Use of complementary and alternative medicines by a sample of Australian women during pregnancy

Background: The use of complementary and alternative medicines (CAM) is growing in Australia, with women higher users than men. Yet, only a few Australian studies have explored the use of CAM during pregnancy.

Aims: To explore the use of CAM, the types of CAM practitioners consulted, physical symptoms/complaints for which CAM are used by a sample of pregnant Australian women, and women's perceptions of the efficacy of CAM in treating those complaints.

Methods: Three hundred and twenty-one pregnant women, who volunteered for a study exploring women's well-being during pregnancy, completed a self-report questionnaire in their late second/early third trimester.

Results: Seventy-three per cent of women had used at least one kind of complementary therapy in the prior eight weeks of pregnancy. Over one-third of the women had visited at least one alternative medicine practitioner during pregnancy. Approximately one-third of the women reported taking CAM to alleviate a specific physical symptom, with 95.7% of these women reporting they either got completely better or a little bit better with use of CAM; one quarter reported planning to use an alternative therapy to assist with labour preparation. Age, number of physical symptoms experienced, income level and level of education were not associated with greater use of CAM (P < 0.05); however, women reporting more physical symptoms were more likely to consult a CAM practitioner.

Conclusion: Findings highlight the substantial use of CAM during pregnancy and the need to have all health professionals adequately informed about such therapies during this life stage.

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Objective:
To identify the prevalence and correlates of three types of pelvic pain (dysmenorrhoea, dyspareunia, and other chronic pelvic pain [CPP]) in a nationally representative sample of Australian women.

Design and setting:
The CPP survey was part of a broader national study of health and relationships. Computer-assisted telephone interviews were administered to a random sample of 8656 Australian households; 4366 women aged between 16 and 64 years were interviewed in 2004 and 2005. Eighteen of the more than 200 potential survey questions related to pelvic pain.

Main outcome measures:
Self-reports of dysmenorrhoea, dyspareunia, and any other CPP not associated with sexual intercourse or menstruation.

Results:
Data on 1983 women aged 16–49 years who were still menstruating and sexually active were analysed. Prevalences were 71.7% for dysmenorrhoea, 14.1% for dyspareunia and 21.5% for other CPP; 23.3% of women reported no pelvic pain of any kind. Severe pain was reported by 15.0% (95% CI, 13.0%–17.1%) of women with dysmenorrhoea, 7.8% (95% CI, 5.0%–11.9%) of women with dyspareunia and 20.0% (95% CI, 16.1%–24.6%) of women with other CPP. Just over a third (34.2%) of women who reported any pain had sought advice from a health professional. Women reporting CPP were also likely to report other health conditions, most notably depression and anxiety. There were clear associations between CPP and sexual difficulties, pregnancy and pregnancy outcomes.

Conclusions:
Rates of pelvic pain in Australian women are high. General practitioners need to be ready to discuss these issues with patients, particularly in relation to underlying anxiety and depression.

Feminine transports and transformations : textual performances of Australian women convicts and emigrants from 1788 to 1850

While scholars have critiqued early representations of the white colonial female in the form of the novel, short story, or historical narrative, analyses of poetry tend to be located only on that produced in Australia and often in light of a nascent national identity. This article examines how poetic renditions of the desolate woman might be viewed as part of imperialism's mythologising process, displacing more worrying versions of womanhood in relation to the new colonies. While social anxieties over the identity of the white colonial female would result in highly controlled productions of the female convict and female emigrant, this article demonstrates how they also prove unstable and point to a disruptive reality beyond language.

Importance of the contribution of Australians to the penetration of China by the China Inland Mission in the period 1888-1953, with particular reference to the work of Australian women missionaries

