2021 |
Melka A, Chojenta C, Holliday E, Loxton D, 'E-cigarette use and cigarette smoking initiation among Australian women who have never smoked', Drug and Alcohol Review, 40 68-77 (2021)
© 2020 Australasian Professional Society on Alcohol and other Drugs Introduction and Aim: Evidence regarding the association between e-cigarette use and subsequent initiation of s... [more]
© 2020 Australasian Professional Society on Alcohol and other Drugs Introduction and Aim: Evidence regarding the association between e-cigarette use and subsequent initiation of smoking mostly relates to the US population. In Australia, no studies are available investigating the association between the uses of e-cigarettes and smoking initiation among young adults who have never smoked. This study aimed to determine the association between lifetime e-cigarette use and subsequent initiation of cigarette smoking among tobacco-naïve Australian women aged 20¿27. Design and Methods: The current study used data (n = 5398) from the third (2015) and fourth (2016) surveys collected from a cohort of Australian women born in 1989¿1995 who participated in the Australian Longitudinal Study on Women's Health. Multivariable logistic regression was used to identify the association between lifetime e-cigarette use at the baseline survey and initiation of cigarette smoking (smoked 100 cigarettes or more in the last year) at the follow up adjusting for possible confounders. Effects were expressed as odds ratios with 95% confidence interval. Results: The mean (± SD) age of the study participants at baseline (third survey) was 22.5 (±1.7). Ever e-cigarette use at baseline was positively associated with smoking initiation at follow up (adjusted odds ratio 3.71; 95% confidence interval 2.33, 5.93). History of depression, binge drinking and higher childhood adversity score were also risk factors for subsequent smoking initiation in the follow up. Discussion and Conclusions: This study identified a strong association between e-cigarette use and subsequent initiation of smoking. Enforcing the existing restriction of sale and supply of e-liquid containing nicotine is essential to prevent never smokers from nicotine addiction via e-cigarettes.
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2021 |
Loxton D, Forder PM, Cavenagh D, Townsend N, Holliday E, Chojenta C, Melka AS, 'The impact of adverse childhood experiences on the health and health behaviors of young Australian women', Child Abuse and Neglect, 111 (2021)
© 2020 Elsevier Ltd Background: Adverse childhood experiences have been linked to poor health and adverse health behavior in adulthood. Objective: This study aimed to estimate the... [more]
© 2020 Elsevier Ltd Background: Adverse childhood experiences have been linked to poor health and adverse health behavior in adulthood. Objective: This study aimed to estimate the prevalence of adverse childhood experiences among young Australian women (aged 20¿25) and examine associations between adverse childhood experiences and adult health behaviors and physical and mental health. Participants and Settings: Data were from the 1989-95 cohort of the Australian Longitudinal Study on Women's Health, who completed the Adverse Childhood Experiences Scale at Survey 3 in 2015 (N = 8609). Methods: Outcomes included: self-rated health, sexual health, psychological distress, depression, anxiety, suicide ideation, self-harm, substance abuse (drinking, smoking, illicit drugs), severe obesity, and exercise. Prevalence of childhood adversities were presented, with the association between childhood adversity and outcomes evaluated using log-binomial multivariable regressions (99% CI). Results: While 59% of women reported experiencing at least one childhood adversity, 10% of participants reported adverse childhood experiences across four or more categories, indicating a significant burden of risk for young Australian women. Women reporting four or more categories had higher rates of poor physical health (adjPR = 1.79, 99% CI = 1.51¿2.12), sexually transmitted infections (adjPR = 1.36, 99% CI = 1.11¿1.67), and poor mental health (adjPR = 2.78, 99% CI = 2.34¿3.32), and increased rates of severe obesity (adjPR = 2.14, 99% CI = 1.61¿2.86) and smoking (adjPR = 2.23, 99% CI = 1.89¿2.64). Conclusion: Using nationally representative data, this study shows adverse childhood experiences directly impact physical and mental health, and health behaviors in adulthood among young Australian women. The management of health and wellbeing in adulthood should look beyond the contemporaneous factors, incorporating a focus on how childhood adversity may negatively influence health behavior, health and wellbeing in later life.
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2021 |
Baldwin JN, Forder PM, Haslam R, Hure A, Loxton D, Patterson AJ, Collins CE, 'Lower Vegetable Variety and Worsening Diet Quality Over Time Are Associated With Higher 15-Year Health Care Claims and Costs Among Australian Women', Journal of the Academy of Nutrition and Dietetics, (2021)
© 2020 Academy of Nutrition and Dietetics Background: The relationship between diet quality and health care costs is unclear. Objective: The aim of this study was to investigate t... [more]
© 2020 Academy of Nutrition and Dietetics Background: The relationship between diet quality and health care costs is unclear. Objective: The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. Design: Data from a longitudinal cohort study were analyzed. Participants/setting: Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health were analyzed. Main outcome measures: Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia's universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change (¿diet quality worsened¿ [ARFS change = ¿4 points], ¿remained stable¿ [¿3 = change in ARFS =3 points], or ¿improved¿ [ARFS change =4 points]). Statistical analyses: Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status. Results: Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]). Conclusions: Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.
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2021 |
Musa A, Chojenta C, Loxton D, 'The association between intimate partner violence and low birth weight and preterm delivery in eastern Ethiopia: Findings from a facility-based study', Midwifery, 92 (2021) [C1]
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2020 |
Khan MN, Harris ML, Loxton D, 'Does unintended pregnancy have an impact on skilled delivery care use in Bangladesh? A nationally representative cross-sectional study using Demography and Health Survey data.', J Biosoc Sci, 1-17 (2020)
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2020 |
Kibret KT, Chojenta C, D'Arcy E, Loxton D, 'Population attributable fraction estimates for factors associated with different types of anaemia among women in Ethiopia: multilevel multinomial analysis.', Public Health Nutr, 1-11 (2020)
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2020 |
Coombe J, Anderson AE, Townsend N, Rae KM, Gilbert S, Keogh L, et al., 'Factors influencing contraceptive use or non-use among Aboriginal and Torres Strait Islander people: a systematic review and narrative synthesis', Reproductive Health, 17 1-17 (2020) [C1]
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2020 |
Khan MN, Harris M, Loxton D, 'Modern contraceptive use following an unplanned birth in Bangladesh: An analysis of national survey data', International Perspectives on Sexual and Reproductive Health, 46 77-87 (2020) [C1]
© 2020, Guttmacher Institute. All rights reserved. CONTEXT: Ineffective use or nonuse of contraceptives following an unplanned birth can contribute to the risk of a subsequent uni... [more]
© 2020, Guttmacher Institute. All rights reserved. CONTEXT: Ineffective use or nonuse of contraceptives following an unplanned birth can contribute to the risk of a subsequent unintended pregnancy; however, the literature on the relationship between unintended pregnancy and postpartum contraceptive use is sparse, especially in low-and middle-income countries. METHODS: Data on 4,493 women from the 2014 Bangladesh Demographic and Health Survey were analyzed; the subjects of the analysis had had a live birth in the three years prior to the survey and were currently at risk of pregnancy. Multilevel logistic regression analysis was used to examine associations between the intendedness of a woman¿s last pregnancy resulting in a live birth and her current modern contraceptive use adjusting for individual, household and community-level variables. RESULTS: Twenty-six percent of women reported that their last pregnancy resulting in a live birth had been unintended (15% mistimed and 11% unwanted); 61% reported current use of a modern contraceptive method. Compared with women who reported the pregnancy as having been wanted, those who reported the pregnancy as mistimed had greater odds of current modern contraceptive use (odds ratio, 1.6); no association was found between having had an unwanted pregnancy and subsequent modern contraceptive use. Other important correlates of modern contraceptive use included women¿s autonomy and desire for children, time since last birth and community-level poverty. CONCLUSIONS: Bangladeshi women who experience an unwanted pregnancy may have an elevated risk of subsequent unintended pregnancy. Broader coverage of family planning services, and integration of family planning with maternal health care, may increase modern contraceptive use following an unplanned birth.
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2020 |
Feyissa TR, Harris ML, Loxton D, 'Discussing Reproductive Plans with Healthcare Providers by Sexually Active Women Living with HIV in Western Ethiopia', AIDS and Behavior, 24 2842-2855 (2020) [C1]
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2020 |
Tegegne TK, Chojenta C, Getachew T, Smith R, Loxton D, 'Giving birth in Ethiopia: a spatial and multilevel analysis to determine availability and factors associated with healthcare facility births', BJOG: An International Journal of Obstetrics and Gynaecology, 127 1537-1546 (2020) [C1]
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2020 |
Khan MN, Harris ML, Loxton D, 'Low utilisation of postnatal care among women with unwanted pregnancy: A challenge for Bangladesh to achieve Sustainable Development Goal targets to reduce maternal and newborn deaths.', Health Soc Care Community, (2020)
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2020 |
Kiross GT, Chojenta C, Barker D, Loxton D, 'The effects of health expenditure on infant mortality in sub-Saharan Africa: evidence from panel data analysis.', Health Econ Rev, 10 5 (2020)
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2020 |
William J, Loong B, Chojenta C, Loxton D, 'The profiles of public and private patients in maternal healthcare: A longitudinal study to examine adverse selection', Annals of Actuarial Science, 14 129-137 (2020) [C1]
© Institute and Faculty of Actuaries 2019. In this article, we investigate differences in the profiles of patients within the Australian mixed public-private maternal health syste... [more]
© Institute and Faculty of Actuaries 2019. In this article, we investigate differences in the profiles of patients within the Australian mixed public-private maternal health system to examine the extent of adverse selection. There are conflicting influences on adverse selection within the private health sector in Australia due to government regulations that incentivise lower risk segments of the population to purchase community-rated private health insurance. We use a two-phase modelling methodology that incorporates statistical learning and logistic regression on a dataset that links administrative and longitudinal survey data for a large cohort of women. We find that the key predictor of private patient status is having private health insurance, which itself is largely driven by sociodemographic factors rather than health-or pregnancy-related factors. Additionally, transitioning between the public-private systems for a subsequent pregnancy is uncommon; however, it is primarily driven by changes in private health insurance when it occurs. Other significant factors when transitioning to the private system for a second pregnancy are hypertension, increased access to specialists and stress related to previous motherhood experiences. Consequently, there is limited evidence of adverse selection in this market, with targeted financial incentives likely outweighing the impact of community rating even during childbearing years where private health service use increases.
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2020 |
Schumacher TL, Frawley J, Pringle KG, Keogh L, Sutherland K, Herden J, et al., 'Contraception usage and the desired number of offspring of Indigenous women from the Gomeroi lands', Australian Journal of Rural Health, 28 360-365 (2020) [C1]
© 2020 National Rural Health Alliance Ltd. Objectives: To describe the current contraception usage patterns from a cohort of Australian Indigenous women, including their ideal fam... [more]
© 2020 National Rural Health Alliance Ltd. Objectives: To describe the current contraception usage patterns from a cohort of Australian Indigenous women, including their ideal family size and spacing between children. Design: Cross-sectional analysis of data (2012-2019). Setting: Data are from a longitudinal study, the Gomeroi gaaynggal (babies from Gomeroi lands) program, based in rural and remote Gomeroi lands in New South Wales. Participants: Women carrying an Indigenous baby who enrolled during pregnancy were eligible for the study. The mother and child are then followed for up to 10¿years. Main outcome measures: Contraception usage in the postnatal period was recorded, as well as whether they were sexually active, whether they wanted more children and their preferred spacing between children. Medical, social and demographic information was also collected. These measures were self-reported via an online tool (Survey Monkey®) at their first visit to the study following the birth of their child. Results: Ninety-nine women were included in the analysis. Most women reported that they were sexually active at the time they were questioned about their contraceptive usage. The most popular contraception choices were condoms, the oral contraceptive pill and implant rods. Those answering that they did not want more children had a median of three children already. Those who wanted more children had a median of one child. The majority of the women stated that 2-3¿years between babies was ideal. Conclusion: The sampled women had clear beliefs about their ideal family size, in which contraceptive usage played an important part.
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2020 |
Feyissa T, 'Contraceptive use among sexually active women living with HIV in western Ethiopia', PLoS ONE, 15 (2020)
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2020 |
Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D, 'The mediation effect of contraceptive use and women's autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia', BMC Public Health, 20 1408-1422 (2020) [C1]
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2020 |
Rowlands IJ, Holder C, Forder PM, Hegarty K, Dobson AJ, Loxton D, 'Consistency and Inconsistency of Young Women's Reporting of Intimate Partner Violence in a Population-Based Study', VIOLENCE AGAINST WOMEN, (2020)
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2020 |
Kibret KT, Chojenta C, D'Arcy E, Loxton D, 'The effect of dietary patterns on hypertensive disorders of pregnancy in North Shewa, Ethiopia: A propensity score matched case-control study', Pregnancy Hypertension, 22 24-29 (2020) [C1]
© 2020 International Society for the Study of Hypertension in Pregnancy Objective: This study aimed to assess the effect of dietary patterns during pregnancy on HDP. A propensity ... [more]
© 2020 International Society for the Study of Hypertension in Pregnancy Objective: This study aimed to assess the effect of dietary patterns during pregnancy on HDP. A propensity score matched case-control study was conducted with 340 pregnant women (71 cases and 269 controls) in North Shewa Zone, Ethiopia. Data were collected through an interviewer-administered questionnaire and maternal anthropometry measurements. After propensity score matching, a conditional logistic regression model was used to identify the independent predictors of HDP by adjusting for the confounders. A p-value of < 0.05 was taken as statistically significant. Results: A high dietary diversity score (Adjusted Odd Ratio (AOR) = 0.45; 95% CI: 0.21, 0.93) was associated with a lower odds of HDP. Being merchant (AOR = 3.71 (95% CI: 1.16, 11.89), having previous history of HDP (AOR = 27.58; 95% CI: 4.53, 168.06) and high hemoglobin level (AOR = 2.26; 95% CI: 1.66, 3.09) were associated with an increased odds of HDP. Diet is an amendable factor, and the promotion of diversified diet is an important approach for preventing the occurrence of HDP. Women should be counselled to diversify their dietary intake to include a high amount of vegetables, legumes, and fruit.
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2020 |
Baldwin JN, Forder PM, Haslam RL, Hure AJ, Loxton DJ, Patterson AJ, Collins CE, 'Change in Diet Quality over 12 Years in the 1946-1951 Cohort of the Australian Longitudinal Study on Women's Health', NUTRIENTS, 12 (2020) [C1]
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2020 |
Tesfaye G, Chojenta C, Smith R, Loxton D, 'Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study', Women and Birth, 33 e216-e226 (2020) [C1]
© 2019 Australian College of Midwives Background: In Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain wome... [more]
© 2019 Australian College of Midwives Background: In Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain women from attending these services have not yet been sufficiently explored. Using qualitative methods, we aimed to explore the factors that delay maternal health service utilization in eastern Ethiopia. Method: A total of 13 audio-recorded focus group discussions were conducted comprising 88 participants. We conducted separate group discussions with reproductive aged women, mothers-in-law, traditional birth attendants, husbands, and Health Extension Workers to capture their knowledge, practices, feelings, thoughts and attitudes towards maternal health service utilization. The recorded sessions were transcribed into the local language and then translated into English for analysis. Result: The study identified a number of factors that may delay maternal health service utilization. Factors were grouped using the Three Delays model as a framework. Low level of awareness regarding need, poor involvement of husband, perceived absence of health problems, social power, community misperceptions and cultural restrictions, negative attitudes towards male midwives, acceptance of traditional birth attendants and poor social networking were Delay One factors. Lack of physical accessibility and high transportation costs were categorised as Delay Two factors for skilled birth care attendance. Perceived or experienced poor quality of care were categorised as Delay Three factors for both skilled birth and postnatal care utilization. Conclusion: Despite the ongoing government measures to improve maternal health service utilization in Ethiopia, numerous factors continue to contribute to delays in service use, which in turn contribute to high maternal mortality.
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2020 |
Khan MN, Harris ML, Oldmeadow C, Loxton D, 'Effect of unintended pregnancy on skilled antenatal care uptake in Bangladesh: analysis of national survey data', Archives of Public Health, 78 81-94 (2020) [C1]
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2020 |
Bagade T, Chojenta C, Harris ML, Nepal S, Loxton D, 'Does gender equality and availability of contraception influence maternal and child mortality? A systematic review', BMJ Sexual and Reproductive Health, 46 244-253 (2020) [C1]
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Background Current global maternal and child health policies rarely va... [more]
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Background Current global maternal and child health policies rarely value gender equality or women's rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality. Methods A systematic review was conducted to investigate the current evidence. Studies were eligible if three themes -namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality -were present together in a single article analysing the same sample at the same time. Results Even though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women's contraceptive use increased the risk of IPV. The third study found that the mother's secondary education attainment significantly reduced child mortality, while the mother's working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality. Conclusion Improvement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.
