Wei Chun Wang

A prospective cohort study of antipsychotic medications in pregnancy: the first 147 pregnancies and 100 one year old babies.

Background Many women diagnosed with varying psychiatric disorders take antipsychotic medications during pregnancy. The safety of antipsychotic medications in pregnancy is largely unknown. Methods We established the National Register of Antipsychotic Medications in Pregnancy in 2005. Women who are pregnant and taking an antipsychotic medication are interviewed every 6 weeks during pregnancy and then followed until their babies are one year old. The babys progress is closely followed for the first year of life. Findings As of April 18 2012, 147 pregnancies had been followed through to completion. There were 142 live births and data is available for 100 one year old babies. 18% of babies were born preterm, with a higher dose of antipsychotic medication correlating to an increased likelihood of premature delivery; 43% of babies required special care nursery or intensive care after birth; 37% had any degree of respiratory distress and 15% of babies developed withdrawal symptoms. Congenital anomalies were seen in eight babies. Most pregnancies resulted in the birth of live, healthy babies. The use of mood stabilisers or higher doses of antipsychotics during pregnancy increased the likelihood of babies experiencing respiratory distress or admission to Special Care Nursery or Neonatal Intensive Care Units. Conclusion There is a great need for safety and efficacy information about the use of antipsychotic medications in pregnancy. Live, healthy babies are the most common outcome following the use of antipsychotic medication in pregnancy, but clinicians should be particularly mindful of neonatal problems such as respiratory distress.

The effect of Tai Chi on psychosocial well-being: a systematic review of randomized controlled trials

OBJECTIVE This systematic review aimed to critically appraise published clinical trials designed to assess the effect of Tai Chi on psychosocial well-being. DATA SOURCES Databases searched included MEDLINE, CINAHL, EMBASE, HEALT, PsycINFO, CISCOM, the Cochrane Central Register of Controlled Trials of the Cochrane Library, and dissertations and conference proceedings from inception to August 2008. REVIEW METHODS Methodological quality was assessed using a modified Jadad scale. A total of 15 studies met the inclusion criteria (i.e. English publications of randomized controlled trials with Tai Chi as an intervention and psychological well-being as an outcome measure), of which eight were high quality trials. The psychosocial outcomes measured included anxiety (eight studies), depression (eight studies), mood (four studies), stress (two studies), general mental health three studies), anger, positive and negative effect, self-esteem, life satisfaction, social interaction and self-rated health (one study each). RESULTS Tai Chi intervention was found to have a significant effect in 13 studies, especially in the management of depression and anxiety. Although the results seemed to suggest Tai Chi is effective, they should be interpreted cautiously as the quality of the trials varied substantially. Furthermore, significant findings were shown in only six high quality studies. Moreover, significant between group differences after Tai Chi intervention was demonstrated in only one high quality study (the other three significant results were observed in non-high quality studies). Two high quality studies in fact found no significant Tai Chi effects. CONCLUSION It is still premature to make any conclusive remarks on the effect of Tai Chi on psychosocial well-being.

Social ideological influences on reported food consumption and BMI

BackgroundThe purpose of this study was to investigate relationships between ideological beliefs, perceptions of the importance of health behaviours, health attitudes, food consumption, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action (Fishbein & Ajzen, 1975).MethodsA survey was conducted among shoppers aged between 40 and 70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested with this empirical data (n = 410) for younger (n = 151) and older (n = 259) age groups using structural equation modelling.ResultsThe findings generally support the study hypotheses. For both groups, egalitarianism had a direct and positive influence on perceptions of the importance of health behaviours. Materialism and masculinity impacted negatively on health attitudes, which positively influenced importance of health behaviours. Perceptions of importance of health behaviours impacted positively on the consumption of healthy foods such as vegetables and fruits, but negatively on consumption of unhealthy foods including sweets and fats. However, BMI was significantly influenced by the consumption of unhealthy foods (e.g., sugar and fats) only for the younger age group. Hence, the associations between beliefs, attitudes, consumption behaviours, and BMI outcomes differed between younger and older age populations.ConclusionSocial ideological beliefs appear to influence health attitudes and thereafter, the consumption of healthy and unhealthy foods and BMI via different pathways.

Comparison of alternative estimation methods in confirmatory factor analyses of the general health questionnaire

This paper examines the implications of violating assumptions concerning the continuity and distributional properties of data in establishing measurement models in social science research. The General Health Questionnaire-12 uses an ordinal response scale. Responses to the GHQ-12 from 201 Hong Kong immigrants on arrival in Australia showed that the data were not normally distributed. A series of confirmatory factor analyses using either a Pearson product-moment or a polychoric correlation input matrix and employing either maximum likelihood, weighted least squares or diagonally weighted least squares estimation methods were conducted on the data. The parameter estimates and goodness-of-fit statistics provided support for using polychoric correlations and diagonally weighted least squares estimation when analyzing ordinal, nonnormal data.

