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To synthesize randomized controlled trials (RCTs) regarding the effectiveness of pre-pregnancy weight loss interventions on the risk of gestational diabetes mellitus (GDM) in women with overweight or obesity.
Comprehensive literature searches were conducted across nine databases from inception to May 2024. RCTs comparing pre-pregnancy weight loss interventions with blank control or active control among adult women with overweight or obesity were included. Meta-analyses, using a random-effects model, were performed to pool results of RCTs.
Six studies, including 1632 participants, were included. The effectiveness of pre-pregnancy weight loss interventions on changes in weight and body mass index (BMI) was statistically significant (mean difference [MD] = −6.02, 95% confidence interval [CI] [−8.94, −3.10], I 2 = 98%; MD = −2.22, 95% CI [−3.44, −1.00], I 2 = 98%). However, there was no statistically significant difference in the risk of GDM in women receiving pre-pregnancy weight loss interventions compared with controls (Odd Ratio [OR] = 0.70, 95% CI [0.48, 1.03], I 2 = 2%).
Pre-pregnancy weight loss interventions do not significantly impact the risk of GDM in women with overweight or obesity. Due to the small number of studies, small sample size, and large heterogeneity of pre-pregnancy weight loss interventions, further research is required.
Trial Registration: ClinicalTrials.gov identifier: CRD42023482808
This Letter comments on the qualitative study by Dowling and Manias (2025) regarding medication communication for rural aged care residents.
To discuss sampling and cultural considerations, and propose strategies to enhance engagement from consultation to collaboration.
Staff training, interdisciplinary collaboration, and culturally tailored interventions are recommended to improve communication and transitional care quality.
To explore the perceptions and experiences of managers in residential aged care settings regarding personal care workers' intention to stay and build a career. Specifically, this study sought to identify enablers and challenges influencing personal care workers' retention and to explore strategies that could improve workforce sustainability.
A qualitative study utilising semi-structured interviews underpinned by the Theory of Planned Behaviour.
The study was conducted in Australia from July 2023 to March 2024. Eleven managers participated in this study. Data were analysed using inductive thematic analysis.
Four themes emerged from the analysis and were conceptualised to illustrate the intricate relationship between recruitment practices, work environment, organisational culture and leadership in influencing personal care workers' intentions to stay in residential aged care. A botanical metaphor was used for each theme. The ‘Diverse Seeds of Varied Potential’ theme highlighted how ad-hoc recruitment processes were a primary driver of workforce instability. Challenging work conditions and differing expectations from personal care workers and management led to ‘Wilting in Adverse Environments’, which also contributed to a broader misalignment between facility culture and values, encapsulated within ‘Mismatched Habitats’. Participants emphasised the need for ‘Building a Greenhouse’, a metaphor for cultivating sustainable leadership and workforce development to address these issues.
This study's findings underscore the critical need for a cohesive approach to workforce development strategies in residential aged care. Transitioning from reactive, ad-hoc recruitment to strategic workforce planning, fostering a supportive organisational culture that aligns with personal care workers' expectations, and prioritising sustainable leadership practices are essential steps. Addressing these interconnected challenges can help build a more stable, committed and skilled workforce, ultimately enhancing the quality and continuity of care for residents.
Strategic workforce planning and sustainable leadership development are essential for building a stable workforce, which directly impacts the quality and continuity of resident care.
This study addressed the critical issue of high turnover among personal care workers in residential aged care facilities, specifically examining managers' perspectives on retention challenges: an underexplored area that is crucial for developing sustainable workforce strategies. The findings revealed that current ad hoc recruitment practices, misalignment between diverse personal care worker profiles and established organisational cultures, have great impact on long-term engagement and retention. These insights are particularly valuable for residential aged care facilities struggling with staffing stability, industry bodies focused on workforce development and educational institutions preparing future aged care workers. Furthermore, the findings can inform policy development aimed at strengthening the aged care workforce, ultimately benefiting the quality of care received by residents.
The Consolidated Criteria for Reporting Qualitative Research (COREQ).
There was no patient or public contribution.
by Allison Anbari, Zachary Massey, Abigail Adediran, Na Wang, LaRissa Lawrie, Priscilla Martinez, Denis McCarthy
Alcohol consumption increases breast cancer risk. We evaluated the responses of 748 United States female participants ages 21–29 to health warning messages addressing the relationship between alcohol consumption and increased breast cancer risk. In an online experiment, participants were randomly assigned to view standalone health warning messages about alcohol, breast cancer, and breast cancer health effects with varying picture and text attributes. Participants then completed post-message exposure assessments that included an immediate open-ended response to the message prompt. We conducted a qualitative content analysis of the responses and coded deductively based on constructs from the Message Impact Framework including message reactions, attitudes and beliefs, and behavioral intentions. These constructs and corresponding variables were present in participants’ responses. Response type did not vary by participants’ demographics or the attributes of the health warning message they viewed. The code new information was applied to 20% of the responses, indicating that those participants had no prior knowledge of alcohol and breast cancer risk. Alcohol and breast cancer messaging could impact drinking behaviors. Given the frequency of responses indicating a lack of awareness, more work in cancer prevention and population health messaging is warranted.
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