 who had accessed residential and non-residential community support services for domestic violence within the UK. Community-based support agencies provided these women with access to letters of invitation and participant information sheet explaining the study. The women notified agency staff who contacted the research team to arrange a mutually convenient time to meet within a safe place for both the women and researchers. It was stressed to all potential participants that no identifiable information would be shared with the agency staff. Women were considered survivors of DV if they defined themselves as such. Data were gathered through semi structured interviews, transcribed verbatim and thematically analysed. RESULTS: Midlife women appear to differ from younger women by transitioning quickly though the stages of change, moving rapidly through the breaking free onto the maintenance stage. This rapid transition is the resultant effect of living with long-term violence causing a shift in the women's perception towards the violent partner, with an associated reclamation of power from within the violent relationship. A realisation that rapid departure from the violence may be critical in terms of personal safety, and the realisation that there was something 'wrong' within the relationship, a 'day of dawning' that had not been apparent previously appears to positively affect the trajectory of leaving. CONCLUSIONS: Midlife women appeared to navigate through the stages of change in a rapid linear process, forging ahead and exiting the relationship with certainty and without considering options. Whilst these findings appear to differ from younger women's process of leaving, further research is needed to explore and understand the optimum time for intervention and support to maximise midlife women's opportunities to escape an abusive partner, before being reflected appropriately in policy and practice.


Assuntos
Violência Doméstica/estatística & dados numéricos , Liberdade , Fatores de Tempo , Adulto , Agressão/psicologia , Violência Doméstica/tendências , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Parceiros Sexuais/psicologia
14.
BMC Health Serv Res ; 16: 141, 2016 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-27101981

RESUMO

BACKGROUND: The use of stimulant medication for Attention Deficit Hyperactivity Disorder (ADHD) to improve classroom behaviour and sustained concentration is well known. Achieving a better academic grade has been reported as the prime motivation for stimulant use and is an increasingly discussed topic. The proliferation of stimulant use for ADHD has been a cause for public, medical and policy concern in Australia. This paper explores individuals' perceptions of ADHD, the meaning that the diagnosis carries for them and their attitudes to stimulant medication treatment. METHODS: This qualitative study was underpinned by a social constructivist approach and involved semi-structured interviews with eight participants. The participants were parents of children with ADHD or were adults who themselves had been diagnosed with ADHD. Interviews were audiotaped, transcribed verbatim and thematically analysed. RESULTS: There were three interrelated yet contradictory overarching themes: (i) An impairment to achieving success, which can be a double-edged sword, but has to be fixed; (ii) Diagnosis as a relief that alleviates fault and acknowledges familial inheritance; (iii) Responsibility to be normal and to fit in with societal expectations. Collectively, these perceptions and meanings were powerful drivers of stimulant use. CONCLUSIONS: Paying attention to perceptions of ADHD and reasons for seeking or not seeking stimulant treatment is important when planning appropriate interventions for this condition.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Atitude Frente a Saúde , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Percepção , Pesquisa Qualitativa , Responsabilidade Social , Austrália Ocidental , Adulto Jovem
15.
BMC Health Serv Res ; 16: 179, 2016 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-27178346

RESUMO

BACKGROUND: Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. METHODS: Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. RESULTS: The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. CONCLUSION: Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Adulto , Humanos , Indonésia , Pessoa de Meia-Idade , Farmácias/estatística & dados numéricos , Prática Profissional/estatística & dados numéricos , Pesquisa Qualitativa
16.
J Adv Nurs ; 72(1): 85-98, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26420352

RESUMO

AIM: To investigate the relationships between participation in mothers' groups and social capital, social support and mental well-being measures for mothers whose oldest child was 0-5 years. BACKGROUND: Evaluations of facilitated mothers' groups have found positive benefits for information sharing and support. Mothers' groups often continue as parent-led groups; however, little is known about the potential benefits of ongoing participation compared with non-participation. DESIGN: Cross-sectional survey. METHODS: Data were collected through a survey from March 2013-January 2014 in Perth, Western Australia. The data from a subgroup of mothers (N = 313) whose oldest child was 0-5 years of age were analysed using multivariable regression. Participation in mothers' groups in the previous 12 months was investigated for associations with social capital {Neighbourhood Cohesion Index (NCI); Families, Social Capital and Citizenship Survey (FSCCS) and Reciprocity}; social support {Medical Outcomes Study-Social Support Survey (MOS-SSS) and Parent Support Outside Home Scale (PSOHS)}; and mental well-being {Warwick Edinburgh Mental Well-Being Scale (WEMWBS)}. Participation was measured as three groups - locally, outside area of residence and non-participation. RESULTS: Mothers who participated in mothers' groups locally scored significantly higher than those who had not participated in mothers' group for 'social capital' (NCI, FSCCS, Reciprocity), 'social support' (MOS-SSS, PSOHS) and 'mental well-being' (WEMWBS). Mothers who participated in mothers' group outside the area scored significantly higher than those who had not participated in mothers' groups for one measure of 'social support' (PSOHS). CONCLUSIONS: Participation in mothers' group locally may provide support and social capital benefits for mothers of children aged 0-5 years, which may influence mental well-being.


