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Australian Women (australian + woman)
Kinds of Australian Women Selected AbstractsGender and Drought: Experiences of Australian Women in the Drought of the 1990sDISASTERS, Issue 1 2000Daniela Stehlik A unique collaborative, sociological study undertaken during 1995,7, explored the social construction of drought as a disaster, with farm families in two Australian states: Queensland (beef producers) and New South Wales (sheep/wheat producers). A decision was made to interview the women and men separately to test our hypothesis that there would be gender issues in any analysis of a disaster, but particularly one which has such a long-term impact on individuals, families and communities, such as drought. Interviews were conducted with over 100 individuals male and female. We conclude that drought as a disaster is a gendered experience. The paper draws on the narratives of some women involved in the study to identify ,themes of difference' which confirm the necessity to maintain gender as a variable in all studies of the social impacts of disaster. [source] "Seeing the Baby": Pleasures and Dilemmas of Ultrasound Technologies for Primiparous Australian WomenMEDICAL ANTHROPOLOGY QUARTERLY, Issue 1 2004Gillian Harris The practice of obstetric ultrasound scans has undergone significant expansion in the last two decades and is now a standard part of many women's antenatal care in Australia as elsewhere. This article reviews recent evidence about the value of obstetric ultrasound, summarizing debates and contradictions in research literature and practitioner guidelines. Pregnant women's interpretations of the significance of ultrasound are examined through multiple interviews with 34 study participants. We find that ultrasound has become an integral part of women's embodied experience of pregnancy, with its own pleasures and dilemmas. The increasing use the technology has augmented the role of scientific biomedicine in the government of pregnancy. This must be understood in the light of trends toward individualized risk management in which the pregnant woman increasingly takes responsibility for the successful outcome of the pregnancy, in a context where pregnancy is discursively constructed as a risky domain of gendered experience in contemporary Australian society, [discourse, obstetric ultrasound, embodiment, pregnancy, feminist] [source] ,I'm living with a chronic illness, not . . . dying with cancer': a qualitative study of Australian women's self-identified concerns and needs following primary treatment for breast cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2008M. OXLAD m.psych, research assistant This study aimed to identify the current concerns and needs of Australian women who had recently completed primary treatment for breast cancer in order to develop a workbook-journal for this population. Focus groups were utilized to allow women to use their own frames of reference, and to identify and verbalize the topics that were important to them following treatment. All focus groups were conducted in a patient education and relaxation room, familiar to the women to assist them to feel more at ease. Ten women aged 36,68 years who had recently completed treatment for early-stage breast cancer at a South Australian public hospital took part in one of three focus groups. Topics covered included current physical, emotional and social needs. Participants reported a sense of apprehension about the future at the completion of primary treatment. In addition to this, five specific areas of concern were identified including physical sequelae of treatment, intimacy issues, fear of recurrence, benefit finding, and optimism versus pessimism about the future. Means of addressing post-treatment concerns were also discussed. Following the presentation of these findings, suggestions to aid health-care professionals in their clinical practice are provided. [source] Comprehensive measurement of maternal satisfaction: The modified Mason SurveyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2002Maree Johnson RN A three-stage process was undertaken to identify and modify a tool that was capable of measuring the many aspects of maternal satisfaction relevant to Australian women. First, the scope of maternal satisfaction to be measured was defined by summarizing available literature and surveys purporting to measure maternal satisfaction (including surveys used in maternity services in New South Wales). The multidimensional nature of maternal satisfaction was confirmed, with 16 core aspects (common to the literature and local surveys) and nine additional unique aspects of maternal satisfaction being identified. Second, these core and additional aspects were used to examine the comprehensiveness of the Mason Survey, a survey recommended by the National Health and Medical Research Council of Australia for use in maternity services. Eighty-eight per cent of the core and additional aspects (22/25) were found to be present in the Mason Survey. Third, an expert panel further modified the Mason Survey by removing items not applicable to the Australian context. The modified Mason Survey is a comprehensive measure of maternal satisfaction suitable for Australian women and capable of