The measurement of knowledge, attitudes and knowledge-seeking behaviours of women in relation to the menopause and health related issues

Research suggests that women are not well informed about the health related issues which are associated with the menopause. The purpose of this study was to determine women\u27s: current knowledge of the menopause and of the disease osteoporosis; attitudes to estrogen replacement therapy (ERT); frequency of menopausal symptoms; knowledge-seeking behaviours In relation to the menopause; and, open-ended responses to menopausal issues. This study surveyed 70 women who responded to an advertisement in Community Newspapers. Data were collected using a Knowledge and attitudes to the menopause and health related issues (KAMHRI) questionnaire. The KAMHRI questionnaire was developed by the researcher and pilot tested with a group of 33 women. The data were statistically analysed using SPSS/PC for the whole group and for demographically related sub-groups of respondents. Findings showed that in general the respondents were well informed about the disease osteoporosis and about the menopausal status. A woman\u27s type of occupation significantly influenced her \u27total knowledge score\u27. Further analysis using Duncan\u27s multiple range test, revealed that sub-groups of type of occupation were significantly different in their achievement of scores of the \u27perceived knowledge of menopausal status\u27 construct. The respondents supported the use of ERT to relieve menopausal symptoms and were not as concerned about the risks associated with ERT as identified by other studies. Significant differences were found with attitudes to ERT, based on level of education and when Duncan\u27s comparison between sub-groups was used, significant differences were found between women of different occupations. The frequency of physical and emotional symptoms experienced by the respondents were reported. Findings showed that, respectively, \u27muscle and joint pain\u27 and \u27fatigue\u27 were the most common physical and emotional symptoms experienced by the respondents. The frequency of physical and emotional symptoms showed significant differences when analysed by sub-groups based on menopausal status, level of education and type of occupation. Even though respondents ranked \u27Menopause Clinics\u27 and \u27Women\u27s Health Care Clinics\u27 as important when making a decision about osteoporosis prevention, these facilities were not utilized by many of the sample when information was sought. The \u27family doctor\u27 remained one of the most important and well used resources of information. The majority of respondents reacted to the open-ended questions with vigour. The answers supported the data gained from the KAMHRI questionnaire and highlighted areas of importance. Specific areas of concern were the occurrence of symptoms other than those listed; the need for more information about the menopause, osteoporosis and EAT in general; and the need for health professionals to assist and guide women before, during and after this major life change. Findings of this research Indicate that this sample of women reported the need for specific health services, information and professional guidance to assist them in making informed decisions at the time of the menopause. In the future, research could ascertain the efficacy of implementing health education programs designed to target the needs of women entering their menopausal years

Nutrition and Vulnerable Groups

Food insecurity is a complex ‘wicked’ problem that results from a range of unstable and uncertain physical, social, cultural and economic factors that limits access to nutritious food. Globally, 800 million people are under-nourished, and around 2 billion are overweight/obese or have micronutrient deficiency. These populations are largely positioned in developing countries where disease burden is high and impacts health budgets and productivity. Similarly developed countries, cities and neighbourhoods are experiencing a greater emergence of vulnerable populations. This is in part explained by the change in the food production and manufacturing, the retraction in economic climates, the increase in food price, and in some regions reduced food availability and access.Vulnerable groups include but are not limited to migrant populations, Indigenous people, elderly, pregnant women, those with disability, homeless, young children and youth. Poor nutrition at significant periods of growth and development and during life impact long term health outcomes increasing non-communicable disease prevalence, health cost and reducing economic productivity

Nutrition and Vulnerable Groups

Food insecurity is a complex ‘wicked’ problem that results from a range of unstable and uncertain physical, social, cultural, and economic factors that limit access to nutritious food [...

Building online community on SNAC: A netnographic study of the early years sector

‘‘Build it and they will come,’’ an adage critiqued as a common misconception of participatory engagement with online communities. Previous research indicated that a netnographic approach based upon researcher– participant engagement would provide the best opportunity to build and sustain a successful support community [...]

The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children

Background: Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children. Methods: A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05. Results: Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge. Conclusions: Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children

Vulnerable, single and living in poverty: Women’s challenges to accessing food in the Australian Capital Territory

Objective: To explore challenges to food access faced by vulnerable women living in the Australian Capital Territory and surrounds. Method: Qualitative study comprising semi‐structured interviews supplemented with quantitative demographic data. Results:Forty‐one women, mean age of 43 years, living in government and community housing who had an income of Conclusion: Access to safe, nutritious and healthy food is difficult for women living in poverty. Acknowledgement of challenges that contribute to women’s food insecurity by all stakeholders is essential to address the problem and build sustainable actions and solutions. Implications for public health: Collaboration from all stakeholders within our food system is required to address current inequities to accessing reliable, nutritious and safe food and to reduce individual food insecurity

South West Food Community: Understanding systemic change, and its associated challenges and successes, among food security projects

