Suchergebnisse

IntroductionInterpregnancy interval (IPI) is a potentially modifiable risk factor for preganncy outcomes, and short and long IPI may be associated with increased rik of pregnancy complications. Record linkage provides the only practiacble means to investigate IPI effects, which requires large generalisable sample sizes and long follow-up time.
Objectives and ApproachThis study examines the effect of IPI on gestational diabetes in Western Australia, with the aim to inform the evidence-base for IPI recommendations in high-income countries. A longitudinal population-based retrospective cohort study was conducted using de-identified, probabilistically-linked records for all births in Western Australia from 1980 to 2015 (inclusive) from the state's Midwives Notification System and the WA Hospital Morbidity Data Collection. Logistic regression model was used to estimate the odds of gestational diabetes by IPI category. Analyses included all women with at least two consecutive singleton live births at 20-44 weeks of gestation.
ResultsA cohort of 320,616 women were included in the study. Of these, 13,680 (4\%) had an IPI > 120 months (AOR:1.53, 95\% CI 1.38-1.70) as compared to 18-23 months.
Conclusion/ImplicationsOur findings show that both short and long IPIs may be associated with increased risk of gestational diabetes in a high-income setting. In this study, data linkage improved ascertainment of the outcome measure. Results suggest 18-23 months following a previous livebirth may be optimal for avoiding complications in future pregnancies.

Background: Female sterilisation is usually performed on an elective basis at perceived family completion, however, around 1-3% of women who have undergone sterilisation elect to undergo sterilisation reversal (SR) at a later stage. The trends in SR rates in Western Australia (WA), proportions of SR procedures between hospital types (public and private), and the effects of Federal Government policies on these trends are unknown. Methods: Using records from statutory state-wide data collections of hospital separations and births, we conducted a retrospective descriptive study of all women aged 15-49 years who underwent a SR procedure during the period 1st January 1990 to 31st December 2008 (n = 1868 procedures). Results: From 1991 to 2007 the annual incidence rate of SR procedures per 10,000 women declined from 47.0 to 3.6. Logistic regression modelling showed that from 1997 to 2001 the odds of women undergoing SR in a private hospital as opposed to all other hospitals were 1.39 times higher (95% CI 1.07-1.81) and 7.51 times higher (95% CI 5.46-10.31) from 2002 to 2008. There were significant decreases in SR rates overall and among different age groups after the Federal Government interventions. Conclusion: Rates of SR procedures in WA have declined from 1990 to 2008, particularly following policy changes such as the introduction of private health insurance (PHI) policies. This suggests decisions to undergo SR may be influenced by Federal Government interventions.

AbstractCorporal punishment is associated with adverse outcomes; however, little empirical data exists about the state of corporal punishment in Australia. This paper presents the first national prevalence estimates of experiences of corporal punishment during childhood among Australians and its use as adults by Australian parents and caregivers. We also report community beliefs about the necessity of corporal punishment. Results show corporal punishment remains common in Australia. A high proportion of Australians (62.5%) experienced corporal punishment in childhood, including almost 6 in 10 (58.4%) young people aged 16–24. Approximately half of all parents surveyed (53.7%) had used corporal punishment. A quarter of Australians (26.4%) believe corporal punishment is necessary to raise children, 73.6% do not view it as necessaryThe use of corporal punishment and belief in its necessity are lower among younger people. Findings indicate the experience of corporal punishment remains unacceptably high in Australia but that the use of corporal punishment and beliefs about its necessity may be changing. These findings have significant implications for policy and practice in Australia. Changes in legislation could reduce this form of violence toward children. Relatively low rates of endorsement of the necessity of corporal punishment suggest the Australian community may be receptive to attempts for law reform in this area.

This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data ( N = 8503), 9.5% of participants identified with a diverse sexuality and .9% with a diverse gender. Diverse identities were more prevalent in the youth cohort, with 17.7% of 16–24 years olds identifying with a diverse sexuality and 2.3% with a diverse gender. Gender and sexuality diversity also intersect – for example, with women (aged 16–24 and 25–44) more likely than men to identify as bisexual. The prevalence of physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence was very high for those with diverse sexuality and/or gender identities. Maltreatment was most prevalent for participants in the youth cohort with diverse gender identities (90.5% experiencing some form of child maltreatment; 77% multi-type maltreatment) or diverse sexualities (85.3% reporting any child maltreatment; 64.3% multi-type maltreatment). The strong association found between child maltreatment and diverse sexuality and gender identities is critical for understanding the social and mental health vulnerabilities of these groups, and informing services needed to support them.

This study aimed to explore key characteristics of the out-of-home care subgroup of a nationally representative Australian sample. To ensure that mental health services are appropriately targeted, it is critical that we understand the differential impacts of childhood experiences for this cohort. Using the Australian Child Maltreatment Study ( N = 8503), we explored patterns of childhood maltreatment and adversity of participants who reported ever being placed in out-of-home care, such as foster care or kinship care. In addition, the prevalence of current and lifetime diagnosis of four mental health disorders were explored. Results showed that the care experienced subgroup reported more types of maltreatment and adverse experiences than the control group. They were also more likely to meet diagnostic threshold for post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder than the control group. These findings can be used to guide mental health practitioners to target interventions more effectively within the out-of-home care cohort.