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Background: Complementary medicine (CM) use is a ubiquitous aspect of an increasingly consumer-driven model of healthcare delivery and plays an increasingly prominent role in the Australian health sector. Yet there is limited empirical research investigating the quality and integrity of protections for consumers in Australia. The aim of this study is to help address this gap in knowledge by exploring how members of the public engage with protection mechanisms related to CM use. Methods: This study utilised a cross-sectional online survey to recruit a sample of 1132 Australian adults aged 18 and over. Purposive convenience sampling was used to recruit participants from an existing database of Australian adults who had expressed interest in participating in research. Results: The majority of the participants (64.0%) had visited a CM practitioner in their lifetime. However, a minority of participants (36.9%) indicated they would feel confident in knowing where to complain if something went wrong with the treatment they received from a CM practitioner. Most participants (74.7%) had used a CM product in their lifetime. Specifically, 32.3% had ‘ever’ used an herbal product and 69.9% had ‘ever’ used a nutritional supplement. However, a minority of participants (32.7%) indicated they would feel confident knowing where to complain if something went wrong with a herbal or nutritional supplement they used. Most participants indicated a lack of knowledge about how CM practitioners and CM products are regulated in Australia. Conclusion: The findings of this study clearly highlight a concerning lack of knowledge by CM patients and consumers regarding the regulation of CM in Australia. From a policy perspective, it is necessary to seek proactive approaches that target complaint-related knowledge of the CM patients and consumers through education and advocacy efforts. [ABSTRACT FROM AUTHOR]

Chronic conditions are prolonged and complex, leading patients to seek multiple forms of care alongside conventional treatment, including complementary medicine (CM). These multiple forms of care are often used concomitantly, requiring patient-provider communication about treatments used in order to manage potential risks. In response, this study describes rates and reasons for disclosure/non-disclosure of conventional medicine use to CM practitioners, and CM use to medical doctors, by individuals with chronic conditions. A survey was conducted online in July and August 2017 amongst the Australian adult population. Participants with chronic conditions were asked about their disclosure-related communication with CM practitioners (massage therapist, chiropractor, acupuncturist, naturopath) and medical doctors. Patients consulting different professions reported varying disclosure rates and reasons. Full disclosure (disclosed ALL) to medical doctors was higher (62.7%-79.5%) than full disclosure to CM practitioners (41.2%-56.9%). The most strongly reported reason for disclosing to both MDs and CM practitioners was I wanted them to fully understand my health status, while for non-disclosure it was They did not ask me about my CM/medicine use. Reasons regarding concerns or expectations around the consultation or patient-provider relationship were also influential. The findings suggest that patient disclosure of treatment use in clinical consultation for chronic conditions may be improved through patient education about its importance, direct provider inquiry, and supportive patient-provider partnerships. Provision of optimal patient care for those with chronic conditions requires greater attention to patient-provider communication surrounding patients' wider care and treatment use. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self-reported doctor-diagnosed arthritis.Objectives: To determine (1) the prevalence and type of CAM use, (2) the difference in characteristics between CAM users and non-CAM users, and (3) the factors related to CAM use, among U.S. adults with self-reported doctor-diagnosed arthritis.Design: Secondary analysis of the 2012 National Health Interview Survey (NHIS) data.Setting: The NHIS is a cross-sectional survey that gathers health-related data on the civilian, noninstitutionalized U.S.Population: Participants: The NHIS 2012 uses a complex, multistage sampling design and oversamples minorities to achieve population representation; it included 34 525 adults, with 7179 adults having arthritis.Methods: Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included sociodemographics and health-related characteristics.Main Outcome Measurements: CAM modalities were categorized into six groups: natural products, manipulative therapies, mind-body therapies, special diets, movement therapies, and other practitioner-based CAM modalities.Results: Of the adults with arthritis, 2428 (weighted estimate of 36.2% of U.S. adult population) had used CAM within the last year. Adults with arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner-based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self-rated health status, and having current symptoms of joint stiffness/pain.Conclusion: As more than one-third of U.S. adults with arthritis seek CAM therapies, open and nonjudgmental conversations between conventional medicine providers, CAM providers, and patients should be encouraged to ensure patient health care needs are being met.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

Objectives: To describe and contrast the prevalence and trends of sick leave in patients with pain or stress disorders referred to inpatient care that integrates conventional and complementary therapies, that is, integrative care (IC). Methods: County council and social insurance data were used to retrospectively observe cross-sectional sick leave prevalence at four time points: 1 year before the first registered inpatient visit with the target diagnosis, after referral at index, and at 1 and 2 years after index. To contrast the IC findings, observations of patients with similar background characteristics referred to conventional care (CC) were used. Results: The sick leave prevalence of IC pain patients and IC stress patients increased from the preceding year to peak at index, where after it decreased back toward preindex levels over 2 years. Overall sick leave prevalence was higher in IC than in CC, where analogous but lower prevalence trends of sick leave changes were observed. Conclusions: Observed sick leave prevalences, which were higher in IC than in CC, gradually decreased over time following IC or CC referral. While natural recovery or other reasons for change of sick leave cannot be excluded, future prospective and randomized clinical trials are recommended. [ABSTRACT FROM AUTHOR]

Background: Modifications to lifestyle risk factors for stroke may help prevent stroke events. This systematic review aimed to identify and summarise the evidence of acupuncture interventions for those people with lifestyle risk factors for stroke, including alcohol-dependence, smoking-dependence, hypertension, and obesity. Methods: MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database were searched from January 1996 to December 2016. Only randomised controlled trials (RCTs) with empirical research findings were included. PRISMA guidelines were followed and risk of bias was assessed via the Cochrane Collaboration risk of bias assessment tool. The systematic review reported in this paper has been registered on the PROSPERO (#CRD42017060490). Results: A total of 59 RCTs (5,650 participants) examining the use of acupuncture in treating lifestyle risk factors for stroke met the inclusion criteria. The seven RCTs focusing on alcohol-dependence showed substantial heterogeneity regarding intervention details. No evidence from meta-analysis has been found regarding post-intervention or long-term effect on blood pressure control for acupuncture compared to sham intervention. Relative to sham acupuncture, individuals receiving auricular acupressure for smoking-dependence reported lower numbers of consumed cigarettes per day (two RCTs, mean difference (MD) = -2.75 cigarettes/day; 95% confidence interval (CI) = -5.33, -0.17; p = 0.04). Compared to sham acupuncture those receiving acupuncture for obesity reported lower waist circumference (five RCTs, MD = -2.79 cm; 95% CI: -4.13, -1.46; p<0.001). Overall, only few trials were considered of low risk of bias for smoking-dependence and obesity, and as such none of the significant effects in favour of acupuncture interventions were robust against potential selection, performance, and detection bias. Conclusions: This review found no convincing evidence for effects of acupuncture interventions for improving lifestyle risk factors for stroke. [ABSTRACT FROM AUTHOR]