providing valuable information on the quality of services and future planning for maternity services. [source] Human papillomavirus genotypes and their association with cervical neoplasia in a cohort of Western Australian womenJOURNAL OF MEDICAL VIROLOGY, Issue 1 2005Brian Brestovac Abstract Human papillomavirus (HPV) is known to be the cause of almost all cervical cancers. The genotypes have been classified into high and low risk types according to their oncogenic potential. However, data for many of the genotypes are limited and some (HPV-26, 53, and 66) have no agreed status. A study was undertaken to determine the HPV genotype distribution in women of Western Australia and the association with cervical neoplasia. Liquid based cervical samples from a cohort of 282 Western Australian women were tested for HPV DNA by PCR followed by DNA sequencing to determine HPV genotypes. HPV-53 and HPV-16 were the most common genotypes found in this population. In addition 86 archived liquid based cervical samples from women with cervical intraepithelial neoplasia grades 1,3 (CIN 1,3) were tested for HPV DNA. Also 32 archived paraffin biopsy samples from women with squamous cell carcinoma were also tested. HPV-16 was the most common genotype found in these samples. Of the cohort of Western Australian women tested, 27% were found to contain HPV and approximately half of these contained known high-risk HPV genotypes, but only 30% of these were types 16 or 18. The data from this study indicate that HPV-53 is not oncogenic based on an R value and odds ratio (OR) of zero. The data also suggest that HPV-73 may be oncogenic, while HPV-66 is unlikely to be. Two high-risk HPV genotypes that are associated with the Asian region (HPV-52 and HPV-58) were found in Western Australian women suggesting a possible epidemiological link between women in these countries. J. Med. Virol. 76:106,110, 2005. © 2005 Wiley-Liss, Inc. [source] Urinary incontinence across the lifespanNEUROUROLOGY AND URODYNAMICS, Issue 6 2003Yvette D. Miller Abstract Aims The objectives of the current study were (1) to measure type and severity of urinary leakage and (2) to investigate the association between these factors and age-related life events and conditions in three groups of Australian women with a history of urinary leakage. Methods Five hundred participants were randomly selected from women in the young (aged 18,22 in 1996), mid-age (45,50), and older (70,75) cohorts of the Australian Longitudinal Study of Women's Health (ALSWH) who had reported leaking urine in the 1996 baseline survey. Details about leaking urine (frequency, severity, situations) and associated factors (pregnancy, childbirth, body mass index [BMI]) were sought through self-report mailed follow-up surveys in 1999. Results & Conclusions Response rates were 50, 83, and 80% in the young, mid-age, and older women, respectively. Most women confirmed that they had leaked urine in the past month, and the majority of these were cases of "mixed" incontinence. Incontinence severity tended to increase with BMI for women of all ages, and increased severity scores were associated with having urine that burns or stings. Additional independent risk factors for increasing incontinence severity were heavy smoking in young women, past or present use of hormone replacement therapy in older women, and BMI and history of hysterectomy in mid-age women. Neurourol. Urodynam. 22:550,557, 2003. © 2003 Wiley-Liss, Inc. [source] Changes in utilisation of hormone replacement therapy in Australia following publication of the findings of the Women's Health Initiative,,§PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2008Penelope Main BSc (Hons) MA MMedSc (Clin Epi) Abstract Purpose To examine the impact of publication of the findings of the Women's Health Initiative (WHI) on the utilisation of hormone replacement therapy (HRT) in Australia with particular reference to the influence that media may have had on prescriber and consumer behaviour. Methods Retrospective data from the Australian Government Department of Health, Ageing DUSC Database and media hits from Factiva were reviewed to obtain prescription numbers, total cost and cost to the pharmaceutical benefits scheme and number of media hits from the year before publication of the combined HRT arm of the WHI. Results Prescribing of HRT products decreased significantly immediately following publication of the combined HRT arm of the WHI and continued to decline at a slower rate following publication of the memory and oestrogen only arms of the study. Conclusions These results represent a more accurate national estimate of the change in HRT use in Australian women relative to previous findings from surveys carried out in Australia. Copyright © 2008 John Wiley & Sons, Ltd. [source] Body frame dimensions are related to obesity and fatness: Lean trunk size, skinfolds, and body mass indexAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010Maciej Henneberg We explore relationships between BMI and skinfolds and anthropometric variables reflecting variation in lean body frame. Data on the middle class adult Australian women (n = 1260) collected in 2002 during a National Body Size and Shape Survey were used. Standard measurements of stature, weight, skeletal dimensions (shoulder width, hip width, chest width, and depth, limb lengths), circumferences of head, trunk, limbs and triceps, subscapular and abdominal skinfolds were taken. Techniques for measurements of skeletal frame minimized the inclusion of adipose tissue thickness. Analysis of variance and parametric and nonparametric correlations were used. Vertical dimensions show weak correlations with fatness, while body frame circumferences and transverse dimensions are consistently, significantly, and substantially correlated with fatness, each explaining from 3 to 44% of variation in skinfold thickness. Skeletal dimensions explain up to 50% of variation in skinfold thickness (multiple regression). Especially high correlations with skinfold thickness occur for chest width, depth, and hip width (r range from 0.42 to 0.66). Body frame dimensions reflect largely trunk volume and the trunk/limb proportions. Larger lean trunk size is associated with greater fatness. Since the size of the abdominal cavity, and thus the gastrointestinal system (GI), is reflected in the trunk size, we speculate that larger frame may predispose to obesity in two ways: (1) larger stomachs require greater bulk of food to produce feeling of satiety as mediated through antral distension, (2) larger GIs may absorb more nutrients. Frame size may help to detect the risk of obesity among young adults. Am. J. Hum. Biol. 2010. © 2009 Wiley-Liss, Inc. [source] Complementary medicine use by Australian women with gynaecological cancerPSYCHO-ONCOLOGY, Issue 3 2006Milica Markovic Abstract Aims and objectives: Social and cultural factors are identified that impact on complementary therapy use among Australia-born and immigrant women diagnosed with gynaecological cancer. Methods: A qualitative study design including in-depth interviews with women diagnosed with gynaecological cancer (N=53) and participant observation was conducted. Results: Approximately one-third of women utilized complementary and alternative medicine, with this being determined by current health concerns and health beliefs related to the efficacy of different modalities. Four types of complementary therapy users emerged: consequential, therapeutic, informed and exploratory. Conclusion: There was a relatively low uptake of complementary treatments. Choice was influenced by women's socio-demographic background, clinical and personal history, lack of personal experiences of gynaecological cancer among study participants' kin and friends, and lack of popular alternative literature on such cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] An interactive process model of psychosocial support needs for women living with breast cancer,PSYCHO-ONCOLOGY, Issue 4 2003Beth Marlow Psychosocial support is acknowledged as an important aspect of the care and recovery process for women diagnosed with breast cancer. To develop an understanding of support needs, a series of focus groups were conducted with a total of 80 Australian women living with breast cancer. The psychosocial needs identified in discussion were summarised into four main categories, Organisation of Care, Sense of Control, Validation of Experience and Feeling of Reassurance. From these themes an interactive model of psychosocial support needs was developed. As a process model it demonstrates that the provision of effective support is, necessarily, an integrated, not a piecemeal, process. The categories of support are broad, and are made more inclusive through interactions with each other, providing room to accommodate individual needs and styles of adjustment. The model is not esoteric or complicated , it is an accessible overview of the process for both client and helper. Copyright © 2003 John Wiley & Sons, Ltd. [source] Older Australian women's use of dentists: A longitudinal analysis over 6 yearsAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2010David W Sibbritt 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. [source] Assessment of the abbreviated Duke Social Support Index in a cohort of older Australian womenAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2004Jennifer R Powers Objectives: To assess the acceptability, reliability and validity of the 11-item Duke Social Support Index (DSSI) in community-dwelling older Australian women, and to describe its relationship with the women's sociodemographic and health characteristics. Methods: Women aged 70,75 years were randomly selected from the national Medicare database, with over-sampling of rural and remote areas. The mailed survey included items about social support, Medical Outcomes Study Short Form Health Survey (SF-36), health service use, recent life events and sociodemographics. Results: All DSSI items were completed by 94% of the 12 939 participants. Internal reliability was reasonable for 10 of the 11 DSSI items and its factors, social interaction (four items) and satisfaction with social support (six items; Cronbach's alpha of 0.8, 0.6, 0.8). The factor structure was consistent for subgroups of women: urban/non-urban; English speaking/non-English speaking background; married/widowed. Summed scores were highly correlated with factor scores and showed good construct validity. Higher social support was associated with better physical and mental health, being