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Background: Australians report consulting with a naturopaths or herbalists to improve their wellbeing, yet little is known about the associations between these consultations and the patients' health behaviours. This cross-sectional study aimed to examine the relationship between health behaviour and consultations with naturopaths or herbalists in three age cohorts of Australian women., Methods: Women aged 19-25 years, 31-36 years, and 62-67 years from the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behaviour; and whether they consulted with naturopath/herbalists in the last 12 months. Associations were analysed using multivariable logistic regression., Results: A total of 9151 (19-25 years), 8200 (31-36 years) and 11,344 (62-67 years) women were included in the analysis. Between 7.3 and 11.9% of women reported to have consulted with naturopaths/herbalists in the last 12 months. Women of all cohorts consulting with naturopath/herbalist were less likely to smoke (19-25 yrs.: Odds Ratio [OR] 0.61; 31-36 years: OR 0.58; 62-67 years: OR 0.29), more likely to report at least moderate levels of physical activity (19-25 yrs.: OR 1.41; 31-36 years: OR 1.34; 62-67 years: OR 1.34), and the use of vegetarian diets(19-25 yrs.: OR 1.40; 31-36 years: OR 1.77; 62-67 years: OR 2.28), compared to women not consulting with naturopaths/herbalists. Women consulting with naturopaths/herbalists however were also more likely to have used marijuana (19-25 yrs.: OR 1.18; 31-36 years: OR 1.42), or illicit drugs in the last 12 months (19-25 yrs.: OR 1.24; 31-36 years: OR 1.40)., Conclusions: Consultations with a naturopath or herbalist are associated with positive health behaviours that are protective of internationally important non-communicable diseases. Psychoactive drug use is also reported among women visiting a naturopath or herbalist. Further research is needed to understand the role naturopaths play in advising patients with regards to health and non-healthy behaviours.

Objective: Examine the generational differences in complementary medicine (CM) utilisation between young women from the X and Millennial generations., Design: Secondary analysis of two cross-sectional surveys from the Australian Longitudinal Study on Women's Health (ALSWH)., Setting: Australia., Main Outcome Measures: Differences between young Generation X women (surveyed 1996; aged 18-23 years), and Millennial women (surveyed 2014; aged 19-24 years) regarding consultations with CM practitioners, sociodemographic characteristics, and health. Predictors for CM consultations were analysed via logistic regression analyses., Results: Of the 14,247 Generation X women, 19.4% reported consulting CM, compared to 26.8% of the 11,344 Millennial women. CM consultations was predicted in both cohorts by higher age, education beyond primary school, non-urban (vs. urban) residence, and frequent back pain or headaches. Obesity and regular smoking predicted non-use in both. Significant cohort differences were found in physical activity levels (moderate/high levels associated with increased CM consultations in Millennial, but not Generation X women), and health status (Generation X women reporting fair-poor health were more likely to consult CM practitioners, while Millennial women reporting good health were less likely to do so, compared to women with very good/excellent health)., Conclusions: The increase in CM utilization among young Australian women from Generation X compared to the Millennial generation could indicate different health consumer patterns for future middle-aged and older adult Australian women. Further increases in CM usage may be observed as current young women age into characteristics traditionally linked with higher CM use such as worsening health status and increased disposable income., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Traditional Chinese Medicine has considerable public support in Australia and elsewhere around the world; the literature suggests Chinese medicine (CM) and acupuncture are particularly popular., Aim: To examine factors associated with CM/acupuncture use among young/middle-aged Australian women., Methods: This research formed part of the Australian Longitudinal Study on Women's Health (ALSWH), a population-based cohort study. Data were obtained from the 'young' (34-39 years; n=8010) and 'middle-aged' (62-67 years; n=9151) ALSWH cohorts, who completed survey 6 (in 2012) and survey 7 (in 2013), respectively. Outcome measures included use of CM and visits to an acupuncturist in the previous 12 months. Predictive factors included demographic characteristics, and measures of health status (diagnosed chronic medical conditions) and health service utilisation. Statistical analyses included bivariate χ 2 tests, two proportions Z-tests and backward stepwise multiple logistic regression modelling., Results: In total, 9.5% and 6.2% of women in the young and middle-aged cohorts, respectively, had consulted an acupuncturist, and 5.7% and 4.0%, respectively, had used CM. Young women with low iron levels and/or endometriosis were more likely to use CM and/or acupuncture. Middle-aged women with low iron levels and/or chronic fatigue syndrome (CFS) were more likely to use CM, while middle-aged women with arthritis and/or CFS were more likely to use acupuncture., Conclusions: Women with chronic conditions (including arthritis, low iron, CFS and endometriosis) were associated with higher odds of CM/acupuncture use. There is a need for further research to examine the potential benefits of CM/acupuncture for these chronic illnesses., Competing Interests: Competing interests: None declared. Participants consent: Obtained., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

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., (Copyright © 2016 Elsevier Inc. All rights reserved.)