Aim: This study examines GP perceptions, attitudes and knowledge of complementary medicine (CM), and to understand contextual factors that influence these perceptions, attitudes and knowledge. Background: CM use is increasing, and its influence on primary care becoming increasingly significant. Although general practitioners (GPs) often have central primary care gate-keeper roles within health systems, few studies have looked specifically at GPs’ perceptions, attitudes and knowledge of CM. Methods: A questionnaire was mailed to all 1486 GPs registered as practicing in non-metropolitan areas of New South Wales. The survey included one free-text qualitative question, where respondents were invited to highlight issues associated with CM in their own words. Free-text responses were analyzed qualitatively using thematic analysis. Findings: In total, 585 GPs responded to the survey (adjusted response rate 40.1%), with 152 (26.0%) filling in the free-text question. Central themes which emerged were risk as a primary concern; opposition to, resistance to and the inappropriateness of complementary therapies; struggles with complexity and ambivalent tolerance. Conclusion: GPs in Australia have a wide variety of perceptions toward CM. A minority of GPs have absolute views on CM, with most GPs having numerous caveats and qualifications of individual CM. Efficacy is only one aspect of CM critically evaluated by GPs when gauging support for individual therapies – risk, alignment with medical principles and an openness to exploring new avenues of treatment where others have failed, all appear to be equally important considerations when GPs form their views around CM. [ABSTRACT FROM AUTHOR]

Objective: This research aims to investigate the health service use—including complementary and alternative medicine (CAM)—and self-care by women aged 62 to 67 with sleeping problems. Method: In total, 9,110 participants (99.6%) responded to questions about sleeping problems, health service utilization and self-care (e.g., herbal medicines and vitamins), demographics, and chronic illnesses. Results: In all, 48.2% (n = 4,394) women indicated that they had a sleeping problem. Women with sleeping problems consulted a general practitioner (GP) more frequently (odds ratio [OR] = 1.72; 95% confidence interval [CI] = [1.36, 2.17]; p < .005) and were more likely to be using herbal medicines (OR = 1.24; 95% CI = [1.13, 1.36]; p < .005) than women without sleeping problems. Discussion: Health professionals, particularly GPs, may need to actively inquire with older patients in their care with sleeping problems about the use of herbal medicines, to ensure their sleeping problems are being directly and effectively treated, particularly in light of increased risks associated with sleeping problems for this age cohort. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the Australian complementary medicine (CM) workforce, including practice and professional characteristics. Design: National cross-sectional survey. Settings/Location: Australia. Subjects: Any individual who self-identified as a practitioner qualified in any one of 14 CM professions and working in any state or territory of Australia was eligible to participate in the survey. Interventions: A 19-item online survey was developed following a review of existing CM workforce data and in alignment with other CM workforce survey projects in progress at the time. The survey items were presented under three main constructs: demographic characteristics, professional characteristics, and practice characteristics. Statistical analysis: Descriptive statistical analysis, including frequencies and percentages, of multiple choice survey items was used. Open response items were analyzed to determine the mean, standard deviation (SD), minimum, and maximum. The demographic data were evaluated for representativeness based on previously reported CM workforce figures. Results: The survey was completed by 1306 CM practitioners and was found to be nationally representative compared with the most recent registrant data from the Chinese Medicine Board of Australia. Participants primarily practiced in the most populous Australian states and worked in at least one urban clinical location. Most participants held an Advanced Diploma qualification or lower, obtained their qualification ten more years ago, and practiced in a clinical environment alongside at least one other practitioner from another health profession. Participants reported diverse clinical practice specialties and occupational roles. Per week, participants worked an average of 3.7 days and treated 23.6 clients. Conclusions: The results from this survey of practitioners from most complementary professions in Australia provide new insights into the national complementary medicine workforce. Further exploration of the CM workforce is warranted to inform all who provide patient care and develop health policy for better patient and public health outcomes. [ABSTRACT FROM AUTHOR]

Objective: To examine the longitudinal change in Australian women's prevalence of cyclic perimenstrual pain and discomfort and the association between their symptoms and use of complementary and alternative medicine (CAM). Method: Data on endometriosis, premenstrual syndrome (PMS), irregular periods, heavy periods, and severe period pain were collected over a 7-year period from the Australian Longitudinal Study on Women's Health, for women aged 28 to 33 years in 2006, and at 3-year follow-ups. Changes in symptoms and patterns of CAM practitioner and therapy/product use associated with these symptoms were analyzed using longitudinal regression modeling. Results: Over the 7-year period, prevalence rates of PMS and heavy periods increased, while prevalence rates of endometriosis, irregular periods, and severe period pain remained stable. The most common use of CAM longitudinally associated with the perimenstrual symptoms was use of vitamins/minerals, yoga/meditation, massage therapy, herbal medicine, and aromatherapy. Excluding consultation with a naturopath/herbalist, over the 7-year survey women's use of all other CAM practitioners increased as did their use of vitamin/minerals, yoga/meditation, and Chinese medicines, while aromatherapy use declined. Conclusion: Only the prevalence of PMS and heavy periods increased with aging in this sample of women. While overall use of CAM practitioner and self-prescribed products/therapies increased over time, CAM was chosen by women mainly to treat endometriosis and PMS. The extent to which this use reflects treatment efficacy is uncertain. [ABSTRACT FROM AUTHOR]

Objective This randomized controlled trial was undertaken to determine whether 12 weeks of Tai Chi (TC) practice can reduce anxiety in healthy but stressed people. Method Fifty participants were randomized into TC (n=17), exercise (n=17), and wait-list (WL) groups (n=16). Outcome measures used were State Trait Anxiety Inventory, Perceived Stress Scale 14 (PSS14), blood pressure and heart rate variability, visual analogue scale (VAS), and Short Form 36. Results Significant improvements were observed from baseline for both TC and exercise groups for both state (p <0.01) and trait (p <0.01) anxiety, PSS14 (p <0.01), VAS (p <0.01), mental health domain (p <0.01), and vitality domain (p <0.01). Superior outcomes were also observed for TC when compared with WL for state and trait anxiety (p <0.01) and mental health domain (p <0.05). Conclusion TC reduces stress levels in healthy individuals and provides a safer, cost effective, and less physically vigorous alternative to exercise. [ABSTRACT FROM AUTHOR]

