scholarly journals New Zealand women’s experiences of managing gestational diabetes through diet: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. L. Lawrence ◽  
K. Ward ◽  
C. R. Wall ◽  
F. H. Bloomfield
Keyword(s):  
New Zealand ◽  
Gestational Diabetes ◽  
Dietary Habits ◽  
Primary Objective ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Diverse Range ◽  
Short Period ◽  
Women’S Perceptions

Abstract Background For women with gestational diabetes mellitus (GDM) poor dietary choices can have deleterious consequences for both themselves and their baby. Diet is a well-recognised primary strategy for the management of GDM. Women who develop GDM may receive dietary recommendations from a range of sources that may be inconsistent and are often faced with needing to make several dietary adaptations in a short period of time to achieve glycaemic control. The aim of this study was to explore how women diagnosed with GDM perceive dietary recommendations and how this information influences their dietary decisions during pregnancy and beyond. Methods Women diagnosed with GDM before 30 weeks’ gestation were purposively recruited from two GDM clinics in Auckland, New Zealand. Data were generated using semi-structured interviews and thematic analysed to identify themes describing women’s perceptions and experiences of dietary recommendations for the management of GDM. Results Eighteen women from a diverse range of sociodemographic backgrounds participated in the study. Three interconnected themes described women’s perceptions of dietary recommendations and experiences in managing their GDM through diet: managing GDM is a balancing act; using the numbers as evidence, and the GDM timeframe. The primary objective of dietary advice was perceived to be to control blood glucose levels and this was central to each theme. Women faced a number of challenges in adhering to dietary recommendations. Their relationships with healthcare professionals played a significant role in their perception of advice and motivation to adhere to recommendations. Many women perceived the need to follow dietary recommendations to be temporary, with few planning to continue dietary adaptations long-term. Conclusions The value of empathetic, individually tailored advice was highlighted in this study. A greater emphasis on establishing healthy dietary habits not just during pregnancy but for the long-term health of both mother and baby is needed.

scholarly journals Sociodemographic Factors Associated with Adherence to Dietary Guidelines in Women with Gestational Diabetes: A Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1884
Author(s):  
Sara Mustafa ◽  
Jane Harding ◽  
Clare Wall ◽  
Caroline Crowther
Keyword(s):  
New Zealand ◽  
Gestational Diabetes ◽  
Previous History ◽  
Sociodemographic Factors ◽  
Dietary Guidelines ◽  
Dietary Advice ◽  
Dietary Adherence ◽  
Dietary Recommendations ◽  
Maternal Characteristics ◽  
Factors Associated

Dietary advice is the cornerstone of care for women with gestational diabetes mellitus (GDM). However, adherence to this advice is variable. We aimed to identify the proportion of women with GDM who adhere to the New Zealand nutrition guideline recommendations and assess the sociodemographic factors linked to dietary adherence. We assessed dietary intake at 36 weeks’ gestation in a cohort of 313 women with GDM and compared this with the dietary recommendations for the management of GDM. Associations between maternal characteristics and dietary adherence were assessed using ANOVA, chi square, logistic regression, and linear regression tests. Women with GDM had an average adherence score of 6.17 out of 10 to dietary recommendations, but no one adhered to all the recommendations. Adherence to recommendations was lowest for saturated fat, and wholegrain breads and cereals. While 85% visited a dietitian, only 28% of women achieved their recommended weight gain. Maternal factors associated with lower dietary adherence were primiparity, no previous history of GDM, being underweight, and smoking. Adherence to the dietary recommendations by women with GDM in New Zealand for the management could be improved. Further research is needed to identify ways for women with GDM to improve their dietary adherence.

Nephrolithiasis

2018 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

Nephrolithiasis

2017 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

scholarly journals Redressing gendered undervaluation in New Zealand aged care: Institutions, activism and coalitions

2020 ◽  
Vol 62 (4) ◽  
pp. 608-629
Author(s):  
Sara Charlesworth ◽  
Lisa Heap
Keyword(s):  
New Zealand ◽  
Aged Care ◽  
Career Progression ◽  
Care Work ◽  
Collaborative Approach ◽  
Equal Pay ◽  
Diverse Range ◽  
Policy Actors ◽  
Employment Standards

This article explores the apparent conundrum of how, with minimal employment standards and limited equal pay laws, New Zealand managed to significantly redress the gendered undervaluation of low-paid aged care work. To draw out the pathways to these reforms, we focus on the long-term strategic coalitions that underpinned them. We examine, in particular, the activism of a diverse range of policy actors – unions, employers, industrial and human rights bodies and civil society groups, which together have worked to ‘undo’ the limitations of equal pay and employment regulation. Our findings point to the benefits of strategic collaboration between policy actors in New Zealand and an approach which recognises the intersection of unequal pay with other gendered dimensions of disadvantage in aged care work. Different strategies used over time by diverse actors helped them overcome inadequate industrial and equal pay infrastructure to realise meaningful increases in hourly rates of pay, buttressed by improved working time arrangements and provision for career progression. We conclude by highlighting some lessons for institutional and policy actors in other national settings drawn from the New Zealand collaborative approach to equal pay in care work.

