Community engagement and collaboration between health, education and the voluntary sector is feasible and integral in developing oral health promotion programmes aimed at children attending primary schools in a deprived area of London.
Background
Pregnant teenagers in rural and regional areas experience distinct disadvantages, that are not simply a function of their age, and these have a substantial impact on their health and that of their baby. Studies demonstrate that antenatal care improves pregnancy outcomes amongst pregnant women, especially adolescents. Understanding teenager’s views and experiences of pregnancy and motherhood is important to ensure antenatal care meets young women’s needs. This study explored teenage women’s experiences and perceptions of barriers and facilitators to engaging in pregnancy care in rural and regional Victoria, Australia.
Methods
Between February–October 2017, pregnant women aged ≤19 years were purposively recruited from one regional and two rural health services in Victoria. Semi-structured, face-to-face interviews guided by naturalistic inquiry were conducted and an inductive approach to analysis was applied.
Results
Four key themes emerged from the analysis of the transcripts of 16 interviews: Valuing pregnancy care, Interactions with Maternity Service, Woman-centred care, and Support systems. Teenage women primary motivation to attend care was to ensure their baby’s wellbeing and lack of engagement occurred when the relevance of antenatal care was not understood. Appointment flexibility and an accessible location was important; most participants were reliant on others for transport. Continuity of carer and respectful, non-judgement communication by staff was highly valued. Many young women had fractured families with pregnancy diminishing their social world, yet having a baby gave them purpose in their lives.
Conclusion
Maternity services and health professionals that provide flexible, adaptable women-centred care and support through pregnancy and early motherhood will assist young women’s engagement in antenatal care.
Progressive deterioration of the incretin system has been shown to be a key component of the pathophysiology of type 2 diabetes. Improved understanding of the physiology underlying incretins has led to the development of new therapies that act through modulation of the incretin system. These agents offer some potential advantages over previous antidiabetes drugs and have been approved for use in type 2 diabetes.
There are two broad classes of incretin-related therapies: dipeptidyl peptidase-4 inhibitors (sitagliptin and saxagliptin) and glucagon-like peptide-1 receptor agonists (exenatide and liraglutide). Although the two classes have some benefits in common—notably a low risk of hypoglycemia—they can be differentiated in terms of their pharmacology, efficacy and safety profiles, and clinical considerations.
Introducing new therapies into everyday clinical use requires careful consideration of the practical implications of their use and how they fit in with current treatment regimens. With regard to incretin-related therapies, some patients with type 2 diabetes may benefit more from their use than others, whereas their use in a small subset of patients with type 2 diabetes should be avoided. With appropriate provider and patient education about the potential benefits and practicalities of incretin-related therapies, these agents should prove to be a valuable resource in type 2 diabetes management.
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