Individual and environmental factors that influence longevity of newcomers to nursing and midwifery: a scoping review.

OBJECTIVE: The objective of this review was to identify the literature and map the individual and environmental factors that influence registered nurses' and midwives' decision to stay or leave their professions within the first 3 years of practice. INTRODUCTION: Nursing and midwifery workforce sustainability is an international concern. One aspect is the retention of new registered nurses and midwives in their first years of practice. Several factors are thought to influence the decisions of new registered nurses and midwives to leave or stay in their professions. This review sought to identify and map those factors to enable further research for workforce sustainability development strategies. INCLUSION CRITERIA: The study cohort included registered nurses and midwives in their first 3 years of practice, which we called newcomers . Nurses who were required to work under the supervision of registered nurses and midwives (eg, enrolled nurses, licensed practical nurses, and licensed vocational nurses) were excluded. Papers were only included if they explored individual or environmental factors influencing nurses' decision to stay in or leave the professions of nursing or midwifery. Studies could be from any country or care environment, and participants were newcomers providing direct clinical care. Newcomers employed in other health roles, such as education, research, administration, and non-nursing/midwifery roles were excluded. All research designs and peer-reviewed papers were included; policy documents were excluded. The date of inclusion was from the earliest publication on this topic, which was 1974 to the date of the search. METHODS: The JBI methodology for scoping reviews was followed, and reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. The search strategy aimed to locate published and unpublished primary studies, reviews, and text and opinion papers. The initial search of relevant databases was conducted in January 2020 and updated in January 2022. Reference lists of included articles were also screened. Following data extraction, descriptive qualitative content analysis was undertaken. RESULTS: Twelve articles from 11 studies were included in this review. They were published between 2005 and 2020 and originated from 5 countries. Two studies were observational, 3 were cross-sectional, 5 were longitudinal studies, 1 was a pre- and post-program evaluation, and 1 was a scoping review. All studies focused on registered nurses: no publications on registered midwives met the inclusion criteria. Individual factors we identified that impact newcomers' intention to stay in or leave the profession included physical and psychological health, professional identity, professional commitment, and development. Environmental factors included workplace culture, engagement, and management. CONCLUSIONS: Professional self-image, identity, and a sense of pride in the profession are important components of newcomer retention. Strategies that positively support transition and create realistic expectations were highlighted. Managers play an important role in registered nurse retention as they can influence many of the newcomers' experiences. It is concerning that no studies about newcomer midwives were found. Many studies explored turnover or intention to leave the job/employer rather than the profession. These are important considerations for future research.

How do new midwives' early workforce experiences influence their career plans? An integrative review of the literature.

AIM: To explore how the early workforce experiences of new midwives influence their career plans. BACKGROUND: Each year, thousands of new midwives graduate from entry-to-practice midwifery courses, gain professional registration, and enter the workforce. Despite this, the world continues to face a shortage of midwives. The first five years of clinical practice, commonly referred to as the early career period, can be highly stressful for new midwives, contributing to early attrition from the profession. Supporting the transition from midwifery student to registered midwife is vital if we are to grow the workforce. Whilst the early career experiences of new midwives have been more broadly explored; little is currently understood about how these can influence their career plans. METHODS: Following Whittemore and Knafl's (2005) five-stage process, an integrative review was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the criteria for inclusion. Thematic analysis was undertaken to organise and present the findings. FINDINGS: Thematic analysis, guided by the review question led to the identification of three overarching themes: 'the need for support', 'sustaining health and wellbeing', and 'being able to provide safe and effective midwifery care'. CONCLUSION: Very little research to date has specifically explored how the early career experiences of new midwives influence their career plans, particularly within the Australian context. Further research is required to better understand how the early workforce experiences of new midwives can either strengthen their commitment to the profession or contribute to the decision to leave midwifery prematurely. This knowledge would provide a basis for the development of appropriate strategies to minimise early attrition from the midwifery profession and promote career longevity.

Mentoring students in doctoral nursing programs: A scoping review.