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., (© 2015 John Wiley & Sons Ltd.)

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.

Background: The use of complementary and alternative medicine (CAM) is commonplace in Australia with massage being a popular CAM modality., Methods: This is a sub-study from the Australian Longitudinal Study on Women's Health (ALSWH). A total of 2120 mid-age (56-61 year old) women who consulted a CAM practitioner were invited to participate in this study. The Short-Form (SF-36) questionnaire was used to measure women's health-related quality of life., Results: A total of 1800 women returned the questionnaire generating a response rate of 85.0%. Overall, 912 (50.7%) women visited a massage therapist in the previous 12 months. Women with lower quality of life scores in terms of bodily pain (p = 0.012) and/or emotional health (p = 0.029) were more likely to consult a massage therapist than those with higher scores., Conclusion: The implications of these associations are important for informing healthcare providers in providing effective and coordinated care for patients with pain and mood symptoms., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

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.

Objectives: Yoga practice during pregnancy is gaining increasing popularity. This study examined the characteristics of pregnant women who practiced yoga in regard to the different locations (at home, in yoga classes, or both)., Design: The study sample was drawn from the Australian Longitudinal Study on Women's Health (ALSWH), a national longitudinal study of women to investigate multiple factors affecting health and well-being of women over a 20-year period., Setting: Postal survey., Participants: Women born between 1973 and 1978, who were randomly selected from the national Medicare database and identified as being pregnant or having recently given birth (n=2316)., Outcome Measures: Relationships between yoga use (attending yoga classes and/or practising yoga at home) and women's characteristics (demographic measures, pregnancy-related health concerns, health service utilisation, attitudes to complementary and alternative medicine)., Results: Practising yoga both at home and in classes was associated with perceiving complementary and alternative medicine (CAM) as preventative (odds ratio (OR)=1.62); perceiving CAM as affording health control (OR=1.50); experiencing sadness (OR=1.72); preparing for labour (OR=2.31); birthing in a birth centre (OR=7.97); and experiencing less vomiting (OR=0.38). Practising at home only was associated with perceiving CAM as affording health control (OR=1.76); perceiving CAM as promoting a holistic health approach (OR=1.65); and birthing in a birth centre (OR=3.54). Practising in classes only was associated with experiencing stress (OR=1.97); and birthing in a birth centre (OR=4.85) (all p<0.05)., Conclusions: The findings suggest that the location in which a woman practices yoga is associated with attitudinal, health-related and birth environmental factors., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

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.

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., (© The Author(s) 2013.)

Objective: To evaluate the relationship between diet quality score, as measured by the Australian Recommended Food Score (ARFS) and six-year weight gain in middle-aged Australian women., Methods: Participants were a sub-sample of women from the Australian Longitudinal Study on Women's Health (ALSWH) who were followed up from 2001 to 2007 (n= 7,155, aged 48 to 56 years). The ARFS was derived from responses to a sub-set of questions from a food frequency questionnaire, with possible scores ranging from 0 to 74 (maximum). Absolute weight gain was calculated from the difference in self-reported weight between 2001 and 2007. Linear regression was used to test the relationship between diet score and weight change., Results: On average, women gained weight during follow-up (1.6 ± 6.2 kg) and had a mean baseline ARFS of 32.6 (SD 8.7) which was not optimal. There was no association between ARFS and weight change during follow-up (β= 0.016; p=0.08) in the fully adjusted model that included total energy intake, education, area of residence, baseline weight, physical activity, smoking and menopause status., Conclusions: Weight gain and low ARFS were common. However, diet quality as measured by the ARFS did not predict six-year weight gain., Implications: This lack of association may be due to limitations related to AFRS, or may be a false negative finding. Further research is warranted to evaluate the impact of promoting optimal diet quality on weight gain prospectively., (© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.)