Australian born, more educated and better able to manage on income. Conclusion: Ten of the 11 DSSI items provided an acceptable, brief and valid measure of social support for use in mailed surveys to community-dwelling older women. [source] Postnatal testing for diabetes in Australian women following gestational diabetes mellitusAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Melinda K. MORRISON Background:, Postnatal blood glucose testing is recommended for reclassification of glucose tolerance following a pregnancy affected by gestational diabetes mellitus (GDM); however, there are limited data on the postnatal follow-up sought by Australian women. Aims:, To describe postnatal diabetes testing patterns in Australian women following a pregnancy affected by GDM and identify factors associated with return for follow-up testing in accordance with the Australasian Diabetes in Pregnancy Society (ADIPS) guidelines. Methods:, A cross-sectional self-administered survey of 1372 women diagnosed with GDM between 2003 and 2005, sampled from the National Diabetes Services Scheme database. Results:, Postnatal diabetes testing was reported by 73.2% of survey respondents with 27.4% returning for an oral glucose test tolerance at six to eight weeks post-GDM pregnancy. Using logistic regression analysis, factors associated with appropriate postnatal testing were receiving individualised risk reduction advice (odds ratio (OR) 1.41 (1.08,1.84)) or written information (OR 1.35 (1.03,1.76)) and in two-way interactions, being under the care of an endocrinologist and not tertiary educated (OR 2.09 (1.49,2.93)) as well as seeing an obstetrician and diabetes educator during pregnancy (OR 1.72 (1.19,2.48)). Every five years increase in age reduced the likelihood of a woman returning for testing by 17%. Conclusions:, Specialist diabetes care in non-tertiary educated women, or a team approach to management with diabetes education and obstetric care may act to reinforce the need for postnatal diabetes testing in accordance with the ADIPS guidelines. Individualised follow up from a health professional and provision of written information following a GDM pregnancy may also encourage return for postnatal testing in this high-risk group. [source] Contraception and pregnancy then and now: Examining the experiences of a cohort of mid-age Australian womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Christine READ Background: More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. Aim: To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. Method: One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. Results: Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an ,accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. Conclusions: While surveys indicate that 66,70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations. [source] Demographic variables routinely collected at colposcopic examination do not predict who will default from conservative management of cervical intraepithelial neoplasia IAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2005Julie A. QUINLIVAN Abstract Objective:, As a result of the low incidence of progression from low grade epithelial abnormalities to cervical intraepithelial neoplasia (CIN) 3 or cervical cancer, a conservative approach to management is supported, especially in young women. Loss to follow-up is a recognised problem with a conservative approach however, with women defaulting known to experience higher rates of cancer. Aim:, To determine if any routinely collected demographic variables could predict which Australian women would subsequently default from care having initially elected to have conservative management of CIN 1 lesions. Methods:, Prospectively collected data was audited on 279 women with a colposcopically directed biopsy diagnosis of CIN 1, confirmed on external review, who were enroled by their own choice into a conservative management program and monitored until a definitive lesion outcome was determined. Women who defaulted from follow-up and were lost to care providers despite follow-up appointments and reminder letters were compared to women who completed follow-up with either lesion resolution or progression requiring treatment, to establish if there were any demographic variables to predict default from care. Results:, Fifty-two (18.5%) women subsequently defaulted from follow-up. There were no significant differences in age, parity, proportion of women who were pregnant at diagnosis, smoking status, immunosuppressed or had a ,human papillomavirus (HPV) effect' reported on Pap-smear or colposcopic examination. Conclusion:, We cannot easily identify a subgroup of women who are more likely to default from follow-up of CIN 1 using routinely collected demographic data. Default from follow-up is a major risk with conservative approaches and further research to reduce default rates are required. [source] Urinary sodium excretion, dietary sources of sodium intake and knowledge and practices around salt use in a group of healthy Australian womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2010Karen Charlton Abstract Objective: Strategies that aim to facilitate reduction of the salt content of foods in Australia are hampered by sparse and outdated data on habitual