Immigrant and non-immigrant women's experiences of maternity care: A systematic and comparative review of studies in five countries

Background: Understanding immigrant women’s experiences of maternity care is critical if receiving country care systems are to respond appropriately to increasing global migration. This systematic review aimed to compare what we know about immigrant and non-immigrant women’s experiences of maternity care. Methods: Medline, CINAHL, Health Star, Embase and PsychInfo were searched for the period 1989–2012. First, we retrieved population-based studies of women’s experiences of maternity care (n = 12). For countries with identified population studies, studies focused specifically on immigrant women’s experiences of care were also retrieved (n = 22). For all included studies, we extracted available data on experiences of care and undertook a descriptive comparison. Results: What immigrant and non-immigrant women want from maternity care proved similar: safe, high quality, attentive and individualised care, with adequate information and support. Immigrant women were less positive about their care than non-immigrant women. Communication problems and lack of familiarity with care systems impacted negatively on immigrant women’s experiences, as did perceptions of discrimination and care which was not kind or respectful. Conclusion: Few differences were found in what immigrant and non-immigrant women want from maternity care. The challenge for health systems is to address the barriers immigrant women face by improving communication,increasing women’s understanding of care provision and reducing discrimination

Breastfeeding evidence based guidelines for the use of medicines

Abstract: Background: General practitioners may consider prescribing medicines for breastfeeding women during the postpartum period. Most medicines can be used safely during breastfeeding at the recommended dose, however there are exceptions that necessitate caution.\ud \ud Objective: This article provides an evidence based review of medicines used for common situations and their compatibility with breastfeeding.\ud \ud Discussion: Breastfeeding women typically use relatively few medicines, and generally these are compatible with breastfeeding. If other medicines are required, information on their safety during breastfeeding can be accessed from pharmacy departments at maternity hospitals or from online resources

Breastfeeding evidence based guidelines for the use of medicines

Abstract: Background: General practitioners may consider prescribing medicines for breastfeeding women during the postpartum period. Most medicines can be used safely during breastfeeding at the recommended dose, however there are exceptions that necessitate caution. Objective: This article provides an evidence based review of medicines used for common situations and their compatibility with breastfeeding. Discussion: Breastfeeding women typically use relatively few medicines, and generally these are compatible with breastfeeding. If other medicines are required, information on their safety during breastfeeding can be accessed from pharmacy departments at maternity hospitals or from online resources

Breastfeeding information in pharmacology textbooks: a content analysis

Women often need to take medicines while breastfeeding and pharmacists need to provide accurate information in order to avoid undue caution about the compatibility of medicines and breastfeeding. The objective of this study was to review information provided about breastfeeding in commonly used pharmacology textbooks. We asked 15 Australian universities teaching pharmacy courses to provide a list of recommended pharmacology textbooks in 2011. Ten universities responded, generating a list of 11 textbooks that we analysed for content relating to breastfeeding. Pharmacology textbooks outline the mechanisms of actions of medicines and their use: however, only a small emphasis is placed on the safety/compatibility of medicines for women during breastfeeding. Current pharmacology textbooks recommended by Australian universities have significant gaps in their coverage of medicine use in breastfeeding. Authors of textbooks should address this gap, so academic staff can recommend texts with the best lactation content

Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet:A randomised controlled trial

BACKGROUND: Whether testosterone treatment has benefits on body composition over and above caloric restriction in men is unknown. We hypothesised that testosterone treatment augments diet-induced loss of fat mass and prevents loss of muscle mass. METHODS: We conducted a randomised double-blind, parallel, placebo controlled trial at a tertiary referral centre. A total of 100 obese men (body mass index ≥ 30 kg/m(2)) with a total testosterone level of or below 12 nmol/L and a median age of 53 years (interquartile range 47–60) receiving 10 weeks of a very low energy diet (VLED) followed by 46 weeks of weight maintenance were randomly assigned at baseline to 56 weeks of 10-weekly intramuscular testosterone undecanoate (n = 49, cases) or matching placebo (n = 51, controls). The main outcome measures were the between-group difference in fat and lean mass by dual-energy X-ray absorptiometry, and visceral fat area (computed tomography). RESULTS: A total of 82 men completed the study. At study end, compared to controls, cases had greater reductions in fat mass, with a mean adjusted between-group difference (MAD) of –2.9 kg (–5.7 to –0.2; P = 0.04), and in visceral fat (MAD –2678 mm(2); –5180 to –176; P = 0.04). Although both groups lost the same lean mass following VLED (cases –3.9 kg (–5.3 to –2.6); controls –4.8 kg (–6.2 to –3.5), P = 0.36), cases regained lean mass (3.3 kg (1.9 to 4.7), P < 0.001) during weight maintenance, in contrast to controls (0.8 kg (–0.7 to 2.3), P = 0.29) so that, at study end, cases had an attenuated reduction in lean mass compared to controls (MAD 3.4 kg (1.3 to 5.5), P = 0.002). CONCLUSIONS: While dieting men receiving placebo lost both fat and lean mass, the weight loss with testosterone treatment was almost exclusively due to loss of body fat. TRIAL REGISTRATION: clinicaltrials.gov, identifier NCT01616732, registration date: June 8, 2012 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-016-0700-9) contains supplementary material, which is available to authorized users