Assuntos
Relações Interpessoais , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Mães/psicologia , Apoio Social , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Psicoterapia de Grupo , Inquéritos e Questionários , Austrália Ocidental
17.
Prev Med ; 76: 26-30, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25849883

RESUMO

OBJECTIVE: To examine long-term cardiovascular disease (CVD) risk disparities by sexual identity using a nationally representative sample of young adults in the United States. METHODS: Data include participants in wave 4 (2008/09; ages 24-34years) of the National Longitudinal Study of Adolescent to Adult Health (7087 females; 6340 males). Sexual identity was self-reported (heterosexual, mostly heterosexual, bisexual, mostly homosexual, homosexual) and a Framingham-based prediction model was used to estimate participants' risk of a CVD event over 30years. Differences in CVD risk by sexual identity, relative to heterosexuals, were calculated with linear regression models adjusted for age, race/ethnicity, education, and financial distress. RESULTS: Average 30-year CVD risk was 17.2% (95% CI: 16.7, 17.7) in males and 9.0% (95% CI: 8.6, 9.3) in females. Compared to heterosexual females, mostly heterosexual (0.8%; 95% CI: 0.2, 1.4) and mostly homosexual females (2.8%; 95% CI: 0.8, 4.9) had higher CVD risk. Bisexual and homosexual females had higher but not statistically significant CVD risk compared to heterosexuals. Among males, differences in CVD risk by sexual identity were not statistically significant. CONCLUSION: Sexual identity was associated with CVD risk in sexual minority subgroups. Population- and clinic-based prevention strategies are needed to minimize disparities in subsequent disease.


Assuntos
Doenças Cardiovasculares , Disparidades em Assistência à Saúde , Comportamento Sexual , Sexualidade , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Grupos Minoritários , Fatores de Risco , Estados Unidos
18.
J Adv Nurs ; 70(12): 2835-46, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24805198

RESUMO

AIM: The aim of this study was to explore the ways that mothers' groups and playgroups support families with children aged 0-5 years and foster community connectedness in newer residential communities in Perth, Western Australia. BACKGROUND: The transition to parenthood is a time of increased support need. Changing community demography has resulted in a loss of traditional support structures and an increased need for local community initiatives to support families with young children. DESIGN: A qualitative descriptive design was used for this initial phase of a mixed methods sequential exploratory study. METHOD: Data were collected between December 2011-August 2012. Interviews and focus groups conducted with 39 mothers provided insights from 16 mothers' groups and 13 playgroups. In addition, interviews were undertaken with three child health nurses and four local government early childhood staff. FINDINGS: For the participants in this study, mothers' groups and playgroups provided opportunities to learn about parenting, to build a supportive network, to forge friendships and a connectedness to the local community. The families who relocated often experienced isolation until new groups and social networks were found. In general, where participation in mothers' groups and playgroups facilitated relationships with others from the local community, connectedness to that community was reported by participants to be enhanced. CONCLUSION: Mothers' groups and playgroups provide important community development opportunities and appear to help reduce potential isolation for mothers with young children. The findings are of interest to nurses and other health professionals working with families with young children.


Assuntos
Redes Comunitárias , Poder Familiar/psicologia , Jogos e Brinquedos , Isolamento Social/psicologia , Apoio Social , Adulto , Pré-Escolar , Feminino , Grupos Focais , Humanos , Lactente , Recém-Nascido , Mães , Austrália Ocidental , Adulto Jovem
19.
Trauma Violence Abuse ; : 15248380241247001, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38686924

RESUMO

As the number of infants entering Out-of-Home Care at birth internationally continues to rise, Hospital-based healthcare workers (HBHCWs) are increasingly likely to become involved in ethically, morally, and legally complex child protection processes. This scoping review aimed to identify and synthesize qualitative literature pertaining to the perspectives of HBHCWs with experiences of involvement in child protection processes occurring in the perinatal period. JBI Methodology for Scoping Reviews guided this review. Databases Ovid MEDLINE, CINAHL Plus, PsycINFO, ProQuest, Web of Science, SCOPUS, and Informit were searched between March 1 and April 30, 2023. Eighteen sources were identified as meeting the criteria for inclusion following screening by two independent reviewers. Data extracted from the included sources are presented in narrative and tabular formats. Involvement in child protection processes is an inherently conflictual experience for HBHCWs and gives rise to internal, interpersonal, and interorganizational tensions. Involvement can have an enduring impact on the HBHCWs, particularly when an infant is removed from hospital by child protection authorities. Appropriate peer, managerial, and organizational level responses are essential to ameliorate risk to HBHCWs themselves and subsequently their practice with women, infants, and families. HBHCWs can provide valuable insight into the challenges of delivering healthcare at the interface of child protection. Future research should focus on building understanding of experiences across disciplines to ensure that interventions designed to prepare and support HBHCWs are effective and evidence-based.

20.
Soc Work Public Health ; 39(4): 379-392, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38482834

RESUMO

Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees' self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.


Assuntos
Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides , Humanos , Pessoal de Saúde/educação , Estudantes , Serviço Social
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