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.

This study aimed to examine the factors associated with Chinese medicine use amongst a sample of 10,287 Australian women aged 56-61 years. Data was obtained from a cross-sectional postal questionnaire conducted in 2007, this being the fifth survey of the Australian Longitudinal Study on Women's Health. This representative sample of 10,287 women was randomly selected from the Health Insurance Commission (Medicare) database. The outcome measure was the use of Chinese medicine in the previous 12 months. The predictive factors included demographics, health status measures and health service utilization measures. Statistical analyses included univariate chi-square and ANOVA tests and backward stepwise multiple logistic regression modelling. The use of Chinese medicine amongst women aged 56-61 years appears to be strongly influenced by their country of birth, consultation with a range of CAM practitioners, and the use of some self-prescribed CAM. Interestingly, severe tiredness was the only symptom or diagnosis that predicted Chinese medicine use. Given the substantial prevalence of Chinese medicine use and the finding that the use of Chinese medicine is heavily integrated alongside the use of many other CAM and conventional treatments, it is imperative for the safety of patients that health professionals (across complementary and conventional healthcare) fully recognise the possible Chinese medicine use amongst their practice populations. In order to help inform relevant practice and policy development it is also important that future research further examining women's decision-making, motivations and evaluations regarding Chinese medicine use considers such issues within the context of broader CAM and conventional health care utilization.

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., (© 2012 The Authors; Australasian Journal on Ageing © 2012 ACOTA.)

Background: Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors., Methods: A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009., Results: The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas., Conclusion: It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.

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

Objective: To identify minimum criteria to assist the prediction of decline in physical health-related quality of life in the elderly., Study Design and Setting: Participants were women from the Australian Longitudinal Study on Women's Health, who responded to three separate Surveys conducted in 1996 (when they were aged 70-75 years), 1999 and 2002. Using data from these Surveys, three categories were generated which described current physical health-related quality of life and future physical decline as measured by the physical component summary score (PCS) of the MOS SF-36 quality of life survey., Results: Bivariate analyses reported a large number of variables significantly associated with physical decline (P < 0.001), including age, falls, number of diagnoses, symptoms, doctor visits and medications, days spent in hospital, body mass index, living arrangements and social support. Multivariate analyses, using decision tree analysis, identified three items which accurately predicted 76% of the women who would exhibit physical decline according to our definition., Conclusions: This study identified a number of variables that may be useful in clinical screening for vulnerability to physical decline.

Background: Although an increase in the use of acupuncture in recent years has been identified, there are few studies that focus attention upon the characteristics of acupuncture users. This survey aimed at providing a first step towards addressing this significant research gap., Methods: This study was conducted as part of the Australian Longitudinal Study on Women's Health, and examined the characteristics of acupuncture users among middle aged Australian women between 50 and 55 years old. Data were collected on demographic measures, health status and health service use., Results: The paper reports on 11 202 middle aged women, surveyed in 2001. We estimate that 4.5% of middle aged women consult an acupuncturist. Women who consult an acupuncturist are less likely to be married or living in a de facto relationship, are more likely to have had a major personal illness in the previous year, to have suffered from a variety of symptoms or have significantly lower scores (ie poorer health) on all eight dimensions of the SF-36 health-related quality of life scale. Women who use acupuncture are also higher users of 'conventional' health services., Conclusions: While the development of a research base and clinical applications for acupuncture are ongoing, health professionals should be aware that acupuncture is currently being used by large numbers of middle aged women. In addition, given the relatively higher prevalence of acupuncture use reported in our study, it is important that further research explores acupuncture use in more detail and the relationship between women's health issues and their use and experience of acupuncture.

Purpose: The purpose of this study was to explore the relationship between oral contraceptive pill (OCP) use and the experience of depressive symptoms among a representative sample of young Australian women., Methods: The study sample comes from the Australian Longitudinal Study on Women's Health. Analysis was confined to women in the youngest cohort who responded to Survey 2, which was conducted in 2000 (n=9688) when they were aged between 22 and 27 years, and to Survey 3, which was conducted in 2003 (n=9081) when they were aged between 25 and 30 years., Results: After adjusting for potential confounders, the odds of a nonuser experiencing depressive symptoms is not significantly different from that of an OCP user [odds ratio=1.05; 95% confidence interval (95% CI)=0.90-1.21]. Women who used OCP for reasons other than contraception were 1.32 (95% CI=1.07-1.62) times as likely to be depressed than women who used OCP for contraception. The percentage of women who reported experiencing depressive symptoms declined as the number of years of OCP use increased (p=.009)., Conclusions: The results of this study suggest that, after adjusting for confounders, there is no independent effect of OCP use on depressive symptoms in young Australian women.

