224 results on '"Rumbold, Alice R."'
Search Results
2. Women’s experiences with using domperidone as a galactagogue to increase breast milk supply: an australian cross-sectional survey
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McBride, Grace M., Stevenson, Robyn, Zizzo, Gabbie, Rumbold, Alice R., Amir, Lisa H., Keir, Amy, and Grzeskowiak, Luke E.
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- 2023
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3. The acute psychological effects of screen time and the restorative potential of nature immersion amongst adolescents: A randomised pre-post pilot study
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Oswald, Tassia K., Kohler, Mark, Rumbold, Alice R., Kedzior, Sophie G.E., and Moore, Vivienne M.
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- 2023
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4. Family planning and multiple sclerosis: A qualitative study of patient experiences to understand information needs and promote informed decision-making
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Fragkoudi, Anna, Rumbold, Alice R., and Grzeskowiak, Luke E.
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- 2023
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5. Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies
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Abdollahain, Mali, Savitri, Ary I., Salvesen, Kjell Åsmund, Bhattacharya, Sohinee, Uiterwaal, Cuno S.P.M., Staff, Annetine C., Andersen, Louise Bjoerkholt, Olive, Elisa Llurba, Daskalakis, George, Macleod, Maureen, Thilaganathan, Baskaran, Ramírez, Javier Arenas, Massé, Jacques, Audibert, Francois, Magnus, Per Minor, Sletner, Line, Baschat, Ahmet, Ohkuchi, Akihide, McAuliffe, Fionnuala M., West, Jane, Askie, Lisa M., Mone, Fionnuala, Farrar, Diane, Zimmerman, Peter A., Smits, Luc J.M., Riddell, Catherine, Kingdom, John C., van de Post, Joris, Illanes, Sebastián E., Holzman, Claudia, van Kuijk, Sander M.J., Carbillon, Lionel, Villa, Pia M., Eskild, Anne, Chappell, Lucy, Prefumo, Federico, Velauthar, Luxmi, Seed, Paul, van Oostwaard, Miriam, Verlohren, Stefan, Poston, Lucilla, Ferrazzi, Enrico, Vinter, Christina A., Nagata, Chie, Brown, Mark, Vollebregt, Karlijn C., Takeda, Satoru, Langenveld, Josje, Widmer, Mariana, Saito, Shigeru, Haavaldsen, Camilla, Carroli, Guillermo, Olsen, Jørn, Wolf, Hans, Zavaleta, Nelly, Eisensee, Inge, Vergani, Patrizia, Lumbiganon, Pisake, Makrides, Maria, Facchinetti, Fabio, Sequeira, Evan, Gibson, Robert, Ferrazzani, Sergio, Frusca, Tiziana, Figueiró-Filho, Ernesto A., Lapaire, Olav, Laivuori, Hannele, Lykke, Jacob A., Conde-Agudelo, Agustin, Galindo, Alberto, Mbah, Alfred, Betran, Ana Pilar, Herraiz, Ignacio, Trogstad, Lill, Smith, Gordon G.S., Steegers, Eric A.P., Salim, Read, Huang, Tianhua, Adank, Annemarijne, Zhang, Jun, Meschino, Wendy S., Browne, Joyce L., Allen, Rebecca E., Da Silva Costa, Fabricio, Klipstein-Grobusch, Kerstin, Jørgensen, Jan Stener, Forest, Jean-Claude, Rumbold, Alice R., Mol, Ben W., Giguère, Yves, Ganzevoort, Wessel, Odibo, Anthony O., Myers, Jenny, Yeo, SeonAe, Teede, Helena J., Goffinet, Francois, McCowan, Lesley, Pajkrt, Eva, Haddad, Bassam G., Dekker, Gustaaf, Kleinrouweler, Emily C., LeCarpentier, Édouard, Roberts, Claire T., Groen, Henk, Skråstad, Ragnhild Bergene, Heinonen, Seppo, Eero, Kajantie, Kenny, Louise C., Anggraini, Dewi, Souka, Athena, Cecatti, Jose, Monterio, Ilza, Coomarasamy, Arri, Smuk, Melanie, Pillalis, Athanasios, Crovetto, Francesca, Souza, Renato, Ann Hawkins, Lee, Gabbay- Benziv, Rinat, Riley, Richard, Snell, Kym, Archer, Lucinda, Figuera, Francesc, van Gelder, Marleen, Sheikh, Jameela, Allotey, John, Kew, Tania, Fernández-Félix, Borja M, Zamora, Javier, Khalil, Asma, and Thangaratinam, Shakila
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- 2022
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6. Effect of Neonatal Unit Interventions Designed to Increase Breastfeeding in Preterm Infants: An Overview of Systematic Reviews.
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Hilditch, Cathie, Rumbold, Alice R., Keir, Amy, Middleton, Philippa, and Gomersall, Judith
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PREMATURE infants , *SEVERANCE pay , *BREAST milk , *BREASTFEEDING , *GESTATIONAL age - Abstract
Introduction: This overview aims to systematically review evidence regarding effects of interventions undertaken in neonatal units to increase breastfeeding in preterm infants. Methods: We followed Cochrane methodology. Systematic reviews published to October 31, 2022, reporting meta-analysis of effects from original studies on breastfeeding rates in preterm infants of neonatal unit interventions designed to increase breastfeeding were included. Results: Avoidance of bottles during breastfeed establishment (comparator breastfeeds with bottle-feeds) demonstrated clear evidence of benefit for any breastfeeding at discharge and exclusive breastfeeding 3 months post-discharge, and possible evidence of benefit for exclusive breastfeeding at discharge, and any breastfeeding post-discharge. Kangaroo mother care (KMC) (comparator usual care) demonstrated clear evidence of benefit for any and exclusive breastfeeding at discharge and possible benefit for any breastfeeding post-discharge. Quality improvement (QI) bundle(s) to enable breastfeeds (comparator conventional care) showed possible evidence of benefit for any breastfeeding at discharge. Cup feeding (comparator other supplemental enteral feeding forms) demonstrated possible evidence of benefit for exclusive breastfeeding at discharge and any breastfeeding 3 months after. Early onset KMC (commenced <24 h post-birth), oral stimulation, and oropharyngeal colostrum administration, showed no evidence of benefit. No meta-analyses reported pooled effects for gestational age or birthweight subgroups. Conclusion: There is ample evidence to support investment in KMC, avoidance of bottles during breastfeed establishment, cup feeding, and QI bundles targeted at better supporting breastfeeding in neonatal units to increase prevalence of breastfeeding in preterm infants and promote equal access to breastmilk. Stratifying effects by relevant subgroups is a research priority. [ABSTRACT FROM AUTHOR]
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- 2024
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7. “Fear of stopping” vs “wanting to get off the medication”: exploring women’s experiences of using domperidone as a galactagogue - a qualitative study
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Zizzo, Gabriella, Rumbold, Alice R., and Grzeskowiak, Luke E.
