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Background: Although widely acknowledged that adequate maternal nutrition is important for mother and baby, limited research has focussed on women with severe mental illnesses (SMI) in pregnancy. The present study reports on nutritional factors and food choices and investigates barriers and facilitators to healthy nutritional choices by pregnant women with SMI. Methods: A prospective mixed method study was undertaken of 38 pregnant women with SMI, including a cross‐sectional survey, a food frequency questionnaire and 12 postnatal qualitative interviews, with integrated analysis of all data. Results: Elevated rates of obesity (35%) were found, with 82% of women having above the recommended gestational weight gain. Despite perceived knowledge, 32% of women did not meet any of the Five Food Group serving recommendations for pregnancy and consumed above‐recommended levels for processed (19%) and sugar snacks (51%). Thematic analysis identified four main barriers: a discrepancy between knowledge and action, food cravings, mental health, and physical health. During pregnancy, food cravings were reported in 66% of women, psychological distress in 71% and physical distress in 37%. Screening identified 19% with potential eating disordered behaviours. Despite the challenges, several facilitators were identified and covered three themes: access to a dietitian, information delivery and support, and comprehensive care. Discussion: Women with SMI in pregnancy struggle with issues of obesity, gestational weight gain, food cravings and possible eating disorder behaviours. They have additional challenges when pregnant, with management of their mental health and physical health having a direct impact. Interventional strategies in this population should incorporate findings from this research. [ABSTRACT FROM AUTHOR]

The article discusses a study on the psychosocial characteristics and smoking behavior of young pregnant women during their first hospital appointment for pregnancy care in Western Australia. Topics mentioned include the rate of suicidal ideation, the prevalence of sexual abuse against young pregnant women, a comparison of the discontinuation rates for cigarettes, alcohol, and marijuana, and the reasons cited by women for smoking including boredom.

Aim. This paper is a report of a study to develop and evaluate a childbirth educational programme for Malawian women. Background. Providing parent education is integral to the midwife's role. Malawian midwives face a challenge in fulfilling this role, with no existing childbirth education programme to facilitate this process. Method. A mixed method approach was used for this three-phase study. In Phase 1, childbirth information needs of Malawian women were determined from literature and interviews with midwives. In Phase 2, a structured childbirth education programme was developed. In Phase 3, a quasi-experimental design using sequential sampling was conducted to evaluate the education programme. Participants were pregnant women who attended antenatal clinics in 2002, with 104 in the control group and 105 in the intervention group. Changes in childbirth knowledge were determined over a 6-week period. Findings. The childbirth education programme included information, teaching strategies and a schedule for implementation for content relevant to the antenatal, labour and birth and postnatal time periods. Results revealed no significant difference in knowledge in the control group between pretest and post-test scores. For the intervention group, however, an overall significant increase in knowledge across all time periods was demonstrated (P < 0.01). Conclusion. A childbirth education programme, developed for the Malawian context, was associated with important increases in maternal knowledge about antenatal, labour and birth and postnatal topics. The findings have implications for midwives in other developing countries and offer an example of a midwifery-led initiative to provide formal childbirth education to these vulnerable women. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to identify research priorities of clinical staff working with families at a Western Australian centre for parenting. Background. Australian centres for parenting focus on children's needs while working in partnership with parents, families and their communities. These agencies incorporate primary healthcare strategies in their unique approach with families. Clinicians' research priorities at these centres have not been explored in an Australian context. Method. In 2005, a Delphi study was conducted in which clinicians were asked to provide a list of five important issues relating to care provided to children, parents and their families. Research topics identified were then ranked for their importance to the family and clinicians. Finally, the top 10 research topics were ranked for priority. Findings. In round 1, 148 research topics were identified. Thirty-six topics were removed, due to the availability of existing evidence. Content analysis was used to collapse statements into 26 research questions, which were further classified into seven categories: parenting issues; sleep and settling issues; postnatal depression; evaluation and impact of programmes; staffing issues; centre marketing services and others. Issues relating to sleep and settling and postnatal depression were rated as top research priorities. Conclusion. The priorities of clinicians working with families provide research direction for this Western Australian centre and potentially other centres in Australia and similar settings elsewhere in the world. The Delphi approach in determining clinicians' perceptions of relevant research areas may be useful to direct research in other contexts. [ABSTRACT FROM AUTHOR]

