Barriers to a healthy lifestyle post gestational-diabetes: An Australian qualitative study

Background

Overseas-born-women from certain ethnicities are at high risk of type-2 diabetes and related metabolic disorders. This study explored the barriers and facilitators to long-term healthy lifestyle recommendations among Australian-born and overseas-born-women who attended health promotion sessions at a tertiary Australian Hospital for gestational diabetes 3–4 years previously.

Parenting groups for parents whose children are in care

Excluding very severe child abuse cases, biological parents are usually encouraged to maintain contact with their children in care. Parent‐child contact is often considered important because it can maintain the child's psychological identity and well‐being. It can also maintain parent‐child attachment and in some cases facilitate reunification. Improving parenting skills is viewed as an important method by which contact between children and their biological parents can be enhanced. However, mainstream parenting groups are often unsuitable for parents whose children are in care for a number of reasons. There is stigma involved with having children in care, such parents have very complex lives and there are reduced opportunities to practise skills learnt with their children. Groups designed specifically for parents whose children are in care appear to be a promising approach to improving the quality of contact between these parents and their children. This paper will review group‐based approaches to working with biological parents whose pre‐school‐aged children have been placed in care. The paper will also report the findings of a research project designed to identify key facilitators and barriers to parental involvement in a group‐based programme which includes contact between parents and their children who have been placed in care. Copyright © 2009 John Wiley & Sons, Ltd.     

What do women with learning disabilities say about their experiences of domestic abuse within the context of their intimate partner relationships?

In 2001 the UK Government launched its strategy ‘Valuing People’. The strategy, underpinned by the Human Rights Act 1998 (Ministry of Justice 1998 Ministry of Justice. 1998. The Human Rights Act, London: HMSO.  [Google Scholar]), the Disability Discrimination Act 1995 (Home Office 1995 Home Office. 1995. Disability Discrimination Act, London: HMSO.  [Google Scholar]) and social inclusion claimed to outline ways for services to work, to meet the needs of individuals with learning disabilities . In this qualitative study, interviews were held with five women with learning disabilities, all of whom experienced domestic abuse from intimate partners. Although women sought help from services to leave their abusive partners, it was either denied or inappropriate to their needs. Women internalised the oppression of their partners and the dual abuse from services that failed them. Helpful service provision included advocacy, a domestic abuse therapy programme, and an empowerment group informed by feminist perspectives.     

A systematic review of the association between lower urinary tract symptoms and falls,injuries, and fractures in community-dwelling older men

Background: Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men.

Methods: We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men. Medline, Embase, and Cinahl were searched for any type of observational study that has been published in a peer-reviewed journal in English language. Studies were excluded if they did not report male-specific data or targeted specific patient populations. Results were summarized qualitatively.

Results: Three prospective cohort studies and six cross-sectional studies were identified. Incontinence, urgency, nocturia, and frequency were consistently shown to have weak to moderate association with falls (the point estimates of odds ratio and relative risk ranged from 1.31 to 1.67) in studies with low risk of bias for confounding. Only frequency was shown to be associated with fractures.

Conclusions: Urinary incontinence and lower urinary tract storage symptoms are associated with falls in community-dwelling older men. The circumstances of falls in men with LUTS need to be investigated to generate hypotheses about what types of interventions may be effective in reducing falls.     

Discovery or Construction? Theorising the Roots of Adult Protection Policy and Practice

This paper outlines two models for understanding the roots of adult safeguarding/adult support and protection (ASP) policy and practice, and considers the strengths and limitations of each model in an educational context. The ‘discovery’ model understands ASP policy to be a response to a growing societal awareness of a phenomenon called ‘harm’ to ‘adults at risk’. It understands ASP practice to be triggered by the discovery of an instance of that phenomenon. The ‘construction’ model understands ASP policy to reflect a particular characterisation of the problem(s) at stake, contingent on particular historical, cultural and political influences. It understands ASP practice to be actively engaged in re-constructing ‘harm’, ‘adults at risk’ and ‘ASP’ itself. The discovery model is argued to be useful in delivering a clear, basic message to practitioners about harm and abuse, particularly where time and the potential for interaction in educational contexts are limited. The construction model is argued to be useful in connecting more deeply with practitioners’ lived experiences, promoting political engagement and developing professional judgement informed by ethical debate.     