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2020 |
Geleto A, Chojenta C, Taddele T, Loxton D, 'Magnitude and determinants of obstetric case fatality rate among women with the direct causes of maternal deaths in Ethiopia: a national cross sectional study', BMC PREGNANCY AND CHILDBIRTH, 20 (2020) [C1]
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2020 |
Shifti DM, Chojenta C, Holliday EG, Loxton D, 'Application of geographically weighted regression analysis to assess predictors of short birth interval hot spots in Ethiopia', PLOS ONE, 15 (2020) [C1]
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2020 |
Harris ML, Coombe J, Forder PM, Lucke JC, Bateson D, Loxton D, 'Young Women's Complex Patterns of Contraceptive Use: Findings from an Australian Cohort Study', Perspectives on Sexual and Reproductive Health, 52 181-190 (2020)
Copyright © 2020 by the Guttmacher Institute CONTEXT: Unintended pregnancy is common among young women. Understanding how such women use contraceptives¿ including method combinati... [more]
Copyright © 2020 by the Guttmacher Institute CONTEXT: Unintended pregnancy is common among young women. Understanding how such women use contraceptives¿ including method combinations¿is essential to providing high-quality contraceptive care. METHODS: Data were from a representative cohort of 2,965 Australian women aged 18¿23 who participated in the 2012¿2013 Contraceptive Use, Pregnancy Intention and Decisions baseline survey, had been heterosexually active in the previous six months, and were not pregnant or trying to conceive. Latent class analysis was employed to characterize women's contraceptive choices; multinomial logistic regression was used to evaluate correlates of membership in the identified classes. RESULTS: The vast majority of women (96%) reported using one or more contraceptives, most commonly short-acting hormonal methods (60%), barrier methods (38%), long-acting contraceptives (16%) and withdrawal (15%). In total, 32 combinations were reported. Four latent classes of method use were identified: no contraception (4% of women); short-acting hormonal methods with supplementation (59%, mostly the pill); high-efficacy contraceptives with supplementation (15%, all long-acting reversible contraceptive users); and low-efficacy contraceptive combinations (21%); supplementation usually involved barrier methods or withdrawal. Class membership differed according to women's characteristics; for example, women who had ever been pregnant were more likely than other women to be in the no-contraception, high-efficacy contraceptive or low-efficacy contraceptive combination classes than in the short-acting hormonal contraceptive class (odds ratios, 2.0-3.0). CONCLUSIONS: The complexity of women's contraceptive choices and the associations between latent classes and such characteristics as pregnancy history highlight the need for individualized approaches to pregnancy prevention and contraceptive care.
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2020 |
Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D, 'Intimate partner violence against women in Ethiopia and its association with unintended pregnancy: a national cross-sectional survey', International Journal of Public Health, 65 1657-1667 (2020) [C1]
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2020 |
Tiruye TY, Chojenta C, Harris ML, Holliday E, Loxton D, 'Intimate partner violence against women and its association with pregnancy loss in Ethiopia: evidence from a national survey', BMC WOMENS HEALTH, 20 (2020) [C1]
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2020 |
Khan MN, Harris ML, Loxton D, 'Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey', PLoS ONE, 15 1-20 (2020) [C1]
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2020 |
Kakoly NS, Earnest A, Loxton D, Teede HJ, Joham AE, 'SAT-015 Incidence and Predictors of Hypertension in a Cohort of Australian Women with and Without Polycystic Ovary Syndrome', Journal of the Endocrine Society, 4 (2020)
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2020 |
Moss KM, Reilly N, Dobson AJ, Loxton D, Tooth L, Mishra GD, 'How rates of perinatal mental health screening in Australia have changed over time and which women are missing out', Australian and New Zealand Journal of Public Health, 44 301-306 (2020) [C1]
© 2020 The Authors Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally a... [more]
© 2020 The Authors Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013¿2017). Methods: A longitudinal community-based study of self-reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results: From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52¿0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60¿0.99) were less likely to have been screened both antenatally and postnatally. Conclusions: Despite improvements, perinatal mental health screening is not yet universal. One-in-five women are not screened both antenatally and postnatally, including women in high-risk populations such as those who have reported emotional distress. Implications for public health: Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed.
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2020 |
Geleto A, Chojenta C, Taddele T, Loxton D, 'Association between maternal mortality and caesarean section in Ethiopia: A national cross-sectional study', BMC Pregnancy and Childbirth, 20 (2020) [C1]
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2020 |
Meazaw MW, Chojenta C, Muluneh MD, Loxton D, 'Systematic and meta-analysis of factors associated with preeclampsia and eclampsia in sub-Saharan Africa.', PloS one, 15 (2020) [C1]
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2020 |
Reilly N, Kingston D, Loxton D, Talcevska K, Austin MP, 'A narrative review of studies addressing the clinical effectiveness of perinatal depression screening programs', Women and Birth, 33 51-59 (2020) [C1]
© 2019 Australian College of Midwives Background: Clinical practice guidelines recommend that women be screened for depression as a routine component of maternity care however the... [more]
© 2019 Australian College of Midwives Background: Clinical practice guidelines recommend that women be screened for depression as a routine component of maternity care however there is ongoing debate about the benefits of depression screening programs in this context. Aim: This narrative review identifies and describes the clinical effectiveness of perinatal depression screening programs in relation to one or more of the following interrelated domains: referral for additional mental health support or treatment; engagement with mental health support or treatment options; and, maternal mental health or parenting outcomes. Methods: English-language studies, published up to July 2017, were identified and their methodological quality was assessed. RCTs and non-RCTs were included. Results: Overall, the majority of the fourteen studies identified showed that participation in a perinatal depression screening program increases referral rates and service use, and is associated with more optimal emotional health outcomes. One of four available studies demonstrated an improvement in parenting outcomes as a result of participation in an integrated postnatal depression screening program. Conclusion: This small but important body of work is integral to the continuing debate over the merits of screening for depression in the perinatal period. Current evidence favours the overall benefits of perinatal depression screening programs across the three focus areas of this review. Future research should consider a woman's broader psychosocial context and should address the economic as well as clinical outcomes of these programs. Rigorous evaluation of emerging digital approaches to perinatal depression screening is also required.
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2020 |
Shifti DM, Chojenta C, Holliday EG, Loxton D, 'Socioeconomic inequality in short birth interval in Ethiopia: A decomposition analysis', BMC Public Health, 20 (2020) [C1]
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2020 |
Tegegne TK, Chojenta C, Forder PM, Getachew T, Smith R, Loxton D, 'Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis', BMJ open, 10 1-11 (2020) [C1]
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2020 |
Tay CT, Teede HJ, Loxton D, Kulkarni J, Joham AE, 'Psychiatric comorbidities and adverse childhood experiences in women with self-reported polycystic ovary syndrome: An Australian population-based study', Psychoneuroendocrinology, 116 (2020)
© 2020 Elsevier Ltd Purpose: PCOS is associated with increased risk for depression and anxiety but its association with other psychiatric disorders is less clear, especially in co... [more]
© 2020 Elsevier Ltd Purpose: PCOS is associated with increased risk for depression and anxiety but its association with other psychiatric disorders is less clear, especially in community drawn populations. We aimed to investigate the prevalence of psychiatric disorders in women with PCOS and examine the factors associated with psychiatric disorders in this population. Method: A cross-sectional analysis of survey data was performed in community-recruited women born 1989-95 from the Australian Longitudinal Study of Women's Health (ALSWH). 760 and 7910 women with and without self-reported PCOS were included. The outcomes examined were self-reported depression, anxiety, post-traumatic stress disorder, bipolar affective disorder, obsessive compulsive disorder, borderline personality disorder and other disorders. The main explanatory variable was self-reported PCOS status. Other factors examined included adverse childhood experience scale (ACES), social support, perceived stress, sociodemographic and lifestyle factors. Chi-square tests were used to examine the differences in prevalence between groups. Logistic regression analyses were performed to assess factors associated with psychiatric disorders. Results: Women with PCOS reported a significantly higher prevalence of the psychiatric disorders examined, compared with women without PCOS. PCOS was significantly associated with depression (adjusted odds ratio (OR) 1.4, 95 % confidence interval (CI) 1.2-1.7), anxiety (adjusted OR 1.2, 95 % CI 1.0-1.5), post-traumatic stress disorder (adjusted OR 1.5, 95 % CI 1.1-1.9) and obsessive compulsive disorder (adjusted OR 1.8, 95 % CI 1.2-2.5). More women with PCOS reported adverse childhood experiences (ACES =4: 19.3 % vs 9.2 %) and this was the strongest factor associated with psychiatric disorders (ACES =4: adjusted OR 2.9, 95 % CI 2.4-3.5). Conclusions: Women with PCOS had higher prevalence of various psychiatric conditions and adverse childhood experiences compared with women without PCOS. ACES was the strongest correlate of psychiatric disorders. These findings support PCOS is a reproductive, metabolic and psychological disorder and reinforces guideline recommendations to assess psychological wellbeing for in women with PCOS.
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2020 |
Tiruye TY, Chojenta C, Harris ML, Holliday E, Loxton D, 'The Role of Maternal Intimate Partner Violence Victimization on Neonatal Mortality in Ethiopia', JOURNAL OF INTERPERSONAL VIOLENCE, (2020)
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2020 |
Khan MN, Harris ML, Loxton D, 'Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey (vol 15, e0242729, 2020)', PLOS ONE, 15 (2020)
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2020 |
Cations M, Keage HAD, Laver KE, Byles J, Loxton D, 'Impact of Historical Intimate Partner Violence on Wellbeing and Risk for Elder Abuse in Older Women.', Am J Geriatr Psychiatry, (2020)
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2020 |
Shifti DM, Chojenta C, Holliday EG, Loxton D, 'Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis', PLOS ONE, 15 (2020) [C1]
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2020 |
Geleto A, Chojenta C, Taddele T, Loxton D, 'Incidence of maternal near miss among women in labour admitted to hospitals in Ethiopia', MIDWIFERY, 82 (2020) [C1]
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2020 |
Musa A, Chojenta C, Loxton D, 'High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study', PLOS ONE, 15 (2020) [C1]
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2020 |
Tekelab T, Chojenta C, Smith R, Loxton D, 'Incidence and determinants of neonatal near miss in south Ethiopia: A prospective cohort study', BMC Pregnancy and Childbirth, 20 (2020) [C1]
© 2020 The Author(s). Background: For every neonate who dies, many others experience a near miss event that could have but did not result in death. Neonatal near miss is three to ... [more]
© 2020 The Author(s). Background: For every neonate who dies, many others experience a near miss event that could have but did not result in death. Neonatal near miss is three to eight times more frequent than neonatal deaths and, therefore, is more useful for assessing the determinants of adverse neonatal outcomes. The aim of this study was to assess the incidence and determinants of neonatal near miss in south Ethiopia. Methods: A facility-based prospective study was conducted among 2704 neonates between 12 July to 26 November 2018. The neonates were followed from the time of admission to hospital discharge or seven postpartum days if the newborn stayed in the hospital. The data were collected by interviewer-administered questionnaire and medical record review. Logistic regression was employed to identify the distant, intermediate and proximal factors associated with neonatal near miss. The independent variables were analysed in three hierarchical blocks. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were used to determine the strength of the associations. Results: The incidences of neonatal near miss and neonatal death were 45.1 (95% CI = 37.7-53.8) and 17.4 (95% CI = 13.0-23.3) per 1000 live births, respectively. Of those newborns who experienced neonatal near miss, more than half (59.8%) of their mothers were referred from other health facilities. After adjusting for potential confounders, the odds of neonatal near miss were significantly higher among neonates with a low monthly income (< 79 USD monthly), a birth interval of less than 24 months and where severe maternal complications had occurred. Conclusion: Strategies to improve neonatal survival need a multifaceted approach that includes socio-economic and health-related factors. The findings of this study highlight important implications for policymakers with regard to neonatal near miss. In particular, addressing inequalities by increasing women's income, promoting an optimal birth interval of 24 months or above through postpartum family planning, and preventing maternal complications may improve newborn survival.
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2020 |
Anderson AE, Cavenagh D, Forder P, Loxton D, Byles J, 'Alcohol-related risk from pre-loading and heavy episodic drinking (HED) among a cohort of young Australian women: a cross-sectional analysis', Australian and New Zealand Journal of Public Health, 44 382-389 (2020) [C1]
© 2020 The Authors Objective: To cross-sectionally examine heavy episodic drinking (HED) and pre-loading with alcohol among young Australian women in relation to the alcohol-induc... [more]
© 2020 The Authors Objective: To cross-sectionally examine heavy episodic drinking (HED) and pre-loading with alcohol among young Australian women in relation to the alcohol-induced adverse outcomes of memory loss, vomiting and injury. Methods: A total of 7,800 participants, aged 20¿25 years, from the 1989¿95 cohort of the Australian Longitudinal Study on Women's Health answered all questions on alcohol use, reported drinking alcohol in the previous year and were not pregnant at the third survey in 2015. Log-binomial models were used to estimate prevalence ratios for adverse outcomes associated with increased frequency of HED and pre-loading. Results: The majority of participants reported HED (83.4%) and/or pre-loading (65.6%), which had a moderate correlation (r=0.646). Just over half (55.2%) of participants experienced at least one adverse event, with vomiting being most common. As the frequency of HED or pre-loading increased, so did the risk of an adverse outcome. Conclusions: Both HED and pre-loading pose a risk to young Australian women, and that risk rises with increased frequency. Implications for public health: Although HED has been a target of public health policy and interventions, pre-loading has received limited attention. In addition to addressing HED, there is a need to consider the risk posed by pre-loading, a related, yet unique risky drinking behaviour.
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2020 |
Feyissa TR, Harris ML, Loxton D, '"They haven't asked me. I haven't told them either": fertility plan discussions between women living with HIV and healthcare providers in western Ethiopia', Reproductive health, 17 (2020) [C1]
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2020 |
Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D, 'Determinants of intimate partner violence against women in Ethiopia: A multi-level analysis', PLOS ONE, 15 (2020) [C1]
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2020 |
Geleto A, Chojenta C, Taddele T, Loxton D, 'Perceptions of midwives on the quality of emergency obstetric care at hospitals in Ethiopia: A qualitative explanatory study', Midwifery, 90 (2020) [C1]
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2020 |
Beyene AS, Chojenta C, Loxton DJ, 'Gender-based violence perpetration by male high school students in Eastern Ethiopia', International Journal of Environmental Research and Public Health, 17 1-14 (2020) [C1]
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Gender-based violence (GBV) perpetration is a global public health problem due to its detrimental effect on health and ed... [more]
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Gender-based violence (GBV) perpetration is a global public health problem due to its detrimental effect on health and education. This study aims to determine the prevalence of gender-based violence perpetration by male students in eastern Ethiopia. A cross-sectional study was conducted in eastern Ethiopia in December 2018. A total of 1064 male students were involved in the study. Data were collected using an adaptation of the WHO Multi-Country Study self-administered questionnaire on the Women Health and Life Event. Descriptive statistics were calculated using STATA version 14. The prevalence of gender-based violence committed by a male in the last 12 months was 55.83% (95% CI: 52.84¿58.82%). The prevalence of emotional abuse against an intimate or non-partner was 45.86% (95% CI: 42.87¿48.86%), physical abuse was 45.77% (95% CI: 42.77¿ 48.77%), and sexual abuse was 31.11% (95% CI: 28.32¿33.90%). The perpetration of multiple types of gender-based violence (emotional, physical, and sexual) was 47.15% (95% CI: 43.15¿51.25%), with 17.72% (95% CI: 14.75¿21.03%) reporting emotionally and physically violent acts, 14.21% (95% CI: 11.51¿17.27%) reporting emotionally violent acts only, and 12.88% (95% CI: 10.29¿15.82%) reporting physically violent acts only. There were statistically significant differences between the age of participants who committed acts of all forms of GBV in the ¿ever¿ timeframe and the past 12 months (p < 0.001). Effective prevention and intervention strategies should be developed at the school level to reduce gender-based violence perpetration.
