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The effects of prenatal psychosocial work stress on adverse pregnancy outcomes: A comprehensive systematic review and meta-analysis
No full textObjective:
Psychosocial work stress is a predictor of adverse pregnancy outcomes. However, there is limited comprehensive and conclusive evidence available on the associations between psychosocial work stress and adverse pregnancy outcomes. This systematic review and meta-analysis paper addressed this gap by synthesizing the available evidence.
Methods:
Studies were retrieved from six electronic databases that include pregnant mothers as study population, psychosocial work stress as variable exposure, and adverse pregnancy outcomes - including pregnancy loss, gestational hypertension and diabetes mellitus, preterm birth, low birth weight, and low fetal growth - as the outcomes of interest. The quality and certainty of evidence were assessed. Depending on the study characteristics, either a fixed or random effect model was employed. Heterogeneity was assessed using I2 statistics, and further subgroup and sensitivity analysis was employed as appropriate.
Results:
A total of 26 studies (N=1 346 686) were included. Psychosocial work stress decreased birth weight by 77.09 grams, increased the occurrence of preeclampsia by 50%, and preterm birth by 18% with moderate certainty of evidence, and increased the chance of pregnancy loss by 20% with low certainty of evidence. With a low grading scale, low birth weight and small-for-gestational-age had no significant association with psychosocial work stress.
Conclusions:
Psychosocial work-stress increased the risks of pre-eclampsia, preterm birth, and pregnancy loss, and decreased fetus weight. Therefore, occupational therapists, employers, policy makers, and relevant stakeholders should work together to minimize the impact of psychosocial work-stress on the mother and baby
FDI and Product and Process Innovation of SMEs in Vietnam: The Role of Institutions
No full textConceptually, institutional arrangements in the host economy are likely to moderate the effect of inward FDI on domestic firms' product and process innovation, which is however not well explored empirically. Filling the gap, this research investigates how such FDI impacts are contingent upon local institutional arrangements, using survey data of 2690 manufacturing SMEs in Vietnam in 2011, 2013 and 2015. We find that institutional quality exerts positive moderating effects on FDI spillovers. That is, higher institutional quality leads to a higher marginal effect of FDI presence on the innovation performance of domestic SMEs. The moderating effects are stronger for developed-country FDI than for developing-country FDI. We also distinguish different institutional components and find that seven out of nine institutional sub-indices have significant moderating effects, of which the control of corruption is the most important factor in promoting FDI spillovers, whilst the effects of business support and labour training policies are negligible
Reimagining the northern Australian beef industry; review of feedbase opportunities for growth
No full textThe current beef industry in northern Australia was established through the adoption of innovative schemes and ideas that transformed the economic viability of the industry in the 20th century. In this paper we argue that a key driver of beef production, the nutrition of the animal or feedbase, can be sustainably exploited with novel ideas to affect a paradigm shift in the northern beef industry in the 21st century. While the current economics of beef production limit adoption of “out-there” ideas, it is nonetheless useful to consider them. It is contended that future global protein shortages for human nutrition may change the economic balance in favour of more creative ideas to utilise the existing and potential, as yet untapped feedbase. The underlying premise is that the beef industry could better take advantage of the varied feedbase opportunities that exist in the north. In doing so the industry would shift the balance from a predominantly pastoral system to a mixed model where extensive grazing co-exists with intensive beef production at the regional scale. Concomitant with this change, the long-term productive and environmental conditions of the industry could be improved. For example, intensification in some locations would allow de-intensification in others. In this review we focus on five potential “game changers” for the industry, some of which are proven but for reasons discussed, under adopted and some of which are more “blue sky”. These game changers are legumes, silage, irrigation, co-products from the crop and vegetable industries and ligno-cellulosic feedstocks. These are all technically feasible and lend themselves to regionally integrated production systems that take advantage of the opportunities across the north – land, sunshine, water, people, infrastructure, markets
Preoperative Sarcopenia in Patients Undergoing Cardiac Surgery: Pilot Study of Two Functional Questionnaires
No full textPurpose:
The adverse association of sarcopenia with postoperative outcomes has been reported. There is no preferred screening tool to identify sarcopenia among this patient group. The aim of this pilot study was to assess the validity of two well-known questionnaires on patients with sarcopenia.
Methodology:
The study included 30 subjects who underwent cardiac surgery at Townsville University Hospital, Queensland, Australia, from July 2023 to January 2024. Patients were assessed pre-operatively based on the Revised European Working Group of Sarcopenia in Older People 2 (EWGSOP) for sarcopenia which defines from a combination of muscle function (MF) and muscle mass (MM). Accordingly, MF was assessed with handgrip strength and five-time chair rise tests. MM was defined according to our cut-off lowest sex-specific quartile of Pectoralis Major area from a cohort of 237 patients undergoing cardiac surgery.