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- 2021
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8. The impact of interpersonal racism on oral health related quality of life among Indigenous South Australians: a cross-sectional study
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Ali, Anna, Rumbold, Alice R., Kapellas, Kostas, Lassi, Zohra S., Hedges, Joanne, and Jamieson, Lisa
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- 2021
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9. It takes a community to conceive: an analysis of the scope, nature and accuracy of online sources of health information for couples trying to conceive
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Kedzior, Sophie G.E., Bianco-Miotto, Tina, Breen, James, Diener, Kerrilyn R., Donnelley, Martin, Dunning, Kylie R., Penno, Megan A.S., Schjenken, John E., Sharkey, David J., Hodyl, Nicolette A., Fullston, Tod, Gardiner, Maria, Brown, Hannah M., and Rumbold, Alice R.
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- 2019
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10. Strategies to improve control of sexually transmissible infections in remote Australian Aboriginal communities: a stepped-wedge, cluster-randomised trial
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Ward, James, Guy, Rebecca J, Rumbold, Alice R, McGregor, Skye, Wand, Handan, McManus, Hamish, Dyda, Amalie, Garton, Linda, Hengel, Belinda, Silver, Bronwyn J, Taylor-Thomson, Debbie, Knox, Janet, Donovan, Basil, Law, Matthew, Maher, Lisa, Fairley, Christopher K, Skov, Steven, Ryder, Nathan, Moore, Elizabeth, Mein, Jacqueline, Reeve, Carole, Ah Chee, Donna, Boffa, John, and Kaldor, John M
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- 2019
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11. A Systematic Review of School-based Programs to Improve Adolescent Sexual and Reproductive Health: Considering the Role of Social Connectedness
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Kedzior, Sophie G. E., Lassi, Zohra S., Oswald, Tassia K., Moore, Vivienne M., Marino, Jennifer L., and Rumbold, Alice R.
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- 2020
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12. ‘It’s complicated’: young people’s views on the complexity of asking for consent and the role for sex and relationships education.
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Kedzior, Sophie GE, Rumbold, Alice R, Manning, Nathan, Calabretto, Helen, Lassi, Zohra S, and Moore, Vivienne M
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There is emerging evidence that young people have a good understanding of consent as a concept, but this does not align with real world practices. The perspectives of young people on the complexities of enacting consent are lacking, as are their views on the role of sex and relationships education. This study explored the topic of consent with 18 young people aged 14–20 years through interviews conducted in South Australia. Interviews were recorded, transcribed, and coded, with four over-arching themes progressively developed through reflexive thematic analysis. Participants had a sound understanding of consent in the abstract and emphasised the importance of explicit verbal communication; however, consent was unlikely to reflect this in practice. In real-life, consent was embedded in social contexts replete with non-verbal cues, in which gendered sexual scripts dominated sexual interaction. Participants made recommendations for making formal sex and relationships education more relevant and useful. [ABSTRACT FROM AUTHOR]
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- 2024
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13. 'Like fumbling around in the dark': Young people's perceptions and realities of healthy relationships.
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Kedzior, Sophie G. E., Moore, Vivienne M., Manning, Nathan, Oswald, Tassia K., Calabretto, Helen, Lassi, Zohra S., and Rumbold, Alice R.
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YOUNG adults ,YOUTH development ,SOCIAL norms ,SEX education ,RELATIONSHIP quality - Abstract
Learning to negotiate relationships is a key feature of adolescence, yet insight into young people's perspectives on what constitutes healthy relationships is lacking. In this study, therefore, insights were sought on healthy relationship qualities, common issues encountered, and relevant educational experiences. Semi-structured interviews were undertaken with 18 young people (11 self-identified as female, 5 male, and 2 trans/gender-diverse) aged 14–20 years, residing in Adelaide, South Australia. Relationships with parents, siblings, peers and intimate partners were topics for discussion. Reflexive thematic analysis was utilised to generate codes and themes. The Five Cs of Positive Youth Development were used to aid understanding of findings. Young people's accounts suggested a disjuncture between desired relationship qualities, realities and education on relationships and sexual health. Young people articulated tensions navigating peer norms and societal expectations in relation to dating and sex, including unrealistic representations, gender stereotyping and strong 'sexpectations'. Participants in this study relied more heavily on personal experience and observation than formal education to develop an understanding of healthy relationships. Achieving healthy relationships was generally perceived to be complex and requiring skills or understanding informants were unsure about. Positive Youth Development could provide a framework for meeting the needs expressed by young people, notably by building communication skills, confidence and agency. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Runs of homozygosity and a cluster of vulvar cancer in young Australian Aboriginal women
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McWhirter, Rebekah E., Thomson, Russell J., Marthick, James R., Rumbold, Alice R., Brown, Matthew A., Taylor-Thomson, Debbie, Maypilama, Elaine L., Condon, John R., and Dickinson, Joanne L.
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- 2014
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15. Trichomonas vaginalis as a Cause of Perinatal Morbidity : A Systematic Review and Meta-Analysis
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Silver, Bronwyn J., Guy, Rebecca J., Kaldor, John M., Jamil, Muhammad S., and Rumbold, Alice R.
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- 2014
16. Investigating a cluster of vulvar cancers in young women: distribution of human papillomavirus and HPV-16 variants invulvar dysplastic or neoplastic biopsies
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Tan, Sarah E., Garland, Suzanne M., Rumbold, Alice R., Zardawi, Ibrahim, Taylor-Thomson, Debbie, Condon, John R., and Tabrizi, Sepehr N.