BACKGROUND: Academic mentorship usually involves an ongoing, supportive relationship between experienced academics and research candidates, and is fundamental to establishing and nurturing scholarship and the skills for dealing with the changing demands of the academic environment. Mentoring is a valuable strategy for the development of students enrolled in doctoral nursing programs (Doctor of Philosophy in Nursing - PhD, Doctor of Nursing Practice - DNP, Doctor of Nursing Science - DNS, and Doctoral Education in Nursing - EdD). PURPOSE: To report mentorship experiences among doctoral nursing students and academic mentors, identify positive and negative attributes of mentors and the relationship between mentors and students, and assess the benefits and barriers of mentoring. METHODS: Relevant empirical studies published until September 2021 were identified using PubMed, CINAHL and Scopus electronic databases. Quantitative, qualitative, and mixed method studies published in English language which reported on mentorship among doctoral nursing students were included. Data were synthesized into a scoping review with findings presented as a narrative summary. RESULTS: The review included 30 articles, mostly from the USA, which reported on the mentoring relationship, experiences, benefits, and barriers of mentoring for the student and the mentor. Students valued mentor attributes such as being a role model, respectful, supportive, inspiring, approachable, accessible, a content expert and a good communicator. Benefits of mentoring included enhanced experience of research endeavours, scholarly writing and scientific publication, networking support, improved student retention, timely completion of the project, and career readiness, as well as developing one's own mentoring skills for future mentoring of others. Despite the identified benefits, there are a number of barriers related to mentoring including access to mentorship support, limited mentoring skills among faculty, and lack of compatibility between students and mentors. CONCLUSIONS: This review highlighted students' expectations versus their reality of mentoring, which suggested areas for improvement in mentoring doctoral nursing students, in particular the need for mentorship competency, support, and compatibility. Additionally, there is a need for more robust research designs to understand the nature and characteristics of mentorship programs for doctoral nursing students and to assess the expectations and wider experiences of mentors.

How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis.

AIM: To identify and understand the scope of the literature published since January 2008 that explored Australian midwives understanding of cultural safety and how this is translated into their practice when caring for First Nations women and families. BACKGROUND: Recognition and understanding of First Nations peoples history and culture and the impact this has on the health and wellbeing of women and their families is essential if the midwife is to promote culturally safe and respectful maternity care. The role and responsibilities of the midwife in ensuring that their practice is culturally safe are now reflected in the Australian professional midwifery codes and standards. Whilst midwifery academics' awareness of cultural safety and how it is taught within midwifery education programs have previously been explored, at present, little is known about midwives' understanding of cultural safety, and how this translates into their clinical practice. METHODS: A Scoping Review was undertaken following Arksey and O'Malley's five step process. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses - Scoping Review extension checklist. Twelve studies met the criteria for inclusion. Thematic analysis was used to analyse the data and organise the results. RESULTS: Thematic analysis, guided by two predetermined review questions led to the identification of six overarching themes: 'Awareness of deficiencies', 'The importance of meeting women's diverse needs', 'Understanding relationships as a foundation for culturally safe care', 'Working in partnership with others', 'Providing individualised care' and 'Fostering effective relationships and communication'. One sub-theme of the first theme was identified, this was named 'Seeking an understanding of culture'. CONCLUSION: Australian midwives' level of understanding of cultural safety and how it is translated into their midwifery practice when caring for First Nations women and their families differ widely. Midwives across Australia require increased and equitable access to appropriate opportunities to improve their knowledge and understanding of cultural safety. Whilst theoretical learning on cultural safety has a place in all midwives annual mandatory training requirements, this should ideally be supplemented, where possible, with opportunities for immersive practice in communities. Immersion was considered the optimal way to gain rich knowledge and understanding to strengthen culturally safe midwifery practice. Continuity models of midwifery care which incorporate the principles of cultural safety should be consistently implemented across Australia. These models enable midwives, women, families, communities, and Aboriginal Support Workers to work in collaboration towards achieving optimal outcomes for mothers and babies. STUDY REGISTRATION: N/A.

Coping with COVID-19. Work life experiences of nursing, midwifery and paramedic academics: An international interview study.