Background: There is growing acupuncture use amongst people with osteoarthritis, and acupuncture has been shown to have a positive effect on osteoarthritis. The aim of the study is to identify the characteristics of Australian women who consult acupuncturists for osteoarthritis treatment in order to help inform patients, practitioners and policy makers about the range of health care options accessed by older women with osteoarthritis.Methods: The research reported here involved participants from a sub-study of the Sax Institute's 45 and Up Study in Australia. The data of 403 Australian women aged 45 and over with osteoarthritis were analysed. Chi-squared tests and stepwise multiple logistic regression modelling were used to determine the characteristics of women who used acupuncture for the treatment of their osteoarthritis.Results: Analysis revealed that 7.7% of women reported using acupuncture in the previous 12 months for their osteoarthritis. Acupuncture use is positively associated with women experiencing longer duration of time since initial diagnosis of osteoarthritis (OR = 1.04), undertaking more exercise (OR = 5.41), living in a rural area (OR = 3.62), having consulted a psychologist (OR = 12.21), and having consulted another complementary and alternative medicine practitioner (OR = 4.18).Conclusions: Our study reveals considerable acupuncture use amongst women with osteoarthritis. There is a need for health care practitioners to be mindful of acupuncture use among their patients presenting with osteoarthritis. Further research is needed to examine the potential benefits of acupuncture for osteoarthritis and to help inform efficient and safe use of this treatment alongside conventional care. [ABSTRACT FROM AUTHOR]

In this article, we explore the use of health services and self-prescribed treatments among 8088 young Australian women with severe tiredness. Data were obtained from the Australian Longitudinal Study on Women's Health. The prevalence of severe tiredness was 49.2%. The frequency of visits to healthcare practitioners was greater among women who sought help for their severe tiredness, compared to women who did not seek help for their severe tiredness or who did not report severe tiredness. Given the impact of this health problem on Australian women, we call for further research on the optimal treatment for severe tiredness. [ABSTRACT FROM AUTHOR]

Background Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. Objective The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? Methods This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. Results The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Conclusions Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. [ABSTRACT FROM AUTHOR]

Background: A wide range of health care options are utilised by pregnant women in Australia. The out-of-pocket costs of maternity care in Australia vary depending on many factors including model of care utilised, health insurance coverage, and women's decision to access health services outside of conventional maternity care provision.Methods: Women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) who identified as pregnant or as recently having given birth in 2009 were invited to complete a sub-study questionnaire investigating health service utilisation during their most recent pregnancy.Results: A total of 1,835 women agreed to participate in the sub-study. The majority of women (99.8%) consulted with a conventional health care practitioner during pregnancy, 49.4% consulted with a complementary and alternative medicine practitioner at least once during pregnancy and 89.6% of the women used a complementary and alternative medicine product. Women reported an average of AUD$781.10 in out-of-pocket expenses for consultations with conventional health care practitioners, AUD$185.40 in out-of-pocket expenses for consultations with complementary and alternative medicine practitioners and AUD$179.60 in out-of-pocket expenses for complementary and alternative medicine products. From the study data we estimate Australian pregnant women spend over AUD$337 M on out-of-pocket health services.Conclusion: While the majority of pregnant women in Australia may obtain health services via the publically-funded health care system and/or private health insurance coverage, our analysis identifies substantial out-of-pocket expenditure for health care by pregnant women - a trend in public spending for maternity care of importance to policy makers, health administrators, and health professionals. [ABSTRACT FROM AUTHOR]

A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status. A large proportion of arthritis sufferers using CAM consider these medicines to be somewhat or very effective but almost half do not inform their healthcare provider about their CAM use. It is suggested that rheumatologists and others providing health care for patients with arthritis should be cognizant of the high prevalence of CAM use and the challenges associated with possible concurrent use of CAM and conventional medicine among their patients. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between health status and health service utilization (including conventional and complementary and alternative medicine [CAM]) accessed by women experiencing urinary incontinence (UI). Although a high number of younger women report symptoms of UI, such as leaking urine, only a small proportion seek help for these symptoms.Materials and Methods: The Australian Longitudinal Study on Women's Health is a large nationally representative study that investigates the health and well-being of women. The 2 most recent surveys (2006 and 2009) of the young cohort (women aged 28-33 and 31-36 respectively) were analyzed.Results: The presence of UI was 8.5% in 2006 (n = 859) and 23.3% in 2009 (n = 1878), whereas the percentage of women who sought help for their UI was 18.6% (n = 160) and 2.2% (n = 182) respectively. Women with UI had poorer health compared with women without UI (P < .005), and women who sought help for their symptoms had poorer physical functioning than women who did not (P < .005). Women who sought help were greater users of conventional and CAM health services (P < .005), including a general practitioner, specialist, hospital doctor, physiotherapist, and naturopath.Conclusion: UI is relatively common in younger women. However, many do not seek help. Of the women who do seek care, a large number visit CAM professionals as well as conventional medical professionals, despite a lack of research evaluating the efficacy of CAM treatment. Research is needed to explore CAM practitioner approaches to the treatment of UI and to evaluate the efficacy of these treatments. [ABSTRACT FROM AUTHOR]

This study examined factors influencing decision-making on complementary and alternative medicine ( CAM) use for back pain and back pain sufferers' communication about CAM use. A cross-sectional postal survey was conducted in 2011/2012 as a sub-study of the Australian Longitudinal Study on Women's Health ( ALSWH). The sample contained 1620 women from the 1945-1951 cohort of the ALSWH, aged 60-65 years who were eligible for the sub-study, as they had experienced back pain during 12 months prior to the survey. Of these, 1310 (80.9%) returned completed questionnaires. A significant proportion of women consulted a CAM practitioner (76%, n = 1001) and/or had self-prescribed CAM treatment (75%, n = 985). Of the women who used CAM for their back pain, 20% consulted their general practitioner ( GP) prior to using CAM and 34% always informed their GP following CAM use. Forty-three per cent of the women were influenced by their doctors, 39% by friends/colleagues, 36% by family/relatives, 33% by their partner, 30% by a CAM practitioner, 20% by a pharmacist, 16% by a book/magazine, 11% by mass media, 10% by an allied health worker and 6% by the Internet. Our results show that information sources used by women for their decision-making on CAM use differed according to the symptoms. While non-professional information sources (e.g. family/relatives) positively influenced women in their decision to use CAM for a range of back pain-related symptoms (e.g. headaches/migraines), doctors and allied health workers (e.g. nurses) negatively influenced women in their decision to consult a CAM practitioner for a range of back pain-related symptoms (e.g. headaches/migraines, neck pain). Women seek information from a wide range of professional and non-professional sources with regard to their decision-making around CAM use for back pain. Back pain care providers need to ensure effective communication with their back pain patients regarding safe, effective and co-ordinated back pain care options. [ABSTRACT FROM AUTHOR]

The article focuses on the health policy reforms in Australia. Particular focus is given to maternity health services, changes in the legislative policies, and the trends in maternity care. Other topics addressed include details of the National Health Act 1953, use of complementary medicines, and the role of midwives in maternity care.