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- 2013
17. Investigating a cluster of vulvar cancers in young women: Distribution of human papillomavirus and HPV-16 variants in vulvar dysplastic or neoplastic biopsies
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Tan, Sarah E, Garland, Suzanne M, Rumbold, Alice R, Zardawi, Ibrahim, Taylor-Thomson, Debbie, Condon, John R, and Tabrizi, Sepehr N
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- 2013
18. The Australasian Epidemiological Association - Membership Profile and Their Views on the Association's Future Strategic Directions
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Freak-Poli, Rosanne, Rumbold, Alice R, Heyworth, Jane S, and Halliday, Jane
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- 2011
19. A Cluster of Vulvar Cancer and Vulvar Intraepithelial Neoplasia in Young Australian Indigenous Women
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Condon, John R., Rumbold, Alice R., Thorn, Jane C., O'Brien, Margaret M., Davy, Margaret J., and Zardawi, Ibrahim
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- 2009
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20. Fixed or Rotating Night Shift Work Undertaken by Women: Implications for Fertility and Miscarriage
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Fernandez, Renae C., Marino, Jennifer L., Varcoe, Tamara J., Davis, Scott, Moran, Lisa J., Rumbold, Alice R., Brown, Hannah M., Whitrow, Melissa J., Davies, Michael J., and Moore, Vivienne M.
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- 2016
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21. Knowledge of Galactagogue Use During Breastfeeding in Australia: A Cross Sectional Online Survey.
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McBride, Grace McKenzie, Stevenson, Robyn, Zizzo, Gabriella, Rumbold, Alice R, Amir, Lisa H, Keir, Amy K, and Grzeskowiak, Luke Edward
- Abstract
Background: Galactagogues have been used for centuries to induce, maintain, or increase a mother's milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information. Research Aim: To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources. Method: An online, prospective, cross-sectional survey of Australian birthing parents (N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors. Results: Among participants, 47% (n = 882) were primiparous and 65% (n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues. Conclusions: Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use. [ABSTRACT FROM AUTHOR]
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- 2022
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22. Challenges to Providing Fetal Anomaly Testing in a Cross-Cultural Environment: Experiences of Practitioners Caring for Aboriginal Women
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Rumbold, Alice R., Wild, Kayli J., Maypilama, Elaine Lawurrpa, Kildea, Sue V., Barclay, Lesley, Wallace, Euan M., and Boyle, Jacqueline A.
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- 2015
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23. Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: analysis of longitudinal clinical service data
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Silver, Bronwyn J, Guy, Rebecca J, Wand, Handan, Ward, James, Rumbold, Alice R, Fairley, Christopher K, Donovan, Basil, Maher, Lisa, Dyda, Amalie, Garton, Linda, Hengel, Belinda, Knox, Janet, McGregor, Skye, Taylor-Thomson, Debbie, Kaldor, John M, Chee, Donna Ah, Boffa, John, Glance, David, Law, Mathew, McDermott, Robyn, and Skov, Steven
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- 2015
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24. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis
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Allotey, John, Snell, Kym I. E., Smuk, Melanie, Hooper, Richard, Chan, Claire L., Ahmed, Asif, Chappell, Lucy C., von Dadelszen, Peter, Dodds, Julie, Green, Marcus, Kenny, Louise, Khalil, Asma, Khan, Khalid S., Mol, Ben W., Myers, Jenny, Poston, Lucilla, Thilaganathan, Basky, Staff, Anne C., Smith, Gordon C. S., Ganzevoort, Wessel, Laivuori, Hannele, Odibo, Anthony O., Ramirez, Javier A., Kingdom, John, Daskalakis, George, Farrar, Diane, Baschat, Ahmet A., Seed, Paul T., Prefumo, Federico, Costa, Fabricio da Silva, Groen, Henk, Audibert, Francois, Masse, Jacques, Skrastad, Ragnhild B., Salvesen, Kjell A., Haavaldsen, Camilla, Nagata, Chie, Rumbold, Alice R., Heinonen, Seppo, Askie, Lisa M., Smits, Luc J. M., Vinter, Christina A., Magnus, Per M., Eero, Kajantie, Villa, Pia M., Jenum, Anne K., Andersen, Louise B., Norman, Jane E., Ohkuchi, Akihide, Eskild, Anne, Epidemiologie, and RS: CAPHRI - R5 - Optimising Patient Care
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BODY-MASS INDEX ,UTERINE ARTERY DOPPLER ,FOR-GESTATIONAL-AGE ,LOW-DOSE ASPIRIN ,RANDOMIZED-CONTROLLED-TRIAL ,OXIDE SYNTHASE GENE ,ADVERSE PREGNANCY OUTCOMES ,MOLECULAR-WEIGHT HEPARIN ,PLACENTAL PROTEIN 13 ,FETAL-GROWTH RESTRICTION - Abstract
Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. Objective : To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. Design: This was an individual participant data meta-analysis of cohort studies. Setting: Source data from secondary and tertiary care. Predictors: We identified predictors from systematic reviews, and prioritised for importance in an international survey. Primary outcomes Early-onset (delivery at = 34 weeks' gestation) and any-onset pre-eclampsia. Analysis: We externally validated existing prediction models in UK cohorts and reported their performance in terms of discrimination and calibration. We developed and validated 12 new models based on clinical characteristics, clinical characteristics and biochemical markers, and clinical characteristics and ultrasound markers in the first and second trimesters. We summarised the data set-specific performance of each model using a random-effects meta-analysis. Discrimination was considered promising for C-statistics of >= 0.7, and calibration was considered good if the slope was near 1 and calibration-in-the-large was near 0. Heterogeneity was quantified using l(2) and tau(2). A decision curve analysis was undertaken to determine the clinical utility (net benefit) of the models. We reported the unadjusted prognostic value of individual predictors for pre-eclampsia as odds ratios with 95% confidence and prediction intervals. Result The International Prediction of Pregnancy Complications network comprised 78 studies (3,570,993 singleton pregnancies) identified from systematic reviews of tests to predict pre-eclampsia. Twenty-four of the 131 published prediction models could be validated in 11 UK cohorts. Summary C-statistics were between 0.6 and 0.7 for most models, and calibration was generally poor owing to large between-study heterogeneity, suggesting model overfitting. The clinical utility of the models varied between showing net harm to showing minimal or no net benefit. The average discrimination for IPPIC models ranged between 0.68 and 0.83. This was highest for the second-trimester clinical characteristics and biochemical markers model to predict early-onset pre-eclampsia, and lowest for the first-trimester clinical characteristics models to predict any pre-eclampsia. Calibration performance was heterogeneous across studies. Net benefit was observed for International Prediction of Pregnancy Complications first and second-trimester clinical characteristics and clinical characteristics and biochemical markers models predicting any pre-eclampsia, when validated in singleton nulliparous women managed in the UK NHS. History of hypertension, parity, smoking, mode of conception, placental growth factor and uterine artery pulsatility index had the strongest unadjusted associations with pre-eclampsia. Limitations: Variations in study population characteristics, type of predictors reported, too few events in some validation cohorts and the type of measurements contributed to heterogeneity in performance of the International Prediction of Pregnancy Complications models. Some published models were not validated because model predictors were unavailable in the individual participant data. Conclusion: For models that could be validated, predictive performance was generally poor across data sets. Although the International Prediction of Pregnancy Complications models show good predictive performance on average, and in the singleton nulliparous population, heterogeneity in calibration performance is likely across settings. Future work: Recalibration of model parameters within populations may improve calibration performance. Additional strong predictors need to be identified to improve model performance and consistency. Validation, including examination of calibration heterogeneity, is required for the models we could not validate.