BACKGROUND: The COVID-19 global pandemic was declared in March 2020. By June 2022, the total deaths worldwide attributed to COVID-19 numbered over 6.3 million. Health professionals have been significantly impacted worldwide primarily those working on the frontline but also those working in other areas including nursing, midwifery, and paramedic higher education. Studies of occupational stress have focused on the clinical health professional roles but scant attention has been drawn to the pressures on university-based academic staff supporting and preparing professionals for frontline health work. DESIGN AND OBJECTIVES: This qualitative study sought to explore the challenges experienced by health academics (nurses, midwives and paramedics), during COVID-19 and identify strategies enlisted. SETTING AND PARTICIPANTS: Six Australian and two United Kingdom universities collaborated, from which 34 health academics were individually interviewed via video or teleconference, using six broad questions. Ethical approval was obtained from the lead site and each participating University. DATA ANALYSIS: Thematic analysis of the data was employed collaboratively across institutions, using Braun and Clarke's method. RESULTS: Data analysis generated four major themes describing academics': Experiences of change; perceptions of organisational responses; professional and personal impacts; and strategies to support wellbeing. Stress, anxiety and uncertainty of working from home and teaching in a different way were reported. Strategies included setting workday routine, establishing physical boundaries for home-working and regular online contact with colleagues. CONCLUSIONS: The ability of nursing, midwifery and, paramedic academic staff to adapt to a sudden increase in workload, change in teaching practices and technology, while being removed from their work environment, and collegial, academic and technological supports is highlighted. It was recognised that these changes will continue post-COVID and that the way academics deliver education is forever altered.

Exploring the contribution of clinical placement to student learning: A sequential mixed methods study.

BACKGROUND: Increasing demand and limited supply of clinical placements in nursing underscore the need to better understand the role of clinical placements in students' learning. Identifying pedagogically rich activities that support work place learning alongside factors that influence educational outcomes has the potential to optimise professional placement experiences. OBJECTIVE: To explore student nurses perceptions of the value of nursing clinical placements to their learning. DESIGN AND METHODS: A descriptive research design was employed using a sequential mixed method approach. A cross-sectional student survey captured students' perceptions of work integrated learning based on the perceived contribution of a pre-determined list of activities undertaken on clinical placement. SETTING AND PARTICIPANTS: Four Australian universities took part. Participants included students undertaking entry to practice programs. RESULTS: Four hundred and sixty-nine students completed the survey. Thirty-eight students participated in 12 focus groups. Participants rated PRA including interacting and time with patients and performing assessments as the most useful activities. Less useful, were activities that took them away from the patient. CONCLUSIONS: To maximise workplace learning, consideration must be given to ensuring students are presented with goal directed activities that support learning and are focused on an expanding scope of practice with opportunities to discuss and engage with staff.

The parents are watching: Midwifery students' perceptions of how workplace bullying impacts mothers and babies.

PROBLEM: Bullying in the midwifery profession has been documented and the problem is now known to extend to the poor treatment of midwifery students. In nursing, research has shown that bullying in the clinical workplace can adversely impact on quality of care. To date, no research has explored whether the bullying of midwifery students has secondary impacts on the experiences and care of mothers, babies, and their support persons. AIM: To examine how midwifery students, who self-identify as having been bullied, perceive the repercussions on women and their families. METHODS: This qualitative descriptive study explored 120 Australian and United Kingdom (UK) based midwifery students. Data were collected using an anonymous online qualitative survey and were thematically analysed. FINDINGS: The findings suggest that the bullying of midwifery students impacts women and their families in a number of ways. Midwifery students perceive that mothers and babies are frequently implicated either directly or indirectly in the enactment of bullying. This can impact their safety, fractures relationships, and impairs the women's confidence in the student and the profession. Students additionally reported that women and/or their support persons can feel compelled to step in to defend and protect the student. CONCLUSIONS: The bullying of midwifery students is perceived to place women at risk, in uncomfortable situations, damage rapport and undermines their confidence in students and the profession. This also impacts adversely on the student's ability to provide women centred care as they lose confidence in front of the woman and her family when they are bullied by registered midwives.

Social culture and the bullying of midwifery students whilst on clinical placement: A qualitative descriptive exploration.

The context within which midwifery students are professionally socialised is thought to impact upon the development of their sense of belongingness, their attitudes and values, and their commitment to the midwifery profession. Negative forms of socialisation are known to lead to undesirable outcomes including desensitisation about humanistic needs. This has potential to extend to an acceptance of workplace bullying and unfair treatment of others, including midwifery students whilst on clinical placement. This study aimed to explore how the social culture of the maternity setting influences midwifery students' experiences of being bullied whilst on clinical placement. One hundred and twenty midwifery students from Australia and the United Kingdom completed a qualitative online survey and the data was thematically analysed. One main overarching theme and four sub themes were identified. These were: 'the organisational culture of acceptance: "in front of"', 'brazen expression', 'group buy-in', 'suppression of dissent', and 'collateral damage'. Each of these factors enabled replication of the problem and led to perpetuation of the bullying cycle. This study illuminated that an entrenched culture of acceptance exists which impacts the students educational experience, the care received by mothers and babies, and the reputation of the midwifery profession.