Australians, in the main, are unaware of the role which Australia played in the evangelization of China in the late nineteenth and the first half of the twentieth century. Most would never have heard of the China Inland Mission (CIM), the largest of the Protestant bodies which penetrated the Middle Kingdom, and few would know of the contribution that its Australian contingent, which consistently comprised about a tenth of the CIM's numbers, made towards the Christianization of that vast country. This thesis aims to raise the level of awareness in this area. Academic researchers have not totally neglected to examine the proselytization of China, and historians of the stature of Latourette have not let it escape their attention. However, most of the studies which have not merely fleetingly focused on the subject while viewing a larger canvas, have been North American, singling out the efforts of United States and Canadian bodies in introducing Christianity to the Chinese. Here, authors like Amerding, Bacon, Creighton, Gates, Hawkes, Ho, Ko, Mensendiek, Michell and Quale have left their mark. In the case of the present thesis, the outlook from which events played out in China are viewed is firmly based in Australia rather than North America. Earlier Australian research has been scarce, and is dominated by Loane and Dixon. Loane, evidently primarily working from Australasian Council minutes, mainly concentrates on the efforts of the CIM's Home Council, examining its endeavours decade by decade against a backdrop of contemporaneous events in China, and briefly referring to aspects of the lives of a cross-section of Australasian missionaries, without providing much idea about what they actually did in the field or what they achieved there. Because of its preoccupation with the Home Council, which never admitted women into its ranks, Loane's treatise is systemically biased towards men, though the more prominent of the women, like Mary Reed and Susie Garland, are given due recognition. The current thesis looks in detail at what Australians did in the field, the level of success they achieved, and at the particular contribution of Australian women towards the evangelization of China. Dixon took upon herself the formidable task of examining the endeavours of all missions in China which contained Australian missionaries. Because of the magnitude of her task, she could not focus to any great extent on particular missions, nor pursue in any detail the work of individual Australian missionaries. Like Loane, she was unable to explore what they actually did in the field or what they achieved there. Neither could she delve to any depth into the work of Australian women missionaries, though on the basis of the information she had accumulated, she drew the conclusion that Australian women had largely only brought about some unintended feminist consequences amongst Chinese women. This sweeping generalization failed to take into account the other very real social changes for Chinese women the Australian female missionaries quite purposely helped to bring about, and this thesis makes good that omission. This thesis studies aspects of the Australian missionary endeavour which both Loane and Dixon have neglected, thereby breaking new ground, and sets out to correct erroneous impressions which Dixon's dissertation has left on the historical record. One of these impressions concerned the longevity of the effect of the Australian effort in China. She had the View, writing in 1978, that the Chinese Church was moribund (a view shared by Varg and Lacy) , and that therefore the effects attributable to the endeavours of any nationality had proved fruitless, whereas the author is able to show, using modern-day sources, that the church has burgeoned in recent years thanks to earlier missionary endeavours and later neo-evangelistic efforts like Gospel radio, and now has a complement of perhaps 50 million adherents, making it second only to the United States in the size of its Protestant evangelical population. Another impression she left was that the Australian input into the evangelization of China can be largely dismissed because no totally Australian organization emerged, leaving the direction of Australia's effort in other hands. Contrary to that impression, the author shows that the Australian impact in China was significant and that Australians enjoyed more power than Dixon ever imagined. The author also shows that Australians were accepted as the equal of other nationalities in the CIM once they had acquired the necessary field expertise, a factor which doubtless also applied in respect of other missions with Australian components in China. Marchant has suggested that it is a fiction perpetuated by mission periodicals that Christianity spread and progressed in a determined manner in China. This thesis establishes that within the CIM's bailiwick, though there was some patchiness, Christianity progressed steadily and inexorably. One mission alone, the CIM, is concentrated upon, firstly in order to render the data manageable, secondly because it was the largest mission in China and had a sizeable Australian (including female) contingent, and thirdly because it exemplified many of the problems which would have been faced by missions in that country and their Australian components. The methodology employed is multifaceted. The written testimony of the missionaries themselves, contained in CIM periodicals, Field Bulletins, Monthly Notes, Annual Reports, autobiographies, personal files, diaries and letters is used to illustrate various aspects of the CIM's work in which Australians were engaged. This approach is augmented by other sources such as China and Australasian Home Council Minutes, missionary conference reports, Candidates' Books, biographies, and other selected material from archival holdings in Australia, Singapore, the United Kingdom, America and Canada. Statistics, especially ratio analyses and growth rate comparisons are used to demonstrate the relative success of different missions, missionaries and genders. Also employed are reminiscences of missionaries and descendants obtained by personal interview, and these are aggregated to provide some general conclusions. Data from these various sources have been synthesized to serve the central objective of demonstrating the importance of the contribution of Australians to the penetration of China by the CIM in the period 1888-1953 with particular reference to the work of Australian women missionaries.