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- 2020
25. External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis
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Snell, Kym IE, Allotey, John, Smuk, Melanie, Hooper, Richard, Chan, Claire, Ahmed, Asif, Chappell, Lucy C, Von Dadelszen, Peter, Green, Marcus, Kenny, Louise, Khalil, Asma, Khan, Khalid S, Mol, Ben W, Myers, Jenny, Poston, Lucilla, Thilaganathan, Basky, Staff, Anne C, Smith, Gordon CS, Ganzevoort, Wessel, Laivuori, Hannele, Odibo, Anthony O, Arenas Ramírez, Javier, Kingdom, John, Daskalakis, George, Farrar, Diane, Baschat, Ahmet A, Seed, Paul T, Prefumo, Federico, da Silva Costa, Fabricio, Groen, Henk, Audibert, Francois, Masse, Jacques, Skråstad, Ragnhild B, Salvesen, Kjell Å, Haavaldsen, Camilla, Nagata, Chie, Rumbold, Alice R, Heinonen, Seppo, Askie, Lisa M, Smits, Luc JM, Vinter, Christina A, Magnus, Per, Eero, Kajantie, Villa, Pia M, Jenum, Anne K, Andersen, Louise B, Norman, Jane E, Ohkuchi, Akihide, Eskild, Anne, Bhattacharya, Sohinee, McAuliffe, Fionnuala M, Galindo, Alberto, Herraiz, Ignacio, Carbillon, Lionel, Klipstein-Grobusch, Kerstin, Yeo, Seon Ae, Browne, Joyce L, Moons, Karel GM, Riley, Richard D, Thangaratinam, Shakila, and IPPIC Collaborative Network
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BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. METHODS: IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. RESULTS: Of 131 published models, 67 provided the full model equation and 24 could be validated in 11 UK cohorts. Most of the models showed modest discrimination with summary C-statistics between 0.6 and 0.7. The calibration of the predicted compared to observed risk was generally poor for most models with observed calibration slopes less than 1, indicating that predictions were generally too extreme, although confidence intervals were wide. There was large between-study heterogeneity in each model's calibration-in-the-large, suggesting poor calibration of the predicted overall risk across populations. In a subset of models, the net benefit of using the models to inform clinical decisions appeared small and limited to probability thresholds between 5 and 7%. CONCLUSIONS: The evaluated models had modest predictive performance, with key limitations such as poor calibration (likely due to overfitting in the original development datasets), substantial heterogeneity, and small net benefit across settings. The evidence to support the use of these prediction models for pre-eclampsia in clinical decision-making is limited. Any models that we could not validate should be examined in terms of their predictive performance, net benefit, and heterogeneity across multiple UK settings before consideration for use in practice. TRIAL REGISTRATION: PROSPERO ID: CRD42015029349 .
- Published
- 2020
26. Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia
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Cunningham, Joan, Rumbold, Alice R, Zhang, Xiaohua, and Condon, John R
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- 2008
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27. A Review of the Impact of Antenatal Care for Australian Indigenous Women and Attempts to Strengthen these Services
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Rumbold, Alice R. and Cunningham, Joan
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- 2008
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28. Exploring the characteristics of the research workforce in Aboriginal and Torres Strait Islander health
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Rumbold, Alice R., Cunningham, Joan, Bailie, Ross S., and Hiller, Janet E.
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Medical research -- Analysis ,Medicine, Experimental -- Analysis ,Australian aborigines -- Health aspects ,Health - Abstract
Objective: This study was conducted to better understand the characteristics of current and past researchers in Indigenous health in Australia and the factors that may influence decisions about working in this field. Methods: A self-administered survey by e-mail or post to all individuals listed as an author on a published paper or who completed a PhD or masters research degree in the field of Indigenous health between 1995 and 2004. Results: We identified 472 papers and 151 theses; from these, 1,067 authors were identified. Completed questionnaires were returned by 373 authors (35%), of whom 32 (9%) identified as Aboriginal and/or Torres Strait Islander. The majority (80%) of respondents were active in research but only 38% considered Indigenous health to be their primary area of research. The most important attractive factor about Indigenous health research (IHR) selected by respondents was 'important area/national priority' (35%) and the most unattractive factor was 'politics' (30%). There was considerable ambivalence about recommending a career in IHR to an early career researcher. When asked what was required to attract researchers into IHR, respondents cited the need for improved institutional support, mentoring, long-term funding and sustainable career pathways. Conclusions and Implications: This study contributes to a greater understanding of Australia's research workforce in Indigenous health. It provides evidence of a strongly perceived need for institutional reform that supports Indigenous health research, for sustainable approaches to funding, and for mentoring initiatives for early career researchers. Key words: Research personnel; Australia; Aborigines, Australia; mentors. doi:10.1111/j.1753-6405.2008.00159.x
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- 2008
29. Vitamins C and E and the risks of preeclampsia and perinatal complications
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Rumbold, Alice R., Crowther, Caroline A., Haslam, Ross R., Dekker, Gustaff A., and Robinson, Jeffrey S.
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Preeclampsia -- Prevention ,Vitamin C -- Health aspects ,Vitamin E -- Health aspects ,Pregnancy, Complications of -- Control - Abstract
A study was conducted to determine whether supplementation with antioxidant vitamins reduces the risk of preeclampsia and perinatal complications. It was found that supplementation with vitamins C and E during pregnancy does not reduce the risk of preeclampsia in nulliparous women, the risk of intrauterine growth restriction or the risk of death or other serious outcomes in their infants.
- Published
- 2006
30. Association between self-reported periodontitis and high-risk oral human papillomavirus infection among Indigenous South Australians: A cross-sectional study.