BACKGROUND: The study documented Australian primigravidas' perceptions about breastfeeding. OBJECTIVES: To examine women's perspectives of their breastfeeding experiences during the first 12 weeks postpartum. DESIGN: A Journal was introduced to an intervention group (n=149) attending prenatal classes at a private hospital at 36 antenatal weeks. Using quantitative data at two days and 12 weeks postpartum, the intervention group was compared with a control group (n=154) that delivered at the same hospital. Qualitative data were also collected about the women's perceptions about breastfeeding to further illuminate their experience. Qualitative data from 203 women at two days postpartum and 252 women at 12 weeks postpartum represented the combined comments from the intervention and control groups. PARTICIPANTS: Participants were recruited as part of a randomised controlled trial of the effects of a Breastfeeding Journal on breastfeeding prevalence, self-efficacy, support, and influence from conflicting advice. The convenience sample of middle class, well-educated primiparous women from a Western Australian hospital had given birth to a singleton infant that was greater than 34 weeks gestation. METHODS: An open-ended question on a questionnaire sought mothers' comments about their breastfeeding experiences. Data were analysed using inductive content analysis. FINDINGS: These mothers described trying to 'get breastfeeding right'. Getting it right included enhancing factors, factors with mixed effect, and negative factors. CONCLUSIONS: Middle class mothers share breastfeeding perceptions with women in more vulnerable groups, including encountering conflicting and unhelpful advice and feeding pressures from health care professionals, family, and community members. [ABSTRACT FROM AUTHOR]

Abstract: Background: The study documented Australian primigravidas’ perceptions about breastfeeding. Objectives: To examine women''s perspectives of their breastfeeding experiences during the first 12 weeks postpartum. Design: A Journal was introduced to an intervention group () attending prenatal classes at a private hospital at 36 antenatal weeks. Using quantitative data at two days and 12 weeks postpartum, the intervention group was compared with a control group () that delivered at the same hospital. Qualitative data were also collected about the women''s perceptions about breastfeeding to further illuminate their experience. Qualitative data from 203 women at two days postpartum and 252 women at 12 weeks postpartum represented the combined comments from the intervention and control groups. Participants: Participants were recruited as part of a randomised controlled trial of the effects of a Breastfeeding Journal on breastfeeding prevalence, self-efficacy, support, and influence from conflicting advice. The convenience sample of middle class, well-educated primiparous women from a Western Australian hospital had given birth to a singleton infant that was greater than 34 weeks gestation. Methods: An open-ended question on a questionnaire sought mothers’ comments about their breastfeeding experiences. Data were analysed using inductive content analysis. Findings: These mothers described trying to ‘get breastfeeding right’. Getting it right included enhancing factors, factors with mixed effect, and negative factors. Conclusions: Middle class mothers share breastfeeding perceptions with women in more vulnerable groups, including encountering conflicting and unhelpful advice and feeding pressures from health care professionals, family, and community members. [Copyright &y& Elsevier]

In this study, Malawian midwives' perceptions of occupational risk of human immunodefiency virus (HIV) infection are described. Knowledge of perceptions of HIV risk in developing countries and consequences on patient care is limited. A qualitative approach using purposive sampling was undertaken with 7 midwives. Participants considered their occupational risk to be high, encompassing these four themes: exposure to body fluids, availability of resources, hand washing practices, and support from management. Additional themes related to the impact of high risk on clinical practice: working in a climate of fear, refraining from touch, loss of interest in midwifery, and improvising care practices. [ABSTRACT FROM AUTHOR]