Pharmacy access to the emergency contraceptive pill : a national survey of a random sample of Australian women

Background : The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women's knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP.

Study Design : A cross-sectional study, using a computer-assisted telephone interview (CATI) survey conducted with a national random sample of 632 Australian women aged 16–35 years.

Results : Most women had heard of the ECP (95%) and 26% had used it. The majority of women agreed with pharmacy availability of the ECP (72%); however, only 48% were aware that it was available from pharmacies without a prescription. About a third (32%) believed the ECP to be an abortion pill. The most common reason for not using the ECP was that women did not think they were at risk of getting pregnant (57%). Logistic regression showed that women aged 20–29 years (OR 2.58; CI: 1.29–5.19) and 30–35 years (OR 3.16; CI: 1.47–6.80) were more likely to have used the ECP than those aged 16–19 years. Women with poor knowledge of the ECP were significantly less likely to have used it than those with very good knowledge (OR 0.28; CI: 0.09–0.77). Those in a de facto relationship (OR 2.21; CI: 1.27–3.85), in a relationship but not living with the partner (OR 2.46; 95% CI 1.31–4.63) or single women (OR 2.40; CI: 1.33–4.34) were more likely to have used the ECP than married women.

Conclusions : Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.

Estimating the impact of mandatory folic acid fortification on the folic acid intake of Australian women of childbearing age

Objective: The primary aim of this study was to estimate the impact of mandatory folic acid (FA) fortification of bread-making flour on the FA intake of Australian women of childbearing age (16-44 years). The secondary objective was to investigate the relationship between estimated FA intake and socio-economic status (SES) and age.

Method: Dietary modelling was used to estimate FA intake under four mandatory fortification scenarios – no supplement use, supplement use unrelated to FA intake, supplement use only among the highest consumers of bread, and increased supplement use. Data were obtained from the 1995 National Nutrition Survey for food intake patterns, the 2007 Victorian Population Health Survey for FA supplement use, and a marketplace survey.

Results: It is estimated that the National Health and Medical Research Council (NHMRC) recommendation for an additional 400 mg/day FA will be achieved by a minimum of 3.9, 25.4, 21.7 and 30% of the target population under scenarios 1-4, respectively. The FA upper level of intake is exceeded by a maximum of 0.1, 1.7, 6.1 and 4.1% of the target population for scenarios 1-4, respectively.

Conclusions: Mandatory FA fortification is not sufficient for the NHMRC recommendations for minimum and maximum intakes to be met by all of the target population under a number of plausible behaviour scenarios.

Implications: Targeted nutrition education campaigns are needed for SES and age sub-groups and research of this nature should be extended to other population groups. Monitoring and evaluation of this policy will be important to ensure appropriate FA intake.

The professionalisation of Australian women's cricket: new times and new opportunities

When the Australian Women&rsquo;s Cricket Team defeated the West Indies in 2013, to win their 5th World Cup from eight attempts, they reaffirmed their status as one of Australia’s most successful international teams. Victory in the 2015 Ashes series, in England, further reinforced their pre-eminent world status. During this time, significant changes also occurred off the field. Cricket Australia introduced pay increases of up to 150% for international and state level players. The sustained success of the national team is attributed to the rapid growth of participation in women&rsquo;s cricket (up 18% 2013 - 2014), a trend that has resulted in females making up almost 25% of all cricket participants across Australia. On face value, the burgeoning profile of women&rsquo;s cricket across Australia is cause for celebration. It is against this backdrop that Cricket Australia faces a range of enduring and emerging issues in the provision and promotion of the women&rsquo;s game. With so many changes and adaptations occurring across the game, we chose to limit the focus of this research to the elite level. Among the enduring issues that are understood at this level are persistently high attrition rates amongst elite and aspiring players and large age differences across teams and squads. A further point of difference in the men’s and women&rsquo;s games is that female teams are largely supervised by male coaches and support staff.

Australian women`s experiences of living with hepatitis C virus: results from a cross-sectional survey

Background: Of the estimated 160 000 Australians currently infected with the hepatitis C virus (HCV), over one-third are women and very few have received clinical treatment, with most managing their illness in non-specialist settings. Little is known about the experiences of women living with HCV in the general community. The present study provides the results from the first comprehensive social survey of Australian women's experiences of living with HCV.

