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This article forms part two of a bigger study that was conducted in a nursing college to explore and describe the reasons for the poor performance of learners. Part one of the study dealt with the issues pertaining to education, while this article (part two) seeks to describe issues pertaining to management, attitudes and values that lead to the poor performance of learners in the nursing college under study. A qualitative, exploratory and descriptive design that was contextual in nature was employed, and three focus groups interviews were conducted. Seven tutors formed one group while other two groups were formed by fourth-year learners following a comprehensive diploma course. All participants voluntarily participated in the study. Data was analyzed using the descriptive method of open coding in accordance with Tesch's protocol (in Creswell, 1994:154-156). Trustworthiness was ensured using the following principles: credibility, conformability, transferability and dependability (Lincoln & Guba 1985:290-326). Findings were categorized into issues pertaining to management, attitudes and values that had an influence on the poor performance of learners as follows: Management: Inadequate resources and study facilities; policies that change frequently; tutors' dissatisfaction with regard to staff development, the lack of involvement by management and lack of management support, staff shortage and maldistribution of staff members; ineffective selection process of learners; inconsistent regulations, and too many of them; policies and procedures resulting in confusion and poor discipline. Attitudes and values: Tutors' lack of motivation and interest, lack of respect by learners and no team work among tutors. Through a conceptualization process and the recommendations by participants, strategies to improve the learners' performance were described. It is recommended that these strategies be submitted to the staff development committee for implementation and future follow-up research be undertaken to determine the effectiveness of the strategies. It is also recommended that other nursing colleges replicate the study within their context. [ABSTRACT FROM AUTHOR]

This paper describes changing smoking and drinking patterns before and during pregnancy in 313 expectant couples. Fathers were more likely to drink and smoke more heavily than mothers throughout. Before pregnancy in only 42% of couples were both partners safe drinkers and non-smokers. This increased to 50% during pregnancy. Most mothers reduced alcohol consumption during pregnancy and although about half of the fathers also changed their drinking patterns, only about a fifth decreased their consumption. Levels of paternal and maternal drinking in pregnancy were positively associated with pre-pregnancy levels. Rates and levels of both maternal and paternal smoking declined in pregnancy. There was a positive association between partners of both the prevalence and level of drinking and smoking between partners. There was some indication that mothers were more likely to reduce smoking and drinking if their partner joined them in doing so. Risk drinking in couples was more common in those who were older and of higher social status, but smoking was more common among the younger couples of lower social status. [ABSTRACT FROM AUTHOR]

The article presents information on two medical trials to compare three methods of imparting basic advice designed to encourage a reduction of alcohol consumption during pregnancy. As part of this study, three methods of imparting basic information and advice at the first visit to the antenatal clinic about the risks of alcohol in pregnancy were compared. The effects on drinking patterns of written information coupled with personalized advice were also assessed and finally written information with personalized advice reinforced by a specially produced video was evaluated.

This paper describes drinking and smoking patterns before and during pregnancy in 363 women from ethnic minorities living in West London. Drinking and smoking were less common and levels of consumption were lower amongst women of Apo-Caribbean, Asian or Oriental origin than amongst Europeans. However, 75% of the Apo-Caribbeans, 56% of the Orientals and 47% of the Asians did drink alcohol before pregnancy. Twenty-one per cent of the Europeans, 5% of the Apo-Caribbeans, 3% of the Orientals drank more than 100g alcohol per week (the level at which fetal harm may result). Drinking and smoking decreased in pregnancy in all ethnic groups, but 31% of Apo-Caribbeans, 29% of Orientals and 18% of Asians continued drinking. It is important to take alcohol and smoking histories from all pregnant women whatever their racial origin as part of good antenatal care. [ABSTRACT FROM AUTHOR]