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2020 |
Meazaw MW, Chojenta C, Muluneh MD, Loxton D, 'Factors associated with hypertensive disorders of pregnancy in sub-Saharan Africa: A systematic and meta-analysis.', PloS one, 15 (2020) [C1]
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2020 |
Feyissa TR, Harris ML, Forder PM, Loxton D, 'Fertility among women living with HIV in western Ethiopia and its implications for prevention of vertical transmission: a cross-sectional study.', BMJ open, 10 (2020) [C1]
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2020 |
Moss KM, Loxton D, Dobson AJ, Slaughter V, Mishra GD, 'Testing competing mediators of the association between pre-conception maternal depression and child health-related quality of life: the MatCH study', Archives of Women's Mental Health, 23 53-62 (2020) [C1]
© 2019, Springer-Verlag GmbH Austria, part of Springer Nature. Maternal depression is a potent risk factor for poor child development across a number of domains but the mechanisms... [more]
© 2019, Springer-Verlag GmbH Austria, part of Springer Nature. Maternal depression is a potent risk factor for poor child development across a number of domains but the mechanisms of transmission are poorly understood. This study aimed to test competing mediators of the association between pre-conception maternal depression and child psychosocial functioning. In 2016, mothers in the 1973¿1978 cohort of the Australian Longitudinal Study on Women¿s Health were asked to be part of the Mothers and their Children¿s Health study and to complete surveys on the health of their three youngest children under 13¿years. The current study includes children aged 0¿12¿years (N = 5532, M = 6.99¿years, SD = 3.22¿years) and their mothers (N = 2917). We used the CESD-10 to measure depression and the PedsQL to measure psychosocial functioning, and used multilevel structural equation modeling to test hypotheses. Pre-conception maternal depression was associated with poorer maternal mental health and parenting after birth. The effect of pre-conception maternal depression was mediated by post-birth maternal depression in children aged 0¿4¿years (unstandardized regression coefficient (B) = - 0.26, 95%CI - 0.38, - 0.13) and children aged 5¿12¿years (B = - 0.25, 95%CI - 0.34, - 0.16), and by post-birth maternal stress (B = - 0.04, 95%CI - 0.08, - 0.01), and parenting (B = - 0.03, 95%CI - 0.04, - 0.02) in children aged 5¿12¿years. Post-birth maternal depression was the strongest mediator. Pre-conception is the optimal time for depression intervention. Post-birth interventions should include a focus on reducing depression and improving negative parenting aspects such as hostility and discipline.
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2020 |
Cations M, Keage HAD, Laver KE, Byles J, Loxton D, 'Intimate Partner Violence and Risk for Mortality and Incident Dementia in Older Women.', J Interpers Violence, 886260520943712 (2020)
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2020 |
Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, Loxton D, 'Honesty and comfort levels in mothers when screened for perinatal depression and anxiety', Women and Birth, 33 e142-e150 (2020) [C1]
© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the ... [more]
© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the perinatal period; to investigate if honesty and comfort are associated with perinatal depression or perinatal anxiety; and to examine the reasons why women may not always respond honestly. Methods: Qualitative and quantitative data from 1597 women from the cross-sectional perinatal mental health substudy (part of the Australian Longitudinal Study on Women's Health) were analysed using a mixed methods approach. Results: When questioned by their health practitioner about their emotional wellbeing in the perinatal period, 20.7% of women indicated they had not always responded honestly. Reasons for not being honest reflected four main themes: normalizing of symptoms/coping; negative perceptions (self-and others); fear of adverse repercussions; and fear of involvement of health services (trust and confidentiality). The 38.9% of women who did not feel comfortable when questioned by their health practitioner about their emotional wellbeing were four times more likely to report perinatal depression (odds ratio = 4.09; 95% confidence interval = 2.55, 6.57) and nearly twice as likely to report perinatal anxiety (odds ratio = 1.90; 95% confidence interval = 1.24, 2.94) than other women. Conclusions: Women who are most likely to need mental health care during the perinatal period are also those least likely to be honest about their mental health. A non-judgemental, open and reassuring approach by clinicians may help to reduce the stigma and fears contributing to lack of honest responses, and improve early diagnosis and treatment of mental health problems.
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2019 |
William J, Chojenta C, Martin MA, Loxton D, 'An actuarial investigation into maternal out-of-hospital cost risk factors', Annals of Actuarial Science, 13 1-35 (2019) [C1]
© Institute and Faculty of Actuaries 2018. This paper adopts an actuarial approach to identify the risk factors of government-funded maternal out-of-hospital costs in Australia, w... [more]
© Institute and Faculty of Actuaries 2018. This paper adopts an actuarial approach to identify the risk factors of government-funded maternal out-of-hospital costs in Australia, with a focus on women who experience adverse birth outcomes. We use a two-phase modelling methodology incorporating both classification and regression trees and generalised linear models on a data set that links administrative and longitudinal survey data from a large sample of women, to address maternal out-of-hospital costs. We find that adverse births are a statistically significant risk factor of out-of-hospital costs in both the delivery and postnatal periods. Furthermore, other significant cost risk factors are in-vitro fertilisation, specialist use, general practitioner use, area of residence and mental health factors (including anxiety, intense anxiety, postnatal depression and stress about own health) and the results vary by perinatal sub-period and the patient's private health insurance status. We highlight these differences and use the results as an evidence base to inform public policy. Mental health policy is identified as a priority area for further investigation due to the dominance of these factors in many of the fitted models.
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2019 |
Kibret KT, Chojenta C, D'Arcy E, Loxton D, 'Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: A multilevel and spatial analysis', BMJ Open, 9 1-14 (2019) [C1]
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2019 |
Kiross GT, Chojenta C, Barker D, Tiruye TY, Loxton D, 'The effect of maternal education on infant mortality in Ethiopia: A systematic review and meta-analysis', PLoS ONE, 14 (2019) [C1]
© 2019 Kiross et al. Introduction Some studies in developing countries have shown that infant mortality is highly associated with maternal education, implying that maternal educat... [more]
© 2019 Kiross et al. Introduction Some studies in developing countries have shown that infant mortality is highly associated with maternal education, implying that maternal education might play an important role in the reduction of infant mortality. However, other research has shown that lower levels of maternal education does not have any significant contribution to infant survival. In this systematic review, we focus on the effect of different levels of maternal education on infant mortality in Ethiopia. Methods MEDLINE, EMBASE, CINAHL, Scopus, and Maternity and Infant Care databases were searched between November 15, 2017 and February 20, 2018. All articles published until February 20, 2018 were included in the study. The data extraction was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA 2009) guidelines. An I2 test was used to assess heterogeneity and a funnel plot was used to check publication bias. Findings We retrieved 441 records after removing duplications. During screening, 31 articles were fully accessed for data extraction. Finally, five articles were included for analysis. The overall pooled estimate indicated that attending primary education was associated with a 28% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.72 (95% CI = 0.66, 0.78). Another pooled estimate indicated that attending secondary education and above was associated with a 45% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.55 (95% CI = 0.47, 0.64).
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2019 |
Coombe J, Loxton D, Tooth L, Byles J, ' I can be a mum or a professional, but not both : What women say about their experiences of juggling paid employment with motherhood', Australian Journal of Social Issues, 54 305-322 (2019) [C1]
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2019 |
Tekelab T, Chojenta C, Smith R, Loxton D, 'The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis', PLoS ONE, 14 (2019) [C1]
© 2019 Tekelab et al. Background Newborns are at greatest risk of dying at and shortly after the time of birth. Newborn mortality remains an urgent concern and is an important ind... [more]
© 2019 Tekelab et al. Background Newborns are at greatest risk of dying at and shortly after the time of birth. Newborn mortality remains an urgent concern and is an important indicator of child health, development and well-being. Studies examining the effectiveness of antenatal care on maternal and newborn health outcomes have provided conflicting results. The aim of this review and meta-analysis was to determine the pooled effect of antenatal care on neonatal mortality in sub-Saharan Africa. Methods We searched PubMed, Medline, EMBASE, CINAHL and Google Scholar from September to November 2016 and then updated our search on April 13, 2019. Two independent reviewers extracted data from eligible studies. The quality of each included study was assessed using the Risk of Bias Assessment tool for Non-Randomized Studies (RoBANS). The results were reported based on risk ratio (RR) with 95% confidence intervals (CI) using a random-effects model. Results Eight hundred and ninety eight studies were initially identified. During screening, 23 studies were found to be relevant for data extraction. Of these, only twelve studies fulfilled the inclusion criteria and were included in the analysis. In five of the twelve studies included in the analysis, antenatal care service utilization had a significant association with neonatal mortality. The pooled risk ratio by the random-effects model was 0.61 (95% CI: 0.43, 0.86) for neonates born to women who received at least one antenatal care visit by a skilled provider as compared to neonates born to women who did not receive antenatal care. Conclusion This review indicates that utilization of at least one antenatal care visit by a skilled provider during pregnancy reduces the risk of neonatal mortality by 39% in sub-Saharan African countries. Thus, in order to accelerate progress towards the reduction of newborn deaths, all pregnant women should receive antenatal care during pregnancy.
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2019 |
Loxton D, Powers J, Townsend N, Harris ML, Forder P, 'Longitudinal inconsistency in responses to survey items that ask women about intimate partner violence', BMC MEDICAL RESEARCH METHODOLOGY, 19 (2019) [C1]
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2019 |
Moss KM, Loxton D, Dobson AJ, Slaughter V, Mishra GD, 'Testing competing mediators of the association between pre-conception maternal depression and child health-related quality of life: the MatCH study (January, 10.1007/S00737-019-0941-7, 2019)', ARCHIVES OF WOMENS MENTAL HEALTH, 23 447-447 (2019)
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2019 |
Loxton D, Townsend N, Dolja-Gore X, Forder P, Coles J, 'Adverse Childhood Experiences and Healthcare Costs in Adult Life', Journal of Child Sexual Abuse, 28 511-525 (2019) [C1]
© 2018, © 2018 Taylor & Francis. The current study aims to present the prevalence of adverse childhood experiences and examine the healthcare costs associated with primary, ... [more]
© 2018, © 2018 Taylor & Francis. The current study aims to present the prevalence of adverse childhood experiences and examine the healthcare costs associated with primary, allied, and specialist healthcare services. The Australian Longitudinal Study on Women¿s Health is a general health survey of four nationally representative age cohorts. The current study uses 20¿years of survey and administrative data (1996¿2015) from the cohort born 1973¿1978. Overall, 41% of women indicated at least one category of childhood adversity. The most commonly reported type of childhood adversity was having a household member with a mental illness (16%), with the most commonly reported ACES category being psychological abuse (17%). Women who had experienced adversity in childhood had higher healthcare costs than women who had not experienced adversity. The healthcare costs associated with experiences of adversity in childhood fully justify a comprehensive policy and practice review.
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2019 |
Melka AS, Chojenta CL, Holliday EG, Loxton DJ, 'Predictors of E-cigarette Use Among Young Australian Women', American Journal of Preventive Medicine, 56 293-299 (2019) [C1]
© 2018 Elsevier Ltd Introduction: E-cigarette use is controversial worldwide. The majority of previous studies on e-cigarette use were not gender specific. This study aimed to ide... [more]
© 2018 Elsevier Ltd Introduction: E-cigarette use is controversial worldwide. The majority of previous studies on e-cigarette use were not gender specific. This study aimed to identify the predictors of e-cigarette use among young Australian women. Methods: This study used cross-sectional data from the 1989¿1995 cohort of the Australian Longitudinal Study on Women's Health. In 2015, study participants (N=8,915) aged 19¿26 years completed an online survey. Multivariable logistic regression was used to identify predictors of e-cigarette use. Data were analyzed in 2018. Results: The prevalence of ever and past-year e-cigarette use among young Australian women was 11.1% and 6.4%, respectively. More than a quarter of past-year and ever e-cigarette users were never cigarette smokers. Use of e-cigarettes in the past year was associated with younger age (AOR per year increase=0.87, 95% CI=0.82, 0.93); financial difficulty (AOR=0.68, 95% CI=0.54, 0.87); being an ex-smoker (AOR=5.05, 95% CI=3.64, 7.01) or current cigarette smoker (AOR=10.01, 95% CI=7.77, 12.89); drinking at a level of lifetime risk of harm from alcohol-related disease or injury (AOR=1.23, 95% CI=1.01, 1.53). Ever e-cigarette use showed similar associations and was also associated with rural residence (AOR=0.74, 95% CI=0.60, 0.91) and intimate partner violence (AOR=1.44, 95% CI=1.17, 1.76). Conclusions: The high prevalence of e-cigarette use among never cigarette smokers has significant public health implications. Interventions to curb the use of e-cigarettes among young Australian women should focus on risk factors, such as early age, cigarette smoking, alcohol use, and intimate partner violence.
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2019 |
Feyissa TR, Harris ML, Melka AS, Loxton D, 'Unintended Pregnancy in Women Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-analysis', AIDS and Behavior, 23 1431-1451 (2019) [C1]
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. In 2014, about 1.5 million pregnancies occurred among HIV-positive women in low and middle-income countries.... [more]
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. In 2014, about 1.5 million pregnancies occurred among HIV-positive women in low and middle-income countries. To pool magnitude and factors associated with unintended pregnancy in women living with HIV in sub-Saharan Africa, a systematic search of electronic databases was undertaken in November 2016. Pooling the magnitude of unintended pregnancy reported by 14 studies yielded a crude summary prevalence of 55.9%. The magnitude of unwanted pregnancy and mistimed pregnancy in six studies ranged from 14 to 59 and 9 to 47.2%, respectively. Contraceptive failure was an important factor for many unintended pregnancies. The magnitude of unintended pregnancy was significantly higher in HIV-positive women than for HIV-negative women in three out of six studies. The available evidence suggests that there is a high magnitude of unintended pregnancy in this population. Improving effective contraceptive utilization is thus a priority to address unintended pregnancies and to prevent mother to child transmission of HIV. PROSPERO Number: CRD42016051310.
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2019 |
Tay CT, Teede HJ, Hill B, Loxton D, Joham AE, 'Increased prevalence of eating disorders, low self-esteem, and psychological distress in women with polycystic ovary syndrome: a community-based cohort study', Fertility and Sterility, 112 353-361 (2019) [C1]
© 2019 Objective: To evaluate the prevalence of eating disorders in women with polycystic ovary syndrome (PCOS) compared with women without PCOS and examine the relationship betwe... [more]
© 2019 Objective: To evaluate the prevalence of eating disorders in women with polycystic ovary syndrome (PCOS) compared with women without PCOS and examine the relationship between PCOS, body mass index, self-esteem, and psychological distress scores. Design: Cross-sectional, community-based study. Setting: Not applicable. Patient(s): A total of 8,467 participants born between 1989 and 1995 in the Australian Longitudinal Study on Women's Health with self-reported PCOS status (PCOS n = 875 vs. non-PCOS n = 7,592). Intervention(s): None. Main Outcome Measures(s): Self-reported eating disorders, Rosenberg Self-Esteem Scale, and Kessler psychological distress scale. Result(s): Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of eating disorders (11.0% vs. 7.6%), low self-esteem (31.7% vs. 24.2%), and psychological distress (severe psychological distress: 21.0% vs. 13.5%). After adjusting for confounders, women reporting PCOS were more likely to report eating disorders (adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2¿2.0). Low self-esteem and psychological distress were highly correlated and further increased the odds of eating disorders in women reporting PCOS. Polycystic ovary syndrome was significantly associated with low self-esteem and psychological distress but not after adjusting for confounders. Obesity was associated with low self-esteem (adjusted OR 1.5, 95% CI 1.2¿1.8) and psychological distress (adjusted OR 1.2, 95% CI 1.0¿1.4) but not eating disorders. Underweight women had increased odds for eating disorders (adjusted OR 2.5, 95% CI 1.8¿3.4). Conclusion(s): Women with PCOS are more likely to report low self-esteem, psychological distress, and eating disorders. Low self-esteem and psychological distress are highly correlated and further increased the risk for eating disorders.
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2019 |
Tekelab T, Chojenta C, Smith R, Loxton D, 'Factors affecting utilization of antenatal care in Ethiopia: A systematic review and meta-analysis', PLOS ONE, 14 (2019) [C1]
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2019 |
Chojenta C, William J, Martin MA, Byles J, Loxton D, 'The impact of a history of poor mental health on health care costs in the perinatal period', Archives of Women's Mental Health, 22 467-473 (2019) [C1]
© 2018, Springer-Verlag GmbH Austria, part of Springer Nature. The perinatal period is a critical time for mental health and is also associated with high health care expenditure. ... [more]
© 2018, Springer-Verlag GmbH Austria, part of Springer Nature. The perinatal period is a critical time for mental health and is also associated with high health care expenditure. Our previous work has identified a history of poor mental health as the strongest predictor of poor perinatal mental health. This study aims to examine the impact of a history of poor mental health on health care costs during the perinatal period. Data from the 1973¿1978 cohort of the Australian Longitudinal Study on Women¿s Health (ALSWH) were linked with a number of administrative datasets including the NSW Admitted Patient Data Collection and Perinatal Data Collection, the Medicare Benefits Scheme and the Pharmaceuticals Benefits Scheme between 2002 and 2011. Even when taking birth type and private health insurance status into account, a history of poor mental health resulted in an average increase of over 11% per birth across the perinatal period. These findings indicate that an investment in prevention and early treatment of poor mental health prior to child bearing may result in a cost saving in the perinatal period and a reduction of the incidence of women experiencing poor perinatal mental health.
