A profile of middle-aged women who consult a chiropractor or osteopath: Findings from a survey of 11,143 Australian women

Purpose: The aim of this study is to examine the prevalence of chiropractic and osteopathy use and the profile of chiropractor/osteopath users among middle-aged Australian women. Methods: This article reports on research conducted as part of the Australian Longitudinal Study on Women's Health. The focus of this article is the middle-aged women who responded to Survey 3 in 2001 when they were between the ages of 50 and 55 years. The demographic characteristics, health status, and health service use of chiropractic/osteopathy users and nonusers were compared using chi(2) tests for categorical variables and t tests for continuous variables. Results: We estimate that 16% of middle-aged women consult with a chiropractor or osteopath (after adjustment for the oversampling of rural women). Area of residence, education, and employment status were all statistically significantly associated with chiropractic and osteopath use. Specifically, women who live in nonurban areas were more likely to consult a chiropractor or osteopath, compared with women who live in urban areas. Women are significantly more likely to consult with a chiropractor/osteopath if they have had a major personal injury in the previous year, and women who use chiropractic/osteopathy are also high users of 'conventional' health services. Conclusions: Chiropractic/osteopathy use among women in Australia is substantial and cannot be ignored by those providing or managing primary health care services for women. It is essential that the interface and communication between chiropractors/osteopaths and other health care providers be highlighted and maximized to establish and maintain effective overall patient coordination and management.

Trends for in situ and invasive melanoma in Queensland, Australia, 1982-2002

Objectives Queensland, the north-eastern state of Australia, has the highest incidence of melanoma in the world. Control measures started earlier here than probably anywhere else in the world; early detection programmes started in the 1960s and primary prevention in the 1980s. Data from the population-based Queensland Cancer Registry therefore provide an internationally unique data source with which to assess trends for in situ and invasive melanomas and to consider the implications for early detection and primary prevention. Methods We used Poisson regression to estimate the annual percentage change in rates across 21 years of incidence data for in situ and invasive lesions, stratified by age and sex. Joinpoint analyses were used to assess whether there had been a statistically significant change in the trends. Results In situ melanomas increased by 10.4% (95% CI: 10.1%, 11.1%) per year among males and 8.4% (7.9%, 8.9%) per year among females. The incidence of invasive lesions also increased, but not as quickly; males 2.6% (2.4%, 2.8%), females 1.2% (0.9%, 1.5%). Valid data on thickness was only available for 1991 to 2002 and for this period thin-invasive lesions were increasing faster than thick-invasive lesions (for example, among males: thin 3.8%, thick 2.0%). We found some suggestive evidence of lower proportionate increase for the most recent years for both in-situ and invasive lesions, but this did not achieve statistical significance. Among people younger than 35 years, the incidence of invasive melanoma was stable and there was a suggestion of a birth cohort effect from about 1958. Mortality rates were stable across all ages, and there was a suggestion of decreasing rates among young women, although this did not achieve statistical significance. Conclusion Age-standardised incidence is continuing to increase and this, in combination with a shift to proportionately more in situ lesions, suggests that the stabilisation of mortality rates is due, in large part, to earlier detection. For primary prevention, after a substantial period of sustained effort in Queensland, there is some suggestive, but not definitive, evidence that progress is being made. Incidence rates are stabilising in those younger than 35 years and the proportionate increase for both in situ and invasive lesions appears to be lower for the most recent period compared with previous periods. However, even taking the most favourable view of these trends, primary prevention is unlikely to lead to decreases in the overall incidence rate of melanoma for at least another 20 years. Consequently, the challenge for primary prevention programmes will be to maintain momentum over the long term. If this can be achieved, the eventual public-health benefits are likely to be substantial.

Trends in morphine prescriptions, illicit morphine use and associated harms among regular injecting drug users in Australia

This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data collected from regular IDU as part of the Australian Illicit Drug Reporting System (IDRS) were analysed (2001-2004). The rate of morphine prescription per person aged 15-54 years increased by 89% across Australia between 1995 and 2003 (from 46.3 to 85.9 mg per person). Almost half (46%) of IDU surveyed in 2004 reported illicit morphine use, with the highest rates in jurisdictions where heroin was less available. Recent morphine injectors were significantly more likely to be male, unemployed, out of treatment and homeless in comparison to IDU who had not injected morphine. They were also more likely to have injected other pharmaceutical drugs and to report injection related problems. Among those who had injected morphine recently, the most commonly reported injecting harms were morphine dependence (38%), difficulty finding veins into which to inject (36%) and scarring or bruising (27%). Morphine use and injection is a common practice among regular IDU in Australia. In some cases, morphine may be a substitute for illicit heroin; in others, it may be being used to treat heroin dependence where other pharmacotherapies, such as methadone and buprenorphine, are perceived as being unavailable or undesirable by IDU. Morphine injection appears to be associated with polydrug use, and with it, a range of problems related to drug injection. Further research is required to monitor and reduce morphine diversion and related harms by such polydrug injectors.

