A review of pregnancy information on nutrition,physical activity and sleep websites

ProblemMost pregnant women report using the internet to source health information during pregnancy. However, little is known about the information presented on the internet and whether it is consistent with current evidence-based guidelines.BackgroundPregnancy is considered a risk period for women as it is associated with poorer health behaviours including an inadequate diet, decreased physical activity and reduced sleep. As a result, pregnant women and their unborn child are at a greater risk of adverse health outcomes.AimThe purpose of this study was to review pregnancy related information about nutrition, physical activity and sleep provided on Australian government and leading industry body websites, and to compare this information to current evidence-based guidelines.MethodsA systematic online search was conducted to identify Australian Government, and leading industry websites that provided information on nutrition, physical activity, or sleep during pregnancy. The content of each website was reviewed and compared against current nutrition, physical activity and sleep guidelines.Findings27 government and leading industry websites were included in this study. 18 websites included nutritional information, none of which aligned 100% with guidelines. Nine websites included physical activity information, only one of which was 100% in accordance with guidelines. Two websites included information on sleep during pregnancy, however neither were in accordance with guidelines.ConclusionWomen are accessing information via the internet that is not in accordance with current evidence-based guidelines. These results call to attention the need for government and leading industry websites to review and update their website information in accordance with current evidence-based guidelines.     

Middle School Children's Perceptions on Welfare and Poverty: An Exploratory, Qualitative Study

This study was undertaken to determine how middle school children assess the effects of welfare reform on their daily lives. The study consisted of thirty interviews with children and their mothers recruited from a middle school in a large, metropolitan area. From the children's perspective, multiple jobs and evening/night hours interfered with the child-parent relationship. Other consequences included grades going down and not getting to school on time. All the children stated that mothers should work, but most children felt mothers should only work when their children are in school. Welfare and poverty were issues about which children were teased at school.     

Gender,lineage, and fertility‐related outcomes in Ghana

A growing literature examines the empirical relationship between the joint reproductive preferences of marital partners and reproductive outcomes in Africa. Less explored is how spousal power in decision making may be influenced by lineage type. Using pooled data from Ghana, we investigate how lineage affects gendered reproductive decision outcomes and find some evidence that matrilineal women are more able than nonmatrilineal women to translate their reproductive preferences into action consistent with their goals.     

Direct and Indirect Causal Effects via Potential Outcomes*

Abstract. The use of the concept of ‘direct’ versus ‘indirect’ causal effects is common, not only in statistics but also in many areas of social and economic sciences. The related terms of ‘biomarkers’ and ‘surrogates’ are common in pharmacological and biomedical sciences. Sometimes this concept is represented by graphical displays of various kinds. The view here is that there is a great deal of imprecise discussion surrounding this topic and, moreover, that the most straightforward way to clarify the situation is by using potential outcomes to define causal effects. In particular, I suggest that the use of principal stratification is key to understanding the meaning of direct and indirect causal effects. A current study of anthrax vaccine will be used to illustrate ideas.     

How do I get my way? A meta-analytic review of research on influence tactics

Despite considerable research investigating the role of influence tactics on work-related outcomes in organizations, consensus on the effectiveness of influence tactics has been elusive. Specifically, there is a lack of integration concerning the relationships between proactive influence tactics and their outcomes. We investigate the effectiveness of 11 influence tactics from a comprehensive perspective using meta-analytic techniques. In particular, the current study focuses on relationships between each of the 11 influence tactics (i.e., rational persuasion, exchange, inspirational appeal, legitimating, apprising, pressure, collaboration, ingratiation, consultation, personal appeals, and coalition) and task- and relations-oriented outcomes. In addition, we investigate the moderating effects of the direction of influence tactics, measurement of influence tactics, singular influence tactic (versus use of a combination of influence tactics), independence of data sources, and study setting involved in the study. Regardless of task- and relations-oriented outcomes, based on 49 independent samples (N = 8987), our results show positive relationships between outcomes and rational persuasion, inspirational appeal, apprising, collaboration, ingratiation, consultation, and a negative relationship between pressure and outcomes. Rational persuasion is the only tactic which held stable positive relationships with both categories of outcomes regardless of moderating factors. Implications and directions for future research in the area of influence tactics are discussed.     