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2019 |
Tegegne TK, Chojenta C, Getachew T, Smith R, Loxton D, 'Antenatal care use in Ethiopia: a spatial and multilevel analysis', BMC PREGNANCY AND CHILDBIRTH, 19 (2019) [C1]
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2019 |
Musa A, Chojenta C, Geleto A, Loxton D, 'The associations between intimate partner violence and maternal health care service utilization: A systematic review and meta-analysis', BMC Women's Health, 19 1-14 (2019) [C1]
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2019 |
Tesfaye G, Chojenta C, Smith R, Loxton D, 'Magnitude and correlates of postnatal care utilization among reproductive aged women in a rural district in eastern Ethiopia: A cross-sectional study', Midwifery, 70 22-30 (2019) [C1]
© 2018 Elsevier Ltd Background: Postnatal care is critical to detect and manage postpartum complications in the early stages as well as to prevent potentially life-threatening hea... [more]
© 2018 Elsevier Ltd Background: Postnatal care is critical to detect and manage postpartum complications in the early stages as well as to prevent potentially life-threatening health conditions that lead to maternal death. However, postnatal care utilization is persistently low in Ethiopia. The aim of this study is to assess the magnitude and correlates of postnatal care utilization among reproductiveaged women in Kersa district, in eastern Ethiopia. Methods: A community based cross-sectional study was conducted in ten randomly selected sub-districts in Kersa district. Respondents were recruited using systematic random sampling techniques. Data were collected by an interviewer-administered questionnaire using iPads. A total of 1206 respondents¿ data were considered in the analysis. Frequency and percentage distributions of the variables were performed. Bivariate and multivariate logistic regression analyses were undertaken to identify the predisposing, enabling and need factors associated with postnatal care utilization. An Odds Ratio with 95% confidence interval was used to ascertain the direction and strength of the association. Results: Less than one in thirteen women attended postnatal care after their last delivery in the study community. The multivariate analysis demonstrated that postnatal care utilization is associated with receiving education on maternal health, best friend's use of maternal care, head of the household, and experience of postpartum complications. Receiving education on maternal health (AOR, 2.32; 95% CI: 1.38, 3.89) and best friend's use of maternal care (AOR, 2.41; 95% CI: 1.39, 4.19) were significant predisposing factors that independently predicted postnatal care utilization. Furthermore, head of the household was a significantly associated enabling factor for postnatal care utilization (AOR, 0.24; 95% CI: 0.07, 0.81). The experience of postpartum complications (AOR, 0.10; 95% CI: 0.05, 0.20) was the only need factor that was associated with postnatal care utilization. Conclusion: Postnatal care utilization is extremely low in the study district. Strengthening health education and promotion activities on maternal health, peer education programs within the women's social networks, strengthening women empowerment programs, and women's mobilization to seek postnatal care before the occurrence of complications are essential actions that can improve postnatal care utilization.
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2019 |
Tegegne TK, Chojenta C, Getachew T, Smith R, Loxton D, 'Service environment link and false discovery rate correction: Methodological considerations in population and health facility surveys.', PLoS One, 14 e0219860 (2019) [C1]
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2019 |
Kibret KT, Chojenta C, Gresham E, Tegegne TK, Loxton D, 'Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: A systematic review and meta-analysis', Public Health Nutrition, 22 506-520 (2019) [C1]
© 2018 The Authors. Objective Epidemiological studies have indicated that dietary patterns during pregnancy are associated with adverse pregnancy and birth outcomes such as hypert... [more]
© 2018 The Authors. Objective Epidemiological studies have indicated that dietary patterns during pregnancy are associated with adverse pregnancy and birth outcomes such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth (PTB) and low birth weight (LBW). However, the results of these studies are varied and inconsistent. The present study aimed to assess the association between dietary patterns and the risk of adverse pregnancy and birth outcomes.Design Systematic review and meta-analysis. Seven databases were searched for articles. Two reviewers performed the study selection and data extraction. A random-effects model was used to estimate pooled effect sizes of eligible studies.Setting Studies conducted all over the world were incorporated.Subjects The review focused on pregnant women.Results A total of twenty-one studies were identified. Adherence to a healthy dietary pattern (intake of vegetables, fruits, legumes, whole grains) was significantly associated with lower odds (OR; 95 % CI) of pre-eclampsia (0·78; 0·70, 0·86; I 2=39·0 %, P=0·178), GDM (0·78; 0·56, 0·99; I 2=68·6 %, P=0·013) and PTB (0·75; 0·57, 0·93; I 2=89·6 %, P=0·0001).Conclusions Our review suggests that dietary patterns with a higher intake of fruits, vegetables, legumes, whole grains and fish are associated with a decreased likelihood of adverse pregnancy and birth outcomes. Further research should be conducted in low-income countries to understand the impact of limited resources on dietary intake and adverse pregnancy and birth outcomes.
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2019 |
Geleto A, Chojenta C, Musa A, Loxton D, 'WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis', SYSTEMATIC REVIEWS, 8 (2019) [C1]
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2019 |
Byles JE, Rahman MM, Princehorn EM, Holliday EG, Leigh L, Loxton D, et al., 'Successful ageing from old to very old: A longitudinal study of 12,432 women from Australia', Age and Ageing, 48 803-810 (2019) [C1]
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissio... [more]
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com. Objectives: We examined the development of disease and disability in a large cohort of older women, the extent to which these conditions exempt them from being classified as successful agers and different trajectories of disease, disability and longevity across women's later life. Methods: We used survey data from 12,432 participants of the 1921-26 birth cohort of the Australian Longitudinal Study of Women's Health from 1996 (age 70-75) to 2016 (age 90-95). Repeated measures latent class analysis (RMLCA) identified trajectories of the development of disease with or without disability and according to longevity. Bivariate analyses and multivariable multinomial logistic regression models were used to examine the association between participants' baseline characteristics and membership of the latent classes. Results: Over one-third of women could be considered to be successful agers when in their early 70s, few women could still be classified in this category throughout their later life or by the end of the study when they were in their 90s (~1%). RMLCA identified six trajectory groups including managed agers long survivors (9.0%) with disease but little disability, usual agers long survivors (14.9%) with disease and disability, usual agers (26.6%) and early mortality (25.7%). A small group of women having no major disease or disability well into their 80s were identified as successful agers (5.5%). A final group, missing surveys (18.3%), had a high rate of non-death attrition. Groups were differentiated by a number of social and health factors including marital status, education, smoking, body mass index, exercise and social support. Conclusions: The study shows different trajectories of disease and disability in a cohort of ageing women, over time and through to very old ages. While some women continue into very old age with no disease or disability, many more women live long with disease but little disability, remaining independent beyond their capacity to be classified as successful agers.
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2019 |
Tesfaye G, Chojenta C, Smith R, Loxton D, 'Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia', REPRODUCTIVE HEALTH, 16 (2019) [C1]
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2019 |
Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ, 'Depression, anxiety and perceived stress in women with and without PCOS: A community-based study', Psychological Medicine, 49 1510-1520 (2019) [C1]
© Cambridge University Press 2018. Background Polycystic ovary syndrome (PCOS) is associated with increased psychological distress in clinical populations. We aimed to assess depr... [more]
© Cambridge University Press 2018. Background Polycystic ovary syndrome (PCOS) is associated with increased psychological distress in clinical populations. We aimed to assess depression, anxiety and perceived stress in women with and without PCOS in a large community-based sample and investigate the role of stress in contributing to and mediating the relationship between PCOS, depression and anxiety.Methods A cross-sectional analysis was performed from the Australian Longitudinal Study of Women's Health (ALWSH) comparing women with (n = 478) or without (n = 8134) a self-reported diagnosis of PCOS. Main outcome measures were depression, anxiety and perceived stress measured using validated scales. The ¿2 and t tests were used to assess differences between groups. Univariable and multivariable regression were performed to determine factors contributing to each outcome.Results Women reporting PCOS, compared with women not reporting PCOS, reported higher prevalence of depression (27.3% v. 18.8%), anxiety symptoms (50% v. 39.2%) and greater score for perceived stress (1.01 ± 0.03 v. 0.88 ± 0.01). After adjusting for body mass index, infertility and socio-demographic factors, women with PCOS were still more likely to be depressed, anxious and to have a higher level of perceived stress. There was a high-level mediation effect of stress between PCOS and both depression and anxiety.Conclusion Compared with women not reporting PCOS, women reporting PCOS have increased depression, anxiety and perceived stress. Stress may play a role in the association between PCOS, depression and anxiety. Further studies should consider assessment and management of stress in PCOS as it may be relevant for understanding the aetiology and treatment of psychological distress.
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2019 |
Loxton D, Harris ML, Forder P, Powers J, Townsend N, Bytes J, Mishra G, 'Factors Influencing Web-Based Survey Response for a Longitudinal Cohort of Young Women Born Between 1989 and 1995', JOURNAL OF MEDICAL INTERNET RESEARCH, 21 (2019) [C1]
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2019 |
Beyene AS, Chojenta C, Roba HS, Melka AS, Loxton D, 'Gender-based violence among female youths in educational institutions of Sub-Saharan Africa: a systematic review and meta-analysis', SYSTEMATIC REVIEWS, 8 (2019) [C1]
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2019 |
Coombe J, Harris ML, Loxton D, 'Examining long-acting reversible contraception non-use among Australian women in their 20s: findings from a qualitative study', CULTURE HEALTH & SEXUALITY, 21 822-836 (2019) [C1]
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2019 |
Khan MN, Harris ML, Shifti DM, Laar AS, Loxton D, 'Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis', International Journal of Public Health, 64 743-754 (2019) [C1]
© 2019, Swiss School of Public Health (SSPH+). Objectives: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-m... [more]
© 2019, Swiss School of Public Health (SSPH+). Objectives: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries. Methods: A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics. Results: A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25¿39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted). Conclusions: Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.
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2019 |
Melka A, Chojenta C, Holliday E, Loxton D, 'Adverse childhood experiences and electronic cigarette use among young Australian women.', Preventive medicine, 126 105759-105759 (2019) [C1]
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2019 |
Coombe J, Harris ML, Loxton D, 'Motivators of contraceptive method change and implications for long-acting reversible contraception (non-)use: A qualitative free-text analysis', Sexual and Reproductive Healthcare, 19 71-77 (2019) [C1]
© 2018 Elsevier B.V. Objective: To develop a greater understanding of the motivators of contraceptive method change over time for young Australian women, with a particular interes... [more]
© 2018 Elsevier B.V. Objective: To develop a greater understanding of the motivators of contraceptive method change over time for young Australian women, with a particular interest in long-acting reversible contraception (LARC) use. Method: Free-text comments from the Contraceptive Use, Pregnancy Intention and Decisions (CUPID) Study were used to explore the reasons for contraceptive method change among women who reported one or more contraceptive changes across the three CUPID surveys. Results: 512 women reported making at least one contraceptive method change, with 740 comments explaining these changes between them. Participants reported a multitude of reasons motivating their contraceptive change. Five key themes were developed to explain these motivators: the natural, sexual and fertile body, specific contraceptive characteristics and other important people. Findings suggest that women's decisions to switch or discontinue a contraceptive depended largely on her ability (and desire) to juggle its impact on her sexual, fertile and natural body. Importantly, the transient and fluid nature of contraceptive practices were demonstrated, as the women adjusted their method to suit their needs at the time. Conclusion: Regarding LARC use, these findings suggest that rather than being appealing, the ¿temporarily permanent¿ nature of these methods may be unappealing and incongruent with the needs of some women.
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2019 |
Tay CT, Teede HJ, Boyle JA, Kulkarni J, Loxton D, Joham AE, 'Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort.', Journal of clinical medicine, 8 (2019) [C1]
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2018 |
Mishra GD, Chung H-F, Gelaw YA, Loxton D, 'The role of smoking in the relationship between intimate partner violence and age at natural menopause: a mediation analysis', Women's Midlife Health, 4 (2018) [C1]
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2018 |
Tesfaye G, Loxton D, Chojenta C, Assefa N, Smith R, 'Magnitude, trends and causes of maternal mortality among reproductive aged women in Kersa health and demographic surveillance system, eastern Ethiopia', BMC WOMENS HEALTH, 18 (2018) [C1]
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2018 |
Melka AS, Chojenta CL, Holliday EG, Loxton DJ, 'Effectiveness of pharmacotherapy for smoking cessation: protocol for umbrella review and quality assessment of systematic reviews', SYSTEMATIC REVIEWS, 7 (2018)
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2018 |
Coombe J, Harris ML, Loxton D, 'Accidentally-on-purpose: Findings from a qualitative study exploring pregnancy intention and long-acting reversible contraceptive use', BMJ Sexual and Reproductive Health, 44 207-213 (2018) [C1]
© 2018 Article author(s). Background Although it is known that pregnancy intention impacts contraceptive use, there has been little exploration into the relationship between pregn... [more]
© 2018 Article author(s). Background Although it is known that pregnancy intention impacts contraceptive use, there has been little exploration into the relationship between pregnancy intention and long-acting reversible contraception (LARC) non-use in the Australian context. Methods Semi-structured telephone interviews with a sample of participants from the Contraceptive Use, Pregnancy Intention and Decisions (CUPID) Study were conducted in 2016. Results Of the 59 women contacted, 15 participated in an interview. One theme arising from these interviews is reported here. Results from the analysis suggest that women with ambivalent or unclear plans toward pregnancy were less likely to perceive LARC as a suitable method for them. Conversely, women who clearly intended to avoid pregnancy and who had clear plans for future pregnancy valued these methods, and often framed their future plans for pregnancy within the context of their chosen LARC. Conclusions Findings presented demonstrated the complex relationship between pregnancy intention and contraceptive use. In particular, this study provided insight into the complex notion of pregnancy ambivalence. Dichotomous definitions of pregnancy as intended or unintended were found to be inadequate in encapsulating actual reproductive experiences.
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2018 |
Loxton D, Tooth L, Harris ML, Forder PM, Dobson A, Powers J, et al., 'Cohort Profile: The Australian Longitudinal Study on Women's Health (ALSWH) 1989-95 cohort.', International journal of epidemiology, 47 391-392e (2018) [C1]
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2018 |
William J, Martin MA, Chojenta C, Loxton D, 'An actuarial investigation into maternal hospital cost risk factors for public patients', Annals of Actuarial Science, 12 106-129 (2018) [C1]
© Institute and Faculty of Actuaries 2017. We investigate an actuarial approach to identifying the factors impacting government-funded maternal hospital costs in Australia, with a... [more]
© Institute and Faculty of Actuaries 2017. We investigate an actuarial approach to identifying the factors impacting government-funded maternal hospital costs in Australia, with a focus on women who experience adverse birth outcomes. We propose a two-phase modelling methodology that adopts actuarial methods from typical insurance claim cost modelling and extends to other statistical techniques to account for the large volume of covariates available for modelling. Specifically, Classification and Regression Trees and generalised linear mixed models are employed to analyse a data set that links longitudinal survey and administrative data from a large sample of women. The results show that adverse births are a statistically significant risk factor affecting maternal hospital costs in the antenatal and delivery periods. Other significant cost risk factors in the delivery period include mode of delivery, private health insurance status, diabetes, smoking status, area of residence and onset of labour. We demonstrate the efficacy of using actuarial techniques in non-traditional areas and highlight how the results can be used to inform public policy.
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2018 |
Byles J, Curryer C, Vo K, Forder P, Loxton D, McLaughlin D, 'Changes in housing among older women: Latent class analysis of housing patterns in older Australian women', Urban Studies, 55 917-934 (2018) [C1]
© 2016, © Urban Studies Journal Limited 2016. Scant research exists on the patterns of changes in older women¿s housing, and whether and when women transition into residential age... [more]
© 2016, © Urban Studies Journal Limited 2016. Scant research exists on the patterns of changes in older women¿s housing, and whether and when women transition into residential aged care (RAC). This study aimed to identify groups of women with different housing patterns (latent classes) over time, with a secondary aim to describe socio-demographic and health characteristics of women in each class. We analysed linked data for 9575 women born 1921¿1926 from the Australian Longitudinal Study of Women¿s Health (ALSWH), Australian National Death Index, and Residential Aged Care (RAC) administrative records for the years 1999 through to 2011. Seven distinct housing patterns (classes) were identified over time. Four classes showed a stable pattern: living in a house for most surveys (47.0%), living in a house but with earlier death (13.7%), living in an apartment (12.8%), living in a retirement village (5.8%). One class showed a pattern of downsizing: moving from a house to retirement village (6.6%). Two patterns showed transition: from an apartment or retirement village, to RAC and death (7.8%), and from house to RAC (6.4%). This study provides new evidence about socio-demographic and health influences on housing patterns and entry into residential care in later life. These findings can inform policy and aged care planning for women in later life, by identifying patterns of transition into residential aged care, or alternatively, remaining in the community.