The objective of the authors in this study was to determine if prior visits to a complementary and alternative medicine (CAM) practitioner were associated with CAM use during pregnancy. The study sample comprised the Australian Longitudinal Study on Women’s Health. Women were surveyed prior to pregnancy in 2006, and then again in 2010 if they were pregnant or had recently given birth, and asked a range of questions relating to demographic variables, health status, and use of CAM. A multivariable analysis identified significant covariates associated with visits to specific CAM practitioner modalities during pregnancy. Of the 447 women who consulted a CAM practitioner prior to pregnancy, 62.4% (n = 279) continued this use during pregnancy. Prior use of massage therapy, acupuncture, herbalist/naturopath, or chiropractor was related to use of the same service during pregnancy. Higher income and working full-time were associated with the continued use of massage, while continued visits to a chiropractor were associated with having depressive symptoms, a urinary tract infection, and living in a rural community. Prior use of CAM was highly related to continuing use during pregnancy. Further research is required to elucidate the benefits women attain from a CAM-model of care that they do not get from their conventional maternity care providers alone. [ABSTRACT FROM PUBLISHER]

Aims: Back, neck and/or pelvic pain are common symptoms experienced by pregnant women. Although pregnant women are known to use complementary and alternative medicine (CAM) frequently, no research to date has provided in-depth examination of healthcare practitioner utilisation of pregnant women who experience back, neck and/or pelvic pain.Methods: A sub-study of 1835 pregnant women from the nationally representative Australian Longitudinal Study on Women's Health (ALSWH). Demographics, health status and healthcare utilisation measures were analysed for symptoms of back, neck and/or pelvic pain during pregnancy, using regression models.Results: During their pregnancy, 39.5% women experienced back pain, 12.4% experienced neck pain and 16.3% women experienced pelvic pain. Pregnant women were more likely to consult a massage therapist for their back pain (32.3%) and neck pain (39.9%), and another alternative practitioner (27.3%) or obstetrician (22.1%) for pelvic pain, while some women did not seek treatment (<30%). Women who sought help for each symptom reported significantly worse levels of mental and physical health across most SF-36 domains (P<.05). Women without health insurance, or pregnancy-related healthcare insurance were less likely to seek treatment.Discussion and Conclusion: Pregnant women experiencing back, neck and/or pelvic pain frequently consult CAM practitioners, particularly if they have healthcare insurance. There is a need for all healthcare practitioners providing maternity care to enquire about possible back, neck and pelvic pain amongst women in their care and be cognisant of possible corresponding CAM use for such symptoms. [ABSTRACT FROM AUTHOR]

Background: Back pain is a common, disabling and costly disorder for which patients often consult with a wide range of health practitioners. Unfortunately, no research to date has directly examined the association between the severity of back pain and back pain sufferers' choice of whom and in what order to consult different health practitioners.Methods: This is a sub-study of the large nationally representative Australian Longitudinal Study on Women's Health (ALSWH). The mid-age cohort women (born 1946-51, n = 13,715) of the ALSWH were recruited from the Australian national Medicare database in 1996. These women have been surveyed six time, with survey 6 being conducted in 2010 (n = 10,011). Mid-age women (n = 1851) who in 2010 had sought help from a health care practitioner for their back pain were mailed a self-report questionnaire targeting their previous 12 months of health services utilisation, health status and their levels of back pain intensity.Results: A total of 1620 women were deemed eligible and 1310 (80.9 %) returned completed questionnaires. Mid-age women with back pain visited various conventional, allied health and CAM practitioners for care: 75.6 % consulted a CAM practitioner; 58.4 % consulted a medical doctor; and 54.2 % consulted an allied health practitioner. Women with the most severe back pain sought conventional care from a general practitioner, and those who consulted a general practitioner first had more severe back pain than those who consulted another practitioner first. Following the general practitioner visit, the women with more severe back pain were more likely to be referred to a conventional specialist, and those with less severe back pain were more likely to be referred to a physiotherapist.Conclusions: Our findings suggest that women with more severe back pain are likely to visit a conventional practitioner first, whereas women with less severe back pain are likely to explore a range of treatment options including CAM practitioners. The improvement of back pain over time following the various possible sequencing of consultations with different types of health practitioners is a topic with implications for ensuring safe and effective back pain care and worthy of further detailed investigation. [ABSTRACT FROM AUTHOR]

Conventional treatments for cyclic perimenstrual pain and discomfort, while numerous and diverse, have drawbacks including side effects, interference with women's reproductive function and, importantly, failure to address symptoms. Many women turn to herbal medicine to treat a myriad of menstrual symptoms. Clinical evidence supports the efficacy of Vitex agnus‐castus but other medicinal herbs typically used by Western herbalists for treating menstrual symptoms are unsupported by clinical trials. This raises concerns around the efficacy and safety of these herbs. Women's treatment options need to be extended and individualised, where current conventional strategies fail, requiring appropriate clinical trials of potentially useful herbal medicines. [ABSTRACT FROM AUTHOR]

Introduction: Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment.Material and Methods: An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women.Results: CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM.Conclusions: This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes. [ABSTRACT FROM AUTHOR]

Background: To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. Methods: Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. Results: The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p<0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p<0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p<0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p<0.05). Conclusions: There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life. [ABSTRACT FROM AUTHOR]

Chronic back pain is a major health and social problem in Australia, often concealed and given limited credibility vis-a-vis other health conditions. Care practices are diversified with allied health, biomedical and complementary and alternative medicine (CAM) practitioners regularly being consulted for help and care, often concurrently. While this differentiated ‘healthcare market’ may on one level be viewed as positive in terms of diverse therapeutic choices, there is also potential for difficulties with regard to care practices and negotiating competing therapeutic modalities. Drawing on qualitative interviews with 50 women aged 60–65 from the Australian Longitudinal Study on Women’s Health living with chronic back pain, this article explores their accounts of suffering and the experiences of engaging in pluralistic healthcare choices, with a particular focus on CAM. The findings reveal the ways by which healthcare pluralism is connected to the dynamics of suffering and relations of recognition. [ABSTRACT FROM AUTHOR]