Background: Analyses of longitudinal health-related quality of life data often exclude participants who die, which limits the generalizability of the results. Methods to incorporate death as a valid score in the Medical Outcomes Study Short-Form (SF-36) have been suggested but need to be evaluated in other populations., Objectives: We sought to apply a method of transforming the SF-36 Physical Component Score (PCS) to include death. A transformation to estimate the probability of being "healthy" in 3 years, based on the current PCS value, will be developed and validated., Subjects: Women in the Australian Longitudinal Study on Women's Health (ALSWH), ages 70-75 years at Survey 1 in 1996 (n = 12,432), were followed-up at 3 yearly intervals for 6 years., Results: The transformation derived from the ALSWH data provides evidence that the methodology for transforming the PCS to account for deaths is sound. The 3-year equation provided good estimates of the probability of being healthy in 3 years and the method allowed deaths to be included in an analysis of changes in health over time., Conclusions: For longitudinal studies involving the SF-36 in which subjects have died, we support the recommendation that both the PCS and its transformed value which includes deaths should be analyzed to examine the influence of deaths on the study conclusions. Using study data to derive empirical parameters for the transformations may be appropriate for studies with follow-up intervals of other lengths.

Complementary and Alternative Medicine (CAM) has become increasingly popular amongst healthcare consumers world-wide. As such, CAM is now an important public health issue with 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. 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.

The use of complementary and alternative medicine (CAM) in the general population has grown considerably in recent years. However, little is known about the prevalence of CAM use amongst women with cancer. Our research provides the first step in addressing this gap in knowledge by reporting on a survey of 9375 Australian women aged 73-78. We found that, for all cancers combined, 14.5% of women with cancer consulted an alternative practitioner. This percentage varied depending on the type of cancer: skin (15.0%), breast (11.5), bowel (8.8%), and other (16.5%). Our findings suggest that CAM is now a significant practice issue for those delivering cancer-patient care and management.

Background: Pregnancy can be a stressful period for most women and their family members, and the mental wellbeing of pregnant women can face serious challenges. Social support can play a role in improving the psychological well-being of pregnant women by enhancing the stress coping ability and alleviating stressful conditions. The current study aimed to assess the mediating effects of social support in the relationship between perceived stress and depressive symptoms as well as anxiety symptoms during pregnancy among Australian women. Methods: Of the 8,010 women who completed Survey 6 of the 1973–78 Australian Longitudinal Study on Women's Health (ALSWH) cohort in 2012, those who reported being pregnant (n = 493) were included in the current analyses. Antenatal depressive and anxiety symptoms were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to examine social support. A parallel mediation model was used to explore the mediational role of each domain of social support between perceived stress and antenatal depressive and anxiety symptoms. Result: The study found that emotional/informational support has a partial mediating effect on the relationship between perceived stress and antenatal depressive symptoms (β = 0.371, 95% CI: 0.067, 0.799) and on the relationship between perceived stress and antenatal anxiety symptoms (β = 0.217, 95% CI: 0.029, 0.462). Affectionate support/positive social interaction and tangible support was found to play no significant mediation role between stress and antenatal depressive and anxiety symptoms. Conclusions: Emotional/informational support appears to play a mediating role in the relationship between stress and antenatal depressive as well as between stress and antenatal anxiety symptoms. In order to further protect pregnant women from the effects of stress, policy makers and maternal health professionals are advised to develop community-based social support programs to enhance prenatal psychosocial support and ensure pregnant women have adequate emotional/information support. Plain language summary: Social support is a resource or a means that an individual can use to cope with stressful events and improve psychological wellbeing. It improves emotional and physical well-being and promotes health for a successful pregnancy. However, the relationship between domains of social support and antenatal depressive and anxiety symptoms remains understudied in Australia. Therefore, our study intended to examine the mediating role of domains of social support in the linkage between stress and depressive and anxiety symptoms during pregnancy among Australian Women. Data were obtained from Survey 6 of the 1973–78 ALSWH cohort, which was conducted in 2012, and those who reported being pregnant were part of the study (n = 493, aged 34–39 years). Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOS-SSS-19 item). A parallel mediation model was used to explore the mediational role of each domain of social support between perceived stress and antenatal depressive and anxiety symptoms. Emotional/informational support plays a mediating role in the relationship between stress and antenatal depressive as well as between stress and antenatal anxiety symptoms. So, to further protect pregnant women from the effect of stress, policymakers and maternal health professionals are advised to develop community-based social support programs. [ABSTRACT FROM AUTHOR]