salt intakes. This study assessed habitual sodium intake through urinary excretion analyses, and identified food sources of dietary sodium, as well as knowledge and practices related to salt use in healthy women. Methods: Cross-sectional, convenient sample of 76 women aged 20 to 55 years, Wollongong, NSW. Data included a 24 hour urine sample, three-day food diary and a self-administered questionnaire. Results: Mean Na excretion equated to a NaCl (salt) intake of 6.41 (SD=2.61) g/day; 43% had values <6 g/day. Food groups contributing to dietary sodium were: bread and cereals (27%); dressings/sauces (20%); meat/egg-based dishes (18%); snacks/desserts/extras (11%); and milk and dairy products (11%). Approximately half the sample reported using salt in cooking or at the table. Dietary practices reflected a high awareness of salt-related health issues and a good knowledge of food sources of sodium. Conclusion: These findings from a sample of healthy women in the Illawarra indicate that dietary sodium intakes are lower in this group than previously reported in Australia. However, personal food choices and high levels of awareness of the salt reduction messages are not enough to achieve more stringent dietary targets of <4 g salt per day. Implications: Urinary Na excretion data are required from a larger nationally representative sample to confirm habitual salt intakes. The bread and cereals food group are an obvious target for sodium reduction strategies in manufactured foods. [source] Socio-economic status and survival from breast cancer for young, Australian, urban womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010Katherine I. Morley Abstract Objective: To estimate the association between measures of socio-economic status (SES) and breast cancer (BC) survival for young, urban Australian women. Methods: We used a population-based sample of 1,029 women followed prospectively for a median of 7.9 years. SES was defined by education and area of residence. Hazard ratios (HRs) associated with SES measures were estimated for (i) distant recurrence (DR) and (ii) all-cause mortality as end-points. Results: HRs for area of residence were not significantly different from unity, with or without adjustment for age at diagnosis and education level. The univariable HR estimate of DR for women with university education compared with women with incomplete high school education was 1.51 (95% CI = 1.08 , 2.13, p = 0.02), which reduced to 1.20 (95% CI = 0.85 , 1.72, p = 0.3) after adjusting for age at diagnosis and area of residence. Adjusting for prognostic factors differentially distributed across SES groups did not substantially alter the association between survival and SES. Conclusions: Among young, urban Australian women there is no association between SES and BC survival. Implications: This lack of estimates of association may be partly attributed to universal access to adequate breast cancer care in urban areas. [source] Infertility in Australia circa 1980: an historical population perspective on the uptake of fertility treatment by Australian women born in 1946-51AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Danielle L. Herbert Abstract Objective: To estimate the prevalence of lifetime infertility in Australian women born in 1946-51 and examine their uptake of treatment. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1946-51 (n=13,715) completed up to four mailed surveys from 1996 to 2004. The odds of infertility were estimated using logistic regression with adjustment for socio-demographic and reproductive factors. Results: Among participants, 92.1% had been pregnant. For women who had been pregnant (n=12738): 56.5% had at least one birth but no pregnancy loss (miscarriage and/or termination); 39.9% experienced both birth and loss; and 3.6% had a loss only. The lifetime prevalence of infertility was 11.0%. Among women who reported infertility (n=1511), 41.7% used treatment. Women had higher odds of infertility when they had reproductive histories of losses only (OR range 9.0-43.5) or had never been pregnant (OR=15.7, 95%CI 11.8-20.8); and higher odds for treatment: losses only (OR range 2.5-9.8); or never pregnant (1.96, 1.28-3.00). Women who delayed their first birth until aged 30+ years had higher odds of treatment (OR range 3.2-4.3). Conclusions: About one in ten women experienced infertility and almost half used some form of treatment, especially those attempting pregnancy after 1980. Older first time mothers had an increased uptake of treatment as assisted reproductive technologies (ART) developed. Implications: This study provided evidence of the early uptake of treatment prior to 1979 when the national register of invasive ART was developed and later uptake prior to 1998 when data on non-invasive ART were first collected. [source] Is inequity undermining Australia's ,universal' health care system?