Objective: The South West Food Community (SWFC) project (2018) aimed to identify initiatives working to support food security in the South West region of Western Australia, and to enhance how these initiatives functioned as a system. The SWFC project used a Systemic Innovation Lab approach that, prior to this study, had not been evaluated. This evaluation aimed to: i) measure system transitions (changes) to initiatives; and ii) understand the challenges and successes associated with system transitions. Methods: SWFC initiative leaders (n=46) such as directors, managers or coordinators, volunteers or committee members were invited to participate in this evaluation. Fifteen stakeholders completed the telephone interviews (32% response rate). Results: Twenty‐five desirable changes in practice were observed. Challenge and success statements determined themes of ‘participation’ and ‘bureaucracy’. Participation sub‐themes included: limited time; poor initiative attendance; community support; organisational support; and effective partnerships. Bureaucracy sub‐themes included: regulation or policy requirements; limited resources; and funding opportunities. Conclusion: The Australian‐first SWFC project has the capacity to support region‐to‐region comparisons; this evaluation increases evidence for scaling to other regions. Implications for public health: This approach can be used to increase collaboration between initiatives, support resource‐sharing between organisations and enhance policies (at local government level) to support food security

Incorporating social determinants of health into the clinical management of type 2 diabetes

Type 2 diabetes (T2DM) is increasing in global and national prevalence. It is more common among people with poor social determinants of health (SDoH). Furthermore, SDoH are known to influence health related choice, and therefore the glycaemic management of people with T2DM. There is a growing body of evidence affirming an irrefutable relationship between SDoH and T2DM. Currently SDoH are considered at a population level, whereas T2DM is usually managed individually. Assessing and addressing SDoH related barriers, at an individual, clinical level may contribute to improved glycaemic management for people with T2DM. Developing an approach to assess SDoH related management barriers, and incorporating it into usual clinical care will allow insight into ‘nonclinical’ obstacles to self-management. Additionally, investigation into strategies to address the identified barriers will extend and contextualise this approach, and could broaden and augment current efforts to improve glycaemic management for people with T2DM. An exploratory, descriptive research design will facilitate the exploration of the most appropriate methods and strategies for incorporating SDoH into clinical practice. These approaches can then be trialled and evaluated to inform an evidence-based approach for this addition to the usual clinical care of people with T2DM. This presentation will describe a current research project that is investigating how SDoH can be incorporated into the clinical management of T2DM, and discuss the findings so far

The food literacy action logic model: A tertiary education sector innovative strategy to support the charitable food sectors need for food literacy training

Food literacy is seen as a key component in improving the increasing levels of food insecurity. While responsibility for providing training falls on the charitable service organizations, they may not have the capacity to adequately reach those in need. This paper proposes a tertiary education - (university or higher education) led model to support the food literacy training needs of the food charity sector. A cross-sectional study comprised of online surveys and discussions investigated food services offered by Western Australia (WA) and Australian Capital Territory (ACT) agencies, food literacy training needs for staff, volunteers and clients, and challenges to delivering food literacy training programs. Purposive sampling was used, and ACT and WA charitable service originations (survey: ACT n = 23, WA n = 32; interviews: ACT n = 3, WA n = 2) were invited to participate. Findings suggest organizations had limited financial and human resources to address the gap in food literacy training. Nutrition, food budgeting, and food safety education was delivered to paid staff only with limited capacity for knowledge transfer to clients. The Food Literacy Action Logic Model, underpinned by a tertiary education engagement strategy, is proposed to support and build capacity for organizations to address training gaps and extend the reach of food literacy to this under-resourced sector

A comprehensive examination of the evidence for whole of diet patterns in Parkinson\u27s disease: A scoping review

Both motor and non-motor symptoms of Parkinson’s disease (PD), a progressive neurological condition, have broad-ranging impacts on nutritional intake and dietary behaviour. Historically studies focused on individual dietary components, but evidence demonstrating ameliorative outcomes with whole-of-diet patterns such as Mediterranean and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) is emerging. These diets provide plenty of antioxidant rich fruits, vegetables, nuts, wholegrains and healthy fats. Paradoxically, the ketogenic diet, high fat and very low carbohydrate, is also proving to be beneficial. Within the PD community, it is well advertised that nutritional intake is associated with disease progression and symptom severity but understandably, the messaging is inconsistent. With projected prevalence estimated to rise to 1.6 million by 2037, more data regarding the impact of whole-of-diet patterns is needed to develop diet-behaviour change programmes and provide clear advice for PD management. Objectives and Methods: Objectives of this scoping review of both peer-reviewed academic and grey literatures are to determine the current evidence-based consensus for best dietary practice in PD and to ascertain whether the grey literature aligns. Results and Discussion: The consensus from the academic literature was that a MeDi/MIND whole of diet pattern (fresh fruit, vegetables, wholegrains, omega-3 fish and olive oil) is the best practice for improving PD outcomes. Support for the KD is emerging, but further research is needed to determine long-term effects. Encouragingly, the grey literature mostly aligned but nutrition advice was rarely forefront. The importance of nutrition needs greater emphasis in the grey literature, with positive messaging on dietary approaches for management of day-to-day symptoms