Melissa Graham

Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index

BackgroundWhile much cross-sectional data is available, there have been few longitudinal investigations of patterns of electronic media use in children. Further, the possibility of a bi-directional relationship between electronic media use and body mass index in children has not been considered. This study aimed to describe longitudinal patterns of television viewing and electronic game/computer use, and investigate relationships with body mass index (BMI).MethodsThis prospective cohort study was conducted in elementary schools in Victoria, Australia. 1278 children aged 5–10 years at baseline and 8–13 years at follow-up had their BMI calculated, from measured height and weight, and transformed to z-scores based on US 2000 growth data. Weight status (non-overweight, overweight and obese) was based on international BMI cut-off points. Weekly television viewing and electronic game/computer use were reported by parents, these were summed to generate total weekly screen time. Children were classified as meeting electronic media use guidelines if their total screen time was ≤14 hrs/wk.ResultsElectronic media use increased over the course of the study; 40% met guidelines at baseline but only 18% three years later. Television viewing and electronic game/computer use tracked moderately and total screen time was positively associated with adiposity cross-sectionally. While weaker relationships with adiposity were observed longitudinally, baseline z-BMI and weight status were positively associated with follow-up screen time and baseline screen time was positively associated with z-BMI and weight status at follow-up. Children who did not meet guidelines at baseline had significantly higher z-BMI and were more likely to be classified as overweight/obese at follow-up.ConclusionElectronic media use in Australian elementary school children is high, increases with age and tracks over time. There appears to be a bi-directional association suggesting that interventions targeting reductions in either screen time or adiposity may have a positive effect on both screen time and adiposity.

Hysterectomy trends in Australia – between 2000/01 and 2004/05

Background:  Hysterectomy is a major and common surgical procedure that has the potential to provide relief from ongoing gynaecological problems, but is often associated with negative impacts on health and wellbeing. Research indicates that hysterectomy rates and trends vary widely between and within countries; yet little is known about patterns in Australia.

Representations of Childless Women in the Australian Print Media

There is an array of socially constructed life scripts which feature the motherhood role as a pinnacle for women; however, increasing numbers of women are remaining childless, violating these very basic informal morals of our society. In Australia, the political and social climate is predominantly pronatalist. Powerful discourses, produced through social, political, medical, and religious institutions, provide commentary on cultural discourses surrounding reproduction, femininity, and motherhood. The media play an important role in reinforcing and communicating these pervasive ideologies. This paper explores how childless women are represented in the Australian print media within the context of a pronatalist society. The representation of childless women was predominantly negative and characterised by reprimanding, pitying, and threatening undertones. Four main representations (sympathy worthy women; career women; the artefact of feminism; and reprimanded women) were identified but ultimately taken together they suggest that being a childless woman is an undesirable position in contemporary Australian society.

Navigating the Terrain of Lived Experience: The Value of Lifeworld Existentials for Reflective Analysis

In qualitative research we are often presented with a tension between having open and fluid interviews to support staying true to the lived experiences of participants and achieving a level of abstraction from the data in order to uncover the essential structures and meanings of that particular lived experience. A way of resolving this tension is through the application of theoretical frameworks. Van Manens four lifeworld existentials offer a lens through which to explore and navigate disparate interview data and uncover the essences of lived experience, without imposing categories upon the data itself. Drawing on a study exploring the lived experiences of childless women, we explore the process and principles in operationalising the existentials and discuss the potential implications for analysis and findings. The article demonstrates how Van Manens lifeworld existentials present us with a holistic and valuable method for reflective practice, in coming to understand lived experience.

