Keryn Johnson

Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive?

BACKGROUND the Australian National Health and Medical Research Council (NHMRC) recently revised its guidelines for alcohol consumption during pregnancy and breast feeding, moving from a recommendation of minimising intake to one of abstinence. Women are potentially exposed to a variety of messages about alcohol and pregnancy, including from the media and social contacts, and are likely to see midwives as the source of expert advice in understanding these contradictory messages. OBJECTIVE to explore the advice that midwives believe they give to pregnant women about alcohol consumption, and the advice that pregnant women believe they receive; the knowledge and attitudes of both groups regarding alcohol consumption and the consistency with the NHMRC guidelines; and the receptivity and comfort of both groups in discussing alcohol consumption in the context of antenatal appointments. DESIGN individual semi-structured interviews with midwives and pregnant women. SETTING face-to-face interviews with midwives and telephone interviews with pregnant women were conducted in two regional areas of New South Wales in 2008-2009. PARTICIPANTS 12 midwives and 12 pregnant women. FINDINGS midwives and pregnant women consistently agreed that conversations about alcohol are generally limited to brief screening questions at the first visit, and the risks are not discussed or explained (except for high-risk women). KEY CONCLUSIONS both groups expressed comfort with the idea of discussing alcohol consumption, but lacked knowledge of the risk and recommendation, and it appears that this opportunity to provide women with information is under-utilised. IMPLICATIONS FOR PRACTICE there is a need to provide midwives with accurate information about the risks of alcohol consumption during pregnancy and effective communication tools to encourage them to discuss the risks and recommendations with their patients.

Teaching critical appraisal skills for Nursing research

BACKGROUND Evidence-based practice is a major focus in nursing, yet the literature continues to document a research-practice gap. Reasons for this gap stem partly from a lack of skills to critique and synthesize the literature, a lack of search skills and difficulty in understanding research articles, and limited knowledge of research by nursing professionals. METHOD An innovative and quality driven subject to improve critical appraisal and critical thinking skills was developed for the School of Nursing, Midwifery and Indigenous Health at the University of Wollongong, based on formative research with postgraduate students and supervisors. Through face-to-face and online teaching modules students worked through a structured process of analysing the key aspects of published papers using structured analysis tools for each study design. RESULTS Pre and post surveys of students found improvements in perceived knowledge of all key skills of critical appraisal. External independent evaluation determined that it was a high quality subject showing many hallmarks of good assessment practice and good practice in use of information and communication technology (ICT) in support of the learning outcomes.

A qualitative study on tobacco smoking and betel quid use among Burmese refugees in Australia

AbstractAnecdotal evidence suggests that there are high rates of smoking among Burmese men in Wollongong, Australia. A qualitative study was undertaken to explore the beliefs and experiences of Burmese refugees in Wollongong on smoking to guide the development of smoking cessation interventions. Three focus groups were conducted with Burmese refugees. Ten semi-structured interviews were conducted with service providers involved with Burmese refugees. Qualitative content analysis was used to categorise responses to the questions. Participants were aware of the health effects of tobacco smoking but had little knowledge of support for quitting. Many participants chewed betel quid and were unaware of the health consequences. Service providers noted the lack of resources on smoking and betel quid use for Burmese people. Smoking cessation interventions for Burmese people should consider the co-related use of betel quid due to the possibility of inadvertently encouraging use of betel nut as an alternative to tobacco.

Evaluating the effects of a physical activity on agitation and wandering (PAAW) experienced by individuals living with a dementia in care homes

Aim and Methods The aim was to evaluate the implementation of a structured physical activity (PA) programme for individuals living with a dementia in care homes. More specifically, the study aimed to test the effects on the behavioural and psychological symptoms of dementia (BPSD) using the Cohen-Mansfield Agitation Inventory and Algase Wandering Scale. The study was undertaken over 16 weeks using a quasi-experimental design. Registered nurses, physiotherapists, assistants in nursing and physiotherapy aids from one aged care organisation in NSW, Australia, undertook the study with academics. Results A total of 72 individuals living with a dementia from four care homes participated. Implementation of the structured PA programme generated statistically significant findings with reductions in agitation (p < 0.001) and eloping (p = 0.001) achieved for individuals living with a dementia in care homes. Conclusions Physiotherapists and exercise physiologists can complement nursing-focused care teams and contribute to a holistic model of care for individuals living with dementia in care homes. The study demonstrated how a structured PA programme positively affected the levels of agitation and wandering experienced by individuals living with a dementia. Individuals living with a dementia in care homes who participated in a structured PA experienced positive outcomes from the programme. The findings demonstrated that they benefited from the programme and PA should be promoted for this group just as it is for other population groups, including general populations of older people.

Improving sun protection behaviour through evidence-based campaigns.

Australia has the highest incidence of skin cancer in the world. Skin cancer is the most common form of cancer in Australia, with incidence rates outnumbering all other forms of cancer by more than three to one. The Australian health system spends more money on the diagnosis and treatment of skin cancer than on any other cancer, an estimated

Guidelines for the development of social marketing programmes for sun protection among adolescents and young adults

420m each year. The majority of these skin cancers could be prevented if the public could be persuaded to adequately protect themselves from the sun.