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Background: Massage is a widely acceptable and popular form of complementary medicine (CM) among Australian women. While there is some research that reports on massage use in younger women, there is minimal research exploring massage use in the treatment of chronic illness in older women. This study provides an estimate of the prevalence of massage use, as well as identifying the characteristics significantly associated with consultation with a massage therapist, for mid-age and older Australian women. Methods: A cross-sectional sub-study was conducted on a sample of women drawn from the 45 and Up Study; a large cohort study of adults aged 45 years and over. Data from 1795 women were included in the analyses and massage use was compared against measures of demographics, health status and health care utilisation. Results: A total of 174 (7.7%) women consulted with a massage therapist in the previous 12 months. Women were more likely to consult a massage therapist if they have tertiary level education (O.R. = 1.67; 95% C.I.: 1.04, 2.65; p = 0.031), private health insurance (O.R. = 6.37; 95% C.I.: 4.41, 9.19; p < 0.001) and/or osteoarthritis (O.R. = 1.72; 95% C.I.: 1.19, 2.48; p = 0.004). They were also more likely to consult a massage therapist if they have a poorer health-related quality of life (HRQoL) (O.R. = 1.14; 95% C.I.: 1.04, 1.27; p = 0.007). Conclusion: Older, tertiary-level educated Australian women with private health insurance were more likely to use massage therapy, as were women with osteoarthritis specifically. Women with lower HRQoL were found to be more likely to use massage therapy in the treatment of their chronic illness. This research provides insight into the determinants of massage use among ageing women and is useful for governments in consideration of accessibility to holistic healthcare when developing public policy for healthcare in Australia. [ABSTRACT FROM AUTHOR]

Complementary and Alternative Medicine (CAM) has become increasingly popular amongst healthcare consumers worldwide. As such, CAM is now an important public health issue with serious implications for healthcare organization and delivery. While previous studies have provided a profile of CAM users, there remains very limited analysis of CAM consumption over time. The purpose of this paper is to describe the changing use of CAM practitioners over time by 11,454 mid-age women in the Australian Longitudinal Study on Women's Health. Over the study period (1996-1998), 10% of women adopted the use of CAM and 9% relinquished CAM. The predominant factor found to be predictive of CAM adoption was changes in health status. Specifically, those women experiencing more illness over time are more likely to adopt CAM than those experiencing no change or better health. CAM relinquishment was associated with use of non-prescription medications, where women were more likely to relinquish CAM if they never used non-prescription medications or if they stopped taking non-prescription medications. This paper constitutes an exploratory investigation into CAM use over time. As such, there is need for further research to provide in-depth examination of the adoption and relinquishment of CAM use over a longer time period. KEYWORDS. Complementary medicine, complementary therapies, longitudinal studies, women's health

Background: Pregnancy is a time for women in which the need for social support is crucial. Social support reduces stressors and improves the emotional and physical well-being of pregnant women. Women receiving low social support during pregnancy are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Methods: Data were obtained from the 1973–1978 cohort of Australian Longitudinal Study on Women's Health (ALSWH) and those who report being pregnant (n = 493) were included in the current analyses. Social support was assessed using Medical Outcomes Study Social Support index (MOSS). A logistic regression model was applied to identify determinants of low social support, separately for each MOSS domain. Result: The study found that 7.1% (n = 35) of pregnant women reported low social support. Significant determinants of low emotional support were non-partnered (AOR = 4.4, 95% CI: 1.27, 14.99), difficulty managing on available income (AOR = 3.1, 95% CI: 1.18, 8.32), experiencing depressive symptoms (AOR = 8.5, 95% CI: 3.29, 22.27) and anxiety symptoms (AOR = 2.9, 95% CI: 1.26, 7.03). Significant determinants of low affectionate support were suffering from depressive symptoms (AOR = 5.3, 95% CI: 1.59, 17.99), having anxiety symptoms (AOR: 6.9, 95% CI: 2.21, 22.11) and being moderately/very stressed (AOR: 3, 95% CI: 1.17, 7.89). Significant determinants of low tangible support were difficulty managing available income (AOR = 3, 95% CI: 1.29, 6.95), and being depressed (AOR = 2.8, 95% CI: 1.48, 5.34). Conclusion: The study revealed that 7.1% of pregnant women reported low social support. Having a mental health problems, being stressed, being from low socio-economic status and being non-partnered were significant determinants of low social support during pregnancy. Maternal health professionals and policymakers can use this information to screen pregnant women at risk of receiving low social support and improve the level of support being provided. Plain Language Summary: Providing strong social support improves emotional and physical well-being, strengthens social relationships, promotes health, and enhances the stress coping ability of pregnant women. However, pregnant women receiving low social support are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Data were obtained from Survey 6 of the 1973–1978 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) (n = 493, pregnant women aged 34–39 years). This cohort is one of ALSWH ongoing community-based study focusing on the health of women in Australia. Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOSS). The prevalence of low social support in each domain was calculated for each of the independent variables. A logistic regression model, using a backward stepwise elimination approach, was employed to identify determinants of low social support. In the final model, the strength of association measured by adjusted odds ratios (AOR) with 95% confidence intervals. The significance level was set at p < 0.05. From the total participant pregnant women, 7.1% of them reported low social support. Significant determinants of low social support among pregnant Australian women were, having a mental illness, being stressed and/or being from low socio-economic status and being non-partnered. Maternal health professionals can use this information to screen pregnant women at risk of receiving low social support as well as develop policy to help enhance the social support being given and the psychological wellbeing being of pregnant women. [ABSTRACT FROM AUTHOR]