Predictors of hysterectomy as a treatment for menstrual symptoms

BACKGROUND Hysterectomy is a common procedure in Australia; approximately 1 in 5 Australian women undergoing a hysterectomy by the age of 50 for indications such as fibroids, disorders of menstruation (including excessive or irregular menstrual bleeding), and endometriosis. However, little is known about the characteristics of women who have had the procedure or the predictors of hysterectomy as a treatment for menstrual problems. This study of 687 middle-aged Australian women suffering from menstrual symptoms aimed to identify the common health and demographic characteristics that were likely to lead to hysterectomy for the treatment of these problems. METHODS A cross-sectional and a prospective cohort study were undertaken as a substudy of the Australian Longitudinal Study on Womens Health (Womens Health Australia). Women from the mid-aged cohort of the Womens Health Australia study who identified having menstrual problems (n = 715) in the 1996 and 1998 surveys or who had undergone a hysterectomy (n = 218) during that time were recruited. A self-administered instrument was mailed to the 933 women in 2000. Data were analyzed using backward logistic regression to identify the characteristics that increased the likelihood of women undergoing hysterectomy for the treatment of menstrual problems. RESULTS Factors that increased the likelihood of hysterectomy as a treatment for menstrual problems were varied. They included the number of menstrual symptoms experienced (odds ratio [OR], 1.63; p < .005) or conditions diagnosed (such as fibroids or excessive menstrual bleeding; OR, 2.5; p < .0005), a perception that information was available about menstrual problems (OR, 1.16; p < .001), being influenced in the decision making process to elect a treatment option (OR, 1.25; p < .025), and dissatisfaction with the other treatments tried before hysterectomy (OR, 0.63; p < .0005). CONCLUSIONS Hysterectomy seem to be the treatment of choice for women experiencing a number of menstrual problems and less than satisfactory outcomes with other treatment options. Importantly, women appear to be making decisions based on the perception of sufficient information available about their menstrual problems, regardless of whether or not this was actually the case. Women are being influenced in their decision-making process to undergo a hysterectomy by health professionals, such as general practitioners and gynecologists.

Teaching research and epidemiology to undergraduate students in the health sciences

Objective: To identify and address particular challenges in the teaching of epidemiological concepts to undergraduate students in non‐clinical health disciplines.

Practising social inclusion

Part 1: Introduction 1. Scoping Social Inclusion Practice Ann Taket, Beth R. Crisp, Melissa Graham, Lisa Hanna and Sophie Goldingay Part 2: Practising Inclusion in Policy 2. Conscience Clauses: Your Right to a Conscience Ends at my Right to Safe, Legal and Effective Health Care Sarah Barter-Godfrey and Julia Shelley 3. Practising Inclusion in Policy Design for People with Disabilities Natasha Layton and Erin Wilson 4. Practising Social Inclusion Through Regulation: Occupational Health and Safety for Commercial Sex Workers Beth R. Crisp and Michael W. Ross Part 3: Practising Inclusion in Service Design 5. Inclusive Service Development: Exploring a Whole of Organisation Approach in the Community Service Sector Sarah Pollock and Ann Taket 6. Increasing Social Cohesiveness in a School Environment Karen Stagnitti, Mary Frawley, Brian Lynch and Peter Fahey 7. Inclusive Service Design for Young People with Learning Disabilities Who Exhibit Behaviours of Concern Sophie Goldingay and Karen Stagnitti Part 4: Practising Inclusion in Service Delivery 8. Working for Connection and Inclusion: The Role of Front Line Practitioners in Strengthening the Relational Base of Marginalized Clients Mark Furlong 9. Experiments in Social Inclusion and Connection: Cases From Lebanon Jihad Makhoul, Tamar Kabakian-Khasholian, Michael El-Khoury and Faysal El-Kak 10. Practising Social Inclusion: The Case of Street-Based Sex Workers and the St. Kilda Gatehouse in Melbourne Rachel Lennon, Pranee Liamputtong and Elizabeth Hoban Part 5: Practising Inclusion in Community Life 11. Promoting Social Inclusion of Frail Older People Living in the Community Ann Taket, Sarah Pollock, Lisa Hanna, Emily Learmonth and Peta Farquhar 12. Enabling New Students to Feel That They Matter: Promoting Social Inclusion Within the University Community Beth R. Crisp and John Fox 13. Community-Driven Social Inclusion Practice: A Case Study of a Multicultural Womens Friendship Group Lisa Hanna and Jan Moore 14. Practicing Social Inclusion: Comfort Zone - A Social Support Group for Teenagers with High Functioning Autism Jessica Gill, Pranee Liamputtong and Elizabeth Hoban Part 6: Practising Inclusion in Research 15. Preventing HIV Through Social Inclusion Using Community Based Participatory Research Suzanne M. Dolwick Grieb, Ndidiamaka Amutah, Jason Stowers, Horace Smith, Kimberli Hammonds and Scott D. Rhodes 16. Inclusive Research with People with Intellectual Disability: Recognising the Value of Social Relationships as a Process of Inclusive Research Erin Wilson and Robert Campain 17. Examining the Notion of Informed Consent and Lessons Learned for Increasing Inclusion Among Marginalised Research Groups Nena Foster and Emily Freeman 18. The Invisibility of Childlessness in Research: A More Inclusive Approach Melissa Graham 19. Inclusion in Participatory Research - What Were the Whitefellas Doing in an Aboriginal Health Project? Sarah Barter-Godfrey, Sarah Pollock and Ann Taket Part 7: Conclusion 20. Implementing the Social Inclusion Agenda Beth R. Crisp, Ann Taket, Melissa Graham and Lisa Hanna