Social networking sites: Can midwives and nurses working with adolescent mothers harness their potential value?

AIM: This paper aims to discuss social networking sites as potentially salutogenic, culturally relevant extensions to maternity care provision for adolescent mothers. BACKGROUND: Studies report that online networking may enhance social capital, a concept linked to enhanced well-being, particularly for marginalized individuals. Improving outcomes for adolescent mothers is an ongoing global strategy; thus, this paper has relevance for all professionals involved in their care. DESIGN: This is a discussion paper. DATA SOURCES: This paper draws on the authors' research and is supported by literature and theory. Key terms and Boolean operators were used to identifiy English-language papers published in January 1995 to January 2019 in nine databases and Google Scholar databases. IMPLICATIONS FOR NURSING: Despite limited evidence specific to adolescent mothers, contextual studies suggest that social networking sites may enhance well-being. Nurses and midwives need to understand adolescent mothers' use of online networks to aid development of innovative, health-enhancing care strategies using adolescent-familiar modalities. CONCLUSION: This paper highlights the need for further research regarding the value of professional engagement in online networks to enhance an adolescent's transition to motherhood.

Reported Levels of Exhaustion by the Graduate Nurse Midwife and Their Perceived Potential for Unsafe Practice: A Phenomenological Study of Australian Double Degree Nurse Midwives.

BACKGROUND: The experiences of graduate nurses and midwives transitioning into the clinical environment as beginning practitioners has been reported as a time period of great challenge. For the graduate double degree nurse midwife, often transitioning into two disciplines of practice concurrently, their experiences have the potential to be heightened. The aim of this research was to explore the transition to practice experiences of double degree graduate nurse midwives practicing in either or both nursing and midwifery in the Australian health care system. METHODS: This research used a Husserlian descriptive phenomenological approach to understand the experiences of 23 double degree graduate nurse midwives working in 20 different health care facilities across Australia. RESULTS: The findings showed that most participants experienced exhaustion from an emotional, physical, and mental perspective during their first year of practice. These experiences were linked with cognitive saturation, professional loneliness, sleep deprivation, and an inability to achieve a work-life balance. The data also highlighted the graduate nurse midwife's concerns for safe practice when feeling mentally, physically, and emotionally depleted. CONCLUSION/APPLICATION TO PRACTICE: Safe practice is paramount for both patient and health care worker. The levels of exhaustion described by the participants in this study influenced their perceived ability to practice safely. As a result, it should be recognized that the graduate nurse midwife's health and well-being is central to their perceptions of safe practice and is fundamental to a positive transition to practice experience.

Midwifery students' perceptions of the modifiable organisational factors that foster bullying behaviours whilst on clinical placement. A qualitative descriptive study.

PROBLEM: An increasing body of research suggests midwifery students experience bullying and harassment whilst on clinical placement. Little is known, however, about factors that foster bullying within this context and how they may be addressed. AIM: To explore and describe midwifery students' perceptions of what modifiable organisational factors foster bullying behaviours and to map the identified factors against the students' perceptions of a solution. METHODS: A qualitative descriptive design was used. A total of 120 midwifery students from the United Kingdom and Australia participated in this study. Participants completed an online qualitative survey and data was thematically analysed. FINDINGS: The midwifery students in this study perceive that several organisational factors exist that help foster bullying behaviours towards them whilst undertaking clinical placement. Three overarching themes were identified relating to ineffective midwifery mentorship, the high stress environment of the maternity unit, and challenges faced with transparency and whistleblowing. Students identified a range of potential structural responses to bullying. CONCLUSIONS: Recommendations are made that midwifery managers and academics acknowledge how students perceive several potentially modifiable organisational factors which either lead to or exacerbate the likelihood of them being the target of bullying whilst on clinical placement. Consideration should be given to solutions that from the student's perspective may help tackle bullying and subsequently lead to fewer students leaving midwifery education and further depleting the future workforce.

Midwifery students' experiences of bullying and workplace violence: A systematic review.