A Tiered Framework for Risk‐Relevant Characterization and Ranking of Chemical Exposures: Applications to the National Children's Study (NCS)

A challenge for large‐scale environmental health investigations such as the National Children's Study (NCS), is characterizing exposures to multiple, co‐occurring chemical agents with varying spatiotemporal concentrations and consequences modulated by biochemical, physiological, behavioral, socioeconomic, and environmental factors. Such investigations can benefit from systematic retrieval, analysis, and integration of diverse extant information on both contaminant patterns and exposure‐relevant factors. This requires development, evaluation, and deployment of informatics methods that support flexible access and analysis of multiattribute data across multiple spatiotemporal scales. A new “Tiered Exposure Ranking” (TiER) framework, developed to support various aspects of risk‐relevant exposure characterization, is described here, with examples demonstrating its application to the NCS. TiER utilizes advances in informatics computational methods, extant database content and availability, and integrative environmental/exposure/biological modeling to support both “discovery‐driven” and “hypothesis‐driven” analyses. “Tier 1” applications focus on “exposomic” pattern recognition for extracting information from multidimensional data sets, whereas second and higher tier applications utilize mechanistic models to develop risk‐relevant exposure metrics for populations and individuals. In this article, “tier 1” applications of TiER explore identification of potentially causative associations among risk factors, for prioritizing further studies, by considering publicly available demographic/socioeconomic, behavioral, and environmental data in relation to two health endpoints (preterm birth and low birth weight). A “tier 2” application develops estimates of pollutant mixture inhalation exposure indices for NCS counties, formulated to support risk characterization for these endpoints. Applications of TiER demonstrate the feasibility of developing risk‐relevant exposure characterizations for pollutants using extant environmental and demographic/socioeconomic data.     

Smoking during pregnancy,stigma and secrets: Visual methods exploration in the UK

BackgroundMoral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this moral gaze.AimTo gain an in-depth understanding of the health issues affecting 10 low income pregnant women from deprived areas of south Wales, UK.MethodsParticipants completed visual activities (timelines, collaging or thought bubbles and dyad sandboxing) prior to each interview. Participants’ visual representations were used in place of a topic guide, to direct the interview. Guided by feminist principles, 28 interviews were completed with 10 women. Data were analysed thematically.FindingsSmoking was discussed at length during interviews, and this paper focuses on this issue alone. Five of the participants had smoked during pregnancy. Negative reactions were directed towards pregnant women who smoked in public, resulting in maternal smoking being undertaken in private. Participants also reported awkward relationships with midwives and other health professionals, including receipt of public health advice in a judgemental tone.DiscussionSmoking during pregnancy is a particularly demonised and stigmatised activity. This stigma is not always related to the level of risk to the foetus, and instead can be seen as a moral judgement about women. We urgently need to move from individualised neo-liberal discourses about the failure of individual smokers, to a more socio-ecological view which avoids victim blaming.ConclusionStigma from friends, family, strangers and health professionals may lead to hidden smoking. This is a barrier to women obtaining evidence based stop smoking support.     

Using a participatory evaluation design to create an online data collection and monitoring system for New Mexico's Community Health Councils

We present the collaborative development of a web-based data collection and monitoring plan for thirty-two county councils within New Mexico's health council system. The monitoring plan, a key component in our multiyear participatory statewide evaluation process, was co-developed with the end users: representatives of the health councils. Guided by the Institute of Medicine's Community, Health Improvement Process framework, we first developed a logic model that delineated processes and intermediate systems-level outcomes in council development, planning, and community action. Through the online system, health councils reported data on intermediate outcomes, including policy changes and funds leveraged. The system captured data that were common across the health council system, yet was also flexible so that councils could report their unique accomplishments at the county level. A main benefit of the online system was that it provided the ability to assess intermediate, outcomes across the health council system. Developing the system was not without challenges, including creating processes to ensure participation across a large rural state; creating shared understanding of intermediate outcomes and indicators; and overcoming technological issues. Even through the challenges, however, the benefits of committing to using participatory processes far outweighed the challenges.     

Need,well‐being and outcomes: the development of policy‐thinking for children's services 1989–2004

This paper describes how government policy thinking about the well‐being of children and young people developed between the Children Act 1989 and the Children Act 2004. These two Acts are milestone statements about how services to children in England and Wales should be delivered. It is an account informed by the author's own experience as a government adviser on children's social care over much of this period and supporting documentation. It traces the strands of government policy thinking about how to deliver services for children from children in need to the articulation of the five Every Child Matters outcomes. It argues that attempts to achieve coordinated service planning for children and young people played a significant role in the formulation of shared objectives and the articulation of child outcomes. However, it argues that looking at real outcomes exposes how children in the UK do relatively badly compared with other rich nations. It questions whether we can realistically expect our services to deliver significantly improved outcomes given the impact of enduring inequality in our society. This paper is dedicated to the memory of David Lambert CBE, former Assistant Chief Inspector of the Social Services Inspectorate in London, who died suddenly on 7 October 2010. He lent me articles to assist me in writing this paper.