Background context Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (eg, acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. Purpose This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. Study design/setting The study is based on an integrative literature review. Methods A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. Results The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. Conclusions The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers’ decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. [ABSTRACT FROM AUTHOR]

The uptake of complementary and alternative medicine (CAM) is common, especially among patients with chronic illness. However, the use of CAM by women with cardiovascular disease and how this influences the interface with conventional medicine is poorly understood. To examine the relation between heart disease, hypertension, and diabetes and the use of CAM and conventional medicine in a cohort of women, data were taken from the 2010 survey (n = 9,748) of the 1946 to 1951 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Analyses focused on women who had been diagnosed or treated for heart disease, diabetes, and/or hypertension. The outcome measures were the use of conventional or CAMtreatments in the previous year. Mostwomen had hypertension only (n=2,335), and few (n=78) reported having heart disease, hypertension, and diabetes. Women with hypertension were less likely (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74 to 0.91) to consult with a CAM practitioner and less likely (OR 0.86, 95% CI 0.77 to 0.97) to use self-prescribed CAM, while women with diabetes were also less likely (OR 0.66, 95% CI 0.54 to 0.81) to consult with a CAMpractitioner and less likely (OR 0.68, 95% CI 0.55 to 0.83) to use self-prescribedCAM. In conclusion, compared with studies conducted on CAM use and other chronic illness groups, the use of CAM by women with heart disease, hypertension, and/or diabetes in this study was lower, and future research is needed to explore patients' perceptions of cardiovascular risk and the role of CAM in their self-management in the community, among other issues. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (N = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (M = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

Objective: there is evidence of high use of complementary and alternative medicine (CAM) by pregnant women. Despite debate and controversy regarding CAM use in pregnancy there has been little research focus upon the impacts of CAM use on birth outcomes. This paper reports findings outlining the incidence of adverse birth outcomes among women accessing CAM during pregnancy. Design: a survey-based cohort sub-study from the nationally-representative Australian Longitudinal Study on Women's Health (ALSWH) was undertaken in 2010. Participants: women (aged 31-36 years) who identified in 2009 as pregnant or recently given birth (n=2445) from the younger cohort (n=8012) of ALSWH were recruited for the study. Measurements and findings: participants' responses were analysed to examine the relationship between use of CAM and adverse birth outcomes from their most recent pregnancy. Of the respondents (n=1835; 79.2%), there were variations in birth outcomes for the women who used different CAM. Notably, the outcome which was most commonly associated with CAM use was emotional distress. This was found to occur more commonly in women who practised meditation/yoga at home, used flower essences, or consulted with a chiropractor. In contrast, women who consulted with a chiropractor or consumed herbal teas were less likely to report a premature birth, whilst participation in yoga classes was associated with an increased incidence of post partum/intrapartum haemorrhage. Key conclusions: the results emphasise the necessity for further research evaluating the safety and effectiveness of CAM for pregnant women, with a particular focus on birth outcomes. Implications for practice: health professionals providing care need to be aware of the potential birth outcomes associated with CAM use during pregnancy to enable the provision of accurate information to women in their care, and to assist in safely supporting women accessing CAM to assist with pregnancy, labour and birth. [ABSTRACT FROM AUTHOR]

People are increasingly compelled to take responsibility for their health and illness trajectories. The existing literature on what may be termed self-care points to the ways that public health initiatives have instigated the transfer of governance onto the individual through campaigns promoting physical activity and diet among other things. Meanwhile, cultural trends may have been enhanced and/or transformed by the increased prominence of complementary and alternative medicine (CAM) which often include a focus on self-determination and self-responsibility for achieving health and wellbeing. This article examines women’s contemporary self-care practices and the logics underpinning their approaches to health, illness and healing. Our findings show that although these women were often positive about the prospects of being autonomous decision-makers, their search for alternatives and practices of self (health) care can be problematic in certain cases and may be viewed as reproducing neoliberal forms of governance and their derivative inequalities. [ABSTRACT FROM PUBLISHER]

Complementary and alternative medicine is increasingly popular in Australia and particularly among women. While existing research provides some understanding of women’s engagement with complementary and alternative medicine and biomedicine, there has been comparatively little examination of the day-to-day character of their experiences. In this study, we utilise solicited diaries with women aged 60–65 years drawn from the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health to capture the temporal dimension of their therapeutic engagement. Focusing on 30 active complementary and alternative medicine users, we explore women’s experiences of managing their health, illness and well-being over a 1-month period. The themes that emerge from their diaries illustrate the day-to-day enactment of lay expertise through informal knowledge networks, practices of self-trialling and experimentation and the moralities underpinning self-care. The diaries provide unprecedented temporal insight into the (often problematic) enactment of lay expertise at the nexus of complementary and alternative medicine and biomedicine. They also point to the value of longitudinal techniques of data collection for augmenting more traditional sociological ways of exploring therapeutic pluralism. [ABSTRACT FROM PUBLISHER]

Objectives: Up to 87% of women are using some form of complementary and alternative medicine (CAM) during their pregnancy, and this study was conducted to investigate the information sources that these women find influential in relation to such use. Design: The study sample was obtained via the Australian Longitudinal Study on Women's Health. This article is based on a substudy of 1835 pregnant women who were surveyed in 2010. The women answered questions about CAM use, pregnancy-related health concerns, and influential information sources in relation to CAM use. Logistic regression models were used to determine the information sources that women reported as influential in their decision making regarding CAM use. Results: Of the respondents ( n=1835, 79.2% response rate), 48.1% ( n=623) of the pregnant women consulted a CAM practitioner and 91.7% ( n=1485) used a CAM product during pregnancy. The results show that, of the women who used CAM, nearly half (48%, n=493) were influenced by their own personal experience of CAM and 43% ( n=423) by family and friends. Other popular sources of information were general practitioners 27% ( n=263), the media (television, radio, books, magazines, newspapers) 22% ( n=220), obstetricians 21% ( n=208) and midwives 19% ( n=190). Numerous statistically significant associations between influential information sources and pregnancy-related health conditions were identified. Conclusions: Women utilize a wide variety of information sources regarding their CAM use during pregnancy. Nonprofessional sources of information were found to be particularly influential, and maternity health care professionals need to have a nonjudgmental and open discussion with women about their CAM use during pregnancy in order to ensure safe and effective maternal outcomes. [ABSTRACT FROM AUTHOR]