BACKGROUND: Workplace violence directed at registered midwives in the maternity setting has been a recognised issue since the early 1990s. More recently it has become evident that midwifery students are also victims of bullying and harassment whilst on clinical placement. Due to the short and long-term impacts this has on students, it is likely to have a detrimental effect on the future and sustainability of the midwifery profession. As a basis for designing a response, it is important to understand what is currently known about this phenomenon. AIM: To systematically review the literature to identify what is known about workplace violence and bullying experienced by midwifery students whilst on clinical placement. METHOD: Reporting of this review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was undertaken of all primary research that focussed upon workplace violence and bullying involving midwifery students whilst on clinical placement, published between January 1990 and December 2019. Pre-defined terms were used to search the following five databases: CINAHL, Web of Science, MEDLINE, Embase, supplemented with Google Scholar. Additional manual searches of reference lists were conducted. An assessment of the quality of each eligible study was then undertaken using an appropriate mixed methods appraisal tool (MMAT). Extracted data were then synthesised using thematic synthesis. FINDINGS: Nine articles met the criteria for inclusion in the review. Studies were primarily qualitative, with some reporting descriptive statistics that do not enable key issues such as prevalence to be reliably addressed. The synthesis identified four main themes that related to workplace violence and bullying of midwifery students whilst on clinical placement. Results were clustered around the role of power in bullying, prevalence and impacts, the culture of compliance, and the victim's response. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A broader understanding of the nature of workplace violence and bullying and how it manifests itself is beginning to emerge, but more and higher quality research is required to establish an empirical base on which to design interventions. Studies suggest that bullying is common and has significant impacts at both a personal and professional level.  This strongly reinforces a need for greater policy and organisational responses to bullying in the clinical education context, in order to break the bullying cycle and ensure the midwives of the future remain in the profession and sustain the workforce.

Individual and environmental factors that influence longevity of newcomers to nursing and midwifery: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify and map the literature that describes the individual and environmental factors that influence nurses and midwives to stay in or leave their discipline within the first three years of practice. INTRODUCTION: The turnover rate of newcomers within their first three years of nursing and midwifery is higher than in later years and is contributing to a worldwide shortage. Both individual and environmental factors, often in combination, contribute to this attrition. Many studies demonstrate the associations of factors with turnover or intention to stay; however, the scope of factors has not been documented. INCLUSION CRITERIA: Newcomers are defined as registered nurses and registered midwives within the first three years of entering their discipline. Quantitative and qualitative studies and systematic reviews that explore individual or environmental factors that influence the decision to leave or to remain in nursing and midwifery in any context will be considered. Factors may include coping, anxiety, mindfulness, practice environment, or combinations such as resilience, satisfaction, and burnout. Articles must have been peer reviewed. Literature published since 1974 in English will be considered. Newcomers who have completed skills-based training will be excluded. METHODS: The JBI method for scoping reviews will be followed. An extensive search of multiple databases and gray literature will be undertaken. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Data extracted will be synthesized and results reported using a mind map, tables, and narrative form.

Social networking sites (SNS) as a tool for midwives to enhance social capital for adolescent mothers.

OBJECTIVE: to explore ways in which midwives can enhance the support provided by social networking sites for adolescent mothers. DESIGN: a narrative approach was employed to guide the research design and processes. Approval was obtained from Edith Cowan University human ethics department. SETTING: focus groups and interviews were undertaken with adolescent mothers and midwives in Western Australia. FINDINGS: the four key themes identified across both groups were validation by midwives, importance of ownership, enhanced community connections and the importance of guideline development. CONCLUSIONS: findings suggest both mothers and midwives consider there are a variety of ways in which healthcare professionals could enhance the support afforded to adolescent mothers by their use of SNS. Midwives were more likely to consider the need for guideline development, but the underlying value of accessible, professionally mediated online support and information was consistent across the two groups. IMPLICATIONS FOR PRACTICE: Midwives would benefit from acknowledging the role played by SNS in providing support to adolescent mothers and by considering ways in which this technology can be used to lend further support to this group of mothers.

Using Colaizzi's method of data analysis to explore the experiences of nurse academics teaching on satellite campuses.