Police negotiators provide leadership and expertise in the de-escalation and resolution of critical incidents, including responding to individuals exhibiting suicidal behaviour. This study describes the frequency and characteristics of suicide-related negotiation incidents in Queensland, Australia as classified in the Queensland Police Service Negotiator Deployment Database, between 2012 and 2014. Incidents were analysed to understand the individuals involved and precipitating factors including mental health problems and intoxication with alcohol or drugs. Police negotiators were deployed to 156 suicide intervention incidents over a 3-year period, half of which occurred at a residence. The cohort had a median age of 32 years and were predominantly male (82%). Four out of five individuals appeared to have a mental health problem, and at least half were intoxicated due to drugs or alcohol. Findings highlight the importance of strong linkages between police, health and social services and the need for innovative and comprehensive, cross-agency programmes., Competing Interests: Megan L. Steele has declared no conflicts of interest Lisa Wittenhagen has declared no conflicts of interest Carla Meurk has declared no conflicts of interest Jane Phillips has declared no conflicts of interest Bobbie Clugston has declared no conflicts of interest Peter Heck has declared no conflicts of interest Elissa Waterson has declared no conflicts of interest Ed Heffernan has declared no conflicts of interest, (© 2023 The Australian and New Zealand Association of Psychiatry, Psychology and Law.)

Objectives: Suicide is a leading cause of maternal mortality. Suicidality during and around the time of pregnancy can have detrimental impacts on a child's development and outcomes. This paper examines prevalence, demographic characteristics, and timing of initial contact with first responders and health services for a cohort of women who experienced suicidality during and around the time of pregnancy., Methods: Findings are drawn from the Partners in Prevention (PiP) study, a population-wide linked data set of suicide-related attendances by police or paramedics in Queensland, Australia. A sub-cohort of women was identified, who were between 6 months preconception and 2 years postpartum at the time of a suicide-related contact with police or paramedics (PiP-Maternal). Findings are compared to other girls and women who had a suicide-related contact with police or paramedics (PiP-Female). Prevalence, demographic characteristics, timing of contact with first responders and health services, re-presentations, and mortality are reported., Results: The PiP-Maternal cohort comprised 3020 individuals and 3400 births. Women in the PiP-Maternal cohort were younger, more likely to be of Aboriginal and/or Torres Strait Islander descent and live outside of a major city than the PiP-Female cohort. There were high rates of out-of-hours calls to police and ambulance, and similar perceived seriousness of the call between women in the PiP-Maternal and PiP-Female cohorts. Women in the PiP-Maternal cohort were less likely to be admitted to an emergency department within 24 hours, even after matching on covariates. Prevalence of suicidality for women who were pregnant and up to 2 years postpartum was 1.32% (95% CI = [1.27, 1.37])., Conclusion: Vulnerabilities and high rates of contact with police or paramedics, coupled with lower levels of follow-up, highlight the critical need to improve service responses for women with mental health needs during these phases of life.

Background and Aims: Police and paramedics play a crucial role in responding to suicide crises in the community. However, little is known about the nature, extent, precipitating factors, pathways and outcomes of a suicide-related call to emergency services and what responses will most effectively and compassionately meet the needs of those in crisis. Partners in Prevention: Understanding and Enhancing First Responses to Suicide Crisis Situations (PiP) was established to address these knowledge gaps., Methods: This article describes (1) the methodology used to construct the PiP dataset, a population-wide linked dataset that investigates the characteristics and health pathways of individuals in Queensland who were the subject of a suicide-related call to police or paramedics; and (2) preliminary findings on service demand, demographics and health services utilisation., Results: We identified 219,164 suicide-related calls to Queensland Police Service or Queensland Ambulance Service that were made over the 3-year period 1 February 2014 to 31 January 2017. A total of 70,893 individuals were identifiable via records linkage. The cohort linked to more than 7,000,000 health records. We estimated that police or paramedics in Queensland received on average 209 calls per day, with increases year on year over the study period. Analysis of demographic data highlighted the heterogeneous nature of this cohort and important demographic variations between individuals in contact with police versus ambulance services., Discussion: The PiP dataset provides a strong foundation for a multi-modal dataset that can be built on over time, both cross-sectionally and longitudinally. Further linkages to Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and social care datasets are planned., Conclusion: Detailed population-level analysis that data linkage can provide is critical to improving understanding and responses to suicide crisis situations. The PiP study is a world first and provides a unique opportunity to improve responses to this public health problem.

