Yvette Miller | Queensland University of Technology (original) (raw)
Papers by Yvette Miller
Faculty of Health; Institute of Health and Biomedical Innovation, 2010
Although independent relationships between sitting behaviors (mainly television viewing) and heal... more Although independent relationships between sitting behaviors (mainly television viewing) and health outcomes have been reported, few studies have examined the measurement properties of self-report sitting questions. This study assessed gender-specific test-retest reliability and validity of a questionnaire that assessed time spent sitting on weekdays and weekend days: 1) traveling to and from places, 2) at work, 3) watching television, 4) using a computer at home, and 5) for leisure, not including television. Test-retest reliability of domain-specific sitting time (min x d(-1)) on weekdays and weekend days was assessed using data collected on two occasions (median = 11 d apart). Validity of domain-specific self-reported sitting time on weekdays and weekend days was assessed against log data and sedentary accelerometer data. Complete repeat questionnaire and log data were obtained from 157 women (aged 51-59 yr) and 96 men (aged 45-63 yr). Reliability coefficients were high for weekday sitting time at work, watching television, and using a computer at home (r = 0.84-0.78) but lower for weekend days across all domains (r = 0.23-0.74). Validity coefficients were highest for weekday sitting time at work and using a computer at home (r = 0.69-0.74). With the exception of computer use and watching television for women, validity of the weekend-day sitting time items was low. This study confirms the importance of measuring domain- and day-specific sitting time. The measurement properties of questions that assess structured domain-specific and weekday sitting time were acceptable and may be used in future studies that aim to elucidate associations between domain-specific sitting and health outcomes.
INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support... more INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support Program (CHSP) consortium: - of 14 service providers delivering clinical and non-clinical in-home services across the Brisbane North and Caboolture Regions in Queensland: - who supported over 8,000 consumers in 2017/18 - with a workforce of over 1,000 health and care staff. Strong commitment to implementing a wellness model in service delivery and maximising learning outcomes from a limited training and development budget. Brisbane North PHN embarked on a multi-organisational human resource planning study.
Journal of Science and Medicine in Sport, Dec 1, 2012
Faculty of Health, Aug 1, 2011
Background: Previous studies have shown that qi-gong, a form of mind-body movement therapy, may b... more Background: Previous studies have shown that qi-gong, a form of mind-body movement therapy, may be benefıcial for people with type 2 diabetes; however, no controlled studies have been conducted to examine the predictors and mediators of qi-gong effects on indicators of diabetes control. This study examined the effects of qi-gong on diabetes control and identifıed the predictors and mediators of these effects.
Faculty of Health; Institute of Health and Biomedical Innovation, 2010
To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme... more To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. A single group pre-post feasibility trial with 11 participants (3 male and 8 female; aged 42-65 years) with elevated blood glucose. Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05, p<0.001), waist circumference (-2.80 cm, p<0.05), and systolic (-11.64 mm Hg, p<0.01) and diastolic blood pressure (-9.73 mm Hg, p<0.001), as well as in HbA1c (-0.32%, p<0.01), insulin resistance (-0.53, p<0.05), stress (-2.27, p<0.05), depressive symptoms (-3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.
Journal of Science and Medicine in Sport, Apr 1, 2004
ABSTRACT
American Journal of Preventive Medicine, Aug 1, 2002
Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the... more Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (M age ϭ 47.5; 82% women). Design: Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control. Main Outcome Measures: Psychosocial variables, including self-efficacy, decisional balance, and processes of change. Results: All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI ϭ 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI ϭ 0.29, 0.80) being attenuated by decreases due to cognitive processes (Ϫ0.17, 95%CI ϭ Ϫ0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI ϭ 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI ϭ 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI ϭ Ϫ0.27, Ϫ0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance. Conclusions: These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost.
Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caes... more Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing information about likelihood of outcomes in relative format, and discouraging patient involvement in decision making. We experimentally investigated how health care provider communication of risk information and women’s role in decision-making influenced women’s mode of birth decisions after a previous caesarean.
