Factors associated with Chinese herbal medicine use among middle-aged and older women with arthritis: evidence from China.

Chinese herbal medicine (CHM) has been used for arthritis in China and elsewhere across the world. However, knowledge about the prevalence and profile of middle-aged and older women who used CHM for arthritis in China is limited. This study aims to identify potentially important insights into the factors associated with CHM use amongst middle-aged and older women with arthritis in China. Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), a population-based survey of Chinese adults aged 45 years or older, comprising 10,833 Chinese women who completed a questionnaire in 2015. Stepwise multiple logistic regression modeling was conducted to determine the key factors (demographic, health condition, and health services use) predicting the use of CHM for the treatment of arthritis. Results revealed that 17.2% of women with arthritis were taking CHM for their arthritic symptoms. Women with arthritis who used CHM were more likely to experience finger pain (OR = 1.70), had difficulty in stooping, kneeling, crouching (OR = 1.40), visited a Traditional Chinese hospital (OR = 2.22), consulted massage therapists (OR = 2.06) and/or had experienced a fall (OR = 1.41). The prevalence of CHM use is high amongst middle-aged and older Chinese women with arthritis. Given the high risk of functional disability and impaired mental health, further research is needed to explore the potential health benefits of CHM for women with arthritis in order to help facilitate the efficacious and safe use of CHM alongside conventional medical care

Use of massage therapy by mid-aged and older Australian women.

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

Workforce interventions to deliver postnatal care to improve neonatal outcomes in low and lower-middle income countries: a narrative synthesis

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Developing a multi-modality complementary medicine practice-based research network: The PRACI project

© 2014 Elsevier Ltd Objectives Outline the protocol to be used in the establishment of the Practitioner and Researcher Collaboration Initiative (PRACI) – an innovative national practice-based research network (PBRN) for complementary medicine (CM) professions in Australia. Design and methods A multiphase research design will be employed. Phase 1 will involve geographical mapping of CM practitioner workforce population and location across Australia. Phase 2 involves initial practitioner member recruitment encompassing a preliminary workforce survey to allow population of key information for the PRACI database. Phase 3 will employ a comprehensive practitioner member survey which examines the nature and characteristics of contemporary CM practice. Results PRACI will be a multi-modality PBRN which encompasses 14 CM professions: acupuncturists, aromatherapists, Ayurveda practitioners, Bowen therapists, Chinese herbalists, homoeopaths, kinesiologists, massage therapists, musculoskeletal therapists, myotherapists, naturopaths, nutritionists (non-dietetic), reflexologists, Western herbalists, and yoga teachers. Once established, researchers will be able to utilise the PRACI network and infrastructure to undertake CM research which is embedded in, responsive to, and informed by clinical practice. An Expression of Interest (EOI) process by which potential new research through PRACI is vetted based upon feedback by researchers, community representatives and practitioner members. The PRACI network will enable a broad range of research designs including experimental, observational and qualitative research. As such, research conducted through PRACI will be able to examine important research questions and advance new knowledge about contemporary CM practice. Conclusions PRACI is a practice-based research network which has the potential to offer the CM professions a legacy of clinically relevant research which is embedded in the realities of practice and which can provide a platform for future critical investigation and rigorous enquiry

A randomised control trial assessing the effect of a Mediterranean diet on the symptoms of depression in young men (the "AMMEND" study): A study protocol.

Depression affects approximately 350 million people worldwide. Evidence suggests that diet plays an important role with the Mediterranean diet displaying promising preliminary results. Currently, most of the research is conducted on women and older adults however, the majority of mental illnesses occur before the age of 25. Men are less likely to seek help than women with only 13% of young men aged 15-24 seeking help for their mental health. Young men are hugely underrepresented in the current research which poses a significant issue. A 12-week randomised control trial will be conducted to examine the effect of a Mediterranean diet on the symptoms of depression in young men aged 18-25. Participants will be randomised to either follow a Mediterranean diet or receive the inactive control therapy befriending. Participants will attend 3 appointments at baseline, week 6 and week 12. The main outcome will be changes to the Becks depression Inventory score. This research aims to answer the question of whether diet can be used effectively in this population. This will be the first trial to examine the effect of a Mediterranean diet on the symptoms of depression in young men. This trial will help fill a significant research gap, contribute to the growing field of nutritional psychiatry, guide future research and inform advice given by clinicians to this specific demographic

Referral to yoga therapists in rural primary health care: A survey of general practitioners in rural and regional New South Wales, Australia.