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Ali, Anna, Rumbold, Alice R., Kapellas, Kostas, Lassi, Zohra S., Hedges, Joanne, and Jamieson, Lisa
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PAPILLOMAVIRUSES , *INDIGENOUS Australians , *PAPILLOMAVIRUS diseases , *PERIODONTITIS , *CONVENIENCE sampling (Statistics) , *LOGISTIC regression analysis , *CROSS-sectional method - Abstract
Introduction: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally, reflecting an increase in human papillomavirus (HPV)-related lesions. Indigenous populations are disproportionately affected by OPSCCs. Currently, testing for oral HPV is not recommended as a screening tool to permit early detection of OPSCCs due to the high population prevalence of HPV infection. Periodontitis may be a marker of oral HPV infection, but previous research evaluating this association has been inconclusive. Here we report a large population-based study examining the association between high-risk oral HPV infection and periodontitis among Indigenous South Australians. Methods: We utilised a large convenience sample of Indigenous South Australians aged 18+ years recruited between February 2018 and February 2020. Of the original cohort (n = 1011), 748 (73.9%) participants participated in the 12 month follow-up. Detailed information on sociodemographic characteristics, health-related behaviours, and sexual history were collected at enrolment. Saliva samples were collected at 12 months and tested for the presence of oral HPV DNA using the optimized general primer (GP) + PCR system. The primary outcomes were the prevalence of any high-risk oral HPV DNA, and separately, HPV 16 and/or 18. Periodontitis was assessed at follow-up by using validated self-reported periodontitis screening questions. Logistic regression analyses were undertaken to assess the association between self-reported periodontitis and oral HPV infection with adjustment for potential sociodemographic and behavioural confounders, with estimates presented as odds ratios (OR) and 95% confidence interval (CI). Results: Data on 673 participants (89.9% of the follow-up cohort) were available. Participants ranged in age from 18 to 80 (mean age 42.2, SD 14.7) and 31.5% were male. Overall, 115 (17.1%) participants had self-reported periodontitis, 40 (5.9%) had any high-risk oral HPV and 14 (2.1%) had HPV 16 and/or 18. Any high-risk HPV was detected among seven (17.5%) participants and HPV 16 and/or 18 was detected in three (21.4%) who self-reported periodontitis. In the regression analyses no significant association was found between self-reported periodontitis and high-risk oral HPV (adjusted OR: 1.10; 95% CI: 0.45–2.70) or HPV 16 and/or 18 (adjusted OR: 1.27; 95% CI: 0.32–5.03). Conclusion: This study did not find any association between self-reported periodontitis and high-risk oral HPV among Indigenous South Australians. Further targeted studies with standardized clinical measures of periodontal disease are needed to clarify the link between high-risk oral HPV and periodontal disease. If confirmed this would add further weight to the importance of recommendations about the utility of periodontitis screening to identify individuals at risk of carrying high-risk oral HPV, who may benefit from more intensive screening and ongoing monitoring. [ABSTRACT FROM AUTHOR]
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- 2022
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31. Measuring what matters in delivering services to remote-dwelling Indigenous mothers and infants in the Northern Territory, Australia
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Steenkamp, Malinda, Rumbold, Alice R., Kildea, Sue, Bar-Zeev, Sarah J., Kruske, Sue, Dunbar, Terry, and Barclay, Lesley
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- 2012
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32. Estimating cancer incidence in Indigenous Australians
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Zhang, Xiaohua, Condon, John R., Rumbold, Alice R., Cunningham, Joan, and Roder, David M.
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- 2011
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33. Fertility treatments and the young women who use them: an Australian cohort study
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Marino, Jennifer L., Moore, Vivienne M., Rumbold, Alice R., and Davies, Michael J.
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- 2011
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34. THE AUTHORS REPLY
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Whitrow, Melissa J., Moore, Vivienne M., Rumbold, Alice R., and Davies, Michael J.
- Published
- 2010
35. Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study
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Whitrow, Melissa J., Moore, Vivienne M., Rumbold, Alice R., and Davies, Michael J.
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- 2009
36. Dietary intake of vitamin C and vitamin E and the development of hypertensive disorders of pregnancy
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Rumbold, Alice R., Maats, Frederike H.E., and Crowther, Caroline A.
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- 2005
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37. systematic review and meta-analysis of the association between periodontitis and oral high-risk human papillomavirus infection.
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Ali, Anna, Lassi, Zohra S, Kapellas, Kostas, Jamieson, Lisa, and Rumbold, Alice R
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ONLINE information services ,MEDICAL information storage & retrieval systems ,MEDICAL databases ,INFORMATION storage & retrieval systems ,META-analysis ,CONFIDENCE intervals ,PERIODONTITIS ,SYSTEMATIC reviews ,OROPHARYNGEAL cancer ,HEALTH outcome assessment ,TREATMENT effectiveness ,PAPILLOMAVIRUS diseases ,DESCRIPTIVE statistics ,RESEARCH funding ,MEDLINE ,ODDS ratio ,SQUAMOUS cell carcinoma ,DISEASE risk factors - Abstract
Background The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCCs) is increasing globally. Common oral conditions such as periodontitis may contribute. We undertook a meta-analysis to quantify the association between periodontitis, oral HPV and OPSCCs. Methods Multiple electronic databases were searched until 12 February 2020. Studies conducted in males and/or females aged ≥ 18 years that examined periodontitis, periodontal procedures, oral HPV infection, and where possible, oral cancers, were eligible. Meta-analyses were conducted and the GRADE approach was used to examine the quality of evidence. Results Of 2709 studies identified, 13 met the eligibility criteria. Five studies could be included in the meta-analyses. There was no significant increase in the odds of high-risk oral HPV infection among individuals with confirmed periodontitis (odds ratio 4.71, 95% confidence interval 0.57–38.97). Individuals with periodontitis had a 3.65 times higher odds of having any type of oral HPV infection compared with those without periodontitis (95% confidence interval 1.67–8.01). The overall body of evidence was rated as low to very-low certainty. Conclusion Meta-analysis confirms there is a positive association between periodontitis and oral HPV infection, although the overall quality of this evidence is low. Evidence for an association between periodontitis and high-risk oral HPV infection is inconclusive. [ABSTRACT FROM AUTHOR]
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- 2021
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38. Aboriginal and Torres Strait Islander womenʼs health: Acting now for a healthy future
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BOYLE, Jacqueline, RUMBOLD, Alice R., CLARKE, Marilyn, HUGHES, Chris, and KANE, Simon
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- 2008
39. Vitamins C and E and the Prevention of Preeclampsia
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Crowther, Caroline A., Rumbold, Alice R., and Robinson, Jeffrey
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- 2006
40. Diagnosis delayed: health profile differences between women with undiagnosed polycystic ovary syndrome and those with a clinical diagnosis by age 35 years.