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2018 |
Wigginton B, Harris ML, Loxton D, Lucke J, 'Who takes responsibility for contraception, according to young Australian women?', SEXUAL & REPRODUCTIVE HEALTHCARE, 15 2-9 (2018) [C1]
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2018 |
Tegegne TK, Chojenta C, Loxton D, Smith R, Kibret KT, 'The impact of geographic access on institutional delivery care use in low and middle-income countries: Systematic review and meta-analysis.', PloS one, 13 e0203130 (2018) [C1]
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2018 |
Geleto A, Chojenta C, Mussa A, Loxton D, 'Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa - a systematic review protocol', SYSTEMATIC REVIEWS, 7 (2018)
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2018 |
Tesfaye G, Chojenta C, Smith R, Loxton D, 'Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia', PLOS ONE, 13 (2018) [C1]
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2018 |
Geleto A, Chojenta C, Musa A, Loxton D, 'Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature.', Systematic reviews, 7 (2018) [C1]
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2018 |
Morgan K, Chojenta C, Tavener M, Smith A, Loxton D, 'Postural Orthostatic Tachycardia Syndrome during pregnancy: A systematic review of the literature', Autonomic Neuroscience: Basic and Clinical, 215 106-118 (2018) [C1]
© 2018 Elsevier B.V. Purpose: Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy... [more]
© 2018 Elsevier B.V. Purpose: Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy. Method: A systematic review was conducted in March 2015 and updated in February 2018. Medline, Embase, PsychInfo, CINHAL, and the Cochrane Library were searched from database inception. The ClinicalTrials.gov site and bibliographies were searched. MeSH and Emtree headings and keywords included; Postural Orthostatic Tachycardia Syndrome, Postural Tachycardia Syndrome, and were combined with pregnancy and pregnancy related subject headings and keywords. Searches were limited to English. Eligible articles contained key words within the title and or abstract. Articles were excluded if Postural Orthostatic Tachycardia Syndrome was not pre-existing. Results: Eleven articles were identified as eligible for inclusion. Studies were appraised using the PRISMA 2009 guidelines. The overall quality of evidence was poor using the NHMRC Evidence Grading Matrix, which was attributed to small sample sizes and mostly observational studies, emphasizing the need for future high quality research. Findings in this review must be used with caution due to the poor quality of the literature available. Conclusions: Postural Orthostatic Tachycardia Syndrome should not be a contraindication to pregnancy. Symptom course is variable during pregnancy and the post-partum period. Continuing pre-conception medication may help symptoms, with no significant risks reported. Obstetric complications, not Postural Orthostatic Tachycardia Syndrome, should dictate mode of delivery. Postural Orthostatic Tachycardia Syndrome did not appear to affect the rate of adverse events. These results are important in determining appropriate management and care in this population.
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2018 |
Sharma BB, Loxton DJ, Murray H, Angeli GL, Oldmeadow C, Chiu S, Smith R, 'A first step to improving maternal mortality in a low-literacy setting; the successful use of singing to improve knowledge regarding antenatal care', American Journal of Obstetrics and Gynecology, 219 615.e1-615.e11 (2018) [C1]
© 2018 Background: Preventable maternal mortality is related to delays in recognizing the problem, transport to a facility, and receiving appropriate care on arrival. Reducing mat... [more]
© 2018 Background: Preventable maternal mortality is related to delays in recognizing the problem, transport to a facility, and receiving appropriate care on arrival. Reducing maternal mortality in low-literacy settings is particularly challenging. In the rural villages of Nepal, the maternal mortality rate is among the highest in the world; the reasons include illiteracy and lack of knowledge of the needs of pregnant women. Culturally, singing and dancing are part of Nepalese daily life and present an opportunity to transmit knowledge of antenatal care and care at birth with a view to reducing the first 2 delays. Objective: We hypothesized that health messages regarding the importance of antenatal care and skilled birth assistance would be effectively transmitted by songs in the limited literacy environment of rural Nepal. Study Design: We randomly grouped 4 rural village development committees comprising 36 villages into 2 (intervention and control) clusters. In the intervention group, local groups were invited to write song lyrics incorporating key health messages regarding antenatal care to accompany popular melodies. The groups presented their songs and dances in a festival organized and judged by the community. The winning songs were performed by the local people in a song and dance progression through the villages, houses, and fields. A wall chart with the key health messages was also provided to each household. Knowledge of household decision makers (senior men and women) was assessed before and after the intervention and at 12 months using a structured questionnaire in all households that also assessed behavior change. Results: Structured interviews were conducted at baseline, immediately postintervention in the control and intervention areas (intervention n = 735 interviews, control n = 775), and at 12 months in the intervention area only (n = 867). Knowledge scores were recorded as the number of correct items out of 36 questions at baseline and postintervention, and of 21 questions at follow-up. Postintervention, test score doubled in the intervention group from a mean of 11.60/36¿22.33/36 (P <.001), with no practically significant change in the control population (17.48/36¿18.26/36). Improvement was greatest among the most illiterate members of the community (6.8/36¿19.8/36, P <.001). At 12 months follow-up, a majority of the participants (63.9%) indicated that they provided information learned from the songs to their neighbors and friends, and 41.3% reported still singing the songs from the intervention. Conclusion: The use of songs bypassed the limitations of literacy in communicating health messages that are key to improving maternal care in this low-literacy rural setting within a developing country. The improvements were maintained without further intervention for 12 months. With appropriate sociocultural adaptation to local contexts, this low-cost method of community education may be applicable to improving maternal health knowledge and behavior change in other low-resource and limited literacy settings that may lead to reductions in maternal mortality.
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2018 |
Rich JL, Wright SL, Loxton D, 'Older rural women living with drought', Local Environment, 23 1141-1155 (2018) [C1]
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2018 |
Mishra GD, Moss K, Loos C, Dobson AJ, Davies PSW, Loxton D, et al., 'MatCH (Mothers and their Children's Health) Profile: Offspring of the 1973-78 Cohort of the Australian Longitudinal Study on Women's Health', LONGITUDINAL AND LIFE COURSE STUDIES, 9 351-375 (2018) [C1]
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2018 |
Sharma BB, Jones L, Loxton DJ, Booth D, Smith R, 'Systematic review of community participation interventions to improve maternal health outcomes in rural South Asia.', BMC pregnancy and childbirth, 18 (2018) [C1]
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2018 |
Forder P, Byles J, Vo K, Curryer C, Loxton D, 'Cumulative incidence of admission to permanent residential aged care for Australian women A competing risk analysis', Australian and New Zealand Journal of Public Health, 42 166-171 (2018) [C1]
© 2017 The Authors Objective: To provide a direct estimate of the risk of admission to permanent residential aged care among older women while accounting for death, according to h... [more]
© 2017 The Authors Objective: To provide a direct estimate of the risk of admission to permanent residential aged care among older women while accounting for death, according to housing type and other variables. Methods: A competing risk analysis from 8,867 Australian women born 1921¿26, using linked data from the Australian Longitudinal Study on Women's Health (ALSWH), Residential Aged Care (RAC), and the Australian National Death Index. Results: After accounting for deaths, around 35% of women will be admitted to RAC between ages 73 and 90. The conditional cumulative incidence of admission to RAC was 26.9% if living in a house, compared to 36.0% from an apartment, 43.6% within a retirement village, and 37.1% if living in a mobile home. Each one-year increase in age was associated with a relative 17% increased risk of RAC. Conclusions: Around one-third of women will enter RAC between age 73 and 90. Living in a house had the lowest risk of entering residential aged care over time. Implications for public health: These findings have important implications for planning for aged care services, including the role of housing in delaying admission to residential aged care, and the need for residential care by a high proportion of women towards the end of life.
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2018 |
Dolja-Gore X, Loxton D, D Este C, Blyth F, Byles J, 'Differences in Use of Government Subsidised Mental Health Services by Men and Women with Psychological Distress: A Study of 229,628 Australians Aged 45 Years and Over', Community Mental Health Journal, 54 1008-1018 (2018) [C1]
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. This study examined factors associated with use of government subsidised mental health services by 229,628 m... [more]
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. This study examined factors associated with use of government subsidised mental health services by 229,628 men and women from the Sax Institute¿s 45 and Up Study. Logistical regression models assessed use of mental health services by gender and according to level of psychological distress. Approximately equal proportion of men and women had high psychological distress scores (approximately 7%) but only 7% of these men and 11% of these women used services. Use was associated with predisposing (younger age and higher education), enabling (private health insurance) and need factors (higher psychological distress scores). Associations were similar for men and women except urban area of residence, separated/divorced marital status, and smoking were associated with service use for women but not men. Results suggest some inequity in the use of services by those with higher levels of need and further efforts may be required to reach people with higher need but lower service use.
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2017 |
Szalacha LA, Hughes TL, McNair R, Loxton D, 'Mental health, sexual identity, and interpersonal violence: Findings from the Australian longitudinal Women's health study', BMC WOMENS HEALTH, 17 (2017) [C1]
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2017 |
Loxton D, Dolja-Gore X, Anderson AE, Townsend N, 'Intimate partner violence adversely impacts health over 16 years and across generations: A longitudinal cohort study', PLOS ONE, 12 (2017) [C1]
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2017 |
Ferreira P, Loxton D, Tooth LR, 'Intimate personal violence and caregiving: Influences on physical and mental health in middle-aged women', Maturitas, 102 34-40 (2017) [C1]
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2017 |
Hure A, Powers J, Chojenta C, Loxton D, 'Rates and Predictors of Caesarean Section for First and Second Births: A Prospective Cohort of Australian Women', Maternal and Child Health Journal, 21 1175-1184 (2017) [C1]
© 2017, Springer Science+Business Media New York. Objective To determine rates of vaginal delivery, emergency caesarean section, and elective caesarean section for first and secon... [more]
© 2017, Springer Science+Business Media New York. Objective To determine rates of vaginal delivery, emergency caesarean section, and elective caesarean section for first and second births in Australia, and to identify maternal predictors of caesarean section. Methods Data were from the Australian Longitudinal Study on Women¿s Health. A total of 5275 women aged 18¿38 years, who had given birth to their first child between 1996 and 2012 were included; 75.0% (n = 3956) had delivered a second child. Mode of delivery for first and second singleton birth(s) was obtained from longitudinal survey data. Socio-demographic, lifestyle, anthropometric and medical history variables were tested as predictors of mode of delivery for first and second births using multinomial logistic regression. Results Caesarean sections accounted for 29.1% (n = 1535) of first births, consisting of 18.2% emergency and 10.9% elective caesareans. Mode of delivery for first and second births was consistent for 85.5% of women (n = 3383) who delivered both children either vaginally or via caesarean section. Higher maternal age and body mass index, short-stature, anxiety and having private health insurance were predictive of caesarean section for first births. Vaginal birth after caesarean section was more common in women who were older, short-statured, or had been overweight or obese for both children, compared to women who had two vaginal deliveries. Conclusions for Practice Rates of caesarean section in Australia are high. Renewed efforts are needed to reduce the number of unnecessary caesarean births, with particular caution applied to first births. Interventions could focus on elective caesareans for women with private health insurance or a history of anxiety.
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2017 |
Htet TD, Teede HJ, de Courten B, Loxton D, Real FG, Moran LJ, Joham AE, 'Asthma in reproductive-aged women with polycystic ovary syndrome and association with obesity', EUROPEAN RESPIRATORY JOURNAL, 49 (2017) [C1]
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2017 |
Harris ML, Oldmeadow C, Hure A, Luu J, Loxton D, Attia J, 'Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling.', PLoS One, 12 e0172126 (2017) [C1]
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2017 |
Stanford S, Jones MP, Loxton DJ, 'Understanding women who self-harm: Predictors and long-term outcomes in a longitudinal community sample', Australian and New Zealand Journal of Psychiatry, 51 151-160 (2017) [C1]
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2017 |
Goldhammer DL, Fraser C, Wigginton B, Harris ML, Bateson D, Loxton D, et al., 'What do young Australian women want (when talking to doctors about contraception)?', BMC Family Practice, 18 1-10 (2017) [C1]
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2017 |
Powers JR, Loxton D, Anderson AE, Dobson AJ, Mishra GD, Hockey R, Brown WJ, 'Changes in smoking, drinking, overweight and physical inactivity in young Australian women 1996-2013 (vol 28, pg 255, 2017)', HEALTH PROMOTION JOURNAL OF AUSTRALIA, 28 266-266 (2017) [C1]
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2017 |
Francis L, Loxton D, James C, 'The culture of pretence: a hidden barrier to recognising, disclosing and ending domestic violence', Journal of Clinical Nursing, 26 2202-2214 (2017) [C1]
© 2016 John Wiley & Sons Ltd Aims and objectives: To explore in detail how women perceived their experience of domestic violence and leaving or ending the abuse. This resear... [more]
© 2016 John Wiley & Sons Ltd Aims and objectives: To explore in detail how women perceived their experience of domestic violence and leaving or ending the abuse. This research also examined how service providers identified their professional role in assisting women to end such relationships. Background: Domestic violence against women continues to occur internationally. Reliable statistics are difficult to capture because of inconsistent definitions, contradictory methods of acquiring data and unreported incidents. Design: A qualitative study, undertaken in two phases, was conducted in Australia. Methods: Twelve women who had experienced domestic violence and ended those relationships participated in one semistructured interview (Phase 1). Twenty-five professionals from health, social sciences and law, whose work included assisting women experiencing domestic violence, participated in three focus groups (Phase 2). Thematic analysis guided by a narrative inquiry approach forms the framework for information collection and interpretation of data in this project. Findings: The barriers that impede women from disclosing abuse and taking action to end domestic violence are complex and varied between participants. Women did not always acknowledge or realise their relationship was precarious and often denied or minimised the abuse to cope with the domestic violence. Professionals identified that women did not always identify or acknowledge abuse inherent in their relationship although this delayed the provision of appropriate services. Conclusion: Whether women disclose abuse or deny violence in their relationship, acceptance by service providers and the offer of support is crucial to assisting women in violent relationships. Relevance to clinical practice: It is hoped that the findings may assist health practitioners, including nurses, to provide nonjudgemental support to women experiencing domestic violence whether women acknowledge the abusive relationship or not.
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2017 |
Coombe J, Harris ML, Loxton D, 'Who uses long-acting reversible contraception? Profile of LARC users in the CUPID cohort', Sexual and Reproductive Healthcare, 11 19-24 (2017) [C1]
© 2016 Elsevier B.V. Objective To explore the characteristics of long-acting reversible contraception (LARC) users in a nationally representative cohort of young Australian women ... [more]
© 2016 Elsevier B.V. Objective To explore the characteristics of long-acting reversible contraception (LARC) users in a nationally representative cohort of young Australian women aged 18¿23. Methods Data from 3155 women who responded to a question about their contraceptive use in the previous six months at the baseline Contraceptive Use, Pregnancy Intention and Decisions (CUPID) survey were included. Results 726 (19.1%) women reported LARC use, with the Implanon being the most popular method (n¿=¿478; 65.8%). A history of pregnancy was strongly associated with increased odds of LARC use in the multivariate model (OR¿=¿2.67, 95% CI¿=¿2.11, 3.34, p¿=¿0.001). Comparatively, using contraception for reasons other than pregnancy prevention was associated with decreased odds of LARC use in the multivariate model (period management: OR¿=¿0.74, 95% CI¿=¿0.60, 0.91, p¿=¿0.004, body management: OR¿=¿0.53, 95% CI¿=¿0.37, 0.77, p¿=¿0.001, medical condition: OR¿=¿0.25, 95% CI¿=¿0.09, 0.66, p¿=¿0.005). Highest education and Medicare card status also contributed to the final multivariate model, and were associated with decreased odds of LARC use. Conclusion Reproductive history and reasons for contraceptive use are strong indications of method choice. Promoting LARC as highly effective may not be a sufficient incentive for young women to take up the method when pregnancy prevention may be equal or secondary to their desired non-contraceptive effects.
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2017 |
Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R, 'Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis.', Reproductive health, 14 (2017) [C1]
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2017 |
Townsend N, Powers J, Loxton D, 'Bullying among 18 to 23-year-old women in 2013', Australian and New Zealand Journal of Public Health, 41 394-398 (2017) [C1]
© 2017 The Authors Objective: To identify the prevalence of bullying among women aged 18¿23 in 2013, and to describe the demographic characteristics, health and risk factors of th... [more]
© 2017 The Authors Objective: To identify the prevalence of bullying among women aged 18¿23 in 2013, and to describe the demographic characteristics, health and risk factors of those who experienced bullying. Methods: Cross-sectional analysis using data from the 1989¿95 cohort of the Australian Longitudinal Study on Women's Health, a nationally representative cohort (n=16,801). Results: More than one-quarter of women (28.4%) indicated they had never been bullied, 53.4% reported experiencing bullying in the past and 18.2% indicated that they were recently bullied. Women who had experienced bullying were more likely to have lower levels of education, less likely to be studying or employed, and had more difficulty managing on their income. Women who experienced bullying were more likely to use tobacco or illicit drugs, be overweight or obese and to be sedentary. Even after adjusting for these factors, women who had experienced bullying were at risk of poor physical health, psychological distress, suicidal thoughts and self-harm. Conclusions: This is the first nationally representative study to demonstrate the strong association between being a victim of bullying and health outcomes in a post-school-age population. Implications for public health: The findings highlight the need for interventions for women who have already experienced bullying and are past school age.