Objective: To test the association between sleeping problems and multiple epidemiological factors among women over 50 with a chronic condition. Method: The Medical Outcomes Study Sleep Scale (MOS-SS) was employed to measure sleep problems among 1,925 participants with chronic conditions who also responded to questions about health service use, self-care and demographics. Results: About 43% of women reported sleeping problems. Women were more likely to have a sleeping problem if they reported some difficulties with available income, odds ratio (OR) = 1.61; 95% confidence interval (CI): [1.27, 2.04]; p <.005, or were struggling with available income (OR = 2.84; 95% CI: [2.04, 3.96]; p <.005). Women were less likely to have sleeping problems if they were highly physically active (OR =.63; 95% CI: [0.51, 0.79]; p <.005). Discussion: Medical professionals should be aware of the significant risk of sleeping problems among mid-age and older women with chronic health conditions, particularly those who have financial concerns, are sedentary, or are not highly physically active. [ABSTRACT FROM AUTHOR]

Abstract Background and purpose Yoga and meditation are predominantly utilised by healthy well-educated young women, but little is known about utilisation by older chronically ill women. Therefore, the purpose of this study was to investigate the characteristics of yoga and meditation use among middle-to-higher aged Australian women with chronic conditions. Materials and methods This is a sub-study of the 45 and Up Study including 1925 Australian women aged 53–95 years diagnosed with chronic conditions (asthma, depression, diabetes, osteoarthritis, and osteoporosis). Information on yoga and meditation use frequencies (categories: 'no yoga', 'at least once daily', 'at least once weekly', and 'at least once monthly'), self-perceived effectiveness and communication with health care providers were assessed via self-report. Logistic regression analyses were conducted to identify independent predictors of yoga and meditation use, using SPSS 24.0. Results Overall 6.8% and 10.7% of women reported the use of yoga and meditation respectively. Meditation was rarely practiced supervised (11.7%), compared to significant higher rates in yoga (53.2%). Predictors for yoga and meditation use were marital status (married/in relationship > not married/in relationship), higher health related hardiness, and higher education, whereas obesity, and diabetes decreased likelihood of use. While the majority found yoga and meditation helpful for their condition, the use was rarely monitored by or discussed with health care practitioners. Conclusion This study finds that yoga and meditation are used by middle-to-higher aged Australian women with chronic illnesses. The lack of communication with health care providers is concerning and might hinder coordinated and effective health care around chronic illness. Further research is necessary to help understand possible concurrent health care use and thereby help inform safe, effective and coordinate health seeking amongst those with chronic illness. Highlights • Yoga and meditation are used by middle-to-older aged Australian women with chronic illnesses. • Older women using yoga or meditation rarely communicate this with their health care providers. • High levels of health hardiness are associated with higher use of yoga and meditation. [ABSTRACT FROM AUTHOR]

Introduction: Complementary medicine (CM) use has been found to influence the uptake of conventional cancer treatment. This study examines associations between CM use and cancer screening rates. Methods: Women aged 62 to 67 years from the Australian Longitudinal Study on Women’s Health were surveyed regarding their use of cancer screening initiatives. Associations between cancer screening behavior and visits to CM practitioners were analyzed. Results: Of the 9151 women, 9049 (98.9%) completed questions about cancer screening. A total of 65.1% of women had received a clinical skin examination, 54.3% colorectal cancer screening, 56.2% Pap test (within past 2 years), 83.3% mammogram (within past 2 years), 55.8% clinical breast examination, and 55.8% had conducted breast self-examination. Women who had consulted a massage therapist were more likely to undergo clinical skin examination (P = .002), clinical breast examination (P = .018), and mammogram (P = .001). Women who had consulted a chiropractor were more likely to undergo a clinical skin examination (P = .001), colorectal cancer screening (P = .020), and mammogram (P = .011). Women who had consulted an acupuncturist were more likely to undergo colorectal cancer screening (P = .019), and those who consulted with an osteopath were more liable to have a Pap test (P = .049). Conclusion: Women who visit CM practitioners are more likely to participate in cancer screening initiatives. Research is required to understand the current and potential role that CM practitioners (can) have as public health advocates, recommending preventative health measures such as cancer screening. Such an examination will help ensure optimal screening utilization and effective, timely care for all cancer patients. [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]

