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This paper uses secondary analysis to understand how COVID-19 shaped people's experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people's experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People's wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a 'COVID-normal' world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options. [ABSTRACT FROM AUTHOR]

Drawing on in-depth interviews conducted during 2002-03 for the Australian Family Formation Decisions (AFFD) Project, this paper probes the relationship formation experiences of 115 women, men and couples of family-forming age living in eastern Australia. Contemporary relationship formation is characterized by a mixture of ambivalence and resignation to having limited control over the process on the one hand ('if it happens it happens'), and urgency on the other, especially among women seeking to fulfil maternal ambitions in their thirties after prioritizing other things earlier in their adult lives. For most the process of partnering involves trial and error, with timing -- finding someone whose expectations of a relationship match one's own -- posing a major challenge. It gives rise to a common phenomenon, the 'too soon syndrome', where relationships with many positive attributes are abandoned because one party perceives the other as too keen to 'settle down', and/or himself or herself as not ready to do so. The paper also examines impediments to partnering, including traditional ones like shyness; negative trial-and-error experiences; the demands of study and career establishment; pursuit of agendas emphasizing travel and enjoyment; sole parenthood; and parental marriage breakdown. A framework is provided by Beck's (1992) concept of reflexive modernization, and his associated proposition that life has become highly individualized with an emphasis on creating 'do-it-yourself' biographies. [ABSTRACT FROM AUTHOR]

Background: Maternal dietary choline has a central role in foetal brain development and may be associated with later cognitive function. However, many countries are reporting lower than recommended intake of choline during pregnancy. Methods: Dietary choline was estimated using food frequency questionnaires in pregnant women participating in population-derived birth cohort, the Barwon Infant Study (BIS). Dietary choline is reported as the sum of all choline-containing moieties. Serum total choline-containing compounds (choline-c), phosphatidylcholine and sphingomyelin were measured using nuclear magnetic resonance metabolomics in the third trimester. The main form of analysis was multivariable linear regression. Results: The mean daily dietary choline during pregnancy was 372 (standard deviation (SD) 104) mg/day. A total of 236 women (23%) had adequate choline intake (440 mg/day) based on the Australian and New Zealand guidelines, and 27 women (2.6%) took supplemental choline (≥ 50 mg/dose) daily during pregnancy. The mean serum choline-c in pregnant women was 3.27 (SD 0.44) mmol/l. Ingested choline and serum choline-c were not correlated (R2) = − 0.005, p = 0.880. Maternal age, maternal weight gain in pregnancy, and a pregnancy with more than one infant were associated with higher serum choline-c, whereas gestational diabetes and environmental tobacco smoke during preconception and pregnancy were associated with lower serum choline-c. Nutrients or dietary patterns were not associated with variation in serum choline-c. Conclusion: In this cohort, approximately one-quarter of women met daily choline recommendations during pregnancy. Future studies are needed to understand the potential impact of low dietary choline intake during pregnancy on infant cognition and metabolic intermediaries. [ABSTRACT FROM AUTHOR]

Few studies have investigated how older people themselves conceptualize and talk about what they do with their time. Even fewer have addressed such issues from the perspective of older people whose living arrangements and lifestyles diverge from majority, middle-class pathways. This paper draws on in-depth interview data from the Ageing Men's Health Project, a three-year ethnographic study of the health, housing, and service use of low income, single, non-homeowning men aged 50 years and over, living in the inner city of Sydney, Australia. Among other topics, the men were asked to describe an average day and otherwise elaborate on the everyday circumstances of their lives. Findings highlight the extent to which the men's everyday lives are constrained and curtailed by economic disadvantage and health deficits. At the same time, the men invest their activities with a range of sociocultural meanings that do not always match professionally constructed categories and understandings. In particular, social relationships with other men appear to be central to the meanings they confer on everyday life. [ABSTRACT FROM AUTHOR]

There has been significant disruption to the lives and mental health of adolescents during the COVID-19 pandemic. The purpose of this study was to assess the psychological and lifestyle impact of the pandemic on Australian adolescents, using an online survey, administered during the outbreak. Self-report surveys were administered online to a sample of 760 Australian adolescents aged 12–18 years assessing impact on a range of domains including behaviour, education, relationships, lifestyle factors (exercise, technology use, and sleep), and mental health outcomes (psychological distress, loneliness, health anxiety and well-being). Results showed that three quarters of the sample experienced a worsening in mental health, since the pandemic began, with negative impacts reported on learning, friendships and family relationships. There were also high higher levels of sleep disturbance, psychological distress and health anxiety, relative to normative samples. Effects on mental health were worse among those who reported a previous diagnosis of depression and/or anxiety relative to those without no such history. Adolescents are already vulnerable to the onset of mental illness at this developmental stage, and the current research underscores the need to find rapid and accessible ways to support adolescent mental health during times of crisis. [ABSTRACT FROM AUTHOR]