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2016 |
Coombe J, Harris ML, Wigginton B, Lucke J, Loxton D, 'Contraceptive use at the time of unintended pregnancy: Findings from the Contraceptive Use, Pregnancy Intention and Decisions study.', Aust Fam Physician, 45 842-848 (2016) [C1]
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2016 |
Tavener MA, Chojenta C, Loxton D, 'Generating qualitative data by design: The Australian Longitudinal Study on Women s Health qualitative data collection.', Public Health Research & Practice, 26 (2016) [C1]
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2016 |
Joham AE, Nanayakkara N, Ranasinha S, Zoungas S, Boyle J, Harrison CL, et al., 'Obesity, polycystic ovary syndrome and breastfeeding: An observational study', Acta Obstetricia et Gynecologica Scandinavica, 95 458-466 (2016) [C1]
© 2016 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica. Introduction. Polycystic ovary syndrome (PCOS) affects 9-21% of ... [more]
© 2016 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica. Introduction. Polycystic ovary syndrome (PCOS) affects 9-21% of reproductive- age women. The relations between PCOS, body mass index (BMI) and breastfeeding are unclear. Our aim was to examine breastfeeding in women with and without PCOS and the relation with BMI. Material and methods. This is a cross-sectional study set in the general community. Participants are women, aged 31-36 years, from the Australian Longitudinal Study on Women's Health (ALSWH), a large community-based study. Data was analyzed from the first child of respondents to Survey five (2009) reporting at least one live born child. Logistic regression analysis was used to examine factors associated with breastfeeding. The main outcome measures studied were breastfeeding initiation and duration and the main explanatory variables included selfreported PCOS and BMI. Results. Of the 4898 women, 6.5% reported PCOS (95% confidence interval 5.8-7.2%). Median duration of breastfeeding was lower in women reporting PCOS (6 months, range 2-10 months) than in women not reporting PCOS (7 months, range 3-12 months) (p = 0.001). On multivariable regression analysis, there was no association between PCOS and breastfeeding outcomes. However, being overweight or obese was associated with not initiating breastfeeding and with breastfeeding for less than 6 months, after adjusting for confounders. Conclusions. High BMI is negatively associated with breastfeeding, whereas PCOS status per se does not appear to be related to breastfeeding initiation and duration, after adjusting for BMI.
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2016 |
Coles J, Anderson A, Loxton D, 'Breastfeeding Duration after Childhood Sexual Abuse: An Australian Cohort Study.', Journal of human lactation : official journal of International Lactation Consultant Association, 32 NP28-NP35 (2016) [C1]
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2016 |
Dillon G, Hussain R, Kibele E, Rahman S, Loxton D, 'Influence of Intimate Partner Violence on Domestic Relocation in Metropolitan and Non-Metropolitan Young Australian Women', Violence Against Women, 22 1597-1620 (2016) [C1]
© 2016, © The Author(s) 2016. Data from a national, population-based longitudinal study of Australian women (26-34 years) were analyzed to investigate the association between dome... [more]
© 2016, © The Author(s) 2016. Data from a national, population-based longitudinal study of Australian women (26-34 years) were analyzed to investigate the association between domestic relocation and multiple explanatory factors, namely intimate partner violence (IPV), metropolitan versus non-metropolitan residence, education, income, housing tenure, number of children, and changes in relationship status. Experience of IPV in the past 12 months was significantly associated with increased odds of domestic relocation. This association remained significant after controlling for age, social support, area of residence, income, number of children, education, and housing situation. Change in relationship status attenuated the association between recent IPV and domestic relocation. Metropolitan versus non-metropolitan residence had no major influence on these results.
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2016 |
Wigginton B, Harris ML, Loxton D, Lucke JC, 'A qualitative analysis of women's explanations for changing contraception: the importance of non-contraceptive effects.', The journal of family planning and reproductive health care, 42 256-262 (2016) [C1]
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2016 |
Harris ML, Byles JE, Townsend N, Loxton D, 'Perceptions of coping with non-disease-related life stress for women with osteoarthritis: a qualitative analysis.', BMJ Open, 6 e010630 (2016) [C1]
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2016 |
Wigginton B, Moran C, Harris ML, Loxton D, Lucke J, 'Young Australian women explain their contraceptive choices', Culture, Health and Sexuality, 18 727-741 (2016) [C1]
© 2015 Taylor & Francis. New developments in female contraceptives allow women increased options for preventing pregnancy, while men¿s options for reversible contraception h... [more]
© 2015 Taylor & Francis. New developments in female contraceptives allow women increased options for preventing pregnancy, while men¿s options for reversible contraception have not advanced beyond the condom. There has been little discursive exploration of how neoliberal and postfeminist discourses shape women¿s accounts of choosing whether or not to use contraception. Our thematic discourse analysis of 760 free-text responses to a question about contraceptive choice considers the social and political climate that promotes the self-governed woman who freely chooses contraception. We examine the ways in which women formulated and defended their accounts of choice, focusing on the theme of free contraceptive choice that constructed women¿s choices as unconstrained by material, social and political forces. We identify two discursive strategies that underpinned this theme: a woman¿s body, a woman¿s choice and planning parenthood, and explore the ways in which choice was understood as a gendered entitlement and how contraceptive choices were shaped (and constrained) by women¿s plans for parenthood. We discuss the implications of these discursive strategies, and neoliberal and postfeminist discourses, in terms of the disallowance of any contextual, social and structural factors, including the absence of men in the ¿contraceptive economy¿.
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2016 |
Powers J, Duffy L, Burns L, Loxton D, 'Binge drinking and subsequent depressive symptoms in young women in Australia', Drug and Alcohol Dependence, 161 86-94 (2016) [C1]
© 2016 Elsevier Ireland Ltd. Background: The long-term impact of binge drinking on subsequent depressive symptoms is unclear. The aims were to identify longitudinal patterns of bi... [more]
© 2016 Elsevier Ireland Ltd. Background: The long-term impact of binge drinking on subsequent depressive symptoms is unclear. The aims were to identify longitudinal patterns of binge drinking and whether binge drinking preceded depressive symptoms in the short-term (1-6 years) and long-term (10-15 years). Methods: Longitudinal data from 1996, 2000 and 2009 mailed surveys of 8,197 women in the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Latent class analysis was used to identify binge drinking patterns and logistic regression to estimate associations with subsequent depressive symptoms. Results: Five binge drinking trajectories were identified with predicted proportions of women who were very infrequent (24%), fluctuating infrequent (17%), frequent (17%), very frequent (26%) or extremely frequent binge drinkers (16%) between 16 and 21 years. At 22-27 years, depressive symptoms were significantly higher for extremely frequent binge drinkers (31% versus 21% in the short-term; 22% versus 16%-18% in the long-term) than for less frequent bingers. Unadjusted odds of depressive symptoms were 1.70 (95%CI:1.38;2.08) times for extremely frequent binge drinkers than very infrequent bingers and were 1.30 (95%CI:1.04;1.63) after adjusting for demographics, relationships and experience of violence. At 31-36 years, the odds of depressive symptoms were 1.34 (95%CI:1.09-1.64) times for extremely frequent than very infrequent binge drinkers, but were not significant after adjusting for relationships and violence. Conclusions: Extremely frequent binge drinking (more than weekly) in late adolescence appears to elevate the risk of subsequent depressive symptoms in young women in their early twenties and thirties, emphasising the need for preventive strategies to curb binge drinking.
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2016 |
Tavener M, Mooney R, Thomson C, Loxton D, 'The Australian Longitudinal Study on Women's Health: Using Focus Groups to Inform Recruitment.', JMIR Res Protoc, 5 e31 (2016) [C1]
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2016 |
Otterbach S, Tavener M, Forder P, Powers J, Loxton D, Byles J, 'The effect of motherhood and work on women's time pressure: A cohort analysis using the Australian Longitudinal Study on Women's Health', SCANDINAVIAN JOURNAL OF WORK ENVIRONMENT & HEALTH, 42 500-509 (2016) [C1]
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2016 |
Dillon G, Hussain R, Loxton D, Khan A, 'Rurality and Self-Reported Health in Women with a History of Intimate Partner Violence.', PLoS One, 11 e0162380 (2016) [C1]
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2016 |
Chojenta CL, Lucke JC, Forder PM, Loxton DJ, 'Maternal Health Factors as Risks for Postnatal Depression: A Prospective Longitudinal Study', PLoS ONE, 11 (2016) [C1]
© 2016 Chojenta et al. Purpose While previous studies have identified a range of potential risk factors for postnatal depression (PND), none have examined a comprehensive set of r... [more]
© 2016 Chojenta et al. Purpose While previous studies have identified a range of potential risk factors for postnatal depression (PND), none have examined a comprehensive set of risk factors at a population-level using data collected prospectively. The aim of this study was to explore the relationship between a range of factors and PND and to construct a model of the predictors of PND. Methods Data came from 5219 women who completed Survey 5 of the Australian Longitudinal Study on Women's Health in 2009 and reported giving birth to a child. Results Over 15% of women reported experiencing PND with at least one of their children. The strongest positive associations were for postnatal anxiety (OR = 13.79,95%CI = 10.48,18.13) and antenatal depression (OR = 9.23,95%CI = 6.10,13.97). Positive associations were also found for history of depression and PND, low SF-36 Mental Health Index, emotional distress during labour, and breastfeeding for less than six months. Conclusions Results indicate that understanding a woman's mental health history plays an important role in the detection of those who are most vulnerable to PND. Treatment and management of depression and anxiety earlier in life and during pregnancy may have a positive impact on the incidence of PND.
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2016 |
Coombe J, Harris ML, Loxton D, 'What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review', Sexual Health, 13 404-419 (2016) [C1]
© 2016 CSIRO. Little research examining qualities of contraception that make them attractive or unattractive to users, particularly young women, exists. The aim of this study is t... [more]
© 2016 CSIRO. Little research examining qualities of contraception that make them attractive or unattractive to users, particularly young women, exists. The aim of this study is to systemically review the evidence regarding desirable and undesirable qualities of long-acting reversible contraception (LARC), including intrauterine devices, the implant and the injection, as perceived by women. Five electronic databases were searched in May 2015 using terms related to LARC and method preference or decision-making. Studies were included if they concerned women aged 18-23 years from developed countries and reported on perceived positive or negative qualities of LARC. Thirty articles were deemed relevant. Five key themes emerged under which qualities were categorised; including: (1) impact on bleeding; (2) impact on the body; (3) device-specific characteristics; (4) general characteristics; and (5) perceptions and misbeliefs. Fit and forget, high efficacy and long-term protection were considered the top desirable qualities of LARC. Undesirable qualities varied among the LARC methods; however, irregular bleeding, painful insertion and removal procedure, weight gain and location in the body were among those most commonly reported. The contraceptive benefits of LARC, including their high efficacy and longevity, are generally considered to be positive qualities by women, while the potential impact of side-effects on the body are considered as negative qualities. This information is crucial in the clinical setting as it provides practitioners with a greater understanding of the qualities women do and do not like about LARC methods. Discussion about these qualities, positive and negative, during consultations about contraception may increase rates of uptake.
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2015 |
Coles J, Lee A, Taft A, Mazza D, Loxton D, 'Childhood sexual abuse and its association with adult physical and mental health: results from a national cohort of young Australian women.', J Interpers Violence, 30 1929-1944 (2015) [C1]
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2015 |
May-Ling JL, Loxton D, McLaughlin D, 'Trauma exposure and the subsequent risk of coronary heart disease among mid-aged women', JOURNAL OF BEHAVIORAL MEDICINE, 38 57-65 (2015) [C1]
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2015 |
Coles J, Lee A, Taft A, Mazza D, Loxton D, 'General practice service use and satisfaction among female survivors of childhood sexual abuse', Australian Family Physician, 44 71-76 (2015) [C1]
Background: Because childhood sexual abuse (CSA) and adult violence are associated with poorer physical and mental health of women, our aim was to investigate the associations bet... [more]
Background: Because childhood sexual abuse (CSA) and adult violence are associated with poorer physical and mental health of women, our aim was to investigate the associations between CSA, adult violence experiences and general practice service use and satisfaction in a community sample of Australian women aged 28-33 years. Methods: Data of 9058 women from the 1973-78 cohort who completed Survey 4 of the Australian Longitudinal Study on Women's Health were analysed. Results: Logistic regressions conducted indicated that after controlling for demographic variables, women with experiences of lifetime violence were more likely to have higher general practice service use compared to those without violence experiences. CSA was not associated with an increase in service use but was significantly associated with a decrease in service satisfaction. This finding remained significant even when they visited the general practice more frequently. Discussion: Implementing trauma-informed care is suggested as a way to improve the satisfaction of this patient group with complex needs.
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2015 |
Powers J, Tavener M, Graves A, Loxton D, 'Loss to follow-up was used to estimate bias in a longitudinal study: A new approach', Journal of Clinical Epidemiology, (2015) [C1]
Objectives: To examine bias arising from loss to follow-up due to lack of contact. Study Design and Setting: The 1973-1978 cohort of Australian Longitudinal Study on Women's ... [more]
Objectives: To examine bias arising from loss to follow-up due to lack of contact. Study Design and Setting: The 1973-1978 cohort of Australian Longitudinal Study on Women's Health was first surveyed in 1996 and followed up in 2000, 2003, 2006, and 2009. At the 2000 survey, 9,688 women responded (responders), 2,972 could not be contacted, of whom 1,515 responded subsequently (temporary no contact) and 1,457 did not (permanent no contact). Characteristics were compared for these groups at baseline and follow-up in 2003, 2006, or 2009. Relative risk ratios were used to estimate bias. Results: No-contacts were younger, more likely to live in cities, to be less educated and stressed about money than responders. No-contacts were more likely to be in de facto relationships, separated, divorced, or widowed, to have experienced partner violence and be smokers. Compared with temporary no contact, permanent no contact were less educated, less likely to be studying or employed. Despite differences in prevalence estimates, relative odds ratios were close to one and had confidence intervals that included one, indicating little effect of bias. Conclusion: Although various characteristics were related to loss to follow-up, the relative risks estimates did not indicate serious bias due to loss to follow-up in this cohort of young women.
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2015 |
Hure AJ, Chojenta CL, Powers JR, Byles JE, Loxton D, 'Validity and Reliability of Stillbirth Data Using Linked Self-Reported and Administrative Datasets', JOURNAL OF EPIDEMIOLOGY, 25 30-37 (2015) [C1]
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2015 |
Powers JR, Anderson AE, Byles JE, Mishra G, Loxton DJ, 'Do women grow out of risky drinking? A prospective study of three cohorts of Australian women', Drug and Alcohol Review, (2015) [C1]
Introduction and Aims: To examine women's drinking behaviour relative to Australian guidelines and identify associated factors over the lifespan. Design and Methods: Data cam... [more]
Introduction and Aims: To examine women's drinking behaviour relative to Australian guidelines and identify associated factors over the lifespan. Design and Methods: Data came from three prospective cohorts of the Australian Longitudinal Study on Women's Health aged 18-23 (n=14247), 45-50 (n=13715) and 70-75 years (n=12432) when first surveyed in 1996. The same women were re-surveyed at roughly 3-year intervals until 2012. At each survey, four drinking behaviours were based on two guidelines: long-term drinking (no more than two standard drinks per day) and episodic drinking (no more than four standard drinks on an occasion): (i) no risk (within both guidelines); (ii) low episodic risk (less than once a month); high episodic risk (at least once a month); long-term risk (more than two drinks per day regardless of episodic drinking). Results: No risk drinking increased with age, low episodic risk drinking remained almost constant between ages 18 and 39, and high episodic risk drinking declined rapidly. Few women drank at long-term risk. Factors associated with risky drinking varied with age; however, being a past or current smoker consistently increased the risk, and risks for smokers increased with age. Risky drinking was less likely to be practised by women providing care and needing help with daily tasks, or by pregnant women and those living with children. Discussion and Conclusions: Risky drinking behaviour should be addressed in younger women and in those who smoke. Interventions to reduce risky drinking, possibly in combination with reducing smoking, could be offered through general practice centres.
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2015 |
Rowlands IJ, Loxton D, Dobson A, Mishra GD, 'Seeking health information online: Association with young australian women's physical, mental, and reproductive health', Journal of Medical Internet Research, 17 (2015) [C1]
Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those wh... [more]
Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those who do and do not go online for health information. Objective: The aim was to identify the sociodemographic, physical, mental, and reproductive health factors associated with young women's use of the Internet for health information. Methods: We used data from 17,069 young women aged 18-23 years who participated in the Australian Longitudinal Study on Women's Health. Multivariable logistic regression was used to estimate the association between sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information. Results: Overall, 43.54% (7433/17,069) of women used the Internet for health information. Women who used the Internet had higher odds of regular urinary or bowel symptoms (OR 1.44, 95% CI 1.36-1.54), psychological distress (very high distress: OR 1.24, 95% CI 1.13-1.37), self-reported mental health diagnoses (OR 1.16, 95% CI 1.09-1.23), and menstrual symptoms (OR 1.25, 95% CI 1.15-1.36) than women who did not use the Internet for health information. Internet users were less likely to have had blood pressure checks (OR 0.85, 95% CI 0.78-0.93) and skin cancer checks (OR 0.90, 95% CI 0.84-0.97) and to have had a live birth (OR 0.74, 95% CI 0.64-0.86) or pregnancy loss (OR 0.88, 95% CI 0.79-0.98) than non-Internet users. Conclusions: Women experiencing "stigmatized" conditions or symptoms were more likely to search the Internet for health information. The Internet may be an acceptable resource that offers "anonymized" information or support to young women and this has important implications for health service providers and public health policy.