Sarc-F (strength, assisting with walking, rising from a chair, climbing stairs, and falling) and Sarc-CalF (SARC and calf circumference) were compared. The diagnostic precision of both methods was determined using the receiver-operating characteristic (ROC) curves and area under the ROC curves (AUC).
Results:
Sarcopenia was identified in 10 (33%) of patients. Comparing the two screening questionnaires, AUC curves of Sarc-F was 0.890 (95% confidence interval [CI], 0.75–0.99) and mildly higher than Sarc-Calf AUC of 0.855 (95% CI, 0.69–0.99) (p>0.05). The sensitivity of Sarc-Calf to diagnose sarcopenia was significantly higher compared to Sarc-F (70.0% (CI,40.0–89.2) vs 60.0% (CI, 31.1–83.2) (p<0.05).
Conclusions:
Sarc-F performance in detecting sarcopenic patients by only assessing muscle function was satisfactory but not sensitive. Addition of calf circumference to Sarc-F as Sarc-Calf, provided a more sensitive screening test for sarcopenia in patients undergoing cardiac surgery. This has implications in the incorporation of muscle morphometry in the objective assessment of sarcopenia
Life beyond the lakes: An analysis and implications of a Pleistocene combustion feature on the Pike River in South Australia
No full textThe Pike River is an anabranch and palaeochannel of the Murray River located in South Australia's Riverland region, in the southwestern part of the Murray-Darling Basin. The floodplain contains abundant and varied archaeological evidence of Aboriginal life, including extensive deposits of shell midden exposed along the high cliff-line bounding the southeastern margin of the floodplain. The oldest of these deposits has been securely dated, so far, to ∼29 ka cal BP. This article presents the results of chronological, micromorphological and sedimentary analyses of a combustion feature also located on this cliff-line. Based on our analysis and interpretation of the feature's stratigraphic context, in combination with 14C and OSL dating, we argue that the feature is ∼43 ka old. Whilst the combustion feature contains no associated cultural material (e.g. stone artefacts or faunal remains) we argue that a cultural origin is, nonetheless, supported given the feature's geometry, sedimentary structures, geochemistry and magnetic response. As such, we argue that the feature provides a rare glimpse into the earliest peopling of the Murray River corridor. Further, the feature is amongst some of the earliest pieces of evidence for human pyrotechnology in the Australasian region and only one of a few examples from an open-air site that is microstratigraphically (micromorphologically) contextualised. The preservation of combustion features of this antiquity in open-context sites is extremely rare, both in this region and globally
Engaging cultural authority towards achieving sustainable operational outcomes: The Gunawuna Jungai story
No full textAlmost twenty years on from the establishment of Australia’s Closing the Gap strategy, there has been limited progress in meeting the agreed targets. Aiming to escalate progress, one discrete Aboriginal community in remote northwestern Queensland, Doomadgee, volunteered to become one of six place-based partnership sites in Australia under the National Closing the Gap Agreement. These place-based partnerships provide a focus for the Priority Reforms underpinning the Closing the Gap targets to change the way that governments are working with Aboriginal and Torres Strait Islander communities, with the objective being to strengthen and establish formal partnerships with governments and shared decision-making. The Doomadgee community nominated Gunawuna Jungai Ltd as its community-controlled, community-owned company built to represent the whole of the Doomadgee community. Governance is one of the main objectives of Gunawuna Jungai. As such, the Gunawuna Jungai’s Governance Structure (colloquially referred to as the dartboard model) reflects the structure of the Doomadgee community and exemplifies their commitment to governance that is based on cultural authority. A qualitative research design comprising a documentary analysis and key informant interviews was used to co-create the story of Gunawuna Jungai to identify learning points throughout their journey from idea to incorporation and operation. The visionary leaders of Gunawuna Jungai built culture into every element of the organisation starting with the dartboard model of governance which captures what already happens in the Doomadgee community and a constitution which is aligned to how families work. Hence, structuring by cultural systems not western systems, gives Gunawuna Jungai an opportunity to govern differently for different results than those experienced in the past. Gunawuna Jungai’s story has relevance for other communities in Northern Australia.