AIM: This paper reports an assessment of the effects of a breastfeeding journal on breastfeeding prevalence and perceptions of conflicting advice, self-management and self-efficacy. BACKGROUND: Breastfeeding prevalence rates in most developed countries are not meeting recommendations. Women's concerns about inconsistent advice, limited involvement in decision-making, accessibility of information and inappropriate follow-up have been recognized. Research on evaluation of interventions addressing these concerns and including antenatal and early postnatal periods is required. Method. An intervention study was conducted from July 2003 to April 2004, with control and intervention groups recruited sequentially. The intervention group received a breastfeeding journal at 36 weeks antenatally in breastfeeding classes that were attended at different times by intervention and control group members. The intervention and control groups were compared during postpartum hospitalization and 12 weeks for breastfeeding prevalence and perceptions of self-efficacy, conflicting advice and self-management. FINDINGS: No statistically significant differences were noted between the intervention and control groups in breastfeeding prevalence at 12 weeks or self-efficacy during hospitalization. There was a statistically significant difference between groups in conflicting advice at both times. Although conflicting advice continues to present a dilemma for women, levels of conflicting advice did not explain breastfeeding self-efficacy. Breastfeeding self-management was a statistically significant contributor to breastfeeding prevalence prior to the addition of breastfeeding self-efficacy. CONCLUSIONS: Women's perceptions of their ability to manage and be actively involved in decision-making explained breastfeeding prevalence at 12-week postpartum. Efforts to encourage women's involvement in decision-making about breastfeeding are a useful strategy to promote breastfeeding. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of the survey was the routine assessment of the MTBDRplus ® kit performance in the determination and characterization of Mycobacterium tuberculosis resistance to rifampicin. The survey was carried out on a collection of 144 strains (126 of which were resistant to rifampicin) isolated on patients from 15 countries. Sensitivity to antituberculosis drugs was determined by a liquid culture system and the reference method was the amplification and sequencing of a target region of the rpoB gene whose mutations are responsible for rifampicin resistance (codons 507 to 533). The assessed kit was based on a reverse hybridization technique using eight overlapping probes covering the target region and four probes representing the most-frequently observed mutations. The assay performance was found excellent, specificity: 100%, sensitivity: 99.2%; 17 mutations affecting 10 codons were reported, two of which were newly identified. [Copyright &y& Elsevier]

Aim. To investigate pre- and postpartum levels of childbirth fear in a cohort of childbearing women and explore the relationship to birth outcomes. Background. While results are mixed, there is evidence that fear of childbirth is associated with mode of birth. Limited theoretical work around childbirth fear has been undertaken with Australian women. Design. A prospective correlation design. Method. Women ( n = 401) completed the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A at 36 weeks gestation, with 243 (61%) women also completing version B at six weeks postpartum. Scores were summarised with means and standard deviations. Content analysis of the free statements identified nine issues of concern. Results. Twenty-six per cent of pregnant women reported low levels of childbirth fear, 48% were moderately fearful and 26% were highly fearful. Fear decreased after birth for those women in the high antenatal fear group, however surgical intervention at birth ( n = 238,anova, F1,230 = 12·39, p = 0·001) and suspected fetal compromise ( F1,230 = 4·33, p = 0·039) increased levels of postpartum fear. Univariately, high antenatal fear was associated with emergency caesarean delivery ( n = 324, Wald 5·05, p = 0·025) however after adjustment for nulliparity and fetal compromise the association disappeared. Australian-born women were more likely to report higher levels of fear and experience higher rates of caesarean section than participants of non-Australian origin. Conclusions. Results support those from earlier studies in showing that nulliparous women experience more fear than parous women before birth and that there is no difference in levels of postpartum fear between these two groups. Fear levels were higher in Australian women when compared to a Swedish sample. Relevance to clinical practice. The results of this study add to our preliminary understanding of the phenomena of childbirth fear within an Australian context and are particularly useful in profiling women for whom secondary fear of childbirth is more likely to occur. [ABSTRACT FROM AUTHOR]