Socioeconomic disadvantage and changes in health risk behaviours in Australia: 1989-90 to 2001

Objective. Lower socioeconomic status (SES) is associated in industrialized countries with unhealthy lifestyle characteristics, such as smoking, physical inactivity and being overweight or obese. This paper examines changes over time in the association between SES and smoking status, physical activity and being overweight or obese in Australia. Methods. Data were taken from three successive national health surveys in Australia carried out in 1989-90 (n = 54 576), 1995 (n = 53 828) and 2001 (n = 26 863). Participants in these surveys were selected using a national probability sampling strategy, and aggregated data for geographical areas are used to determine the changing association between SES and lifestyle over time. Findings. Overall, men had less healthy lifestyles, In 2001 inverse SES trends for both men and women showed that those living in lower SES areas were more likely to smoke and to be sedentary and obese, There were some important socioeconomic changes over the period 1989-90 to 2001. The least socioeconomically disadvantaged areas had the largest decrease in the percentage of people smoking tobacco (24% decrease for men and 12% for women) and the largest decrease in the percentage of people reporting sedentary activity levels (25% decrease for men and 22% for women). While there has been a general increase in the percentage over time of those who are overweight or obese, there is a modest trend for being overweight to have increased (by about 16% only among females) among those living in areas of higher SES. Conclusion. Socioeconomic inequalities have been increasing for several key risk behaviours related to health; this suggests that T specific population-based prevention strategies intended to reduce health inequalities are needed.

Predictors and outcomes of early motherhood in the Australian Longitudinal Study on Women's Health

Early motherhood is identified as a social problem, and having children at an early age is assumed to lead to psychological distress, welfare dependence and socioeconomic disadvantage. Analysis of responses from 9,689 young participants in the Australian Longitudinal Study on Women's Health was used to examine predictors and outcomes of early motherhood in Australia. Survey 1 (1996, aged 18 - 23) and Survey 2 (2000, aged 22 - 27), were used to categorize women as Childless, Existing Mothers (before Survey 1) and New Mothers (became mothers before Survey 2). Multivariate logistic regressions provided comparisons on sociodemographics, gynaecological variables, psychological wellbeing and health behaviours. Survey 1 data show that Existing Mothers experience socioeconomic disadvantages and unhealthy lifestyles. However, those who will go on to become mothers earlier than their peers already experience similar disadvantages. Further, the Survey 2 data show that, when these pre-existing disadvantages are controlled for, the additional deficits experienced by early mothers are relatively minor. Social disadvantage predisposes women to become mothers early, and to adopt unhealthy behaviours. However, young Australian women cope well with the challenges of early motherhood. In the longer term, unhealthy lifestyles and low education may lead to ill health and disadvantage, but early motherhood is not the initiator of this trajectory.

Gendered dichotomies and segregation patterns in computing jobs in Australia

The uneven distribution of women and men in IT employment is often depicted as reflecting adistinction between 'hard' and 'soft' tasks, skills and attributes. This article uses detailed occupational data on professional computing jobs in Australia to examine the extent to which patterns of gender segregation are consistent with such dichotomies. Additionally, we draw on qualitative interview data from aset oforganisational case studies for insights into the ways in which segregation patterns are reproduced and/or reshaped at"the workplace level. While perceptions ofgendered dichotomies were evident among many of our interviewees, overall our analysis shows considerably more complexity, with segregation patterns not necessarily aligned with clear-cut dichotomies and career directions often directly influenced by the organisation ofworking time in particular occupational streams.

Searching for cancer deaths in Australia: National Death Index vs Cancer Registries

OBJECTIVE: To compare the accuracy, costs and utility of using the National Death Index (NDI) and state-based cancer registries in determining the mortality status of a cohort of women diagnosed with ovarian cancer in the early 1990s. METHODS: As part of a large prognostic study, identifying information on 822 women diagnosed with ovarian cancer between 1990 and 1993, was simultaneously submitted to the NDI and three state-based cancer registries to identify deceased women as of June 30, 1999. This was compared to the gold standard of "definite deaths". A comparative evaluation was also made of the time and costs associated with the two methods. RESULTS: Of the 450 definite deaths in our cohort the NDI correctly identified 417 and all of the 372 women known to be alive (sensitivity 93%, specificity 100%). Inconsistencies in identifiers recorded in our cohort files, particularly names, were responsible for the majority of known deaths not matching with the NDI, and if eliminated would increase the sensitivity to 98%. The cancer registries correctly identified 431 of the 450 definite deaths (sensitivity 96%). The costs associated with the NDI search were the same as the cancer registry searches, but the cancer registries took two months longer to conduct the searches. CONCLUSIONS AND IMPLICATIONS: This study indicates that the cancer registries are valuable, cost effective agencies for follow-up of mortality outcome in cancer cohorts, particularly where cohort members were residents of those states. For following large national cohorts the NDI provides additional information and flexibility when searching for deaths in Australia. This study also shows that women can be followed up for mortality with a high degree of accuracy using either service. Because each service makes a valuable contribution to the identification of deceased cancer subjects, both should be considered for optimal mortality follow-up in studies of cancer patients.