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Fernandez, Renae C, Moore, Vivienne M, Rumbold, Alice R, Whitrow, Melissa J, Avery, Jodie C, and Davies, Michael J
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POLYCYSTIC ovary syndrome ,DIAGNOSIS ,CAREER development ,SYMPTOMS ,MEDICAL assistance ,DELAYED diagnosis ,RESEARCH ,CROSS-sectional method ,RESEARCH methodology ,RETROSPECTIVE studies ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,RESEARCH funding ,DISEASE complications - Abstract
Study Question: Are reproductive, metabolic or psychological health profiles of women with clinically diagnosed polycystic ovary syndrome (PCOS) different from those with undiagnosed PCOS?Summary Answer: Obtaining a clinical diagnosis of PCOS is strongly linked to the experience of fertility problems, but not clinical depression or poor metabolic health, although these were highly prevalent in women with PCOS irrespective of when they were diagnosed.What Is Known Already: PCOS is an endocrine disorder that is relative common, but heterogeneous in presentation. This may impact on the pathways to diagnosis and timely treatment.Study Design, Size, Duration: A cross-sectional analysis of a community-based cohort of 974 women, established retrospectively when women were around 30 years of age.Participants/materials, Setting, Methods: In this cohort of women born in Adelaide, South Australia, half of women who met the Rotterdam criteria for PCOS were previously undiagnosed. We compared women with prior clinical diagnosis of PCOS, those diagnosed through participation in this research, and the remainder in the cohort. Sociodemographic characteristics, reproductive, metabolic and psychological health, including medical conditions and medications were considered. Logistic regression was undertaken to identify independent predictors of prior clinical diagnosis.Main Results and the Role Of Chance: There were 56 women with a prior clinical diagnosis of PCOS (5.7%) and a further 64 (6.6%) were undiagnosed until study entry. The great majority of women with a prior diagnosis of PCOS reported having had problems with periods (95%) and excess body hair (63%). Corresponding proportions for women undiagnosed until study participation were slightly lower (81% and 45%, respectively). Although the proportion of women attempting or achieving pregnancy was similar across all groups, those with a prior diagnosis of PCOS were four times more likely to have reported difficulties becoming pregnant than those undiagnosed (odds ratio = 4.05, 95% CI 1.74-9.45) and frequently sought medical assistance. Metabolic problems were higher in both PCOS groups compared to women without PCOS. In both PCOS groups, the prevalence of clinical depression was 50% higher than in those with no PCOS (P = 0.021).Limitations, Reasons For Caution: The number of women who were diagnosed with PCOS both prior to and during the study limited statistical power available to detect modest differences between the PCOS groups. Some women in the group classified as not having PCOS may have remained undiagnosed, but any bias from this source would contribute to more conservative findings.Wider Implications Of the Findings: Findings reinforce the need for early detection of PCOS symptoms from adolescence, ensuring timely diagnosis and appropriate health care. The high prevalence of depression among clinically diagnosed and undiagnosed women with PCOS suggests this is a feature of the condition and supports recent recommendations in the international PCOS guidelines to screen all women with PCOS for depression and anxiety.Study Funding/competing Interest(s): This work was supported by a project grant (2017) from the National Health and Medical Research Council of Australia (NHMRC) Centre for Research Excellence in Polycystic Ovary Syndrome (Grant ID APP1078444). R.C.F. and J.C.A. were supported by Robinson Research Institute Lloyd Cox Career Development Fellowships (2018). Establishment of the cohort was funded by an NHMRC Strategic Award No. 465455, a Career Development Award in Population Health (No. 349548) and the Australian Research Council (Future Fellowship FT100101018) awarded to M.J.D. All authors declared no conflict of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]- Published
- 2021
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41. Use and experiences of galactagogues while breastfeeding among Australian women.
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McBride, Grace M., Stevenson, Robyn, Zizzo, Gabriella, Rumbold, Alice R., Amir, Lisa H., Keir, Amy K., and Grzeskowiak, Luke E.
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BREASTFEEDING ,AUSTRALIANS ,BREAST milk ,PREMATURE labor ,GENERAL practitioners ,MILK yield - Abstract
Background: Galactagogues are substances thought to increase breast milk production, however evidence to support their efficacy and safety remain limited. We undertook a survey among Australian women to examine patterns of use of galactagogues and perceptions regarding their safety and effectiveness. Methods: An online, cross-sectional survey was distributed between September and December 2019 via national breastfeeding and preterm birth support organisations, and networks of several research institutions in Australia. Women were eligible to participate if they lived in Australia and were currently/previously breastfeeding. The survey included questions about galactagogue use (including duration and timing), side effects and perceived effectiveness (on a scale of 1 [Not at all effective] to 5 [Extremely effective]). Results: Among 1876 respondents, 1120 (60%) reported using one or more galactagogues. Women were 31.5 ± 4.8 years (mean ± standard deviation) at their most recent birth. Sixty-five percent of women were currently breastfeeding at the time of the survey. The most commonly reported galactagogues included lactation cookies (47%), brewer's yeast (32%), fenugreek (22%) and domperidone (19%). The mean duration of use for each galactagogue ranged from 2 to 20 weeks. Approximately 1 in 6 women reported commencing galactagogues within the first week postpartum. Most women reported receiving recommendations to use herbal/dietary galactagogues from the internet (38%) or friends (25%), whereas pharmaceutical galactagogues were most commonly prescribed by General Practitioners (72%). The perceived effectiveness varied greatly across galactagogues. Perceived effectiveness was highest for domperidone (mean rating of 3.3 compared with 2.0 to 3.0 among other galactagogues). Over 23% of domperidone users reported experiencing multiple side effects, compared to an average of 3% of women taking herbal galactagogues. Conclusions: This survey demonstrates that galactagogues use is common in Australia. Further research is needed to generate robust evidence about galactagogues' efficacy and safety to support evidence-based strategies and improve breastfeeding outcomes. [ABSTRACT FROM AUTHOR]
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- 2021
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42. The risk-risk trade-offs: Understanding factors that influence women's decision to use substances to boost breast milk supply.