A role for workforce competencies in evidence-based health promotion education.

Education programs should be based on research about the knowledge and skills required for practice, rather than on intuition or tradition, but there is limited published curriculum research on health promotion education. This paper describes a case study of how workforce competencies have been used to assist evidence-based health promotion education in the areas of curriculum design, selection of assessment tasks and continuous quality assurance processes in an undergraduate program at an Australian university. A curriculum-competency mapping process successfully identified gaps and areas of overlap in an existing program. Previously published health promotion workforce competencies were effectively used in the process of selecting assessment items, providing clear guidelines for curriculum revision and a useful method to objectively assess competency content in an evidence informed framework. These health promotion workforce competencies constituted an additional tool to assess course quality. We recommend other tertiary institutions consider curriculum-competency mapping and curriculum based assessment selection as quality and evidence based curriculum review strategies.

An examination of the health and wellbeing of childless women: A cross-sectional exploratory study in Victoria, Australia

BackgroundChildlessness among Australian women is increasing. Despite this, little is known about the physical and mental health and wellbeing of childless women, particularly during the reproductive years. The aims of this exploratory study were to: 1) describe the physical and mental health and wellbeing and lifestyle behaviours of childless women who are currently within the latter part of their reproductive years (30 - 45 years of age); and 2) compare the physical and mental health and wellbeing and lifestyle behaviours of these childless women to Australian population norms.MethodsA convenience sample of 50 women aged between 30 and 45 years were recruited to participate in a computer assisted telephone interview. The SF-36 Health Survey v2 and lifestyle indicators were collected in regards to womens health and wellbeing. Data were analysed using descriptive statistics, t-tests for independent sample means and 95% confidence intervals for the difference between two independent proportions.ResultsChildless women in this study reported statistically significant poorer general health, vitality, social functioning and mental health when compared to the adult female population of Australia. With the exception of vegetable consumption, lifestyle behaviours were similar for the childless sample compared to the adult female population in Australia.ConclusionsChildless women may be at a greater risk of experiencing poor physical and mental health when compared to the Australian population. A womans health and wellbeing during her reproductive years may have longer term health consequences and as such the health and wellbeing of childless women requires further investigation to identify and address implications for the provision of health (and other social) services for this growing population group.

Is Being Childless Detrimental to a Woman's Health and Well-Being Across Her Life Course?

BACKGROUND Childlessness is a growing phenomenon. Previous research examining health and well-being differentials between women with and without children has produced conflicting results. Most of this research has been conducted in the United States or parts of Europe. There has been limited research in Australia that has examined the health and well-being of women with and without children across the life course. The aim of the current study was to examine the association between motherhood status and general physical and mental health and well-being over a 10-year time period. METHODS Using 10 waves of data from the Household, Income and Labour Dynamics in Australia study, longitudinal linear mixed models with time varying variables (both dependent and independent) were constructed to assess the effect of childlessness on health and well-being based on the Short Form-36 Health Survey Version 1 (n=52,381 observations). FINDINGS Findings suggest that childless women experience poorer physical and mental health and well-being during the peak reproductive years; however, this trend is reversed for women aged 65 years or more. Although never-married, childless women experienced better health and well-being compared with mothers, this was not the case for childless women who were divorced, separated, or widowed or in a relationship. CONCLUSION The findings support the notion that whether or not a woman has children does have consequences for her health and well-being; however, this differs across the life course.