Recent changes in heart failure hospitalisations in Australia

Aim: To assess trends in admissions of patients with heart failure (HF) to all hospitals in Australia between 1996-1997 and 2003-2004. Methods and results: We carried out a retrospective analysis of the official population-based National Hospital Morbidity Data in Australia. Although the absolute number of separations with a principal diagnosis of HF remained stable, the age- and sex-standardized separation rate for HF recorded as principal diagnosis decreased from 2.0 per 1000 population in 1996-1997 to 1.6 per 1000 population in 2003-2004. The corresponding values for HF recorded in any diagnostic position were 7.7 and 4.7 per 1000 population. Men had higher in-hospital mortality than women (8.9% versus 8.1%,p < 0.001) and also a larger decrease in this measure over the study period (21.9% versus 14.4%). While the geometric mean length of stay for HF as principal diagnosis fell from 5.4 days in 1996-1997 to 4.9 days in 2003-2004, the proportion of bed-days related to such diagnoses relative to total bed days attributed to circulatory diseases increased from 12.8% to 13.7% (p < 0.001). Conclusion: There were no increase in number of admissions involving HF and standardized rates of hospital separations with HF fell in Australia between 1996 and 2004. The explanation for the observed declines in in-hospital case fatality and the separation rates should be sought in whole-of-community studies. (c) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Where Do Flappers Fit In?: The Photography of Modern Fashion in Australia

The visual technique of fashion photography is examined which taught Australian women to look modern. Especially fashion photography intervenes ambivalently into the story of Australian modernism and modernity. During 1920s and 1930s within the fashion press there were synergies and differences between commercial fashion photography, celebrity and cinematic portraiture, and social set endorsement. However, modernism was widely acknowledged in Australia during the 1920s through women's spaces, their fashions and culture of department stores.

Going up? Women in the public sector

Abstract: Purpose – This paper aims to document women's reflections on their careers over a ten-year period to provide quantitative baseline data on which to frame follow-up in-depth interviews. The participants work in the public service in Queensland (Australia) and had been recommended for, and participated in, women in management (WIM) courses conducted in the early 1990s. Design/methodology/approach – Data were collected by means of a survey (containing closed and open items) which gathered demographic data and data related to employment history, perceptions of success and satisfaction, and the women's future career expectations. Findings – Findings revealed that the percentage of women in middle and senior management had increased over the ten-year period, although not to the extent one might have anticipated, given that the women had been targeted as high flyers by their supervisors. While not content with their classification levels (i.e. seniority), the majority of the cohort viewed their careers as being successful. Practical implications – Questions arise from this study as to why women are still “not getting to the top”. There are also policy implications for the public service concerning women's possible “reinventive contribution” and training implications associated with women only courses. Originality/value – The study is part of an Australian longitudinal study on the careers of women who attended a prestigious women-only management course in the early 1990s in Queensland. This is now becoming a study of older women.

Fetal growth patterns in fetuses of women with pregestational diabetes mellitus

Objective To assess the effect of glucose control on the rate of growth of fetuses in women with pregestational diabetes mellitus (Types 1 and 2). Methods All pregestational diabetic women booked at Mater Mothers’ Hospital, Brisbane, Australia, between 1 January 1994 and 31 December 2002, were included. Pregnancies with congenital fetal anomalies, multiple pregnancies, and pregnancies terminated prior to 20 weeks’ gestation were excluded. Dating scans were performed before 14 weeks’ gestation and serial scans were performed at 18, 24, 28, 32 and 36 weeks. Fetal parameters, including biparietal diameter, femur length and abdominal circumference, were recorded. The daily growth rates for biparietal diameter, femur length, and fetal abdominal area were calculated and compared with those in a low-risk (non-diabetic) population. The growth rates in fetuses of women with satisfactory diabetic control (HbA1c

The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004

Objective: To survey the use, cost, beliefs and quality of life of users of complementary and alternative medicine (CAM). Design: A representative population survey conducted in 2004 with longitudinal comparison to similar 1993 and 2000 surveys. Participants: 3015 South Australian respondents over the age of 15 years (71.7% participation). Results: In 2004, CAMs were used by 52.2% of the population. Greatest use was in women aged 25-34 years, with higher income and education levels. CAM therapists had been visited by 26.5% of the population. In those with children, 29.9% administered CAMs to them and 17.5% of the children had visited CAM therapists. The total extrapolated cost in Australia of CAMs and CAM therapists in 2004 was AUD$1.8 billion, which was a decrease from AUD$2.3 billion in 2000. CAMs were used mostly to maintain general health. The users of CAM had lower quality-of-life scores than non-users. Among CAM users, 49.7% used conventional medicines on the same day and 57.2% did not report the use of CAMs to their doctor. About half of the respondents assumed that CAMs were independently tested by a government agency; of these, 74.8% believed they were tested for quality and safety, 21.8% for what they claimed, and 17.9% for efficacy. Conclusions: Australians continue to use high levels of CAMs and CAM therapists. The public is often unaware that CAMs are not tested by the Therapeutic Goods Administration for efficacy or safety.