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Socio-economic inequalities in the use of specialist medical, non-medical ambulatory health care Abstract Objectives: To quantify need-adjusted socio-economic inequalities in medical and non-medical ambulatory health care in Australia and to examine the effects of specific interventions, namely concession cards and private health insurance (PHI), on equity. Methods: We used data from a 2004 survey of 10,905 Australian women aged 53 to 58 years. We modelled the association between socio-economic status and health service use , GPs, specialists, hospital doctors, allied and alternative health practitioners, and dentists , adjusting for health status and other confounding variables. We quantified inequalities using the relative index of inequality (RII) using Poisson regression. The contribution of concession cards and PHI in promoting equity/inequity was examined using mediating models. Results: There was equality in the use of GP services, but socio-economically advantaged women were more likely than disadvantaged women to use specialist (RII=1.41, 95% CI:1.26,1.58), allied health (RII=1.21,1.12,1.30), alternative health (RII=1.29,1.13,1.47) and dental services (RII=1.61,1.48,1.75) after adjusting for need, and they were less likely to visit hospital doctors (RII=0.74,0.57,0.96). Concession cards reduced socio-economic inequality in GP but not specialist care. Inequality in dental and allied health services was partly explained by inequalities in PHI. Conclusions and implications: Substantial socio-economic inequity exists in use of specialist and non-medical ambulatory care in Australia. This is likely to exacerbate existing health inequalities, but is potentially amenable to change. [source] Regional variation in the survival and health of older Australian women: a prospective cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Dimitrios Vagenas Abstract Objective: Older people may act as sensitive indicators of the effectiveness of health systems. Our objective is to distinguish between the effects of socio-economic and behavioural factors and use of health services on urban-rural differences in mortality and health of elderly women. Methods: Baseline and longitudinal analysis of data from a prospective cohort study. Participants were a community-based random sample of women (n=12778) aged 70-75 years when recruited in 1996 to the Australian Longitudinal Study on Women's Health. Measures used were: urban or rural residence in Australian States and Territories, socio-demographic characteristics, health related behaviour, survival up to 1 October 2006, physical and mental health scores and use of medical services. Results: Mortality was higher in rural than in urban women (hazard ratio, HR 1.14; 95% CI, 1.03,-1.26) but there were no differences between States and Territories. There were no consistent baseline or longitudinal differences between women for physical or mental health, with or without adjustment for socio-demographic and behavioural factors. Rural women had fewer visits to general practitioners (odds ratio, OR=0.54; 95% CI, 0.48-0.61) and medical specialists (OR=0.60; 95% CI, 0.55-0.65). Conclusions: Differences in use of health services are a more plausible explanation for higher mortality in rural than urban areas than differences in other factors. Implications: Older people may be the ,grey canaries' of the health system and may thus provide an ,early warning system' to policy makers and governments. [source] Comparing knowledge and perceived risk related to the human papilloma virus among Australian women of diverse sexual orientationsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009Ruth McNair Abstract Objectives: The study compared levels of awareness of human papilloma virus (HPV) as a sexually transmissible infection (STI) between women of different sexual orientations. It also examined self-reported risk factors for HPV infection, perceived level of personal risk, and willingness to have the HPV vaccine. Methods: Recruitment occurred through community sampling and data was collected using a self-completion questionnaire. Results: A convenience sample of 349 women completed the questionnaire in early 2007, 309 were sexually active; 47.6% had lifetime sexual partners of both genders, 26.9% had only male partners, and 25.5% had only female partners. Women with partners of both genders were more likely to have ever had a pap test but were also more likely to report an abnormal result (OR 3.19) than women with only male partners. Only 68% of the sample had heard of HPV and women with partners of both genders were significantly more likely to be aware than women with only male partners (OR 2.56). Forty-four per cent did not know how HPV was transmitted and less than half correctly identified HPV-associated clinical problems, with no differences according to gender of partners. The majority of women had risk factors for HPV, however, few felt personally at risk. Conclusions: The very low personal risk perception for HPV, particularly among women who have female and male sexual partners, suggests the need for targeted education for this group regarding HPV transmission and prevention. Implications: Health promotion regarding HPV should be broadened to specifically include information about HPV as an STI between women. [source] Physical activity, Body Mass Index and health care costs in mid-age Australian womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2008Wendy J. Brown Abstract Objective: This study examined the relationships between combined categories of physical activity (PA) and Body Mass Index (BMI) with health care