Social ideological influences on food consumption, physical activity and BMI

We investigated relationships between ideological beliefs (i.e., diaphanous body image and environmental concerns), food attitudes, evening meal patterns, physical activity, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action. A survey was conducted among shoppers aged 40-70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested among female baby boomers (n=547) for younger (n=245) and older (n=302) age groups using structural equation modeling. Findings showed that diaphanous body image had a direct and positive influence on negative food attitudes, which is likely to lead to higher BMI for both age groups. Body image beliefs were positively related to physical activity only for women aged 56-70 years. In contrast, among women aged 40-55 years, strong pro-environmental concerns suggested less consumption of both healthy (e.g., fruit and vegetables) and unhealthy (e.g., sugar and fats) foods. Moreover, strong pro-animal concerns resulted in higher BMI for the younger women. As expected, increased physical activity negatively influenced BMI. Importantly, the associations between ideological beliefs, attitudes, evening meal patterns, and BMI differed between younger and older female baby boomers.

Who cooks from scratch and how do they prepare food

Purpose – There is increasing interest in the domestic preparation of food and with the postulated health benefits of “cooking from scratch”. The purpose of this paper is to examine the demographic and food preparation associations of this term in order to examine its operational value. Design/methodology/approach – A national online survey was conducted during 2012 in Australia among 1,023 domestic food providers, half of whom were men. Questions were asked about cooking from scratch, demographic characteristics, food preparation practices and interest in learning about cooking. Findings – Three quarters of the sample reported they often or always “cooked from scratch” (CFS). More women than men always CFS; fewer 18-29 year olds did so often or always but more of the over 50s always did so; fewer single people CFS than cohabiting people. No statistically significant ethnic, educational background or household income differences were found. High levels of cooking from scratch were associated with interest...

Classification of main meal patterns--a latent class approach.

Relatively little examination of the meals that are prepared in households has been conducted, despite their well-defined properties and widespread community interest in their preparation. The purpose of the present study was to identify the patterns of main meal preparation among Australian adult household meal preparers aged 44 years and younger and 45 years and over, and the relationships between these patterns and likely socio-demographic and psychological predictors. An online cross-sectional survey was conducted by Meat and Livestock Australia among a representative sample of people aged 18–65 years in Australia in 2011. A total of 1076 usable questionnaires were obtained, which included categorical information about the main meal dishes that participants had prepared during the previous 6 months along with demographic information, the presence or absence of children at home, confidence in seasonal food knowledge and personal values. Latent class analysis was applied and four types of usage patterns of thirty-three popular dishes were identified for both age groups, namely, high variety, moderate variety, high protein but low beef and low variety. The meal patterns were associated differentially with the covariates between the age groups. For example, younger women were more likely to prepare a high or moderate variety of meals than younger men, while younger people who had higher levels of education were more likely to prepare high-protein but low-beef meals. Moreover, young respondents with higher BMI were less likely to prepare meals with high protein but low beef content. Among the older age group, married people were more likely to prepare a high or moderate variety of meals than people without partners. Older people who held strong universalist values were more likely to prepare a wide variety of meals with high protein but low beef content. For both age groups, people who had children living at home and those with better seasonal food knowledge were more likely to prepare a high variety of dishes. The identification of classes of meal users would enable health communication to be tailored to improve meal patterns. Moreover, the concept of meals may be useful for health promotion, because people may find it easier to change their consumption of meals rather than individual foods.

Changes in Doctors’ Working Hours A Longitudinal Analysis

The study examined changes in doctors’ working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply.

Demographic and psychographic associations of consumer intentions to purchase healthier food products

Objective This study investigated the associations of nutrition concerns, demographics, universalism (community oriented) values, perceived control over personal health and food buying, and perceived influence over the food system with intentions to purchase low fat, sugar and salt (LFSS) food products. Methods A national online survey of 2204 Australian consumers administered in November 2011. Structural equation modeling was used to examine associations of LFSS purchasing intentions with demographic, values, perceived control, and influence factors. Results Nutrition concern, perceived influence over the food system, and universalism values were key predictors of LFSS purchasing intentions. Almost two thirds (64.6%) of the variance associated with LFSS purchasing was explained by the structural equation model. Conclusion Communication programs which focus on universalism values, nutrition concern and perceived influence over the food system are likely to increase LFSS purchasing and perhaps reduce the demand for energy dense, nutrient poor foods.

Retirement patterns of Australian doctors aged 65 years and older

OBJECTIVE To investigate retirements over a 4-year period among Australian general practitioners (UPs) and specialists aged 65 years and over, and factors influencing retirement. METHODS Data from Medicine in Australia: Balancing Employment and Life (MABEL) for the years 2009-12 were analysed for 435 GPs and 643 specialists aged 65 years and over at the time of entry to the MABEL survey. Discrete time survival analysis was used. RESULTS The retirement rates were 4.1% (2009), 5.1% (2010), 4.2% (2011) and 10.4% (2012). Retirement was associated with: (1) the intention to leave medical work in 2009 and 2010; (2) working fewer hours in private consulting rooms in 2010 and 2012; (3) having lower job satisfaction in 2009 and 2011; (4) being older in 2009; (5) working fewer hours in a public hospital in 2012; and (6) working fewer hours in a private hospital in 2010. Doctors who intended to reduce their working hours were less likely to retire in 2009. CONCLUSIONS Strategies to support doctors at the late career stage to provide their valued contributions to the medical workforce for as long as possible may include increasing job satisfaction and addressing barriers to reducing work hours.