Back pain is a significant health service issue in Australia and internationally. Back pain sufferers can draw upon a range of health care providers including complementary and alternative medicine (CAM) practitioners. Women are higher users of health services than men and tend to use CAM frequently for musculoskeletal conditions. However, there remain important gaps in our understanding of women's consultation patterns with CAM practitioners for back pain. The objective of this study is to examine the prevalence of use and characteristics of women who use CAM practitioners for back pain. The method used was a survey of a nationally representative sample of women aged 60-65 years from the Australian Longitudinal Study on Women's Health. Women consulted a massage therapist (44.1 %, n = 578) and a chiropractor (37.3 %, n = 488) more than other CAM practitioners for their back pain. Consultations with a chiropractor for back pain were lower for women who consulted a General Practitioner (GP) (OR, 0.56; 95 % CI 0.41, 0.76) or a physiotherapist (OR, 0.53; 95 % CI 0.39, 0.72) than for those who did not consult a GP or a physiotherapist. CAM practitioner consultations for back pain were greater for women who visited a pharmacist (OR, 1.99; 95 % CI 1.23, 3.32) than for women who did not visit a pharmacist. There is substantial use of CAM practitioners alongside conventional practitioners amongst women for back pain, and there is a need to provide detailed examination of the communication between patients and their providers as well as across the diverse range of health professionals involved in back pain care. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the determinants that are related to women’s likelihood to consult with a complementary and alternative medicine (CAM) practitioner during pregnancy. Primary data were collected as a sub-study of the Australian Longitudinal Study on Women’s Health (ALSWH) in 2010. We completed a cross-sectional survey of 2,445 women from the ALSWH “younger” cohort (n = 8,012), who had identified as being pregnant or had recently given birth in 2009. Independent Poisson backwards stepwise regression models were applied to four CAM practitioner outcome categories: acupuncturist, chiropractor, massage therapist, and naturopath. The survey was completed by 1,835 women (79.2%). The factors associated with women’s consultation with a CAM practitioner differed by practitioner groups. A range of demographic factors were related, including employment status, financial status, and level of education. Women’s health insurance coverage, health status, and perceptions toward both conventional maternity care and CAM were also associated with their likelihood of consultations with all practitioner groups, but in diverse ways. Determinants for women’s consultations with a CAM practitioner varied across practitioner groups. Stakeholders and researchers would benefit from giving attention to specific individual modalities when considering CAM use in maternity care. [ABSTRACT FROM AUTHOR]

Objectives: This study examines involvement with a range of complementary and alternative medicine (CAM) during pregnancy on the use of pharmacologic (PPMT) and nonpharmacologic (NPMT) pain management techniques for labor and birth. Design: Longitudinal analysis of survey data. Participants: A substudy ( n=2445) of the 'young' cohort of the nationally representative Australian Longitudinal Study on Women's Health was conducted. Outcome measures : Use of PPMT and NPMT during labor and birth. Results: The survey was completed by 1835 women (response rate, 79.2%). Most respondents used either intrapartum PPMT (81.9%) or NPMT (74.4%). Many (60.7%) used some form of CAM during pregnancy and also used PPMT during birth. More than two thirds of women (66.7%) who used NPMT used CAM during pregnancy. There was a general trend of increased likelihood of NPMT use by women who applied CAM during pregnancy. There was an inverse effect on use of epidural analgesia for women who consumed herbal teas during pregnancy (odds ratio, 0.60). Conclusions: Because of the study design, this paper does not confirm a causative relationship between the use of CAM during pregnancy and intrapartum pain management choices. It does, however, indicate that the use of CAM during pregnancy may not significantly affect the uptake of intrapartum PPMT, despite possible attempts to reduce PPMT by using NPMT. It also highlights the possibility of potential interactions between CAM and PPMT, given the high prevalence of concomitant use. [ABSTRACT FROM AUTHOR]

Despite growing interest and controversy regarding the value of doulas in contemporary maternity care, little is known about the profile of women who choose to involve a doula in their care team. This preliminary analysis indicates that women's attitudes towards maternity care may influence their use of a doula more so than demographic factors. Further research examining these issues in more detail is needed for all those involved in maternity care to ensure safe maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Background Pregnant women have been identified as high users of complementary and alternative medicine (CAM). However, no research to date has provided a detailed analysis of the prevalence and determinants of CAM consumption amongst pregnant women. Aim To examine the prevalence and determinants of CAM use by pregnant women, utilising a national representative sample. Methods The study sample was obtained via the Australian Longitudinal Study on Women's Health. This paper is based on a sub-study of 1,835 pregnant women, administered in 2010. The women answered questions about CAM use, demographics, pregnancy-related health concerns and health service utilisation. Results Complementary and alternative medicine use was found to be high with 48.1% ( n = 623) of pregnant women consulting a CAM practitioner and 52.0% ( n = 842) of women using CAM products (excluding vitamins and minerals) during pregnancy. CAM practitioner visits were more likely for selected pregnancy-related health concerns, namely back pain or back ache, neck pain and labour preparation. Women were less likely to consult a CAM practitioner if they suffered with headaches/migraines. Employment was also found to be predictive of pregnant women's visits to a CAM practitioner. Significant health history and demographic predictors of CAM product use were tiredness and fatigue, embarking on preparation for labour and having a university education. Conclusion Most pregnant women are utilising CAM products and/or services as part of their maternity care and obstetricians, general practitioners and midwives need to enquire with women in their care about possible CAM use to help promote safe, effective coordinated maternity care. [ABSTRACT FROM AUTHOR]

The proliferation of complementary and alternative medicine (CAM), and women’s high level of engagement with these practices, has presented sociology with a range of questions regarding gender, embodiment and identity work in the context of contemporary medical pluralism. The current study, drawing on 60 qualitative interviews with women from the Australian Longitudinal Study on Women’s Health (ALSWH), examines how a group of Australian women negotiate CAM and biomedicine in a range of health and illness contexts. Selected from the mid-aged cohort of this national study, here we explore their accounts of engagement with CAM and biomedicine, unpacking their logics underpinning, and rhetorical practices surrounding, their therapeutic engagement. The results provide significant insight into: the importance of ideas about nature, holism and strengthening; perceptions of the harshness and softness of medicines for women’s bodies; and, the relative importance of scientific proof vis-a-vis individual subjectivities. Ultimately, their accounts illustrate gendered and embodied strategies of strategic integration, and importantly, border crossing. We conclude that while women’s engagement with CAM and biomedicine may be indeed be gendered in character, we suggest a rethinking of gender-based resistance (to biomedicine) or gender-alignment (to CAM) arguments; the notion of women as designers would more adequately capture the landscapes of contemporary medical pluralism. [ABSTRACT FROM PUBLISHER]