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2015 |
Harris ML, Loxton D, Wigginton B, Lucke JC, 'Harris et al. respond to "social media recruitment"', American Journal of Epidemiology, 181 750-751 (2015) [C3]
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2015 |
Harris ML, Loxton D, Wigginton B, Lucke JC, 'Recruiting online: Lessons from a longitudinal survey of contraception and pregnancy intentions of young Australian women', American Journal of Epidemiology, 181 737-746 (2015) [C1]
© 2015 The Author. Recruitment of young people for epidemiologic research remains challenging, with marked decreases in the effectiveness of face-to-face, mail, and telephone recr... [more]
© 2015 The Author. Recruitment of young people for epidemiologic research remains challenging, with marked decreases in the effectiveness of face-to-face, mail, and telephone recruitment methods. We report on the implementation and feasibility of an innovative and flexible approach used to recruit participants for a longitudinal cohort study about contraceptive use and pregnancy (the Contraceptive Use, Pregnancy Intention, and Decisions (CUPID) Study). Australian women aged 18-23 years were recruited using a range of online, networking, and offline methods, including social media (primarily Facebook (Facebook Inc., Menlo Park, California; http://www.facebook.com)), face-to-face events, distribution of promotional material, and media releases. Over the course of the 1-year recruitment period (beginning in September 2012), a total of 3,795 eligible women were recruited to complete the online survey, at a cost of approximately A$11 per participant. This sample was found to be broadly representative of the Australian population of women aged 18-23 years in terms of demographic characteristics, with the exception of an overrepresentation of tertiary-educated women (88.7% compared with 72.6%). This study demonstrated that although current recruitment strategies are required to be innovative and flexible in order to engage young people in epidemiologic research, representative samples can be achieved online at reasonable cost.
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2015 |
Wigginton B, Harris ML, Loxton D, Herbert D, Lucke J, 'The feminisation of contraceptive use: Australian women's accounts of accessing contraception', FEMINISM & PSYCHOLOGY, 25 178-198 (2015) [C1]
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2015 |
Dillon G, Hussain R, Loxton D, 'Intimate partner violence in the young cohort of the Australian longitudinal study on women's health: urban/rural comparison and demographic associations', Advances in Mental Health, 13 18-29 (2015) [C1]
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2015 |
Gresham E, Forder P, Chojenta CL, Byles JE, Loxton DJ, Hure AJ, 'Agreement between self-reported perinatal outcomes and administrative data in New South Wales, Australia', BMC Pregnancy and Childbirth, 15 (2015) [C1]
© 2015 Gresham et al. Background: Many epidemiological studies that focus on pregnancy rely on maternal self-report of perinatal outcomes. The aim of this study was to evaluate th... [more]
© 2015 Gresham et al. Background: Many epidemiological studies that focus on pregnancy rely on maternal self-report of perinatal outcomes. The aim of this study was to evaluate the agreement between self-reported perinatal outcomes (gestational hypertension with or without proteinuria, gestational diabetes, premature birth and low birth weight) in a longitudinal study and linked to administrative data (medical records). Methods: Self-reported survey data from the Australian Longitudinal Study on Women's Health was linked with the New South Wales Perinatal Data Collection. Agreement between the two sources was evaluated using percentage agreement and kappa statistics. Analyses were conducted at two levels by: i) the mother and ii) each individual child. Results: Women reliably self-report their perinatal outcomes (=87 % agreement). Gestational hypertension with or without proteinuria had the lowest level of agreement. Mothers' reports of perinatal outcomes were more reliable when evaluated by child. Restricting the analysis to complete and consistent reporting further strengthened the reliability of the child-specific data, increasing the agreement from >92 to >95 % for all outcomes. Conclusions: The present study offers a high degree of confidence in the use of maternal self-reports of the perinatal outcomes gestational hypertension, gestational diabetes, preterm birth and low birth weight in epidemiological research, particularly when reported on a per child basis. Furthermore self-report offers a cost-effective and convenient method for gathering detailed maternal perinatal histories.
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2015 |
Loxton D, Powers J, Anderson AE, Townsend N, Harris ML, Tuckerman R, et al., 'Online and Offline Recruitment of Young Women for a Longitudinal Health Survey: Findings From the Australian Longitudinal Study on Women's Health 1989-95 Cohort', JOURNAL OF MEDICAL INTERNET RESEARCH, 17 (2015) [C1]
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2015 |
Powers JR, Dobson AJ, Berry HL, Graves AM, Hanigan IC, Loxton D, 'Lack of association between drought and mental health in a cohort of 45-61 year old rural Australian women.', Aust N Z J Public Health, 39 518-523 (2015) [C1]
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2015 |
Harris ML, Byles JE, Sibbritt D, Loxton D, '"Just get on with it": Qualitative insights of coming to terms with a deteriorating body for older women with osteoarthritis', PLoS ONE, 10 (2015) [C1]
© 2015 Harris et al. Objective: To qualify the psychosocial burden of osteoarthritis for older women and identify factors perceived to assist with psychological adjustment to the ... [more]
© 2015 Harris et al. Objective: To qualify the psychosocial burden of osteoarthritis for older women and identify factors perceived to assist with psychological adjustment to the disease. Methods: Women who indicated being diagnosed/treated for osteoarthritis in the previous three years in the fifth survey of the Australian Longitudinal Study on Women's Health provided the sampling frame. Participants were randomly sampled until saturation was reached using a systematic process. Thematic content analysis was applied to the 19 semi-structured telephone interviews using a realist framework. Results: The findings indicate that the emotional burden of osteoarthritis is considerable, and the process of psychological adjustment complex. Older women with osteoarthritis have psychological difficulties associated with increasing pain and functional impairment. Psychological adjustment over time was attributed primarily to cognitive and attitudinal factors (e.g. stoicism, making downward comparisons and possessing specific notions about the cause of arthritis). This was a dynamic 'day to day' process involving a constant struggle between grieving physical losses and increasing dependence amidst symptom management. Conclusion: The findings of this study add to the current understanding of the complex processes involved in psychological adjustment over time. Targeted interventions focused on assisting women with arthritis redefine self-concepts outside the confines of caring responsibilities, coupled with public health education programs around understanding the destructive nature of arthritis are required. Understanding the destructive and (potentially) preventable nature of arthritis may facilitate early detection and increased uptake of appropriate treatment options for osteoarthritis that have the ability to modify disease trajectories.
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2015 |
Dobson AJ, Hockey R, Brown WJ, Byles JE, Loxton DJ, McLaughlin D, et al., 'Cohort Profile Update: Australian Longitudinal Study on Women's Health.', Int J Epidemiol, 44 1547-1547f (2015) [C2]
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2014 |
Chojenta C, Harris S, Reilly N, Forder P, Austin MP, Loxton D, 'History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum', PLoS ONE, 9 (2014) [C1]
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during su... [more]
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during subsequent pregnancies and births. This paper examined the impact of any type of pregnancy loss on mental health in a subsequent pregnancy and postpartum. Data were obtained from a sub-sample (N = 584) of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health, a prospective cohort study that has been collecting data since 1996. Pregnancy loss was defined as miscarriage, termination due to medical reasons, ectopic pregnancy and stillbirth. Mental health outcomes included depression, anxiety, stress or distress, sadness or low mood, excessive worry, lack of enjoyment, and feelings of guilt. Demographic factors and mental health history were controlled for in the analysis. Women with a previous pregnancy loss were more likely to experience sadness or low mood (AOR = 1.75, 95% CI: 1.11 to 2.76, p = 0.0162), and excessive worry (AOR = 2.01, 95% CI: 1.24 to 3.24, p = 0.0043) during a subsequent pregnancy, but not during the postpartum phase following a subsequent birth. These results indicate that while women who have experienced a pregnancy loss are a more vulnerable population during a subsequent pregnancy, these deficits are not evident in the postpartum. © 2014 Chojenta et al.
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2014 |
Anderson AE, Hure AJ, Forder PM, Powers J, Kay-Lambkin FJ, Loxton DJ, 'Risky drinking patterns are being continued into pregnancy: a prospective cohort study.', PLoS One, 9 e86171 (2014) [C1]
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2014 |
Anderson AE, Hure AJ, Kay-Lambkin FJ, Loxton DJ, 'Women's perceptions of information about alcohol use during pregnancy: a qualitative study.', BMC Public Health, 14 1048 (2014) [C1]
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2014 |
Mishra GD, Hockey R, Powers J, Loxton D, Tooth L, Rowlands I, et al., 'Recruitment via the internet and social networking sites: The 1989-1995 cohort of the Australian longitudinal study on women's health', Journal of Medical Internet Research, 16 (2014) [C1]
Background: Faced with the challenge of recruiting young adults for health studies, researchers have increasingly turned to the Internet and social networking sites, such as Faceb... [more]
Background: Faced with the challenge of recruiting young adults for health studies, researchers have increasingly turned to the Internet and social networking sites, such as Facebook, as part of their recruitment strategy. As yet, few large-scale studies are available that report on the characteristics and representativeness of the sample obtained from such recruitment methods.Objective: The intent of the study was to describe the sociodemographic and health characteristics of a national sample of young Australian women recruited mainly through the Internet and social networking sites and to discuss the representativeness of their sociodemographic, health, and lifestyle characteristics relative to the population.Methods: A cohort of 17,069 women (born between 1989 and 1995) was recruited in 2012-13 for the Australian Longitudinal Study on Women's Health. Sociodemographic characteristics (percentages, means, and 95% confidence intervals) from the online survey data were compared with women aged 18-23 years from the 2011 Australian Census. Sample data were compared by age and education level with data from the 2011-13 Australian Health Survey (AHS).Results: Compared to the Australian Census data, study participants were broadly representative in terms of geographical distribution across Australia, marital status (95.62%, 16,321/17,069) were never married), and age distribution. A higher percentage had attained university (22.52%, 3844/17,069) and trade/certificate/diploma qualifications (25.94%, 4428/17,069) compared with this age group of women in the national population (9.4% and 21.7% respectively). Among study participants, 22.05% (3721/16,877) were not in paid employment with 35.18% (5931/16,857) studying 16 or more hours a week. A higher percentage of study participants rated their health in the online survey as fair or poor (rather than good, very good, or excellent) compared with those participating in face-to-face interviews in the AHS (18.77%, 3203/17,069 vs 10.1%). A higher percentage of study participants were current smokers (21.78%, 3718/17,069 vs 16.4%) and physically active (59.30%, 10,089/17,014 were classified as sufficiently active vs 48.3%) but alcohol consumption was lower (59.58%, 9865/16,558 reported drinking alcohol at least once per month vs 65.9% in the AHS). Using self-reported height and weight to determine body mass index (BMI, kg/m2), 34.80% (5901/16,956) of the cohort were classified as overweight or obese (BMI of 25 or more), compared with 33.6% respectively using measured height and weight in the AHS.Conclusions: Findings indicated that using the Internet and social networking sites for an online survey represent a feasible recruitment strategy for a national cohort of young women and result in a broadly representative sample of the Australian population.
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2014 |
Dixon SC, Herbert DL, Loxton D, Lucke JC, ''As many options as there are, there are just not enough for me': Contraceptive use and barriers to access among Australian women', European Journal of Contraception and Reproductive Health Care, 19 340-351 (2014) [C1]
© 2014 The European Society of Contraception and Reproductive Health. Objective A comprehensive life course perspective of women's experiences in obtaining and using contrace... [more]
© 2014 The European Society of Contraception and Reproductive Health. Objective A comprehensive life course perspective of women's experiences in obtaining and using contraception in Australia is lacking. This paper explores free-text comments about contraception provided by women born between 1973 and 1978 who participated in the Australian Longitudinal Study on Women's Health (ALSWH). Methods The ALSWH is a national population-based cohort study involving over 40,000 women from three age groups, who are surveyed every three years. An initial search identified 1600 comments from 690 women across five surveys from 1996 (when they were aged 18-23 years) to 2009 (31-36 years). The analysis included 305 comments from 289 participants. Factors relating to experiences of barriers to access and optimal contraceptive use were identified and explored using thematic analysis. Results Five themes recurred across the five surveys as women aged: (i) side effects affecting physical and mental health; (ii) lack of information about contraception; (iii) negative experiences with health services; (iv) contraceptive failure; and (v) difficulty with accessing contraception. Conclusion Side effects of hormonal contraception and concerns about contraceptive failure influence women's mental and physical health. Many barriers to effective contraception persist throughout women's reproductive lives. Further research is needed into reducing barriers and minimising negative experiences, to ensure optimal contraceptive access for Australian women.
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2014 |
Dolja-Gore X, Loxton DJ, D'Este CA, Byles JE, 'Mental health service use: Is there a difference between rural and non-rural women in service uptake?', Australian Journal of Rural Health, 22 92-100 (2014) [C1]
This study examines differences in uptake of the Medicare items rolled out in 2006 under the 'Better Access Scheme' (BAS) between rural and non-rural Australian women. I... [more]
This study examines differences in uptake of the Medicare items rolled out in 2006 under the 'Better Access Scheme' (BAS) between rural and non-rural Australian women. It compares differences in women's uptake of the BAS services by area of residence (ARIA+) across time using the Australian Longitudinal Study of Women's Health (ALSWH) survey data linked to Medicare data. Women aged 28-33 years at the time the BAS was introduced that responded to the self-reported question on depression/anxiety and consented to linkage of their survey data with Medicare data (n=4316). Participants were grouped by ARIA+according to BAS use, diagnoses of anxiety/depression but no BAS use and other eligible women. Across all areas, women born 1973-1978 with a self-reported diagnosis of depression/anxiety or having treatment under the BAS had a significantly lower mean mental health score compared to other women. Significantly more women living in non-rural areas had used at least one service provided under the BAS initiative compared to women in outer regional, inner regional or remotes areas (21% versus 18% versus 13% versus 7%, respectively), and across all areas, 12% of women reported having a diagnosis of depression/anxiety but not been treated under the BAS. While there is a gradual uptake of the new BAS services, a large percentage of women who have a diagnosis of depression/anxiety have not been treated under the BAS. The data suggest that women in urban areas have been better able to take up the services compared to non-urban women. © 2014 National Rural Health Alliance Inc.
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2014 |
Byles J, Leigh L, Chojenta C, Loxton D, 'Adherence to recommended health checks by women in mid-life: data from a prospective study of women across Australia', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 38 39-43 (2014) [C1]
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2014 |
Harris ML, Herbert D, Loxton D, Dobson A, Wigginton B, Lucke JC, 'Recruiting young women for health surveys: Traditional random sampling methods are not cost-effective', Australian and New Zealand Journal of Public Health, 38 495 (2014) [C3]
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2014 |
Tavener M, Byles J, Loxton D, 'Expert perceptions of the popular baby boomer image', Australasian Journal on Ageing, 33 E31-E35 (2014) [C1]
© 2013 ACOTA. Aim: This paper explored how gerontology experts described baby boomers, whether they challenged the popular image, and if they provided alternatives to the popularl... [more]
© 2013 ACOTA. Aim: This paper explored how gerontology experts described baby boomers, whether they challenged the popular image, and if they provided alternatives to the popularly reported baby boomer behaviours and characteristics. Methods: Qualitative interviews were conducted with ten experts from different areas across Australia. The interviews were semi-structured and guided by a 'sense-making' approach to explore the baby boomer construct and identify expert narratives that differed from the popularly tendered image. Results: The majority of experts were identified as baby boomers and made use of phrases associated with the popular baby boomer image, such as 'cashed up', 'reinventing retirement' and 'sea change'. Lifestyle and wealth were recognised as staple features of the popular image. To a lesser degree, the experts also recognised alternative characteristics and behaviours, including people with disabilities and those who struggle financially. Conclusions: Experts appeared to identify with the popular baby boomer label, but not necessarily the accompanying stereotypes.
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2014 |
Duffy L, Adams J, Sibbritt D, Loxton D, 'Complementary and alternative medicine for victims of intimate partner abuse: A systematic review of use and efficacy', Evidence-based Complementary and Alternative Medicine, 2014 (2014) [C1]
Objectives. To examine: (i) the extent to which victims of intimate partner abuse (IPA) use complementary and alternative medicine (CAM) and (ii) the effects of CAM on their menta... [more]
Objectives. To examine: (i) the extent to which victims of intimate partner abuse (IPA) use complementary and alternative medicine (CAM) and (ii) the effects of CAM on their mental health. Methods. Medline, Scopus, and Web of Science were searched for studies measuring the extent of CAM use amongst victims of IPA and trials assessing the impact of CAM on mental health amongst this population. Risk of bias was assessed using the Cochrane collaboration tool. Results. No studies measuring the level of CAM use amongst IPA victims, and only three studies assessing the effect of CAM on the mental health of this population were identified. Two studies looked at yogic breathing, while one assessed the effect of music therapy. All three studies showed some beneficial effects; however, each had a small sample, brief intervention period, and no follow-up measurement and were considered to be at high risk of bias. Conclusions. The review found little evidence for the benefits of CAM for IPA victims. Findings suggest positive effects of music therapy and yogic breathing; however, methodological limitations mean that these results should be interpreted with caution. It is important that more research into the use and effects of CAM amongst this population are undertaken. © 2014 Luke Duffy et al.