Background/objectives: We previously demonstrated that fruit and vegetable consumption, was associated with less weight gain over 6 years in young women for all body mass index (BMI) categories. This study evaluated the relationship between diet quality and 6-year weight change, in Australian women initially in the healthy weight range (≥18.5 BMI <25 kg/m2) at baseline.Subjects/methods: A total of 4083 young women (27-31 years) in the healthy weight range (≥18.5 BMI <25 kg/m2) enroled in the Australian Longitudinal study on Women's Health (ALSWH) were analysed. Diet quality was measured by the Australian Recommended Food Score (ARFS) and the Fruit and Vegetable Index (FAVI) using dietary data derived from a validated food frequency questionnaire. Weight change was calculated as the difference between baseline and 6-year follow-up weight (kg). Multiple linear regression models were used to analyse the association between baseline ARFS and FAVI and 6-year weight change.Results: At baseline, mean diet quality was low for both indices [ARFS (maximum 72) = 29.9 and FAVI (maximum 333) = 94.2] and women gained 3.7 kg of weight during 6 years of follow-up. Regression modelling revealed that every one point increase over 6 years in either the ARFS or FAVI score was associated with statistically significantly less weight gain over 6 years, although the amount was small (33 and 12 g, respectively).Conclusions: Higher diet quality predicts lower prospective weight gain in young women however, further research is needed over a longer follow-up period and in diverse population groups. [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]

Objectives: To examine the relationship between yoga/meditation practice and health behavior in Australian women.Methods: Women aged 19-25years, 31-36years, and 62-67years from the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behavior; and whether they practiced yoga/meditation on a regular basis. Associations of health behaviors with yoga/meditation practice were analyzed using multiple logistic regression modelling.Results: 11,344, 8200, and 9151 women aged 19-25years, 31-36years, and 62-67years, respectively, were included of which 29.0%, 21.7%, and 20.7%, respectively, practiced yoga/meditation. Women practicing yoga/meditation were significantly more likely to report at least moderate physical activity levels (OR=1.50-2.79), to follow a vegetarian (OR=1.67-3.22) or vegan (OR=2.26-3.68) diet, and to report the use of marijuana (OR=1.28-1.89) and illicit drugs in the last 12 months (OR=1.23-1.98).Conclusions: Yoga/meditation practice was associated with higher physical activity levels, a higher likelihood of vegetarian or vegan diet use, and a higher likelihood of drug use. While health professionals should keep the potential vulnerability of yoga/meditation practitioners to drug use in mind, the positive associations of yoga/meditation with a variety of positive health behaviors warrant its consideration in preventive medicine and healthcare. [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]

Objective: Nausea, vomiting and reflux are common conditions experienced by women during pregnancy. The objective of this project was to examine women's use of health services for these conditions.Methods: The study sample was obtained via the Australian Longitudinal Study on Women's Health. A total of 2445 women who were pregnant or who had recently given birth in 2009 were invited to complete a sub-survey in 2010 about pregnancy and health service utilisation. A response rate of 79.2% was obtained.Results: During their pregnancy, 604 (32.9%) respondents experienced nausea, with 255 (42.2%) of these women seeking help from a health care practitioner. A total of 201 women (11%) reported repeated vomiting, and 637 women (34.7%) reported reflux, of which 78.6% and 59.2% sought help, respectively. There were no significant differences in the mental and physical health measures between women with nausea, vomiting and/or reflux who sought help and women who did not. Having private health insurance with obstetric cover was associated with seeking help for reflux; this was the only demographic measure significantly associated with seeking help for any condition.Conclusion: Research is required to understand why many women do not seek professional help for common gastrointestinal conditions during pregnancy. [ABSTRACT FROM AUTHOR]