New Zealand Jockeys’ Dietary Habits and Their Potential Impact on Health

2002 ◽  
Vol 12 (2) ◽  
pp. 220-237 ◽  
Author(s):  
Mark A. Leydon ◽  
Clare Wall
Keyword(s):  
New Zealand ◽  
Nutritional Status ◽  
Eating Behaviors ◽  
Dietary Habits ◽  
Weight Restrictions ◽  
Male And Female ◽  
Number Of Factors ◽  
Short And Long Term ◽  
Hot Baths

The purpose of this study was to determine the nutritional status, eating behaviors, and body composition of 20 jockeys working in the New Zealand Racing Industry. Seven-day weighed food records showed the mean daily energy intake for male and female jockeys was 6769 ± 1339 kJ and 6213 ± 1797 kJ, respectively. Energy and carbohydrate intakes were below the recommendations for athletes, and the jockeys did not meet the RDI for a number of micronu-trients. Of the jockeys, 67% used a variety of methods to "make weight". including: diuretics, saunas, hot baths, exercise, and the restriction of food and fluids. A number of jockeys (20%) showed signs of disordered eating. Forty-four percent of jockeys were classified as osteopenic, and a number of factors may have contributed to this outcome, namely: reduced calcium intake, delayed menarche (14.5 years) in female jockeys, alcohol intake, and smoking. Percent body fat of male and female jockeys was 11.7 ± 2.9 and 23.6 ± 3.8, respectively. Current weight restrictions imposed on jockeys by the horseracing industry impacts on their nutritional status, which may compromise their sporting performance and both their short- and long-term health.

Nephrolithiasis

2017 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

scholarly journals From Work to Residence: An Evaluation of Work Policies that Provide a Pathway to Permanent Residence in New Zealand

1970 ◽  
Author(s):  
Paul Merwood
Keyword(s):  
New Zealand ◽  
Quantitative Analysis ◽  
Administrative Data ◽  
Online Survey ◽  
Qualitative Interviews ◽  
Diverse Range ◽  
Permanent Residence ◽  
Work Permit ◽  
Highly Skilled

In 2002, the Department of Labour introduced three ’work to residence’ policies, which were designed to help New Zealand employers recruit and retain highly skilled and talented migrants. These policies included the Talent Visa (Accredited Employers), Talent Visa (Arts, Culture and Sports), and the Long Term Skill Shortage List Occupation work permit. This paper describes the characteristics of migrants approved through the work to residence policies, the characteristics of accredited employers and the migrants they employ, and the transition patterns from temporary to permanent residence. The research involved a quantitative analysis of administrative data, an online survey of accredited employers, and qualitative interviews with policy stakeholders. The research showed that over 4,000 migrants had been granted a work permit through these policies, and almost one third had made the transition to permanent residence. Migrants brought to New Zealand a diverse range of skills, and of those migrants approved for permanent residence, most did so through a skilled residence category. It was found that the Talent Visa (Accredited Employers) policy enabled employers to expedite the recruitment of overseas workers, and the work to residence aspect was an attractive incentive for potential migrants.

Nephrolithiasis

2018 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

Evaluating Health Futures in Aotearoa

2019 ◽  
Vol 11 (4) ◽  
pp. 379-395
Author(s):  
Malcolm Bruce Menzies ◽  
Lesley Middleton
Keyword(s):  
New Zealand ◽  
Health Sector ◽  
Decision Makers ◽  
Strategic Decision ◽  
General Context ◽  
Scenario Development ◽  
Diverse Range ◽  
Time Period ◽  
High Level

This article describes a high-level evaluation of a scenario exercise that took place in the New Zealand health sector in 1997 and derives some lessons for future evaluations. By extension, such an evaluation tests the efficacy of scenario development and futures thinking (foresight) in general. Context for the evaluation is provided by a brief reflection on scenarios as a technique, both generally and in the health field. Then a discussion of the process used in 1997 to develop five scenarios is followed by a description of the logic and methodology for the evaluation itself. Findings suggest that the process used to develop the 1997 scenarios was valuable in opening up decision-makers’ minds to possibilities without them needing to feel threatened or defensive, but it may not have been inclusive enough for the New Zealand context. Using criteria identified by Schoemaker the scenarios themselves were relevant, credible, and coherent, but not particularly archetypal or long term. Their impact on strategic decision-making was short-lived, but they were prescient in many respects and have been referred to within academia. Future considerations of health futures should be clearer as to purpose, get more explicit buy-in of key decision-makers and draw on a more diverse range of inputs. We also suggest that rather than being carried out during a discrete time period, scenario development should be a continuous and constantly updated process.

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