BACKGROUND: Yoga is an increasingly accepted complementary treatment modality for referral in Australian general practice, yet this practitioner group has largely escaped research attention in Australia. Complementary medicine use is highest in rural and regional areas, where a number of primary health care challenges are also more pronounced. Despite the significant role of complementary therapists in rural and regional Australia, and the increasing acceptance of yoga therapy in general practice, there has been little exploration of the interface between yoga therapists and conventional primary health care practitioners in this area. MATERIALS AND METHODS: A 27-item questionnaire was sent to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. RESULTS: Completed questionnaires were returned by 585 GPs, with 49 returned as 'no longer at this address' (response rate 40.7%). One-in-eight GPs (12.1%) advised their patients of specific yoga therapies and protocols, and 7.2% advised specific meditation techniques. Three-quarters of GPs (76.6%) referred to a yoga therapist at least a few times per year, with 12.5% of GPs referring at least once per week. GPs being in a remote location (OR = 10.95; CI: 1.55, 77.31), being female (OR = 1.85; 95% CI: 1.16, 2.94), GPs graduating from an Australian medical school (OR = 4.52; 95% CI: 2.61, 7.80), perceiving lack of other treatment options (OR = 3.29; 95% CI: 1.61, 6.74), GPs reporting good or very good knowledge of yoga therapies (OR = 18.2; 95% CI: 9.19, 36.19), and GPs using CAM for their own personal health (OR = 4.53; 95% CI: 2.60, 7.87) were all independently predictive of increased referral to yoga therapists amongst the rural GPs in this study. CONCLUSIONS: There is a significant interface between yoga therapists in Australian rural and regional general practice. There is generally high support for yoga therapies among Australian GPs, with low levels of opposition to the incorporation of these therapies in patient care. There is a need for increased research into yoga therapies practice, policy and regulation in these areas

The urban-rural divide in complementary and alternative medicine use: A longitudinal study of 10,638 women

Background: Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia.Methods: Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables.Results: Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005).Conclusions: In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas. © 2011 Adams et al; licensee BioMed Central Ltd

What impact do essential newborn care practices have on neonatal mortality in low and lower-middle income countries? evidence from Bangladesh

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What impact do essential newborn care practices have on neonatal mortality in low and lower-middle income countries? Evidence from Bangladesh

© 2016 Nature America, Inc. Objective:To assess the impact of essential newborn care (ENC) practices on the mortality of neonates delivered at home in Bangladesh.Study design:This study used cross-sectional data from the 2011 Bangladesh Demographic and Health Survey. Adjusted logistic regression model was used to examine the effect of ENC practices on neonatal mortality based on 3190 live-born infants.Result:Delayed bathing (72 h after delivery) significantly contributed to reducing neonatal mortality. A significant but counterintuitive relation was observed between the dry cord care and neonatal deaths.Conclusion:Neonatal mortality may be reduced through emphasizing delayed bathing. Specific guidelines on the cleanliness of the fabric used to dry and wrap newborns, as well as emphasizing the use of clean delivery kits and initiation of immediate and exclusive breastfeeding, may improve neonatal outcomes. Further, the ENC guidelines in Bangladesh should include the application of topical antiseptics to the cord stump

Is mental health co-morbidity an influencing factor in the health service utilisation of women with diabetes mellitus?

Diabetes Mellitus, affecting nearly half a billion people worldwide, is a substantial global public health issue. Although diabetes predominantly affects men, women with diabetes have specific risks and self-management characteristics. Women have a higher risk of either presenting with or developing depression or anxiety, as well as being high users of complementary medicine which can create clinical governance issues. In spite of these known gender differences, limited research has explored gender-specific diabetes care, especially health service use patterns. As increasing attention has turned to supporting people with diabetes to successfully self-manage their diabetes, it is important that we understand how women with diabetes are using health services, and if their specific risk profile is influencing their health care choices. Our study sought to examine the relationship between mental health status and the patterns of conventional and complementary medicine health service use by women diagnosed with diabetes mellitus. Our results showed that women with diabetes and any mental health co-morbidity were more likely to visit their general practitioner more frequently or use herbal medicine than those without a mental health co-morbidity. Women with depression and anxiety were also less likely to consult a physiotherapist and those with anxiety less likely to consult a podiatrist over time when compared to the other mental health groups