Summary: We identified demographic, health and lifestyle factors associated with falls in adults aged 50–64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults. Introduction: Between ages 40–44 and 60–64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50–64 years. Methods: Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51–58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40–64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55–64 years in 2012–13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis. Results: In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34–2.07) and urinary incontinence (OR range = 1.53–2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors. Conclusion: Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required. [ABSTRACT FROM AUTHOR]

Women's physical functioning declines with age and the rate of decline increases with age, but substantial disparities exist in trajectories over time. To inform development of interventions to optimise physical functioning across the adult life span, the aim is to explore which lifestyle and socio-economic position (SEP) factors contribute to disparities in physical functioning across the adult life span in women. Younger (born 1973–1978, n = 14,247), middle-aged (born 1946–1951, n = 13,715) and older (born 1921–1926, n = 12,432) participants from the Australian Longitudinal Study on Women's Health completed six questionnaires between 1996 and 2012 at approximate 3-year intervals. Physical functioning was measured with a 10-item subscale of the Short-Form Health Survey (score 1–100). Relationships between age and physical functioning were modelled using spline regression, stratified by baseline categories of physical activity, alcohol intake, smoking status, level of education, managing on income and index of neighbourhood socio-economic disadvantage for area. Multivariable models excluding one of the six factors were compared with models including all six factors to examine the relative importance of each factor. Women with unhealthy lifestyles (inactive, smokers or risky alcohol intake) and lower SEP had lower levels of physical functioning and more rapid declines across the adult life span. The variables with the greatest relative contribution to the models for physical functioning differed by age cohort: i.e. education and physical activity in younger women, managing on income and physical activity in middle-aged women and physical activity in older women. For optimal physical functioning, socio-economic factors seemed particularly important in younger and middle-aged women, while physical activity seemed important at all ages. [ABSTRACT FROM AUTHOR]

Purpose: Hysterectomy is one of the most common gynaecological procedures worldwide. Changes in endocrine function may impact age-associated decline in physical function and these changes may be accelerated by hysterectomy. The aim of this study was to investigate associations between hysterectomy status and self-reported physical function limitations.Methods: Our study sample (n = 8624) came from the mid-cohort (born 1945-1950) of the Australian Longitudinal Study on Women's Health (ALSWH). Self-report of physical function was measured by the Physical Functioning (PF) subscale of the Medical Outcomes Study Short Form Health Survey (SF-36) over seven surveys (1998-2016), categorised into substantial, moderate and minimal PF-limitations. The associations between hysterectomy status and de novo substantial or moderate PF-limitations versus minimal PF-limitations were investigated using log-multinomial regression.Results: By Survey 8 (2016), 20% of the study sample had a hysterectomy with ovarian conservation (hysterectomy only) and 9% had a hysterectomy and both ovaries removed (hysterectomy-bilateral oophorectomy). Women with a hysterectomy only had a small increase in risk of substantial PF-limitations (versus minimal PF-limitations) compared to women with no hysterectomy (relative risk [RR]: 1.13; 95% confidence interval [95% CI] 1.00-1.27); the point estimate was stronger for women with a hysterectomy-bilateral oophorectomy (RR: 1.26; 95% CI 1.09-1.46). In a supplementary analysis, the increased risk of substantial PF-limitations was seen only in women who had surgery before the age of 45 years.Conclusions: Compared to women with no hysterectomy, women with hysterectomy-bilateral oophorectomy were at increased risk of substantial PF-limitations versus minimal PF-limitations over 18 years of follow-up. [ABSTRACT FROM AUTHOR]

Students attending Seventh-day Adventist (Adventist) schools in Australia have been shown to have better health status and behaviours compared to secular norms, yet these schools cater for a high percentage of non-Adventist students. The purpose of this study was to investigate the influence of religious affiliation (Adventist/non-Adventist) on the health status and behaviours of students attending Adventist secondary schools in Australia. The sample included 1734 students who responded to a health and lifestyle survey that captured demographic details, self-reported height and weight, self-reported health status, mental health and select health behaviours. Students who identified themselves as Adventist reported significantly better health behaviours than the non-Adventist students in several behavioural domains, especially among the male students. However, this did not translate to a difference in health status. Further research is needed to understand the causal mechanisms responsible for the potential health advantage of Adventist students, which may include family or church religious influences. [ABSTRACT FROM AUTHOR]