Abstract: Objectives: The purpose of this study was to evaluate survey data from a national cross-sectional sample of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) practitioner types and the levels of CAM use across urban and nonurban areas. Methods: A cross-sectional survey of 1427 middle-aged participants from the Australian Longitudinal Study on Women''s Health conducted in 2009 was performed. The survey was designed to investigate multiple factors affecting the health and well-being of a cohort of women, with a particular emphasis on urban and nonurban residence. Women in 3 age groups (“young” 18-23 years, “mid-age” 45-50 years, and “older” 70-75 years) were randomly selected from the national Medicare database. The survey covered place of residence, measures of health status, rating of health care providers/services, and consultation with CAM practitioners. Results: The most commonly consulted CAM practitioners for this sample were massage therapists (n = 912; 63.9%), doctors of chiropractic/chiropractors (n = 614; 43.0%), and naturopaths/herbal therapists (n = 327; 22.9%). Statistically significant differences between the areas of residence were found for women who used chiropractors (P = .0165), yoga practitioners (P = .0087), and osteopaths (P < .0001). Women residing in nonurban areas were more likely to consult with a chiropractor compared with women residing in major cities. Women in major cities were more likely to consult with a yoga practitioner or osteopath than women from nonurban areas. Women from nonurban areas who consulted a chiropractor were significantly less satisfied with their access to a medical specialist (P < .0001), access to a female general practitioner (P = .043), the number of general practitioners they have to choose from (P = .001), how long they have to wait for an appointment (0.0146), and the amount of information sharing by their general practitioner (P = .003), compared with urban women. Conclusions: For the population sample studied, the higher overall consultation rates with CAM therapists by Australian nonurban women were caused by consultations for chiropractic care. [Copyright &y& Elsevier]

Objectives: There has been a dramatic increase in the use of complementary medicines over recent decades. Glucosamine is one of the most commonly used complementary medicines in Western societies. An understanding of glucosamine consumption is of significance for public health and future health promotion. This paper, drawing upon the largest dataset to date with regards to glucosamine use (n = 266,844), examines the use and users of glucosamine amongst a sample of older Australians. Design: Analysis of the self-reported data on use of glucosamine, demographics and health status as extracted from the dataset of the 45 and Up Study, which is the largest study of healthy ageing ever undertaken in the Southern Hemisphere involving over 265,000 participants aged 45 and over. Results: Analysis reveals that 58,630 (22.0%) participants reported using glucosamine in the 4 weeks prior to the survey. Use was higher for those who were female, non-smokers, residing in inner/outer regional areas, with higher income and private health insurance. Of all the health conditions examined only osteoarthritis was positively associated with use of glucosamine, while cancer, heart attack or angina and other heart disease were all negatively associated with glucosamine use. Conclusions: This study suggests that a considerable proportion of the Australia population aged 45 and over consume glucosamine. There is a need for health care practitioners to enquire with their patients about their use of glucosamine and for further attention to be directed to providing good quality information for patients and providers with regards to glucosamine products. [ABSTRACT FROM AUTHOR]

Summary: Objectives: The existing knowledge base on the use of complementary and alternative medicine among patients with allergies is built upon findings of cross-sectional surveys and there is a lack of longitudinal data. There is also a lack of studies that examine both the use of conventional medicine and complementary and alternative medicine among allergy patients. Design and setting: : This paper reports the findings of the first ever longitudinal study of the use of conventional providers, practitioners of complementary and alternative medicine, and self-prescribed modalities amongst women with allergies, hayfever and sinusitis from a large nationally representative sample. Main outcome measures: : Analysis focused upon data from 7538 women from the younger cohort of the Australian Longitudinal Study on Women''s Health collected between 1996 and 2006. Chi-square tests were employed to compare the groups across consultations and self-prescribed treatments and one-way analysis of variance was used to compare the groups across health status. A modified Bonferroni test was used to correct for multiple comparisons. Results: The study identified that women who sought help for their allergic disorder were more likely to consult a range of practitioners and self-prescribed complementary and alternative medicine than women who either did not seek help or did not have allergic disorders. The analysis shows that many women with allergic disorders use complementary and alternative medicine alongside or as a complement to conventional healthcare services. Conclusions: The frequent use of a range of conventional providers and practitioner-based and self-prescribed complementary and alternative medicine amongst women with allergic disorders warrants further investigation. [Copyright &y& Elsevier]

Aim: The aim of this study was to examine sex differences in complementary and alternative medicine (CAM) use among older adults. Methods: Cross-sectional analysis of data from two cohort studies of community-dwelling women (n = 5399) and men (n = 3188) aged 82-87 and 77-91 years, respectively. The main outcome measure was self-report of consultations with an alternative health practitioner. Results: Men were 1.79 (95% confidence interval (CI): 1.46, 2.20) times more likely to use CAM than women. People born in a non-English speaking country were 1.49 times (95% CI: 0.94, 2.35) more likely to use CAM. Self-reported general health (P = 0.01) and bodily pain (P < 0.01) were significantly associated with CAM use. Conclusion: In contrast to previous research, CAM use is more prevalent among older men than older women in our sample. Both men and women are using CAM to maintain good health and for the treatment of ongoing conditions. [ABSTRACT FROM AUTHOR]