BACKGROUND: Phenomenology is a useful methodological approach in qualitative nursing research. It enables researchers to put aside their perceptions of a phenomenon and give meaning to a participant's experiences. Exploring the experiences of others enables previously unavailable insights to be discovered. AIM: To delineate the implementation of Colaizzi's ( 1978 ) method of data analysis in descriptive phenomenological nursing research. DISCUSSION: The use of Colaizzi's method of data analysis enabled new knowledge to be revealed and provided insights into the experiences of nurse academics teaching on satellite campuses. Local adaptation of the nursing curriculum and additional unnoticed responsibilities had not been identified previously and warrant further research. CONCLUSION: Colaizzi's ( 1978 ) method of data analysis is rigorous and robust, and therefore a qualitative method that ensures the credibility and reliability of its results. It allows researchers to reveal emergent themes and their interwoven relationships. Researchers using a descriptive phenomenological approach should consider using this method as a clear and logical process through which the fundamental structure of an experience can be explored. IMPLICATIONS FOR RESEARCH: Colaizzi's phenomenological methodology can be used reliably to understand people's experiences. This may prove beneficial in the development of therapeutic policy and the provision of patient-centred care.

Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS).

AIM: This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers. BACKGROUND: Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support. DESIGN: Discussion paper. DATA SOURCES: This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017. IMPLICATIONS FOR PRACTICE/RESEARCH: Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents. CONCLUSION: Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study.

OBJECTIVE: To perform a pilot project to determine if this research design was appropriate to explore potential causal relationships between oral probiotic use and vaginal Group B Streptococcal (GBS) colonisation rates in pregnant women. METHOD: Thirty-four GBS-positive women at 36 weeks pregnant were recruited. The participants were randomly allocated to the control group, who received standard antenatal care, or to the intervention group, who received standard antenatal care and a daily oral dose of probiotics for three weeks or until they gave birth. A vaginal GBS swab was collected three weeks post consent or during labour. FINDINGS: No significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21days of probiotics. A subgroup analysis, including only those who had completed 14days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. The findings did show significantly more vaginal commensals in the probiotics group (p=0.048). DISCUSSION: Five possible reasons for the lack of significant results are: the length of the intervention was too short; the dosage of the probiotics was too low; the wrong strains of probiotics were used; the sample size was inadequate; or oral probiotics are ineffective in impacting vaginal GBS. IMPLICATIONS: The finding of a significant increase of vaginal commensals in women who completed 14days or more of probiotics supports the potential of probiotics to impact vaginal GBS in pregnancy.

Self-Reported Nutrition Education Received by Australian Midwives before and after Registration.

Educating midwives to provide nutrition advice is essential. Limited research focuses on midwives' nutrition education. This paper explores self-reported nutrition education received by Australian midwives before and after registration. It draws on quantitative and qualitative data from a larger online survey conducted with the members of the Australian College of Midwives (response rate = 6.9%, n = 329). Descriptive and content analyses were used. Of the midwives, 79.3% (n = 261) reported receiving some nutrition education during, before, and/or after registration. However, some described this coverage as limited. It lacked sufficient focus on topics such as weight management, nutrition assessment, and nutrition for vulnerable groups. Continuing education often occurred through personal initiatives, such as the midwife enrolling in external courses or exploring issues on the Internet and with colleagues. The majority of participants indicated a need for increased nutrition education (94.2%, n = 310) and guidelines tailored for them to provide nutrition advice (87.8%, n = 289). Australian midwives may not be receiving adequate nutrition education to provide nutrition advice. Inclusion of evidence-based nutrition components in midwifery education and regular updates for practising midwives focusing on challenging nutrition issues is required to ensure that they are supported in this important role.

Informing Nutrition Care in the Antenatal Period: Pregnant Women's Experiences and Need for Support.

This study aimed to provide insights into Australian women's experiences in gaining nutrition information during pregnancy. Individual semistructured telephone interviews were conducted with 17 pregnant (across all trimesters) and 9 postpartum women in five Australian states. Data were transcribed and analysed using inductive thematic analysis. Women valued nutrition information, actively sought it, and passively received it mainly from three sources: healthcare providers (HCPs), media, and their social networks. Women reported HCPs as highest for reliability but they had limited time and indifferent approaches. Various media were easily and most frequently accessed but were less reliable. Social networks were considered to be the least reliable and least accessed. Women reported becoming overwhelmed and confused. This in turn influenced their decisions (pragmatic/rational) and their eating behaviours ("overdo it," "loosen it," "ignore it," and "positive response"). Individual and environmental barriers impacted their application of knowledge to dietary practice. Women wanted more constructive and interactive engagement with their HCPs. This study identified the need to establish and maintain mutually respectful environments where women feel able to raise issues with their HCPs throughout their pregnancies and where they are confident that the information they receive will be accurate and meet their needs.

Corrigendum to "Australian Pregnant Women's Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action".

[This corrects the article DOI: 10.1155/2016/8162645.].