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]

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]

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: 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]

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]

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]

Summary: Objective: To determine the characteristics of yoga and meditation users and non-users amongst young and mid-aged Australian women. Design and setting: The research was conducted as part of the Australian Longitudinal Study on Women''s Health (ALSWH) which was designed to investigate multiple factors affecting the health and well being of women over a 20-year period. Participants: The younger (28–33 years) (n =8885) and mid-aged (56–61 years) (n =10,324) cohorts of the ALSWH who completed Survey 5 in 2006 and 2007 respectively. Main outcome measure: Use of yoga. Results: This study estimates that 35% of Australian women aged 28–33 and 27% of Australian women aged 56–61 use yoga or meditation. Younger women with back pain (OR=1.28; 95% CI: 1.08, 1.52) and allergies (OR=1.25; 95% CI: 1.06, 1.49) were more likely to use yoga or meditation, while younger women with migraines or headaches (OR=0.73; 95% CI: 0.62, 0.87) were less likely to use yoga or meditation. Mid-age women with low iron (OR=1.68; 95% CI: 1.29, 2.19) and bowel problems (OR=1.37; 95% CI: 1.13, 1.65) were more likely to use yoga or meditation, while mid age women with hypertension (OR=0.62; 95% CI: 0.52, 0.76) were less likely to use yoga or meditation. Conclusion: A large percentage of the female population are using yoga or meditation. Given that women who regularly use yoga or meditation positively associated with measures of mental and physical health, there is a need for further research to examine the experiences and potential benefits of these mind-body practices for women''s health. [Copyright &y& Elsevier]

Back problems and back pain are amongst the most prevalent conditions afflicting Australians and carry high direct and indirect costs for the health care systems of all developed countries. A major gap in the research literature on this topic is the longitudinal analysis of health seeking behaviour for people with back pain. All studies to date have been cross-sectional and it is important that the use of different providers (both conventional and complementary and alternative medicine, CAM) is examined over time. This study analysed data from a longitudinal study conducted over a 3-year period on 8,910 young Australian women. Information on health service use, self-prescribed treatments, and health status was obtained from two questionnaires mailed to study participants in 2003 and 2006. We found that there is little difference in the consultation practises or use of self-prescribed CAM between women who recently sought help for back pain and women who had longer-term back pain; the only difference being that women with longer-term back pain consulted more with chiropractors. We conclude that women who seek help for their back pain are frequent visitors to a range of conventional and CAM practitioners and are also high users of self-prescribed CAM treatments. The frequent use of a range of conventional providers and practitioner-based and self-prescribed CAM amongst women with back pain warrants further investigation. [ABSTRACT FROM AUTHOR]

Globally, depressive disorders affect over 311 million people and women are more likely than men to suffer depression. However, no study has comprehensively described the diverse health services used for managing depression in middle-aged and older women. A cross-sectional survey was sent to 800 Australian women aged over 45-years reporting a diagnosis of depression, (a sub-study of the 45 and Up Study) in 2016. The survey measured consultations with conventional, allied, and complementary health practitioners, and use of medications and complementary health products/practices for depression, and the associated out-of-pocket expenses. Of the 361 (45.1%) participants returning a completed questionnaire, most women (72.2%) consulted at least one health practitioner, while 40.7% used at least one prescription medication and 51.8% used at least one form of complementary product or practice for depression in the previous 12 months. Women with more severe self-reported depression were more likely to consult with doctors and allied health practitioners, and use prescription medications and multiple complementary health products/practices. Combined integrative health out-of-pocket expenditure on depression management by the women in our study was $568.0 per annum, equating to approximately AU$367 million per annum for Australian women aged 50 years and over. Middle-aged and older Australian women were high users of integrative health services for the management of depression. Women with depression have an additional financial burden associated with their mental health services requiring consideration by primary health practitioners when recommending treatments for depression. [ABSTRACT FROM AUTHOR]

The article presents a research on the prevalence and characteristics of older Australian women who had consulted a dentist. Women, who were randomly selected from the Medicare database, were asked about consulting a dentist, demographic characteristics, smoking history, and medical history. Results of this research show that 35% of Australian women aged 73-78 years consult a dentist within a year.