Methods: In 2000, a questionnaire was administered to a largely non-clinical sample of women with HCV (n = 462) living in the state of Victoria and the Australian Capital Territory, Australia. The questionnaire was self-administered with a return rate of 75%. The mean age was 35 years and 83% were 'current' or 'past' injecting drug users. The mean time since diagnosis was 4.6 years (SD = 4.0) and the mean time since infection was 10.5 years (SD = 8.2).

Results: Fifty-eight percent of women reported experiencing symptoms related to their HCV, the most common being tiredness (78%) and nausea (44%). Of the sample, 56% currently saw a doctor for their HCV, and while 52% had ever been referred to a specialist, only 17% of the total sample had ever begun interferon-based combination or monotherapy. Forty-eight percent of women reported experiencing less favorable treatment by a health professional because of their HCV. Age-related self-assessed health status was significantly lower than Australian norms, as were SF-12 physical and mental health scores. The SF-12 physical and mental health scores were highly correlated, indicating a significant physical and mental health burden associated with HCV.

Conclusion: The social, physical and mental health needs of women living with HCV are considerable. Most women had not accessed specialist treatment and the response of the primary health care system to HCV-related women's health issues requires improvement.

To stand by the women of the Orient : Australian women and China in the twentieth century

This paper will examine the history of Australian women living and working in China in the twentieth century. To do this I will compare the Australian experience with research on American, British and New Zealander women. The paper includes a study of two categories of Australian women in China: the expert observers, and the secular reformers. Using current theorising of post-colonialism, I will identify the specific contribution and dimensions of Australian women's experience in China.

The prevalence of mood and anxiety disorders in Australian women

Objective: We aimed to report the prevalence, age-of-onset and comorbidity of mood and anxiety disorders in an age-stratified representative sample of Australian women aged 20 years and over.

Method: Mood and anxiety disorders were diagnosed utilising a clinical interview (SCID-I/NP). The lifetime and current prevalence of these disorders was determined from the study population (n = 1095) and standardized to 2006 census data for Australia.

Results: Approximately one in three women (34.8%) reported a lifetime history of any mood and/or anxiety disorder, with mood disorders (30.0%) being more prevalent than anxiety disorders (13.5%). Of these, major depression (23.4%), panic disorder (5.5%) and specific phobia (3.5%) were the most common. The lifetime prevalence of other disorders was low (≤3%). A total of 14.4% of women were identified as having a current mood and/or anxiety disorder, with similar rates of mood (8.9%) and anxiety disorders (8.0%) observed. The median age-of-onset for mood disorders was 27.0 years and 18.5 years for anxiety disorders.

Conclusions: This study reports the lifetime and current prevalence of mood and anxiety disorders in the Australian female population. The findings emphasize the extent of the burden of these disorders in the community.

High prevalence of symptoms associated with ovarian cancer among Australian women

Background: Symptoms associated with ovarian cancer are often vague and non-specific, such as abdominal bloating and pain. Presently, nothing is known about the prevalence of these symptoms among women in the community.
Aims: To identify the prevalence and correlates of symptoms associated with ovarian cancer in a nationally representative sample of Australian women.
Methods: Women answered questions about symptoms associated with ovarian cancer via computer-assisted telephone interviews. Binomial regression was used to assess the association between reporting symptoms, demographic characteristics and sexual problems.
Results: Data on 2235 women aged 18–70 who had not had an oophorectomy or hysterectomy were analysed.
Prevalences of symptoms were abdominal bloating 52%, abdominal pain 37%, increased abdominal size 30%, pelvic pain 29%, feeling full quickly 18% and unable to eat normally 15%. One-third of women (32%) reported three or more symptoms, 2% reported all six and 32% of women reported none. Severe symptoms were generally reported by <10% of women reporting symptoms, and symptoms usually persisted for 5 days or less a month. Older women were less likely to report symptoms, as were women who had been pregnant. There was an association between symptoms and sexual difficulties whereby women who reported multiple ovarian cancer symptoms were more likely to report sexual problems.
Conclusions: There is a high prevalence of ovarian cancer symptoms in the Australian community. Because of this, awareness campaigns will likely impact a large number of women who do not have ovarian cancer.