Learnings
1.How to identify cultural authority with community
2.How to develop a governance model based on cultural authority
3.How a cultural governance model can achieve sustainable operational outcome
Effects of death anxiety on social media addiction and internet gaming disorder: Roles of fear of missing out and self-esteem
No full textDespite the extensive literature on risk factors for digital addictions, it is surprising that death anxiety (DA) has not been examined as a potential risk factor, given its transdiagnostic nature for various psychological disorders. This study investigated the effect of DA on social media addiction (SMA) and internet gaming disorder (IGD) and examined whether these relationships were mediated by fear of missing out (FOMO) and moderated by self-esteem. Participants were 178 (53.93% females) social media and gaming users, aged between 18 and 84 years. They completed instruments assessing DA, FOMO, self-esteem, SMA, and IGD. Results revealed that the relationship between DA and SMA was partially mediated by FOMO but not moderated by self-esteem. In addition, the relationship between DA and IGD was not mediated by FOMO but was moderated by self-esteem. Specifically, DA predicted higher levels of IGD when self-esteem levels were low and average, but not at high levels of self-esteem. These findings broaden current understanding of digital addictions by accounting for the role of death-related fears and mechanisms that may contribute to the development and maintenance of SMA and IGD
Factors positively influencing GP obstetricians to remain in rural and remote obstetric practice
No full textObjective:
To explore factors that enable and encourage GP Obstetricians (GPOs) to remain in their role providing perinatal care and delivery services in rural and remote locations.
Setting:
Rural and remote locations in North and Far North Queensland.
Participants:
Participants were GPOs providing maternity care and delivery services. They were invited to be interviewed for the study via hospital email and snowballing.
Design:
We conducted 11 semi-structured interviews with GPOs from July to August 2023. Interview data were coded and analysed using thematic analysis into themes and subthemes.
Results:
We identified two overarching themes as enablers: job satisfaction and support. Job satisfaction was composed of enjoyment arising from an interest in the field and procedural work, and feelings of fulfilment deriving from serving the community. Support centred around constant, supportive interactions with midwifery and medical colleagues in the workplace, medical colleges, and staff at regional referral centres.
Conclusion:
As GPOs who remain in rural and remote areas identify support as a key enabler, establishing strategies to improve service delivery and retention involves expanding and supporting the current system as well as implementing new approaches to support practitioners both at work and home. Skill maintenance should be tailored toward individual needs, referral centres need to have a fostering and inclusive mindset toward their rural practitioners, review systems should be inquisitive and constructive rather than punitive, and colleges should foster and support their fellows
Distal airway epithelial progenitors mediate TGF-β release to drive lung CD8+ TRM induction following mucosal BCG vaccination
No full textA principal reason for the high global morbidity and mortality of tuberculosis (TB) is the lack of efficacy of the only licensed TB vaccine, Bacillus Calmette-Guérin (BCG), as intradermal BCG does not induce local pulmonary immune memory. Animal studies have shown that inhalation of BCG vaccination provides superior mucosal protection against TB due to generation of lung resident memory T cells (TRM). Here, we demonstrated that following mucosal vaccination with the genetically modified more virulent BCG strain, BCG::RD1, distal airway epithelial progenitors were mobilized to assist with restoration of alveolar epithelium. By way of their integrin-mediated activation of latent TGF-β, lung CD8+ TRM differentiation was induced. Mucosal vaccinations using nonvirulent strains of BCG in which airway epithelial progenitors were not mobilized, as well as genetic inhibition of integrin-mediated activation of TGF-β, resulted in significantly lower numbers of lung CD8+ TRM with subsequent reduced protection against Mycobacterium tuberculosis (Mtb)-induced lung pathology in mice. The results link airway epithelial progenitor-mediated repair of injured lung tissue with a role in the induction of resident CD8+ T cell memory. These findings provide further explanation why mucosal vaccination with virulent BCG strains is more protective against TB and thus has implications for future TB vaccine development
A review of the efficacy of clinical tuberculosis vaccine candidates in mouse models
No full textTuberculosis (TB) remains one of the deadliest infectious diseases worldwide, causing over a million deaths annually. The only licensed TB vaccine for human use, Bacille Calmette-Guérin (BCG), a mycobacteria-based live-attenuated vaccine, confers immunity to children but fails to efficiently protect adults from pulmonary TB. Several TB vaccine candidates have been developed over the last two decades, but some have failed to provide substantially better protection than BCG in clinical trials. Most of these vaccine candidates were initially evaluated for their protective capacity in mouse models of TB. With the availability of several mouse strains, vaccination routes and Mycobacterium tuberculosis (Mtb) challenge strains, to-date there is no consensus in the field about the predictive value of different murine models of TB, and it remains a matter of debate whether host genetics or vaccine-driven parameters primarily determine vaccine efficacy. Here we reviewed the performance of all TB vaccine candidates that have entered clinical trials over the last 25 years. We extracted protective efficacy data from all published studies that utilized mouse models to assess vaccination efficacy. The efficacy of each vaccine candidate to reduce lung bacterial burden depending on the mouse genotype, the vaccine administration route, and the Mtb challenge strain at different time-points was evaluated. Our data reveals insights into the effect of experimental parameters on vaccine performance and emphasizes the potential benefits of standardizing TB mouse models across vaccination-challenge studies to identify pre-clinical vaccine candidates with the highest potential to succeed