To evaluate a case management (CM) model for people with mild dementia, whereby resources within ... more To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used. Method: Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N ¼ 59) or usual care only (control group, N ¼ 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months. Result: CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (x 2 , p > 0.05). Conclusion: Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.
Research Square (Research Square), Mar 27, 2023
Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness... more Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness evidence available for evaluating alternative Maternity Models of Care (MMC) and to summarize ndings narratively. Methods: Articles that included a decision tree or state-based (Markov) model to explore the cost-effectiveness of an MMC, and at least one comparator MMC, were identi ed from a systematic literature review. The MEDLINE, Embase, Web of Science, CINAHL and Google Scholar databases were searched for papers published in English, Arabic, and French. A narrative synthesis was conducted to analyse results. Results: Three studies were included; all using cost-effectiveness decision tree models with data sourced from a combination of trials, databases, and the literature. Study quality was fair to poor. Each study compared midwife-led or doula-assisted care to obstetrician-or physician-led care. The ndings from these studies indicate that midwife and doula led MMCs may provide value. Conclusion: The ndings of these studies indicate weak evidence that midwife and doula models of care may be a cost-effective or costsaving alternative to standard care. However, the poor quality of evidence, lack of standardised MMC classi cations, and the dearth of research conducted in this area are barriers to conclusive evaluation and highlight the need for more research incorporating appropriate models and population diversity. Highlights No conclusions could be drawn regarding the cost-effectiveness of individual MMCs due to the limited and low-quality studies eligible for inclusion in this review. Very few studies exist in the literature that use modelling to assess the cost-effectiveness of MMCs. This paucity of evidence hinders the determination of the best value maternity services and may lead to inappropriate policy and funding.
QUT ePrints (Queensland University of Technology), 2007
Mental health in the workplace is a major concern, with rising rates of depression and stress imp... more Mental health in the workplace is a major concern, with rising rates of depression and stress impacting productivity and well-being. Resilient adults are adaptable and able to manage their working and personal lives, as well as the demands of the workplace and technological change. The pilot for an innovative, prevention program, the Promoting Adult Resilience (PAR) program, was conducted in a resource-sector company over 11 weeks. 20 employees took part and a comparison group was drawn from a parallel on-line study on adult well-being. The sessions synthesized cognitive behavioural and mental health promotion strategies with work-life balance to promote mental health and well-being amongst working adults. Participant outcomes and treatment integrity were assessed throughout the duration of the program. Process evaluation assessed the manualised program, the facilitator, the volunteers as participants and diary notes from the facilitator on each session, and found that treatment integrity was maintained throughout the program. Pre and post testing of the participants of the PAR program showed significantly reduced levels of depression and stress and improved levels of coping selfefficacy, in relation to the comparison group.
Journal of Public Health
Objective This study aimed to explore the relationship between different complementary feeding (C... more Objective This study aimed to explore the relationship between different complementary feeding (CF) indicators and coexisting forms of malnutrition (CFM) in Pakistan. Methodology This study involves secondary data analysis of eight national and regional datasets of Pakistan, which were retrieved from the Demographic Health Survey (DHS) and UNICEF. From these datasets, data of children aged between 6 to 23.9 months was analysed after excluding incomplete and/or invalid data related to their feeding practices and anthropometry. Thus, data of 30,097 Pakistani children between the ages of 6 to 23.9 months was analysed in this study using Jamovi software. Results The prevalence of CFM in this sample of children was 28.1%. Cereals and dairy were chiefly used for CF. With the exception of continuation of breastfeeding and coadministration of breastmilk with solid/semi-solid/soft food, adherence to all other CF indicators (minimum dietary diversity, minimum meal frequency, iron & folate con...
BMC Public Health
Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of ... more Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an individual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. Methods A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in individuals were included. The quality of included studies was assessed using the Joanna Briggs...
Breastmilk is the only recommended source of nutrition for infants below six-months of age. Howev... more Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) ...
Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caes... more Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing inf...
Faculty of Health; Institute of Health and Biomedical Innovation, 2010
Although independent relationships between sitting behaviors (mainly television viewing) and heal... more Although independent relationships between sitting behaviors (mainly television viewing) and health outcomes have been reported, few studies have examined the measurement properties of self-report sitting questions. This study assessed gender-specific test-retest reliability and validity of a questionnaire that assessed time spent sitting on weekdays and weekend days: 1) traveling to and from places, 2) at work, 3) watching television, 4) using a computer at home, and 5) for leisure, not including television. Test-retest reliability of domain-specific sitting time (min x d(-1)) on weekdays and weekend days was assessed using data collected on two occasions (median = 11 d apart). Validity of domain-specific self-reported sitting time on weekdays and weekend days was assessed against log data and sedentary accelerometer data. Complete repeat questionnaire and log data were obtained from 157 women (aged 51-59 yr) and 96 men (aged 45-63 yr). Reliability coefficients were high for weekday sitting time at work, watching television, and using a computer at home (r = 0.84-0.78) but lower for weekend days across all domains (r = 0.23-0.74). Validity coefficients were highest for weekday sitting time at work and using a computer at home (r = 0.69-0.74). With the exception of computer use and watching television for women, validity of the weekend-day sitting time items was low. This study confirms the importance of measuring domain- and day-specific sitting time. The measurement properties of questions that assess structured domain-specific and weekday sitting time were acceptable and may be used in future studies that aim to elucidate associations between domain-specific sitting and health outcomes.
INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support... more INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support Program (CHSP) consortium: - of 14 service providers delivering clinical and non-clinical in-home services across the Brisbane North and Caboolture Regions in Queensland: - who supported over 8,000 consumers in 2017/18 - with a workforce of over 1,000 health and care staff. Strong commitment to implementing a wellness model in service delivery and maximising learning outcomes from a limited training and development budget. Brisbane North PHN embarked on a multi-organisational human resource planning study.
Journal of Science and Medicine in Sport, Dec 1, 2012
Faculty of Health, Aug 1, 2011
Background: Previous studies have shown that qi-gong, a form of mind-body movement therapy, may b... more Background: Previous studies have shown that qi-gong, a form of mind-body movement therapy, may be benefıcial for people with type 2 diabetes; however, no controlled studies have been conducted to examine the predictors and mediators of qi-gong effects on indicators of diabetes control. This study examined the effects of qi-gong on diabetes control and identifıed the predictors and mediators of these effects.
Faculty of Health; Institute of Health and Biomedical Innovation, 2010
To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme... more To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. A single group pre-post feasibility trial with 11 participants (3 male and 8 female; aged 42-65 years) with elevated blood glucose. Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05, p<0.001), waist circumference (-2.80 cm, p<0.05), and systolic (-11.64 mm Hg, p<0.01) and diastolic blood pressure (-9.73 mm Hg, p<0.001), as well as in HbA1c (-0.32%, p<0.01), insulin resistance (-0.53, p<0.05), stress (-2.27, p<0.05), depressive symptoms (-3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.
Journal of Science and Medicine in Sport, Apr 1, 2004
ABSTRACT
American Journal of Preventive Medicine, Aug 1, 2002
Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the... more Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (M age ϭ 47.5; 82% women). Design: Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control. Main Outcome Measures: Psychosocial variables, including self-efficacy, decisional balance, and processes of change. Results: All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI ϭ 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI ϭ 0.29, 0.80) being attenuated by decreases due to cognitive processes (Ϫ0.17, 95%CI ϭ Ϫ0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI ϭ 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI ϭ 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI ϭ Ϫ0.27, Ϫ0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance. Conclusions: These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost.
Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caes... more Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing information about likelihood of outcomes in relative format, and discouraging patient involvement in decision making. We experimentally investigated how health care provider communication of risk information and women’s role in decision-making influenced women’s mode of birth decisions after a previous caesarean.