Aim To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'. Background The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Design Online cross-sectional survey. Methods Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression. Results Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Conclusion Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety. [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]

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]

Issue addressed The present study investigated the association between diet quality, measured using the Australian Recommended Food Score (ARFS), and 6-year risk of becoming overweight or obese in mid-age women from the Australian Longitudinal Study of Women's Health (ALSWH). Methods Women (n=1107) aged 47.6-55.8 years who were a healthy weight (body mass index (BMI) between ≤18.5 and <25.0kgm(-2)) at baseline and who reported valid total energy intakes were included in the study. BMI was calculated from self-reported data in 2001 and 2007. ARFS scores were calculated from data collected using the Dietary Questionnaire for Epidemiological Studies Version 2. Logistic regression was used to examine the relationship between ARFS score as a continuous variable and risk of becoming overweight or obese. Results The 6-year incidence of overweight and obesity was 18.5% and 1.1%, respectively. The mean (± s.d.) ARFS (maximum possible 74) among those who remained within the healthy weight range and those who became overweight or obese at follow-up was 35.3±8.1 and 34.3±8.8, respectively. There was no relationship between baseline ARFS and risk of becoming overweight or obese over 6 years. Women who were smokers were more likely to become overweight or obese (odds ratio 1.5; 95% confidence interval 1.11-2.09; P=0.008). Conclusions Poor diet quality was common among mid-age women of a healthy weight in the ALSWH. Higher diet quality was not associated with the risk of overweight or obesity after 6 years, yet smoking status was. So what? Better diet quality alone will not achieve maintenance of a healthy weight, but should be encouraged to improve other health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Falls are the leading cause of injuries in women across all ages. While yoga has been shown to increase balance, it has also been associated with injuries due to falls during practice. This study aimed to analyse whether regular yoga or meditation practice is associated with the frequency of falls and fall-related injuries in upper middle-aged Australian women.Methods: Women aged 59-64 years from the Australian Longitudinal Study on Women's Health (ALSWH) were queried regarding falls and falls-related injuries; and whether they regularly practiced yoga or meditation. Associations of falls and falls-related injuries with yoga or meditation practice were analysed using chi-squared tests and multiple logistic regression modelling.Results: Of 10,011 women, 4413 (44.1%) had slipped, tripped or stumbled, 2770 (27.7%) had fallen to the ground, 1398 (14.0%) had been injured as a result of falling, and 901 (9.0%) women had sought medical attention for a fall-related injury within the previous 12 months. Yoga or meditation was practiced regularly by 746 (7.5%) women. No associations of falls, fall-related injuries and treatment due to falls-related injury with yoga or meditation practice were found.Discussion: No association between yoga or meditation practice and falls or fall-related injuries have been found. Further studies are warranted for conclusive judgement of benefits and safety of yoga and meditation in relation to balance, falls and fall-related injuries. [ABSTRACT FROM AUTHOR]

Background: The benefits of exercise and weight reduction for overweight or obese people with coronary heart disease and/or diabetes mellitus are well recognised. The Healthy Eating and Exercise Lifestyle Program demonstrated these outcomes at 4 months, but longer-term outcomes are not yet reported. Aim: To determine whether positive weight, body mass index, waist and exercise duration outcomes were sustained in the long term (12 months) and to identify the independent predictors of these outcomes at 4 and 12 months. Methods: Longitudinal design, combining data of all Healthy Eating and Exercise Lifestyle Program participants (intervention and wait-list control, n = 134). Participants had a body mass index between 27 and 39 kg/m2 and had completed cardiac rehabilitation and/or diabetes education programmes. Healthy Eating and Exercise Lifestyle Program intervention included an active phase of two 1-hour group-based supervised structured exercise sessions every week for 4 months and four 90-minute group information and support sessions. The maintenance phase included one 90-minute group-based booster information session and three 15-minute goal-focused telephone follow-up calls over 8 months. Results: Participants had statistically significant reductions from baseline in weight, body mass index and waist circumference and improvements in exercise duration and capacity at 4 and 12 months. Time, self-efficacy, depressive symptoms and male gender were independent predictors for body mass index, waist and/or exercise duration (p < 0.05). Conclusion: The Healthy Eating and Exercise Lifestyle Program was an effective programme to achieve and sustain weight loss and increase exercise participation over 1 year. [ABSTRACT FROM AUTHOR]