Social support: proposing a conceptual model for application to midwifery practice

The notion of social support is one which midwives often intuit rather than clearly articulate or conceptualise. Increasingly social support is being touted as an area of midwifery assessment and potential intervention which may improve birthing outcomes for mothers and their infants. This paper is the first of three to address social support within the discipline of midwifery. It aims to review the fundamental theoretical constructs relating to social support and proposes a conceptual model to assist midwives in applying social support theory to their practice. Further papers will address social support-related research assumptions and the validation of measurement instruments in midwifery research.     

‘You are not born being racist,are you?’ Discussing racism with primary aged-children

Ethnic-racial socialisation is broadly described as processes by which both minority and majority children and young people learn about and negotiate racial, ethnic and cultural diversity. This article extends the existing ethnic-racial socialisation literature in three significant ways: (1) it explores ways children make sense of their experiences of racial and ethnic diversity and racism; (2) it considers ways children identify racism and make distinctions between racism and racialisation; and (3) it examines teacher and parent ethnic-racial socialisation messages about race, ethnicity and racism with children. This research is based on classroom observations, semi-structured interviews and focus groups with teachers, parents and students aged 8–12?years attending four Australian metropolitan primary schools. The findings reveal that both teachers and parents tended to discuss racism reactively rather than proactively. The extent to which racism was discussed in classroom settings depended on: teachers’ personal and professional capability; awareness of racism and its perceived relevance based on student and community experiences; and whether they felt supported in the broader school and community context. For parents, key drivers for talking about racism were their children’s experiences and racial issues reported in the media. For both parents and teachers, a key issue in these discussions was determining whether something constituted either racism or racialisation. Strategies on how ethnic-racial socialisation within the school system can be improved are discussed.     

A qualitative inquiry into women’s experiences of severe maternal morbidity

Severe acute maternal morbidity (SMM) is a near-death experience during pregnancy, childbirth or termination of a pregnancy. Nine women recruited from hospital intensive care or high dependency units following the birth of their baby participated in two qualitative interviews about their SMM experience. The interpretative phenomenological analysis led to the identification of three superordinate themes related to participants: moving from a state of normal pregnancy to being severely unwell, being in critical care and returning to normal. Participants’ transition to a SMM event occurred quickly and was frightening, with participants expressing concerns about their husbands/partners’ trauma. Participants’ time in hospital was particularly hard for those separated from their baby, with this eased by staff kindness and family support. After discharge participants continued to seek explanations for their SMM. Implications include more formal support for mothering when women are in maternal critical care, and support for husbands/partners following a SMM event.     

Simulation based learning in midwifery education: a systematic review

AimTo critically examine the evidence for simulation based learning in midwifery education.BackgroundSimulated Learning Programs (SLPs) using low to high fidelity techniques are common in obstetric professionals’ education and focus on the development of team work, labour and obstetric emergencies.Review methodsA systematic review incorporating critical appraisal approaches, setting clear objectives and a defined search and analysis strategy. Evidence from obstetrics, neonatology, technical and non-technical skills (teamwork) was included where it informed the development of midwifery curricula. Studies in English from 2000 to 2010 were included searching CINAHL Plus, OVID Medline, Cochrane, SCOPUS and ProQuest and Google Scholar.ResultsTwenty-four papers were identified that met the inclusion criteria. All were quantitative reports; outcomes and levels of evidence varied with two notable papers indicating that simulation had an impact on clinical practice. Benefits of SLP over didactic formats were apparent, as were the development of non-technical skills confidence and competence. The study outcomes were limited by the range of evidence and context of the reports which focussed on obstetric emergency training using a number of simulation techniques.ConclusionThere is evidence that simulated learning of midwifery skills is beneficial. Simulation learning has an educational and clinical impact and advantages over didactic approaches. Where clinical practice is infrequent i.e. obstetric emergencies, simulation is an essential component of curricula. Simulation enhances practice and therefore may reduce the time taken to achieve competence; however there is no evidence from the literature that simulation should replace clinical practice.