costs in women and assessed the potential cost savings of improving PA and BMI in sedentary mid-age women. Methods: Cross-sectional analysis of 2001 survey data linked to health service use data for the same year from 7,004 mid-age women (50-55 years) participating in the Australian Longitudinal Study on Women's Health. Results: The mean (median; interquartile range) annual cost of Medicare-subsidised services was $542 (355; 156-693) per woman. Costs were 17% higher in obese than in healthy-weight women and 26% higher in sedentary than in moderately active women. For sedentary obese women, mean costs were 43% higher than in healthy weight, moderately active women. After adjustment for potential confounders, the relative risk of ,high' claims (,15 claims per year) for overweight women who reported ,moderate' or ,high' PA were lower than for women with healthy BMI who reported no PA. Conclusions and Implications: Lower PA and higher BMI are both associated with higher health care costs, but costs are lower for overweight active women than for healthy-weight sedentary women. At the population level these data suggest that there would be significant cost savings if all sedentary mid-age women could achieve at least ,low' levels of PA (60-150 minutes a week). [source] The cost-effectiveness of cervical screening in Australia: what is the impact of screening at different intervals or over a different age range?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2008Rob Anderson Abstract Objective: To estimate the cost-effectiveness of altering the currently recommended interval and age range for cervical screening of Australian women. Methods: The cost and effectiveness estimates of alternative screening strategies were generated using an established decision model. This model incorporated a Markov model (of the natural history of cervical cancer and pre-cancerous lesions) and decision trees which: ,mapped' the various pathways to cervical cancer screening; the follow-up of abnormal Pap test results; and the management of confirmed lesions. The model simulated a hypothetical large cohort of Australian women from age 15 to age 85 and calculated the accumulated costs and life-years under each screening strategy. Results: Our model estimated that moving from the current two-yearly screening strategy to annual screening (over the same age range) would cost $379,300 per additional life-year saved. Moving from the current strategy to three-yearly screening would yield $117,100 of savings per life-year lost (costs and effects both discounted at 5% per year), with a relatively modest (<5%) reduction in the total number of life-years saved by the program. Conclusions: Although moving to annual screening would save some additional lives, it is not a cost-effective strategy. Consideration should be given to increasing the recommended interval for cervical screening. However, the net value of any such shift to less effective (e.g. less frequent) and less costly screening strategies will require better evidence about the cost-effectiveness of strategies that encourage non-screeners or irregular screeners to have a Pap test more regularly. [source] Do women have equitable access to quality breast prosthesis services?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2000P LIVINGSTON Although up to 90% of women who have had a mastectomy use breast prostheses, significant gaps exist around current breast prosthesis services for Australian women. These gaps include the timeliness and quality of information provision, the disparity in financial assistance, and the lack of knowledge regarding the determinants of what constitutes a "quality" breast prosthesis. Revised policy initiatives are central to addressing these gaps to ensure equitable access to quality breast prosthesis services. [source] Changing patterns of antiepileptic drug use in pregnant Australian womenACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010F. J. E. Vajda Vajda FJE, Hollingworth S, Graham J, Hitchcock AA, O'Brien TJ, Lander CM, Eadie MJ. Changing patterns of antiepileptic drug use in pregnant Australian women. Acta Neurol Scand: 2010: 121: 89,93. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To trace the pattern of antiepileptic drug (AED) use in pregnant Australian women annually from 1999 to 2007, and correlate it with the pattern of AED use in the wider community. Methods,,, Analysis of data from the Australian Register of AEDs in Pregnancy, related to Australian population data for AED prescriptions. Results,,, Over the study period, prescribing of carbamazepine, phenytoin and valproate for pregnant women decreased, and prescribing of lamotrigine, topiramate and levetiracetam increased. These changes tended to parallel prescribing trends in the wider community, except for valproate, whose prescribing in the overall community increased as its prescribing, and its dosage prescribed, decreased in pregnancy. Concomitant with this, there was a trend towards fewer births of foetuses with abnormalities. Conclusions,,, While otherwise following national AED prescribing trends, Australian prescribers are reducing the use and dose of valproate in pregnant women, likely in recognition of the teratogenic hazards of this drug. [source] | ||||||||||||||||