The purpose of this scoping review was to summarize research that uses linked data to examine peripartum suicidal behaviours and critically appraise studies to identify evidence gaps and future research priorities. A systematic search of PubMed, Scopus, and grey literature was undertaken to identify data linkage studies that examined suicidal behaviours among women in the peripartum period. All articles available through PubMed and Scopus up until the search date of 26 September 2019 were deemed eligible for inclusion. A grey literature search was also undertaken, through the Google search engine, on 11 November 2019. Studies were analysed descriptively and synthesized qualitatively. Eighteen studies were identified that met inclusion criteria. All studies examined the incidence of suicidal behaviours. Twelve studies examined sociodemographic correlates, associations, or risk factors, and nine studies examined mental health. There was a high degree of variability regarding how both peripartum status and suicidal behaviours were defined. Few studies used data linkage to examine suicidal behaviours from a health services or social services perspective. The evidence base could benefit from conceptual clarity and standardization of constructs regarding suicidal behaviours in the peripartum period, to enable meaningful synthesis of results across studies. Data linkage can be used to improve understandings of risk factors and pathways. It can also be harnessed to examine both health and social services utilization, to inform coordinated multi-sectoral interventions and care pathways for women and their children.

Since 1974 numerous clinical studies have made it clear that heavy alcohol consumption during pregnancy (in excess of 80 g or 8 units daily) can result in a child being born with a specific combination of physical and mental disabilities known as the Fetal Alcohol Syndrome. More moderate levels of intake (as little as 10 g of 1 unit daily) are associated with other fetal problems known as Fetal Alcohol Effects. The most common of these is growth retardation. Reduction of alcohol consumption is beneficial to pregnancy outcome. However, despite this great clinical and research interest within the field there has been comparatively little attention paid to researching possible preventative strategies and appropriate policy development. This paper first describes the size of the problem posed by drinking in pregnancy in the U.S.A. and the U.K., detailing the contrasting policy response on either side of the Atlantic. It examines the difficulties of formulating appropriate advice and then assesses the available research reports on preventative measures. The strategies described include general publicity and counselling for pregnant women. In addition, attention has been paid to the problems of dissemination by emphasising professional education. One major shortcoming is that most of these studies appear to have been carried out with little reference to existing knowledge on health education and promotion, or educational work in the antenatal or alcohol fields. In addition, little attention appears to have been paid to the characteristics of the groups at whom intervention might be targeted or the underlying social or psychological factors which maintain drinking in these groups. The second part of this paper, therefore, attempts to suggest appropriate avenues for developing preventative strategies by presenting a wide-ranging review with special reference to British experience. Particular attention is given to the issues of form and content of appropriate messages, targeting of risk populations, the venue for intervention, and media and the actual mechanisms involved in implementing the programme. We conclude that women should be advised to limit their alcohol consumption to no more than one unit a day when they are either pregnant or planning a pregnancy. We recommend that pregnant women should be asked about their alcohol and given appropriate advice during routine antenatal clinic visits. We suggest that the form of advice should be designed with the characteristics of the risk population in mind.(ABSTRACT TRUNCATED AT 400 WORDS)

Previous studies of the effects of moderate drinking on the outcome of pregnancy are assessed. The results of a prospective study of the association between alcohol consumption in pregnancy and birthweight, length of baby, head circumference and premature delivery are described. Consumption of more than 10 g alcohol per day in very early pregnancy or even before conception approximately doubled the risk that the infant would have a low birthweight. Cigarette smoking was also a risk factor for low birthweight. It may therefore be beneficial for women to reduce their alcohol consumption to one drink a day or less from before conception and give up smoking as well.