Objective To determine rates of vaginal delivery, emergency caesarean section, and elective caesarean section for first and second births in Australia, and to identify maternal predictors of caesarean section. Methods Data were from the Australian Longitudinal Study on Women's Health. A total of 5275 women aged 18-38 years, who had given birth to their first child between 1996 and 2012 were included; 75.0% (n = 3956) had delivered a second child. Mode of delivery for first and second singleton birth(s) was obtained from longitudinal survey data. Socio-demographic, lifestyle, anthropometric and medical history variables were tested as predictors of mode of delivery for first and second births using multinomial logistic regression. Results Caesarean sections accounted for 29.1% (n = 1535) of first births, consisting of 18.2% emergency and 10.9% elective caesareans. Mode of delivery for first and second births was consistent for 85.5% of women (n = 3383) who delivered both children either vaginally or via caesarean section. Higher maternal age and body mass index, short-stature, anxiety and having private health insurance were predictive of caesarean section for first births. Vaginal birth after caesarean section was more common in women who were older, short-statured, or had been overweight or obese for both children, compared to women who had two vaginal deliveries. Conclusions for Practice Rates of caesarean section in Australia are high. Renewed efforts are needed to reduce the number of unnecessary caesarean births, with particular caution applied to first births. Interventions could focus on elective caesareans for women with private health insurance or a history of anxiety. [ABSTRACT FROM AUTHOR]

Background/objectives: Evidence supporting the association between skipping breakfast and children's body mass index (BMI) has been widely reported, and some consideration has been given to children aged 2-5 years. However, no evidence has considered an association between children skipping breakfast and mother's BMI. This study therefore investigated associations between skipping breakfast, child's BMI and mother's BMI in a large cohort of Australian children.Subjects/methods: Data were drawn from wave 2 (2-3 years, n=4601) and wave 3 (4-5 years, n=4381) of the Longitudinal Study of Australian Children. The primary outcome was skipping breakfast. Child's and mother's BMI was assessed by trained professionals.Results: Girls at 4-5 years were significantly more likely to skip breakfast compared with boys (56.9% versus 43.1%; P=0.031). In cross-sectional data analysis, obese boys at 2-3 years (odds ratio (OR) 2.38; P=0.039) and at 4-5 years (OR 2.32; P=0.046), and also obese girls at 4-5 years (OR 2.26; P=0.018), were more likely to skip breakfast. Skipping breakfast was positively associated with boys at 2-3 years (OR 2.04; P=0.042) whose mothers were overweight and with girls at 4-5 years (OR 2.60; P=0.001) whose mothers were obese. In longitudinal cross-lagged analysis, boys at 2-3 years whose mothers were obese were more likely to skip breakfast 2 years later at age 4-5 years (OR 2.36; P=0.045).Conclusions: Skipping breakfast was associated with higher BMI in children and mothers. Future interventions should target obese mothers to promote breakfast intake among children. The interventions may involve changes to dietary and lifestyle habits and provision of education on the benefits of breakfast intake. [ABSTRACT FROM AUTHOR]

The objective of the current study was to examine whether a history of comorbid depression and anxiety predicted new onset of heart disease. Data from 6 surveys, spanning 15 years, of the Australian Longitudinal Study on Women's Health, a large prospective cohort study were used, including health status, lifestyle, and sociodemographic measures. Participants of the 1946-1951 cohort who did not self-report heart disease at surveys 1 (1996) and 2 (1998) were included in the study (n = 11,828). After adjusting for health status, lifestyle and sociodemographic factors, a history of comorbid depression and anxiety (odds ratio (OR) = 1.78; 95 % confidence interval (CI) = 1.41-2.24) was associated with new onset of heart disease. A history of comorbid depression and anxiety is an important predictor of new onset of heart disease in mid-aged women. Due to the possible detrimental consequences of heart disease, psychological factors as well as established predictors should be considered when assessing a person's risk for heart disease. [ABSTRACT FROM AUTHOR]

Objectives: Inadequate vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations <50 nmol/L) is an increasingly important public health issue in Australia. The aim of this analysis is to describe 25(OH)D levels in community dwelling men aged ≥70 years in Sydney, Australia, and to determine associations between serum 25(OH)D levels and socioeconomic and lifestyle factors. Design: A population-based, crosssectional analysis of the baseline phase of the Concord Health and Ageing in Men Project (CHAMP), a large epidemiological study conducted in Sydney between January 2005 and May 2007. Participants: 1659 noninstitutionalised men aged ≥70 years. Methods: The cross-sectional analysis of the baseline phase of the Concord Health and Ageing in Men Project (CHAMP), a large epidemiological study conducted in Sydney between January 2005 and May 2007. Participants included 1659 community dwelling men who were interviewed and had clinical assessments. Main outcome measurements included serum 25(OH)D levels measured in blood samples using a radioimmunoassay kit (DiaSorin Inc., Stillwater, MN). Covariates included age, socioeconomic measures, season of blood sample, physical activity, sun exposure, vitamin D supplement use, cigarette smoking status, alcohol consumption, obesity and measures of health. Results: Prevalence of vitamin D insufficiency was 43.0%; highest in winter (55.5%) and spring (53.9%), and was associated with season (winter and spring), low physical activity, avoidance of sun exposure, current smoking and obesity, even after adjustment for confounding factors. Conclusion: Inadequate vitamin D status is highly prevalent among Australian older men and is associated with specific lifestyle factors. These findings emphasize the need to screen and monitor 25(OH)D levels in this population group, despite living in a sunny country such as Australia. [ABSTRACT FROM AUTHOR]