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2014 |
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Austin MP, 'The impact of routine assessment of past or current mental health on help-seeking in the perinatal period', Women and Birth, (2014) [C1]
Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value o... [more]
Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial. Aim: The current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum. Methods: A subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N = 398) or in the 12 months following birth (N = 380) participated in the study. Results: Multivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR = 0.09, 95%CI: 0.04-0.24) and the postpartum (adjOR = 0.07, 95%CI: 0.02-0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR = 0.26, 95%CI: 0.15-0.45; postnatal: adjOR = 0.14, 95%CI: 0.07-0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident. Conclusion: This study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes. © 2014 Australian College of Midwives.
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2013 |
Loxton D, Powers J, Fitzgerald D, Forder P, Anderson A, Taft A, Hegarty K, 'The Community Composite Abuse Scale: Reliability and Validity of a Measure of Intimate Partner Violence in a Community Survey from the ALSWH', Journal of Women's Health, Issues & Care, 2 (2013) [C1]
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2013 |
Vashum KP, McEvoy M, Shi Z, Milton AH, Islam MR, Sibbritt D, et al., 'Is dietary zinc protective for type 2 diabetes? Results from the Australian longitudinal study on women's health', BMC Endocrine Disorders, 13 (2013) [C1]
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2013 |
Loxton D, Robertson J, Walkom EJ, 'Costs of medicines and health care: a concern for Australian women across the ages.', BMC Health Services Research, 13 (2013) [C1]
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2013 |
Rich JL, Byrne JM, Curryer C, Byles JE, Loxton D, 'Prevalence and correlates of depression among Australian women: A systematic literature review, January 1999- January 2010', BMC Research Notes, 6 (2013) [C1]
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2013 |
Baker AT, Byles JE, Loxton DJ, McLaughlin D, Graves A, Dobson A, 'Utility and acceptability of the modified telephone interview for cognitive status in a longitudinal study of Australian women aged 85 to 90', Journal of the American Geriatrics Society, 61 1217-1220 (2013) [C1]
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2013 |
Lucke JC, Herbert DL, Watson M, Loxton D, 'Predictors of Sexually Transmitted Infection in Australian Women: Evidence from the Australian Longitudinal Study on Women's Health', ARCHIVES OF SEXUAL BEHAVIOR, 42 237-246 (2013) [C1]
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2013 |
Nanyakkara N, Joham A, Eszter V, Zoungas S, Loxton DJ, Teede H, 'Breastfeeding in women with Polycystic Ovary Syndrome: Data from the Australian Longitudinal Women s Health Study', Medicus, 53 (2013) |
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2013 |
Adams J, Sibbritt D, Broom A, Loxton D, Wardle J, Pirotta M, Lui C, 'Complementary and Alternative Medicine Consultations in Urban and Nonurban Areas: A National Survey of 1427 Australian Women', Journal of Manipulative and Physiological Therapeutics, 36 12-19 (2013) [C1]
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2013 |
Austin M-P, Loxton D, Chojenta CL, Reilly N, 'Maternal mental health in the perinatal period: Outcomes from Australian epidemiological and longitudinal based studies', Archives of Women's Mental Health, 16 (suppl 1) S42 (2013)
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2013 |
Herbert D, Harris ML, Loxton D, Lucke J, 'Contraceptive use and unintended pregnancy among 18-23 year old women in Australia: the first findings of the CUPID study', European Journal of Contraception and Reproductive Health Care, 18 S78-S78 (2013)
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2013 |
Chojenta CL, Loxton D, Lucke J, Forder P, 'A longitudinal analysis of the predictors and antecedents of postnatal depression in Australian women', Archives of Women's Mental Health, 16 (suppl 1) S111 (2013)
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2013 |
Harris ML, Loxton D, Sibbritt DW, Byles JE, 'The Influence of Perceived Stress on the Onset of Arthritis in Women: Findings from the Australian Longitudinal Study on Women's Health', ANNALS OF BEHAVIORAL MEDICINE, 46 9-18 (2013) [C1]
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2013 |
Powers JR, McDermott LJ, Loxton DJ, Chojenta CL, 'A Prospective Study of Prevalence and Predictors of Concurrent Alcohol and Tobacco Use During Pregnancy', MATERNAL AND CHILD HEALTH JOURNAL, 17 76-84 (2013) [C1]
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2013 |
Herbert DL, Loxton D, Bateson D, Weisberg E, Lucke JC, 'Challenges for Researchers Investigating Contraceptive Use and Pregnancy Intentions of Young Women Living in Urban and Rural Areas of Australia: Face-to-Face Discussions to Increase Participation in a Web-Based Survey', JOURNAL OF MEDICAL INTERNET RESEARCH, 15 (2013) [C1]
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2013 |
Anderson AE, Hure AJ, Forder P, Powers JR, Kay-Lambkin FJ, Loxton DJ, 'Predictors of antenatal alcohol use among Australian women: A prospective cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, 120 1366-1374 (2013) [C1]
Objective To identify predictors of antenatal alcohol consumption among women who usually consume alcohol. Design Prospective cohort study. Setting Australian Longitudinal Study o... [more]
Objective To identify predictors of antenatal alcohol consumption among women who usually consume alcohol. Design Prospective cohort study. Setting Australian Longitudinal Study on Women's Health (ALSWH). Population or Sample A total of 1969 women sampled from the ALSWH 1973-78 cohort. Methods Women were included if they were pregnant in 2000, 2003, 2006 or 2009. The relationship between antenatal alcohol consumption and sociodemographics, reproductive health, mental health, physical health, health behaviours, alcohol guidelines and healthcare factors was investigated using a multivariate logistic regression model. Main outcome measures Alcohol use during pregnancy. Results Most (82.0%) women continued to drink alcohol during pregnancy. Women were more likely to drink alcohol during pregnancy if they had consumed alcohol on a weekly basis before pregnancy (odds ratio [OR] 1.47; 95% confidence interval [95% CI] 1.13-1.90), binge drank before pregnancy (OR 2.28; 95% CI 1.76-2.94), or if they were pregnant while alcohol guidelines recommended low alcohol versus abstinence (OR 1.60; 95% CI 1.26-2.03). Drinking during pregnancy was less likely if women had a Health Care Card (OR 0.63; 95% CI 0.45-0.88) or if they had ever had fertility problems (OR 0.64; 95% CI 0.48-0.86). Conclusions Most Australian women who drank alcohol continued to do so during pregnancy. Prepregnancy alcohol consumption was one of the main predictors of antenatal alcohol use. Alcohol guidelines, fertility problems and Health Care Card status also impacted antenatal alcohol consumption. © 2013 RCOG.
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2013 |
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Disparities in reported psychosocial assessment across public and private maternity settings: a national survey of women in Australia', BMC Public Health, 13 632 (2013) [C1]
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2013 |
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Referral for Management of Emotional Health Issues During the Perinatal Period: Does Mental Health Assessment Make a Difference?', Birth, 40 297-306 (2013) [C1]
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2013 |
Loxton D, Chojenta C, Anderson AE, Powers JR, Shakeshaft A, Burns L, 'Acquisition and Utilization of Information About Alcohol Use in Pregnancy Among Australian Pregnant Women and Service Providers', Journal of Midwifery & Women s Health, 58 523-530 (2013) [C1]
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2013 |
Schofield MJ, Powers JR, Loxton D, 'Mortality and Disability Outcomes of Self-Reported Elder Abuse: A 12-Year Prospective Investigation', Journal of the American Geriatrics Society, 61 679-685 (2013) [C1]
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2013 |
Powers JR, Loxton DJ, O'Mara AT, Chojenta CL, Ebert L, 'Regardless of where they give birth, women living in non-metropolitan areas are less likely to have an epidural than their metropolitan counterparts', WOMEN AND BIRTH, 26 E77-E81 (2013) [C1]
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2013 |
Teede HJ, Joham AE, Paul E, Moran LJ, Loxton D, Jolley D, Lombard C, 'Longitudinal weight gain in women identified With polycystic ovary syndrome: Results of an observational study in young women', Obesity, 21 1526-1532 (2013) [C1]
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2013 |
Hure AJ, Powers JR, Chojenta CL, Byles JE, Loxton D, 'Poor Adherence to National and International Breastfeeding Duration Targets in an Australian Longitudinal Cohort', PLOS ONE, 8 (2013) [C1]
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2013 |
Rich JL, Chojenta C, Loxton D, 'Quality, Rigour and Usefulness of Free-Text Comments Collected by a Large Population Based Longitudinal Study - ALSWH', PLOS ONE, 8 (2013) [C1]
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2012 |
Harris ML, Loxton DJ, Sibbritt DW, Byles JE, 'The relative importance of psychosocial factors in arthritis: Findings from 10,509 Australian women', Journal of Psychosomatic Research, 73 251-256 (2012) [C1]
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2012 |
Dillon G, Hussain R, Loxton DJ, Rahman S, 'Mental and physical health and intimate partner violence against women: A review of the literature', International Journal of Family Medicine, (2012) |
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2012 |
Rich JL, Wright SL, Loxton DJ, ''Patience, hormone replacement therapy and rain!' Women, ageing and drought in Australia: Narratives from the mid-age cohort of the Australian Longitudinal Study on Women's Health', Australian Journal of Rural Health, 20 324-328 (2012) [C1]
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2012 |
Powers JR, Loxton DJ, Baker J, Rich JL, Dobson AJ, 'Empirical evidence suggests adverse climate events have not affected Australian women's health and well-being', Australian and New Zealand Journal of Public Health, 36 452-457 (2012) [C1]
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2012 |
Anderson AE, Hure AJ, Powers JR, Kay-Lambkin FJ, Loxton DJ, 'Determinants of pregnant women's compliance with alcohol guidelines: A prospective cohort study', BMC Public Health, 12 1-10 (2012) [C1]
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2012 |
Chojenta CL, Loxton DJ, Lucke J, 'How do previous mental health, social support, and stressful life events contribute to postnatal depression in a representative sample of Australian women?', Journal of Midwifery & Womens Health, 57 145-150 (2012) [C1]
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2012 |
Hure AJ, Powers JR, Mishra GD, Herbert DL, Byles JE, Loxton DJ, 'Miscarriage, preterm delivery, and stillbirth: Large variations in rates within a cohort of Australian women', PLOS One, 7 1-8 (2012) [C1]
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2011 |
Adams J, Sibbritt DW, Broom A, Loxton DJ, Pirotta M, Humphreys J, Lui C-W, 'A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women', BMC Complementary and Alternative Medicine, 11 85 (2011) [C1]
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2011 |
Stavrou E, Vajdic CM, Loxton DJ, Pearson S-A, 'The validity of self-reported cancer diagnoses and factors associated with accurate reporting in a cohort of older Australian women', Cancer Epidemiology, 35 e75-e80 (2011) [C1]
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2011 |
Byles JE, Dolja-Gore X, Loxton DJ, Parkinson L, Stewart Williams JA, 'Women's uptake of medicare benefits schedule mental health items for general practitioners, psychologists and other allied mental health professionals', Medical Journal of Australia, 194 175-179 (2011) [C1]
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2011 |
Mackerras D, Powers JR, Boorman J, Loxton DJ, Giles GG, 'Estimating the impact of mandatory fortification of bread with iodine on pregnant and post-partum women', Journal of Epidemiology and Community Health, 65 1118-1122 (2011) [C1]
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2011 |
Burns L, Black E, Powers JR, Loxton DJ, Elliott E, Shakeshaft A, Dunlop AJ, 'Geographic and maternal characteristics associated with alcohol use in pregnancy', Alcoholism: Clinical and Experimental Research, 35 1230-1237 (2011) [C1]
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2011 |
Lucke J, Herbert D, Loxton DJ, Weisberg E, 'Unintended pregnancies: Reducing rates by improving access to contraception', Australian Family Physician, 40 849 (2011) [C3]
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2011 |
Astbury J, Bruck D, Loxton DJ, 'Forced sex: A critical factor in the sleep difficulties of young Australian women', Violence and Victims, 26 53-72 (2011) [C1]
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2011 |
Dolja-Gore X, Byles JE, Loxton DJ, Hockey RL, Dobson AJ, 'Increased bulk-billing for general practice consultations in regional and remote areas, 2002-2008', Medical Journal of Australia, 195 203-204 (2011) [C1]
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2010 |
Powers JR, Loxton DJ, Burns LA, Shakeshaft A, Elliott EJ, Dunlop AJ, 'Assessing pregnant women's compliance with different alcohol guidelines: An 11-year prospective study', Medical Journal of Australia, 192 690-693 (2010) [C1]
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2010 |
Powers JR, Loxton DJ, 'The impact of attrition in an 11-Year prospective longitudinal study of younger women', Annals of Epidemiology, 20 318-321 (2010) [C1]
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2010 |
Lucke JC, Brown W, Tooth L, Loxton DJ, Byles JE, Spallek M, et al., 'Health across generations: Findings from the Australian Longitudinal Study on Women's Health', Biological Research for Nursing, 12 162-170 (2010) [C1]
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2009 |
Loxton DJ, Powers JR, Schofield M, Hussain R, Hosking SJ, 'Inadequate cervical cancer screening among mid-aged Australian women who have experienced partner violence', Preventive Medicine, 48 184-188 (2009) [C1]
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2007 |
Loxton DJ, Byles JE, Dobson A, Brown WJ, 'Conducting longitudinal research: Practical lessons from the Australian Longitudinal Study on Women's Health', International Journal of Multiple Research Approaches, 1 (2007) [C2]
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2007 |
Loxton DJ, 'Editorial', International Journal of Multiple Research Approaches, 1 78-79 (2007) [C3] |
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2007 |
Warner-Smith PA, Loxton DJ, Brown WJ, 'Human Resources for Longitudinal Studies: Matching people to skills and tasks', International Journal of Multiple Research Approaches, 1 92-103 (2007) [C1]
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2007 |
Loxton DJ, Young AF, 'Longitudinal survey development and design', International Journal of Multiple Research Approaches, 1 114-125 (2007) [C1]
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2007 |
Chojenta CL, Byles JE, Loxton DJ, Mooney RH, 'Communication and dissemination of longitudinal study findings', International Journal of Multiple Research Approaches, 1 199-209 (2007) [C1]
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2007 |
Helman J, Loxton DJ, Adamson LR, Graves AM, Powers JR, 'Conducting substudies in a longitudinal research project', International Journal of Multiple Research Approaches, 1 187-198 (2007) [C1]
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2006 |
Loxton DJ, Mooney RH, Young AF, 'The psychological health of sole mothers in Australia', Medical Journal of Australia, 184 265-268 (2006) [C1]
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2006 |
Loxton DJ, Schofield M, Hussain R, 'Psychological health in midlife among women who have ever lived with a violent partner or spouse', Journal of Interpersonal Violence, 21 1092-1107 (2006) [C1]
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2006 |
Loxton DJ, Schofield M, Hussain R, Mishra G, 'History of domestic violence and physical health in midlife', Violence against Women, 12 715-731 (2006) [C1]
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2005 |
Loxton DJ, 'What future? The long term implications of sole motherhood for economic wellbeing', Just Policy, 39-44 (2005) [C1] |
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2005 |
Loxton DJ, 'What future? The long-term implications of sole motherhood for economic wellbeing', Just Policy, 35 39-44 (2005) |
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2004 |
Loxton DJ, Schofield M, Hussain R, 'History of domestic violence and health service use among mid-aged Australian women', Australian and New Zealand Journal of Public Health, 28 383-388 (2004) [C1]
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2004 |
Minichiello V, Plummer D, Loxton DJ, 'Factors predicting sexual relationships in older people: an Australian study', Australasian Journal on Ageing, 23 125-130 (2004) [C1]
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2001 |
Hussain R, Schofield MJ, Loxton D, 'Cosmetic surgery history is related to higher health service use in mid-life: Womens Health Australia', The Medical Journal of Australia, 176 576-579 (2001) [C1]
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2001 |
Schofield MJ, Hussain R, Loxton D, Miller Z, 'Psychosocial and health behavioural covariates of cosmetic surgery: Women''s Health Australia study', Journal of Health Psychology, 7 445-457 (2001) [C1]
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2000 |
Minichiello V, Plummer D, Loxton D, 'Knowledge and Beliefs of Older Australians about Sexuality and Health (2000) [C1]
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Loxton D, Harris ML, Forder P, Powers J, Townsend N, Byles J, Mishra G, 'Factors Influencing Web-Based Survey Response for a Longitudinal Cohort of Young Women Born Between 1989 and 1995 (Preprint)
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