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Zizzo, Gabriella, Amir, Lisa H., Moore, Vivienne, Grzeskowiak, Luke E., and Rumbold, Alice R.
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BREAST milk ,MILK supply ,INFLUENCE ,SUBSTANCE abuse ,MEDICAL personnel ,BREASTFEEDING ,INFANT development ,MATERNAL age - Abstract
Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The aim of this study is to explore factors influencing women's decisions to use galactagogues during lactation. Twenty-two semi-structured interviews were conducted in October and November 2019 (over the telephone or in person) with participants located in most Australian states and territories, including metro and regional areas. Interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo. Analysis revealed that following a concern about breast milk supply, the decision to use galactagogues was influenced by three core and interrelated domains: access to and quality of breastfeeding support, maternal agency and determination to provide breast milk. Women revealed many problematic experiences with health care professionals that left them feeling dismissed and confused due to provision of inconsistent and insufficient information that was sometimes at odds with their desire to provide breast milk. In this instance, some women turned to galactagogues to regain agency. A range of broader dimensions influencing decision-making also emerged. These were separated into categories that emphasise distinctions relating to breast milk supply, which included: maternal emotional wellbeing, social norms and pressures, concerns about infant development, maternal physical health and lactation history, as well as those relating specifically to galactagogue use, including: desire for a guaranteed/urgent response, risk-risk trade-off, acceptance and trust, and accessibility and cost. In understanding the complexity of decision-making concerning these substances, we identify opportunities to improve breastfeeding counselling and support. We recommend that support be individually tailored to manage conflicting information, adopt communication styles that encourage trust and processes that enable shared decision-making to enhance or restore maternal agency. There is also considerable need to address evidence gaps regarding the effectiveness and safety of commonly used galactagogues, so that women can be appropriately counselled about potential benefits and harms. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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43. Investigating a cluster of vulvar cancer in young women: a cross-sectional study of genital human papillomavirus prevalence
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Rumbold Alice R, Tan Sarah E, Condon John R, Taylor-Thomson Debbie, Nickels Maria, Tabrizi Sepehr N, Davy Margaret LJ, O’Brien Margaret M, Connors Christine M, Zardawi Ibrahim, Stankovich Jim, and Garland Suzanne M
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Human papillomavirus ,Population prevalence ,Vulvar neoplasms ,Young women ,Indigenous women ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Vulvar cancer is a relatively rare malignancy, which occurs most often in postmenopausal women. We have previously identified a geographic cluster of vulvar cancer in young Indigenous women living in remote communities in the Arnhem Land region of Australia. In this population, we investigated the prevalence of oncogenic human papillomavirus (HPV) infection in anogenital samples (vulvar/vaginal/perianal area and cervix) and compared the overall, type-specific and multiple infection prevalence between sites. Methods A cross-sectional survey of 551 Indigenous women aged 18–60 years was undertaken in 9 Arnhem Land communities. Women were consented for HPV detection and genotyping collected by a combined vulvar/vaginal/perianal (VVP) sweep swab and a separate PreservCyt endocervical sample collected during Pap cytology screening. HPV DNA testing was undertaken using PCR with broad spectrum L1 consensus PGMY09/11 primers with genotyping of positive samples by Roche Linear Array. The primary outcomes were the prevalence of cervical and VVP high-risk (HR) HPV. Results The prevalence of VVP HR-HPV was 39%, which was significantly higher than the cervical HR-HPV prevalence (26%, p Conclusions In this population experiencing a cluster of vulvar cancer, the prevalence of cervical oncogenic HPV infection was similar to that reported by studies of other Australian women; however there was a significantly higher prevalence of vulvar/vaginal/perianal infection to cervical. The large discrepancy in HPV prevalence between anogenital sites in this population may represent more persistent infection at the vulva. This needs further investigation, including the presence of possible environmental and/or genetic factors that may impair host immunity.
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- 2012
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44. The effects of house moves during early childhood on child mental health at age 9 years
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Rumbold Alice R, Giles Lynne C, Whitrow Melissa J, Steele Emily J, Davies Christopher E, Davies Michael J, and Moore Vivienne M
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Residential mobility ,Child behaviour ,Child development ,Housing ,Longitudinal studies ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Residential mobility is common in families with young children; however, its impact on the social development of children is unclear. We examined associations between the number, timing and type of house moves in childhood and child behaviour problems using data from an ongoing longitudinal study. Methods Complete data on residential mobility and child behaviour was available for 403 families. Three aspects of mobility were considered: (a) number of house moves from birth to Results Moving house ≥2 times before 2 years of age was associated with an increased internalizing behaviour score at age 9 years. This association remained after adjustment for sociodemographic and household factors. There was no association between increased residential mobility in other time periods and internalizing behaviour, or mobility in any period and externalizing behaviour. There was no effect of lifetime number of moves, or of an upwardly or downwardly mobile housing trajectory. However, a housing trajectory characterized by continuous rental occupancy was associated with an increased externalizing behaviour score. Conclusions These findings may suggest that there is a sensitive period, in the first few years of life, in which exposure to increased residential mobility has a detrimental effect on mental health in later childhood.
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- 2012
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45. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative
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Kwedza Ru K, Liddle Helen E, O'Donoghue Lynette, Cox Rhonda J, Kennedy Catherine M, Dowden Michelle C, Si Damin, Bailie Ross S, Rumbold Alice R, Thompson Sandra C, Burke Hugh P, Brown Alex DH, Weeramanthri Tarun, and Connors Christine M
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Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4) were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation) were consistently identified as opportunities for improvement across services.
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- 2011
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46. The risk of adverse pregnancy outcomes in women who are overweight or obese
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Willson Kristyn J, Rumbold Alice R, Athukorala Chaturica, and Crowther Caroline A
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Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. Methods A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI. Conclusion The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed. Trial Registration Current Controlled Trials ISRCTN00416244
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- 2010
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47. Adverse pregnancy and neonatal outcomes associated with systematic review and meta-analysis.