Depression is a common comorbidity in patients with cardiovascular conditions. This study aims to assess the association between comorbid depression and health-promoting behavior in middle-aged and older Australian women with hypertension or heart disease. Data are from a subset of 45 and Up Study participants with diagnosed chronic illness (n = 1,925). Health behaviors including smoking status, alcohol consumption, and physical activity were assessed. Associations of depression with health behaviors in women with hypertension or heart disease were analyzed using unadjusted and adjusted (for chronic conditions and demographic measures) logistic regression models. A total of 666 women with hypertension and 220 women with heart disease were included in the analysis. In adjusted analyses, women with hypertension and comorbid depression were 2.36 (95% confidence interval, 1.02–5.46) times more likely to be risky or high-risk drinkers and 55% (adjusted odds ratio, 0.45; 95% confidence interval, 0.27–0.73) less likely to be highly physically active, compared with women without depression. Women with heart disease and comorbid depression were 65% (adjusted odds ratio, 0.35; 95% confidence interval, 0.12–0.95) less likely to be highly physically active, compared with women without depression. This study provides the first data indicating that depression may be a barrier to health-promoting behavior in middle-aged and older women with hypertension or heart disease. Given that physical inactivity and risky alcohol consumption are important risk factors for aggravation of cardiologic conditions, health-promoting behaviors should be specifically targeted in the treatment of women with comorbid depression. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the impact of physical activity on depression symptom severity in women 45 years and older with a chronic illness diagnosis, and explore relations between physical activity and psychological and health-related characteristics predicting depression symptoms.Methods: 1932 women diagnosed with one of five chronic illnesses: asthma, depression, diabetes, osteoarthritis, or osteoporosis participated in a sub-study of the 45 and Up Study-a cross-sectional study of people aged 45 years and older. The survey included items measuring demographics, depression symptoms, health-related quality of life (HRQoL), health-related hardiness, sleep quality, and health behaviours, such as physical activity.Results: A multiple regression model explained 43% of the variance in depression symptoms (R2 = 0.43, F (18) = 61.72, p < .001); intensity of physical activity was a significant predictor of depression symptoms (p < .001), and HRQoL was found to explain the most variance (B = -10.00) in depression symptoms. Mediation analysis confirmed that HRQoL partially mediated the relation between physical activity and depression symptoms; however, the effect was very small.Limitations: Cross-sectional data and self-report measures limit the implications of the findings.Conclusion: Women with chronic illness engaging in more vigorous physical activity had less severe depression symptoms. Findings suggest that improving HRQoL is critical to the prevention and management of depression symptoms in women with chronic illness. Psychological and health-related factors that influence HRQoL, such as sleep quality and health-related hardiness, are important clinical considerations for health practitioners. [ABSTRACT FROM AUTHOR]

Abstract: This article explores why women in rural and remote areas of Australia use complementary and alternative medicine (CAM) at higher rates than their counterparts in urban areas. Drawing on qualitative interviews with 60 women 60–65 years of age, currently living in rural Australia, we explore the possibility that CAM use in rural areas may be embedded in processes of spatialised identity-building and the health-creating practices of mobile, ex-urban, individuals who drive this process. We problematise previous explanations which suggest CAM use in rural areas is principally derived from a lack of biomedical service provision and enhanced community ties showing instead how and why identity and mobility are useful additional variables for understanding CAM use in rural areas. [Copyright &y& Elsevier]

Large population-based studies of complementary and alternative medicine (CAM) and conventional medicine use amongst menopausal women are lacking. This study helps address this gap by analysing data from a nationally representative sample of 10 011 Australian women aged 59–64 years. Overall, 39% of menopausal women consulted CAM practitioners, 75% used self-prescribed CAM, 95% consulted general practitioners (GP) and 50% consulted specialists during the previous year, and 12% were current hormone replacement therapy (HRT) users. Our findings suggest that CAM is a significant healthcare option utilized by women to treat menopausal symptoms, and so requires attention from GPs and specialists. [ABSTRACT FROM AUTHOR]