ABSTRACT
Problem: The dietitian service at a metropolitan health service in Queensland, Australia has a non-engagement rate for high-risk antenatal women of 50%. Aim: Determine which attributes are related to non-attendance at dietitian appointments, and women's perceptions and attitudes towards dietitian appointments during pregnancy. Methods: An explanatory mixed-methods design was utilised, with first phase including 103 antenatal women referred to a dietitian in 2021 and compared the attributes of those who attended with those who did not engage. Queensland Health electronic databases were used to collect attribute data, which were then analysed with Jamovi (version 1.6) for descriptive, correlational, multivariate analyses of variance MANOVA. Second phase included seven semi-structured interviews with women attending a dietitian appointment, and subsequently analysed through thematic analysis. Results: Distance from clinic was not related to clinic attendance, and women reported they would attend regardless of distance or work status. Non-attendance was related to higher gravidity, parity, and if referred for obesity, but not previous gastric sleeve or underweight referral. Six themes were identified from the interview data: "Women want to be treated like an individual," "It's all about expectations," "Midwives hold the key," "Preferences in receiving dietary information," "Weight has been a long-term problem and is a sensitive topic," and "Barriers to attendance." Conclusion: Antenatal services can adjust service delivery to improve engagement in weight management services during pregnancy. Telehealth appointments may reduce non-engagement due to distance from clinic. Demystifying the dietitian appointment, ensuring non-judgemental referral processes and collaboration between midwives and dietitians will ensure that women value the service.
ABSTRACT
Background and objectives: The evolution of healthcare from 18th-century reductionism to 21st-century postgenomic holism has been described in terms of systems medicine, and the impact of the built environment on human health is the focus of investigation and development, leading to the new specialty of evidence-based, therapeutic architecture. The traditional system of Vastu architecture-a design paradigm for buildings which is proposed to promote mental and physical health-has been applied and studied in the West in the last 20 years, and features elements absent from other approaches. This review critically evaluates the theory and research of a well-developed, standardized form of Vastu-Maharishi Vastu® architecture (MVA). MVA's principles include development of the architect's consciousness, universal recommendations for building orientation, siting, and dimensions; placement of key functions; and occupants' head direction when sleeping or performing tasks. The effects of isolated Vastu elements included in MVA are presented. However, the full value of MVA, documented as a systematic, globally applicable practice, is in the effect of its complete package, and thus this review of MVA includes evaluating the experience of living and working in MVA buildings. Methods: The published medical and health-related literature was systematically surveyed for research on factors related to isolated principles applied in MVA as well as on the complete system. Results: Published research suggests that incorporating MVA principles into buildings correlates with significant improvements in occupants' physical and mental health and quality of life: better sleep, greater happiness of children, and the experience of heightened sense of security and reduced stress. The frequency of burglaries, a social determinant of health, also correlates. Potential neurophysiological mechanisms are described. Conclusions: Findings suggest that MVA offers an actionable approach for managing a key social determinant of health by using architectural design as preventive medicine and in public health.
ABSTRACT
This study is the first of its kind to systematically investigate the relationship between the clinical practice of Maharishi á¾¹yurVeda pulse assessment and cardiovascular health. Given that cardiovascular disease is a major threat to the health of people in many countries, the question of diagnostic validity of a traditional, non-invasive method of health assessment is an important one for prevention and therapeutics. For this reason, we investigated the diagnostic validity of examining the pulse of patients using the technique of Maharishi Nadi-Vigyan compared to an objective measure of blood pressure and to self-reports of other cardiovascular risk factors. The study sample consisted of 160 participants at a Maharishi á¾¹yurVeda clinic in the United States and assessed consistency of diagnoses between Maharishi Nadi-Vigyan and hypertension as measured by blood pressure using a standard sphygmomanometer, and patient self-reports of elevated cholesterol, insomnia, and psychological stress (operationalised in this study as 'state of mind'). Our findings showed diagnostic validity of 95% for hypertension by Maharishi Nadi-Vigyan compared to objectively measured hypertension. For elevated cholesterol, insomnia, and psychological stress, the agreement was 76%. Previous studies assessed the reliability of conventional forms of pulse examination in á¾¹yurVeda and found relatively low levels of both inter-rater and within-rater reliability, whereas the present study of Maharishi Nadi-Vigyan found generally higher levels. These findings have implications for the use of Maharishi Nadi-Vigyan as a diagnostic approach in the context of holistic, integrated, and preventive healthcare offered by Maharishi á¾¹yurVeda. We conclude the study with a discussion of key theoretical domains which underpin the findings, namely the traditional forms of á¾¹yurVeda and Nadi-Vigyan, and the introduction of next generation Maharishi á¾¹yurVeda and Maharishi Nadi-Vigyan. Finally, we consider the influence pulse assessment might have on the future of cardiovascular healthcare.