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Vallely, Lisa M., Egli-Gany, Dianne, Wand, Handan, Pomat, William S., Homer, Caroline S. E., Guy, Rebecca, Silver, Bronwyn, Rumbold, Alice R., Kaldor, John M., Vallely, Andrew J., and Low, Nicola
- Abstract
Objective: To examine associations between Neisseria gonorrhoeae (NG) infection during pregnancy and the risk of preterm birth, spontaneous abortion, premature rupture of membranes, perinatal mortality, low birth weight and ophthalmia neonatorum.Data Sources: We searched Medline, EMBASE, the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature for studies published between 1948 and 14 January 2020.Methods: Studies were included if they reported testing for NG during pregnancy and compared pregnancy, perinatal and/or neonatal outcomes between women with and without NG. Two reviewers independently assessed papers for inclusion and extracted data. Risk of bias was assessed using established checklists for each study design. Summary ORs with 95% CIs were generated using random effects models for both crude and, where available, adjusted associations.Results: We identified 2593 records and included 30 in meta-analyses. Women with NG were more likely to experience preterm birth (OR 1.55, 95% CI 1.21 to 1.99, n=18 studies); premature rupture of membranes (OR 1.41, 95% CI 1.02 to 1.92, n=9); perinatal mortality (OR 2.16, 95% CI 1.35 to 3.46, n=9); low birth weight (OR 1.66, 95% CI 1.12 to 2.48, n=8) and ophthalmia neonatorum (OR 4.21, 95% CI 1.36 to 13.04, n=6). Summary adjusted ORs were, for preterm birth 1.90 (95% CI 1.14 to 3.19, n=5) and for low birth weight 1.48 (95% CI 0.79 to 2.77, n=4). In studies with a multivariable analysis, age was the variable most commonly adjusted for. NG was more strongly associated with preterm birth in low-income and middle-income countries (OR 2.21, 95% CI 1.40 to 3.48, n=7) than in high-income countries (OR 1.38, 95% CI 1.04 to 1.83, n=11).Conclusions: NG is associated with a number of adverse pregnancy and newborn outcomes. Further research should be done to determine the role of NG in different perinatal mortality outcomes because interventions that reduce mortality will have the greatest impact on reducing the burden of disease in low-income and middle-income countries.Prospero Registration Number: CRD42016050962. [ABSTRACT FROM AUTHOR]- Published
- 2021
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48. Borderline gestational diabetes mellitus and pregnancy outcomes
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Crowther Caroline A, Willson Kristyn J, Rumbold Alice R, and Ju Hong
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Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background The impact of borderline gestational diabetes mellitus (BGDM), defined as a positive oral glucose challenge test (OGCT) and normal oral glucose tolerance test (OGTT), on maternal and infant health is unclear. We assessed maternal and infant health outcomes in women with BGDM and compared these to women who had a normal OGCT screen for gestational diabetes. Methods We compared demographic, obstetric and neonatal outcomes between women participating in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS) who had BGDM and who screened negative on OGCT. Results Women who had BGDM were older (mean difference 1.3 years, [95% confidence interval (CI) 0.3, 2.2], p = 0.01) and more likely to be obese (27.1% vs 14.1%, relative risk (RR) 1.92, [95% CI 1.41, 2.62], p < 0.0001) than women who screened negative on OGCT. The risk of adverse maternal outcome overall was higher (12.9% vs 8.1%, RR 1.59, [95% CI 1.00, 2.52], p = 0.05) in women with BGDM compared with women with a normal OGCT. Women with BGDM were more likely to develop pregnancy induced hypertension (17.9% vs 11.8%, RR 1.51, [95% CI 1.03, 2.20], p = 0.03), have a caesarean for fetal distress (17.1% vs 10.5%, RR 1.63, [95% CI 1.10, 2.41], p = 0.01), and require a longer postnatal hospital stay (mean difference 0.4 day, [95% CI 0.1, 0.7], p = 0.01) than those with a normal glucose tolerance. Infants born to BGDM mothers were more likely to be born preterm (10.7% vs 6.4%, RR 1.68, [95% CI 1.00, 2.80], p = 0.05), have macrosomia (birthweight ≥4.5 kg) (4.3% vs 1.7%, RR 2.53, [95% CI 1.06, 6.03], p = 0.04), be admitted to the neonatal intensive care unit (NICU) (6.5% vs 3.0%, RR 2.18, [95% CI 1.09, 4.36], p = 0.03) or the neonatal nursery (40.3% vs 28.4%, RR 1.42, [95% CI 1.14, 1.76], p = 0.002), and have a longer hospital stay (p = 0.001). More infants in the BGDM group had Sarnat stage 2 or 3 neonatal encephalopathy (12.9% vs 7.8%, RR 1.65, [95% CI 1.04, 2.63], p = 0.03). Conclusion Women with BGDM and their infants had an increased risk of adverse health outcomes compared with women with a negative OGCT. Intervention strategies to reduce the risks for these women and their infants need evaluation. Trial registration Current Controlled Trials ISRCTN00416244
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- 2008
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49. Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review.
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Oswald, Tassia K., Rumbold, Alice R., Kedzior, Sophie G. E., and Moore, Vivienne M.
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META-analysis , *TEENAGERS , *PSYCHOLOGICAL well-being , *CROSS-sectional method , *COGNITIVE ability - Abstract
Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5–11 years), early adolescents (12–14 years), and older adolescents (15–18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era. [ABSTRACT FROM AUTHOR]
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- 2020
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50. Recurrence patterns identify aggressive form of human papillomavirus‐dependent vulvar cancer.
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McWhirter, Rebekah E., Otahal, Petr, Taylor‐Thomson, Debbie, Maypilama, Elaine Lawurrpa, Rumbold, Alice R., Dickinson, Joanne L., Thorn, Jane C., Boyle, Jacqueline A., and Condon, John R.
- Subjects
CANCER relapse ,INDIGENOUS peoples ,LONGITUDINAL method ,PAPILLOMAVIRUS diseases ,VULVAR tumors ,RETROSPECTIVE studies ,DISEASE progression ,DESCRIPTIVE statistics ,CERVICAL intraepithelial neoplasia ,DISEASE complications - Abstract
Background: Vulvar cancer is rare and, as a result, is understudied. Treatment is predominantly surgery, irrespective of the type of vulvar cancer, and is associated with physical, emotional and sexual complications. A cluster of human papillomavirus (HPV)‐dependent vulvar cancer patients was identified in Arnhem Land Northern Territory (NT), Australia, in which young Indigenous women were diagnosed at 70 times the national incidence rate. Aims: To assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality. Materials and methods: A retrospective cohort study of NT‐resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events. Results: Indigenous women from Arnhem Land experienced more recurrences after treatment than non‐Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years. Conclusions: In characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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