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]

Background:Population-based epidemiological studies can contribute to the spectrum of research evidence regarding the potential role of the arts in improving health and well-being among older people. To date, these studies are uncommon. The aim of the current study was to investigate health-related factors associated with participation in creative hobbies in women aged in their eighties living in Australia.Method:Descriptive and regression analyses were performed on data from the Australian Longitudinal Study on Women's Health 2008 postal survey of women born 1921–1926 (n = 5470).Results:Creative hobbies were undertaken by 52.7% of the sample and positively associated with physical health (IADL), health-related quality of life (general health, social functioning) and other social and demographic indicators.Conclusion:The relationship between participation in creative hobbies and health in older women is likely to be complex and influenced by many factors including individual physical capacity and independence as well as access to art-making activities. [ABSTRACT FROM AUTHOR]

Background Back pain is an increasingly prevalent health concern amongst Australian women for which a wide range of treatment options are available, offered by biomedical, allied health and complementary and alternative medicine (CAM) providers. Although there is an emerging literature on patterns of provider utilisation, less is known about the reasons why women with back pain select their chosen practitioner. In this paper we explore the influences on back pain sufferers' decision-making about treatment seeking with practitioners for their most recent episode of back pain. Methods Drawing on 50 semi-structured interviews with women aged 60-65 years from the Australian Longitudinal Study on Women's Health (ALSWH) who have chronic back pain, we focus on the factors which influence their choice of practitioner. Analysis followed a framework approach to qualitative content analysis, augmented by NVivo 9 qualitative data analysis software. Key themes were identified and tested for rigour through inter-rater reliability and constant comparison. Results The women identified four predominant influences on their choice of practitioner for back pain: familiarity with treatment or experiences with individual practitioners; recommendations from social networks; geographical proximity of practitioners; and, qualifications and credentials of practitioners. The therapeutic approach or evidence-base of the practices being utilised was not reported by the women as central to their back pain treatment decision making. Conclusions Choice of practitioner appears to be unrelated to the therapeutic approaches, treatment practices or the scientific basis of therapeutic practices. Moreover, anecdotal lay reports of effectiveness and the 'treatment experience' may be more influential than formal qualifications in guiding women's choice of practitioner for their back pain. Further work is needed on the interpersonal, collective and subjective underpinnings of practitioner choice, particularly over time, in order to better understand why women utilise certain practitioners for back pain. [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]

Background: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. Objective: To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. Methods: Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the ‘1946-51 cohort’ of the Australian Longitudinal Study on Women’s Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. Results: In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. Conclusions: Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women’s access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in excess of AU$1.4billion, thus indicating the prominence of back pain as a major economic, social and health burden. [ABSTRACT FROM AUTHOR]

Background: Psychosocial factors are considered as risk factors for some chronic diseases. A paucity of research exists surrounding the role of perceived stress in arthritis onset. Purpose: Perceived stress as a risk factor for arthritis development was explored in an ageing cohort of Australian women. Methods: This study focused on 12,202 women from the 1946-1951 cohort who completed the Australian Longitudinal Study on Women's Health surveys in 2001, 2004 and 2007. Longitudinal associations were modelled, with and without a time lag. Results: Findings from the multivariate time lag modelling, excluding women with persistent joint pain, revealed that perceived stress predicted the onset of arthritis, with women experiencing minimal and moderate/high stress levels having a 1.7 and 2.4 times greater odds of developing arthritis 3 years later, respectively ( p's < 0.001). Conclusion: Chronically perceiving life as stressful is detrimental to future health. The findings provide support for perceived stress to be considered alongside other modifiable risk factors. [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]

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]