To evaluate a case management (CM) model for people with mild dementia, whereby resources within ... more To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used. Method: Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N ¼ 59) or usual care only (control group, N ¼ 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months. Result: CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (x 2 , p > 0.05). Conclusion: Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.
Research Square (Research Square), Mar 27, 2023
Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness... more Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness evidence available for evaluating alternative Maternity Models of Care (MMC) and to summarize ndings narratively. Methods: Articles that included a decision tree or state-based (Markov) model to explore the cost-effectiveness of an MMC, and at least one comparator MMC, were identi ed from a systematic literature review. The MEDLINE, Embase, Web of Science, CINAHL and Google Scholar databases were searched for papers published in English, Arabic, and French. A narrative synthesis was conducted to analyse results. Results: Three studies were included; all using cost-effectiveness decision tree models with data sourced from a combination of trials, databases, and the literature. Study quality was fair to poor. Each study compared midwife-led or doula-assisted care to obstetrician-or physician-led care. The ndings from these studies indicate that midwife and doula led MMCs may provide value. Conclusion: The ndings of these studies indicate weak evidence that midwife and doula models of care may be a cost-effective or costsaving alternative to standard care. However, the poor quality of evidence, lack of standardised MMC classi cations, and the dearth of research conducted in this area are barriers to conclusive evaluation and highlight the need for more research incorporating appropriate models and population diversity. Highlights No conclusions could be drawn regarding the cost-effectiveness of individual MMCs due to the limited and low-quality studies eligible for inclusion in this review. Very few studies exist in the literature that use modelling to assess the cost-effectiveness of MMCs. This paucity of evidence hinders the determination of the best value maternity services and may lead to inappropriate policy and funding.
QUT ePrints (Queensland University of Technology), 2007
Mental health in the workplace is a major concern, with rising rates of depression and stress imp... more Mental health in the workplace is a major concern, with rising rates of depression and stress impacting productivity and well-being. Resilient adults are adaptable and able to manage their working and personal lives, as well as the demands of the workplace and technological change. The pilot for an innovative, prevention program, the Promoting Adult Resilience (PAR) program, was conducted in a resource-sector company over 11 weeks. 20 employees took part and a comparison group was drawn from a parallel on-line study on adult well-being. The sessions synthesized cognitive behavioural and mental health promotion strategies with work-life balance to promote mental health and well-being amongst working adults. Participant outcomes and treatment integrity were assessed throughout the duration of the program. Process evaluation assessed the manualised program, the facilitator, the volunteers as participants and diary notes from the facilitator on each session, and found that treatment integrity was maintained throughout the program. Pre and post testing of the participants of the PAR program showed significantly reduced levels of depression and stress and improved levels of coping selfefficacy, in relation to the comparison group.
Journal of Public Health
Objective This study aimed to explore the relationship between different complementary feeding (C... more Objective This study aimed to explore the relationship between different complementary feeding (CF) indicators and coexisting forms of malnutrition (CFM) in Pakistan. Methodology This study involves secondary data analysis of eight national and regional datasets of Pakistan, which were retrieved from the Demographic Health Survey (DHS) and UNICEF. From these datasets, data of children aged between 6 to 23.9 months was analysed after excluding incomplete and/or invalid data related to their feeding practices and anthropometry. Thus, data of 30,097 Pakistani children between the ages of 6 to 23.9 months was analysed in this study using Jamovi software. Results The prevalence of CFM in this sample of children was 28.1%. Cereals and dairy were chiefly used for CF. With the exception of continuation of breastfeeding and coadministration of breastmilk with solid/semi-solid/soft food, adherence to all other CF indicators (minimum dietary diversity, minimum meal frequency, iron & folate con...
BMC Public Health
Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of ... more Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an individual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. Methods A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in individuals were included. The quality of included studies was assessed using the Joanna Briggs...
Breastmilk is the only recommended source of nutrition for infants below six-months of age. Howev... more Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) ...
Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caes... more Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing inf...