Risk factors for female sexual dysfunction in the general population : exploring factors associated with low sexual function and sexual distress

<b>Introduction.</b> No previous population-based studies have used validated instruments to measure female sexual dysfunction (FSD) in Australian women across a broad age range.<br /><b>Aim.</b> To estimate prevalence and explore factors associated with the&nbsp; components of FSD.<br /><b>Main Outcome Measures.</b> Sexual Function Questionnaire measured low sexual function. Female Sexual Distress Scale measured sexual distress.<br /><b>Methods.</b> Multivariate analysis of postal survey data from a random sample of 356 women aged 20&ndash;70 years.<br /><b>Results. </b>Low desire was more likely to occur in women in relationships for 20&ndash;29 years (odds ratio 3.7, 95% confidence intervals 1.1&ndash;12.8) and less likely in women reporting greater satisfaction with their partner as a lover (0.3, 0.1&ndash;0.9) or who placed greater importance on sex (0.1, 0.03&ndash;0.3). Low genital arousal was more likely among women who were perimenopausal (4.4, 1.2&ndash;15.7), postmenopausal (5.3, 1.6&ndash;17.7), or depressed (2.5, 1.1&ndash;5.3), and was less likely in women taking hormone therapy (0.2, 0.04&ndash;0.7), more educated (0.5, 0.3&ndash;0.96), in their 30s (0.2, 0.1&ndash;0.7) or 40s (0.2, 0.1&ndash;0.7), or placed greater importance on sex (0.2, 0.05&ndash;0.5). Low orgasmic function was less likely in women who were in their 30s (0.3, 0.1&ndash;0.8) or who placed greater importance on sex (0.3, 0.1&ndash;0.7). Sexual distress was positively associated with depression (3.1, 1.2&ndash;7.8) and was inversely associated with better communication of sexual needs (0.2, 0.05&ndash;0.5). Results were adjusted for other covariates including age, psychological, socioeconomic, physiological, and relationship factors.<br /><b>Conclusions.</b> Relationship factors were more important to low desire than age or menopause, whereas physiological and psychological factors were more important to low genital arousal and low orgasmic function than relationship factors. Sexual distress was associated with both psychological and relationship factors.<br />

General practitioners' nutrition promotion among cardiac patients

General practitioners fall into three categories in their pursuit of dietary counselling: little involvement, or provider of referrals, or they have strong involvement. The barriers to dietary counselling are inadequate partnerships with dietitians, patients suffering multiple medical conditions and the view that HMG-CoA-reductase-inhibitors (statins) reduce the need for dietary change.

General practitioners' role in health assessment of humanitarian settlers

An approach to health assessment of humanitarian settlers was developed and evaluated from the perspective of general practitioners (GPs). While conducting assessment was found to be feasible, there were significant barriers which GPs without a primary interest in refugee health and those working in private practice may find difficult to transcend.

Medicine non-adherence in kidney transplantation

Background: The increasing prevalence of chronic kidney disease, the relative shortage of kidney donors and the economic- and health-related costs of kidney transplant rejection make the prevention of adverse outcomes following transplantation a healthcare imperative. Although strict adherence to immunosuppressant medicine regimens is key to preventing kidney rejection, evidence suggests that adherence is sub-optimal. Strategies need to be developed to help recipients of kidney transplants adhere to their prescribed medicines. Findings: This review has found that a number of factors contribute to poor adherence, for example, attitudes towards medicine taking and forgetfulness. Few investigations have been conducted, however, on strategies to enhance medicine adherence in kidney transplant recipients. Strategies that may improve adherence include pharmacist-led interventions (incorporating counselling, medicine reviews and nephrologist liaison) and nurse-led interventions (involving collaboratively working with recipients to understand their routines and offering solutions to improve adherence). Strategies that have shown to have limited effectiveness include supplying medicines free of charge and providing feedback on a participant's medicine adherence without any educational or behavioural interventions. Conclusion: Transplantation is the preferred treatment option for people with end-stage kidney disease. Medicine non-adherence in kidney transplantation increases the risk of rejection, kidney loss and costly treatments. Interventions are needed to help the transplant recipient take all their medicines as prescribed to improve general well-being, medicine safety and reduce healthcare costs. &copy; 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

A longitudinal analysis of self-prescribed complementary and alternative medicine use by a nationally representative sample of 19,783 Australian women, 2006-2010

BACKGROUND: Complementary and alternative medicine (CAM) use is increasingly popular amongst general populations around the world with women constituting substantial CAM users. However, self-prescribed CAM use does raise potential safety concerns and so it is important to identify those risk factors associated with self-prescribed CAM use. METHODS: Data was obtained from the Australian Longitudinal Study on Women's Health (ALSWH). Longitudinal data analyses were conducted on questionnaire data from the 1973-78 cohort (n=9,145) and the 1946-51 cohort (n=10,638), collected over the period 2006-2010. RESULTS: In the 1973-78 cohort, use of self-prescribed CAM was 73.2% in 2006 and 75.3% in 2009. For the 1946-51 cohort, use of self-prescribed CAM was 73.9% in 2007 and 74.7% in 2010. There were similar levels of use of individual self-prescribed CAM, with the exception that the use of herbal medicine was much higher among the 1946-51 cohort (20% vs. 27%). There was a substantial increase over three years in the use of vitamins/minerals in both cohorts (21% and 19%, respectively). In contrast, there was a considerable decline over three years in use of aromatherapy oils in both cohorts (34% and 28%, respectively). CONCLUSION: Self-prescribed CAM use is popular amongst women in Australia and it is important that conventional practitioners providing women's health care be cognizant of such use amongst their patients. In order to ensure effective practice, there is a need for further research to explore women's decision-making and experiences around self-prescribed CAM use.