Aim: To explore how changed participation in painting pictures or playing a musical instrument is related to change in physical and mental health in older women. Method: Women enrolled in the 1921-1926 birth cohort of the Australian Longitudinal Study on Women's Health were surveyed in 2005 and 2008. Changed participation in painting pictures or playing a musical instrument was considered in relation to changes in social activity, social support, health status and health-related quality of life. Results: Data were available for 5058 women. Improvements in instrumental activities of daily living (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.0-1.2; P = 0.004) and role limitations due to emotional factors (OR 1.6, 95% CI 1.0-2.5; P = 0.002) were associated with starting participation. Decline in mental health-related quality of life (OR 4.1, 95% CI 2.3-7.2; P < 0.0001) was associated with stopping. Conclusion: Changed participation was associated with change in functional capacity and tied to emotional well-being. [ABSTRACT FROM AUTHOR]

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: 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]

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]

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]

Background: Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia. Methods: Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables. Results: Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005). Conclusions: In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas. [ABSTRACT FROM AUTHOR]

Aim: To identify factors associated with dentist consultation by older Australian women. Methods: Participants from the older cohort of the Australian Longitudinal Study on Women's Health which originally involved 12 432 older women. Results: The percentage of women who consulted a dentist in the years 1999, 2002 and 2005 were 35%, 36% and 37%, respectively. Women were more likely to consult with a dentist if they lived in urban areas (RR = 1.26; 95% CI: 1.21, 1.32), were non-smokers (RR = 1.38; 95% CI: 1.21, 157), did not have diabetes (RR = 1.16; 95% CI: 1.08, 1.25), had better physical health (RR = 1.02 (95% CI: 1.01, 1.02). Women were less likely to consult with a dentist if they found it difficult to live on their income (RR = 0.90; 95% CI: 085, 0.95). Conclusion: Access to dentists, cost of consultations and poor health appear to be significant factors influencing visits to a dentist by older Australian women. [ABSTRACT FROM AUTHOR]

Background: urinary incontinence carries major social burden and considerable costs for health care systems. Objective: the aim of this study was to investigate changes in continence status among a large cohort of older women, and to identify factors associated with incidence of incontinence in later life. Subjects: participants of the Australian Longitudinal Study of Women's Health (ALSWH), aged 70-75 years in 1996 and who have completed four health surveys over the past 10 years. Methods: continence status across four survey periods, spanning 9 years, were defined according to women's reports of `leaking urine' at each survey. Generalised estimating equation (GEE) models were used in longitudinal analyses of the factors associated with changing continence status over time. Results: this study presents longitudinal data on the prevalence and incidence of incontinence from a large cohort of older women, over 9 years of follow-up. Over this time, 14.6% (95% CI 13.9-15.3) of the women in the study who had previously reported leaking urine 'rarely' or 'never' developed incontinence, and 27,2% (95% CI 26.2%, 28.3%) of women participating in Survey 4 (S4) in 2005 reported leaking urine 'sometimes' or 'often' at that survey, with women being twice as likely to report incontinence at S4 as they were 6 years earlier. Longitudinal models demonstrated the association between incontinence and dementia (P < 0.001; OR = 2.34; 95% CI 1.64, 3.34), dissatisfaction with physical ability (P < 0.001; OR = 1.70; 95% CI 1.52, 1.89), falls to the ground (P<0.001; OR = 1.23; 95%CI 1.13, 1.33), BMI (P <0.001; OR = 2.18; 95% CI 1.70,2.80 for obese), constipation (P< 0.001; OR 1.46; 95% CI 1.34-1.58), urinary tract infection (P< 0.001; OR 2.07; 95% CI 1.89-2.28), history of prolapse (P⩽ 0.001; OR = 1.53; 95% CI 1.35, 1.74) and prolapse repair (P= 0.002; OR = 1.23; 95% CI 1.08, 1.40). Stroke (P= 0.01), parity (P= 0.017) and hysterectomy (P= 0.026) and number of visits to the general practitioner (P= 0.040) were less strongly associated with incontinence in the final longitudinal model. Incontinence was not significantly associated with area of residence (P = 0.344), education (P = 0.768), smoking (P = 0.055), diabetes (P = 0.072), attending support groups (P = 0.464) or attending social groups (P = 0.022). Conclusion: strong associations between BMI, dysuria and constipation indicate key opportunities to prevent incontinence among older women. [ABSTRACT FROM AUTHOR]