Background: There is little known about women's concurrent use of conventional and complementary health care during pregnancy, particularly consultation patterns with complementary and alternative medicine (CAM). This study examines health service utilisation among pregnant women including consultations with obstetricians, midwives, general practitioners (GPs) and CAM practitioners. Methods: A sub-study of pregnant women (n=2445) was undertaken from the nationally-representative Australian Longitudinal Study on Women's Health (ALSWH). Women's consultations with conventional practitioners (obstetricians, GPs and midwives) and CAM practitioners for pregnancy-related health conditions were analysed. The analysis included Pearson chi-square tests to compare categorical variables. Results: The survey was completed by 1835 women (response rate = 79.2%). A substantial number (49.4%) of respondents consulted with a CAM practitioner for pregnancy-related health conditions. Many participants consulted only with a CAM practitioner for assistance with certain conditions such as neck pain (74.6%) and sciatica (40.4%). Meanwhile, women consulted both CAM practitioners and conventional maternity health professionals (obstetricians, midwives and GPs) for back pain (61.8%) and gestational diabetes (22.2%). Women visiting a general practitioner (GP) 3-4 times for pregnancy care were more likely to consult with acupuncturists compared with those consulting a GP less often (p=<0.001, x2=20.5). Women who had more frequent visits to a midwife were more likely to have consulted with an acupuncturist (p=<0.001, x2=18.9) or a doula (p=<0.001, x2=23.2) than those visiting midwives less frequently for their pregnancy care. Conclusions: The results emphasise the necessity for a considered and collaborative approach to interactions between pregnant women, conventional maternity health providers and CAM practitioners to accommodate appropriate information transferral and co-ordinated maternity care. The absence of sufficient clinical evidence regarding many commonly used CAM practices during pregnancy also requires urgent attention. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) has increased significantly in Australia over the past decade. Back pain represents a common context for CAM use, with increasing utilisation of a wide range of therapies provided within and outside conventional medical facilities. We examine the relationship between back pain and use of CAM and conventional medicine in a national cohort of mid-aged Australian women. Methods: Data is taken from a cross-sectional survey (n = 10492) of the mid-aged cohort of the Australian Longitudinal Study on Women's Health, surveyed in 2007. The main outcome measures were: incidence of back pain the previous 12 months, and frequency of use of conventional or CAM treatments in the previous 12 months. Results: Back pain was experienced by 77% (n = 8063) of the cohort in the previous twelve month period. The majority of women with back pain only consulted with a conventional care provider (51.3%), 44.2% of women with back pain consulted with both a conventional care provider and a CAM practitioner. Women with more frequent back pain were more likely to consult a CAM practitioner, as well as seek conventional care. The most commonly utilised CAM practitioners were massage therapy (26.5% of those with back pain) and chiropractic (16.1% of those with back pain). Only 1.7% of women with back pain consulted with a CAM practitioner exclusively. Conclusions: Mid-aged women with back pain utilise a range of conventional and CAM treatments. Consultation with CAM practitioners or self-prescribed CAM was predominantly in addition to, rather than a replacement for, conventional care. It is important that health professionals are aware of potential multiple practitioner usage in the context of back pain and are prepared to discuss such behaviours and practices with their patients. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies. Methods: Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Women's Health collected between 1996 and 2006. Chi-square tests were employed for the cross-sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis. Results: Complementary and alternative medicine use among pregnant and nonpregnant women continued to increase over the 10-year period. Although pregnancy status was not predictive of the use of alternative treatments, pregnant women employed these therapies or modalities for the relief of pregnancy-related complaints and symptoms. Analysis also revealed that women used complementary and alternative treatments selectively during pregnancy. Conclusions: This study highlights the need for further research that is sensitive to the consumption of specific complementary and alternative therapies or modalities and to the wider contexts within which women perceive risk associated with their use of complementary and alternative treatments. (BIRTH 38:3 September 2011) [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to chart the patterns and determine the factors associated with acupuncture consultations among a large cohort of mid-aged women in Australia over a 6-year period. Design: A longitudinal analysis of questionnaires completed in 2001, 2004, and 2007 as part of the Australian Longitudinal Study on Women's Health. Statistical analyses included Generalized Estimating Equations. Subjects: Mid-aged women ( n=11,200) were randomly selected from the Australian Medicare database, with oversampling of women from rural and remote areas. Outcome measure: The outcome measure was consultation with an acupuncturist in the 12 months prior to each survey. Results: The percentage of women who consulted an acupuncturist in the years 2001, 2004, and 2007 were 4.2%, 4.3%, and 5.9%, respectively. Only 0.5% of women consulted with an acupuncturist at all survey periods, 2.0% at two survey periods, and 7.4% at only one survey period. Acupuncture consultations significantly increased if the women had back problems (odds ratio [OR]=1.5), arthritis (OR=1.3), had higher levels of education (OR=1.9), were high users of general practitioners/family practitioners (OR=2.6), and high users of biomedical specialists (OR=1.4). Conclusions: Use of acupuncturists among mid-age women appears to be strongly influenced by poor physical health. The percentage of women in the community who use acupuncture remained relatively consistent over the study period. Women do not tend to consistently use acupuncture over time, but instead appear to use acupuncture as a one-off treatment or at selected time points. [ABSTRACT FROM AUTHOR]

Objective: Complementary and alternative medicine (CAM) use is high in rural health and an agenda for research in the geography of CAM has been outlined. Unfortunately, no studies to date have mapped the geographic distribution of CAM practitioners in rural areas. For the first time we investigate CAM practitioner distributions across a large district/region in rural Australia. Setting and design: A CAM infrastructure audit of practitioners was performed in rural Divisions of General Practice in New South Wales, Australia. Results: CAM providers form a significant part of the health care system in rural New South Wales with substantial representation across all degrees of rurality and in both under‐serviced and well‐serviced areas. CAM practitioners outnumbered GPs in four NSW Divisions of General Practice and in no Division numbered less than half of the total number of GPs. Conclusions: Given the challenges of access to and recruitment and retention of conventional health care providers in rural settings and the significant presence of CAM practitioners, it is possible to consider such practitioners as an untapped resource in rural health care delivery. Assuming appropriate regulatory and quality standards are in place this resource should attract careful attention as part of future rural health policy and planning. The significant presence and high prevalence of use of CAM practitioners should also serve as an impetus to reform CAM service delivery in Australia. [ABSTRACT FROM AUTHOR]

Background. There is evidence of asthma patients using complementary and alternative medicine (CAM). This article reports the findings of the first ever longitudinal study of CAM use among women with asthma from a large nationally representative sample. Methods. A longitudinal analysis of questionnaires completed in 1996, 2000, 2003, and 2006 as part of the Australian Longitudinal Study on Women's Health. The cohort began with 14,701 randomly selected young women (aged 18--22 years). CAM use was defined as a consultation with a range of complementary practitioners in the 12 months prior to each survey. Statistical analyses included the use of generalized estimating equations. Results. Over the 10-year period, approximately 26%% of the women were asthmatic. Asthmatic women were significantly more likely to use CAM (19%%, 22%%, and 36%% for surveys 2--4, respectively) than non-asthmatic women (15%%, 20%%, and 32%% for surveys 2--4, respectively). CAM use increased as time since asthma diagnosis increased. However, only the increase in consultations with a naturopath//herbalist remains statistically significant when the CAM modalities are considered individually alongside asthma status. The longitudinal model suggests that women with asthma are 1.13 (95%% CI: 1.05--1.21) times more likely to consult with a CAM practitioner ( p< .001). The study also shows that CAM users have a higher dissatisfaction with conventional healthcare services and consultations when compared to CAM non-users. Conclusion. These findings suggest that women with asthma may turn to CAM after conventional care fails to adequately address their healthcare needs. [ABSTRACT FROM AUTHOR]