Siva Prema Siva’s scientific contributions

Introduction: A WA Parliamentary inquiry was conducted following suicides in fly in, fly out (FIFO) workers. It found that there was limited information available about the mental health of FIFO fathers. The aim of this study was to explore rates of anxiety and depression in FIFO fathers across the years of 2013 to 2015, as the WA mining boom was ending. Methods: A prospective study of FIFO fathers enrolled in the Australian Father’s Study was conducted. Men were asked to complete Hospital Anxiety and Depression Scale (HADS), and Satisfaction with Life Scales (SWLS) in the third trimester of their partner’s pregnancy. Demographic and qualitative data were also collected. Results: 129 FIFO men were recruited over the three year period (2013 N=40, 2014 N=43, 2015 N=46). Mean age of FIFO fathers significantly increased across the period (28 to 31 years, p<0.01). The proportion of FIFO fathers with a university qualification rose (8/40 to 19/46). Mean HADS (Anxiety) and HADS (Depression) subscale scores increased (Anxiety 3.2 to 5.9, Depression 2.1 to 4.8, both p<0.01). There was a corresponding decline in SWLS (28.7 to 26.4, p<0.01). The decline in paternal mental health significantly correlated to changes world iron ore prices (p<0.001). Conclusion: The age and level of education of FIFO fathers has risen in association with the demise of the WA mining boom. Anxiety and depression symptomatology have risen and quality of life scores fallen. Declining FIFO paternal mental health and wellbeing may impact upon the family unit.

Introduction: Non-attendance from antenatal care is a common problem. Social exclusion theory suggests that social factors will impact upon access to healthcare and therefore healthcare outcomes. We were interested in looking at which social factors influence women's attendances for antenatal care. Methods: A prospective cohort study was conducted. Institutional ethics approval was obtained. Participants in the study were consecutive patients attending clinics at a major metropolitan Australian hospital who were tracked for five years to assess subsequent attendance at antenatal clinics. Multivariate analysis was undertaken to determine factors associated with non-attendance. Results: Of 581 women approached, consent was obtained from 574 women (99%). Of these, 216 (38%) were referred to an antenatal clinic in the follow up period. In the multivariate analysis conducted, risk factors associated with significantly higher levels of non-attendances to antenatal appointments were exposure to domestic violence (non-attendance; 15% vs. 3%, p=0.003) and housing instability (non-attendance; 21% vs. 3%, p=0.00006). Conclusion: Domestic violence and housing instability are independent associations for women not attending antenatal appointments. Strategies should be put in place to target this group of patients to improve antenatal attendances.