Aim: To assess the association between weight gain at different time periods during childhood and measures of adiposity in late adolescence.Methods: A population-based birth cohort carried out in Pelotas, a 320 000-inhabitant city in a relatively developed area in Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. Weight gain from 0-1, 1-2, 2-4 and 4-15 years were expressed as changes in weight-for-age Z-scores relative to the NCHS/WHO reference. In 2000, 79% (2250) of all males were located when enrolling at the national Army. Weight and height were assessed. Body composition indicators (fat mass/height(2), lean mass/height(2), fat mass/lean mass(2.3)) were estimated through bioimpedance. Analyses were adjusted for maternal and social factors, as well as for gestational age.Results: In the adjusted analyses, birthweight and weight gain in the first year of life were positively associated with attained height at age 18 years. Except for the fat mass/lean mass(2.3) ratio, all weight-related outcomes were positively associated with weight gain in different periods of life. Children who gained weight rapidly in more than one time period became fatter at age 18 years, independently of when fast growth took place.Conclusions: Height was primarily determined by fetal and infant growth. Weight-related indices, including the fat/lean mass ratio, were more strongly influenced by later growth. No clear critical windows of growth during which absolute tissue masses are programmed could be identified. [ABSTRACT FROM AUTHOR]

An abstract of the article "The Association Between Women's Choice of Birth Setting and Their Use of CAM During Labor and Birth" by Amie Steel, David Sibbritt, Jon Adams, Jane Frawley, Alex Broom and Cindy Gallois is presented.

Background Preconception is acknowledged globally as an important part of ensuring health for the next generation and is underpinned by principles of health promotion and preventive medicine. There is a demand for more holistic, preventive health care within preconception health services. Many women are also using complementary medicine during their reproductive years. Materials and Methods This paper presents a longitudinal analysis of women's consultations with a complementary medicine practitioner while attempting to become pregnant, and the characteristics of women who choose to consult a complementary medicine practitioner during the preconception period. The cross-sectional and longitudinal analyses conducted in this study utilise data from the 1973 through 1978 cohort of the Australian Longitudinal Study on Women's Health ( n = 13,224). Multivariate logistic regression models and generalized estimating equation models, with and without time lag, were used. Results Women who identified as attempting to conceive were more likely to consult with an acupuncturist (adjusted odds ratio, 1.46) or a naturopath/herbalist (adjusted odds ratio, 1.30). Women who consulted with an acupuncturist were likely to be consulting with a specialist doctor (odds ratio, 3.73) and/or have previous fertility issues (odds ratio, 2.30). Women who consulted with a naturopath were more likely to report experiencing premenstrual tension (odds ratio, 2.30) but less likely to have had a previous miscarriage (odds ratio, 0.18). Conclusions Policymakers and other health professionals need to be aware that health professionals who are largely unregulated and structurally isolated from conventional health care may be actively contributing to women's reproductive and physical health during the preconception period. [ABSTRACT FROM AUTHOR]

Background Recent research points to high levels of herbal medicine use during pregnancy. The objectives of this study were to elucidate the prevalence and understand the determinants of both the use and self-prescription of herbal medicine during pregnancy. Methods The study sample was obtained via the Australian Longitudinal Study on Women's Health. Women who were pregnant or who had recently given were invited to complete a subsurvey in 2010 about pregnancy, and complementary and alternative medicine use. Findings A response rate of 79.2% ( n = 1,835) was attained and 34.4% ( n = 588 of 1,835) of the sample were utilizing herbal medicine during pregnancy, of which 77.9% ( n = 458 of 588) were self-prescribing these products. The women in our study (aged 33–38) were more likely to use herbal medicine if they had anxiety (odds ratio [OR], 1.30; 95% CI, 1.02–1.64; p = .031), sleeping problems (OR, 1.55; 95% CI, 1.15–2.11; p = .005), or fatigue (OR, 1.32; 95% CI, 1.04–1.68; p = .025), but less likely to use herbal medicine if they had nausea (OR, 0.71; 95% CI, 0.56–0.91; p = .007). Women were more likely to self-prescribe herbal medicine if they suffered from varicose veins (OR, 2.46; 95% CI, 1.04–5.84; p = .041) and less likely to self-prescribe herbal medicine if they suffered from preeclampsia (OR, 0.23; 95% CI, 0.81–0.63; p = .005). Women who self-prescribed herbal medicine during pregnancy were also more likely to live in a rural environment (OR, 2.22; 95% CI, 1.32–3.73; p = .003). Conclusions Many Australian women are consuming herbal medicine during pregnancy. The self-prescription of herbal medicine by pregnant women is of particular concern owing to potential safety issues, and it is important that maternity health care providers have an open and nonjudgmental conversation with women about herbal medicine use during pregnancy. [ABSTRACT FROM AUTHOR]