The aims of this study were to examine: (1) the association between sociodemographic and lifestyle factors and sleep quality in a population-based cohort of Australian women and (2) possible influence of reproductive status and mental and physical health factors on these associations. Data on 3,655 women (mean age = 46.6 years, range 34.3-67.4) were obtained from the Mater Hospital University of Queensland Study of Pregnancy for this cross-sectional study. Self-rated sleep quality was assessed using the Pittsburgh Sleep Quality Index. For the purpose of this study, two cutoff points (scores 5 and 10) were used to divide women into three categories: normal (65.2 %), moderately poor (26.4 %), and very poor sleep quality (8.5 %). Other covariates were measured at 21-year follow-up as well. After adjusting for reproductive status, mental and physical health, there were significant associations between moderately poor sleep quality and education and between very poor sleep quality and unemployment, both measures of socioeconomic status. In addition, work-related exertion was associated with increased rates of moderately poor sleep quality, whereas those women undertaking moderate exercise were less likely to experience very poor sleep quality. Independent associations between sociodemographic factors and exercise with moderately poor and very poor sleep quality were identified. These findings demonstrate the dynamic nature of the association between exercise/exertion, socioeconomic status, and sleep quality and highlight the importance of taking these into consideration when dealing with issues of poor sleep quality in women. [ABSTRACT FROM AUTHOR]

Background: Surveys of the public in several countries have found a predominant belief in social environmental causes of mental disorders. The present study was conducted to determine whether this has changed over time in Australia.Method: Beliefs about causes and risk factors were assessed using questions based around case vignettes of a person with depression or schizophrenia. These questions were asked in a national survey of 2,031 Australians aged 18-74 carried out in 1995, and a second survey of 1,823 persons carried out in 2003-2004.Results: The major changes were an increase in belief in genetic causes of both depression and schizophrenia, increases in beliefs about problems from childhood and the death of someone close as causes of depression, and a decrease in the belief that "weakness of character" is a cause of schizophrenia.Conclusion: There has been an increase in belief about genetic causes, which may be due to publicity about the human genome project and related scientific advances. This change has not been at the expense of belief in social causes, and it has been accompanied by a decrease in the belief that personal weakness is a cause. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate associations between body mass index (BMI) and family characteristics, including lifestyle, in parents and offspring from Australian families. DESIGN AND SUBJECTS: Longitudinal survey of 219 families of Australian children who had been surveyed 3-yearly between the ages of 9 and 18 y. MEASUREMENTS: Socio-economic status, weight and height, diet from 3 day records or food frequency questionnaires, alcohol consumption, smoking habits and physical fitness in offspring (bicycle ergometry in 18-y-olds). RESULTS: In 18-y-olds, in models examining offspring's lifestyle variables, BMI was predicted negatively by physical fitness (P=0.012), and positively by alcohol intake (P=0.046) in sons while, in daughters, only a negative association with physical fitness was significant. In models including parental characteristics, BMI in 18-y-old sons and daughters was significantly predicted by mothers' and fathers' BMI, independently of offsprings' alcohol intake, smoking, physical fitness and parents' education, and, in daughters, by fathers' alcohol intake. These models explained 48% of variance in daughters and 33% in sons. In both sons and daughters, BMI over the 9 y of the survey was consistently higher in offspring with overweight or obese fathers (P=0.033 for sons, P=0.024 for daughters) or mothers (P=0.031 for sons, P=0.037 for daughters). Physical fitness at the ages of 12, 15 and 18 y was negatively related to fathers' obesity in daughters and mothers' obesity in sons. Obesity in fathers was associated with a four-fold increase in risk of obesity at the age of 18 y in both sons and daughters with an independent eightfold increase in risk for daughters if mothers were obese. Birthweight was unrelated to overweight or obesity in the 18-y-olds. Alcohol intake in sons related significantly to alcohol intake in either parent while, for daughters, there was a significant association only with fathers' alcohol consumption. In daughters, fat intake... [ABSTRACT FROM AUTHOR]