Journal articles on the topic 'Older women Care Australia'
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Waling, Andrea, Anthony Lyons, Beatrice Alba, Victor Minichiello, Catherine Barrett, Mark Hughes, Karen Fredriksen-Goldsen, and Samantha Edmonds. "Trans Women’s Perceptions of Residential Aged Care in Australia." British Journal of Social Work 50, no. 5 (October 24, 2019): 1304–23. http://dx.doi.org/10.1093/bjsw/bcz122.
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Abstract Many older people in trans communities in Australia and elsewhere have experienced long histories of violence and discrimination in the health and social care sectors, making some of them fearful of interacting with contemporary health and social care providers. This study explored older trans women’s perceptions of these services. It involved a qualitative, thematic analysis of semi-structured, one-on-one audio-recorded interviews with ten trans women aged sixty years and older in Australia. Participants expressed a number of concerns about using residential facilities for older people in Australia, including potential for abuse and discrimination as a result of being trans, and not having access to appropriate treatments. Participants indicated a range of alternatives in using services, such as renovating the home, relocating to areas with greater access to trans-inclusive services and potential euthanasia. Participants perceived that service providers were not adequately trained for trans and gender diverse needs, and highlighted a number of ways aged care services could better support the trans and gender diverse community. The findings provide important information to assist health and social care professionals, including social workers, as well as residential care service providers, in supporting the health and well-being of older trans women.
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Huang, Hui, Farzad Sharifian, Susan Feldman, Hui Yang, Harriet Radermacher, and Colette Browning. "Cross-cultural conceptualizations of ageing in Australia." Cognitive Linguistic Studies 5, no. 2 (December 31, 2018): 261–81. http://dx.doi.org/10.1075/cogls.00021.hua.
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Abstract In this paper, the framework of Cultural Linguistics is employed to examine how older people from two different ethnic backgrounds in Australia conceptualize ageing and their own experience of ageing. The paper employs a qualitative method for the instantiations of interviews from two focus groups of Australian women. The results indicated that women of Anglo-Celtic background had a more self-oriented perception of ageing, aged care and self, while women of Chinese background had a more relational outlook. However, the evidence indicated that changes were taking place in both traditions despite a certain degree of continuity.
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Byles, Julie, Cassie Curryer, Kha Vo, Peta Forder, Deborah Loxton, and Deirdre McLaughlin. "Changes in housing among older women: Latent class analysis of housing patterns in older Australian women." Urban Studies 55, no. 4 (August 15, 2016): 917–34. http://dx.doi.org/10.1177/0042098016661309.
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Scant research exists on the patterns of changes in older women’s housing, and whether and when women transition into residential aged care (RAC). This study aimed to identify groups of women with different housing patterns (latent classes) over time, with a secondary aim to describe socio-demographic and health characteristics of women in each class. We analysed linked data for 9575 women born 1921–1926 from the Australian Longitudinal Study of Women’s Health (ALSWH), Australian National Death Index, and Residential Aged Care (RAC) administrative records for the years 1999 through to 2011. Seven distinct housing patterns (classes) were identified over time. Four classes showed a stable pattern: living in a house for most surveys (47.0%), living in a house but with earlier death (13.7%), living in an apartment (12.8%), living in a retirement village (5.8%). One class showed a pattern of downsizing: moving from a house to retirement village (6.6%). Two patterns showed transition: from an apartment or retirement village, to RAC and death (7.8%), and from house to RAC (6.4%). This study provides new evidence about socio-demographic and health influences on housing patterns and entry into residential care in later life. These findings can inform policy and aged care planning for women in later life, by identifying patterns of transition into residential aged care, or alternatively, remaining in the community.
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Flicker, Leon, Kate Mead, Robert J. MacInnis, Caryl Nowson, Sam Scherer, Mark S. Stein, Jennifer Thomasx, John L. Hopper, and John D. Wark. "Serum Vitamin D and Falls in Older Women in Residential Care in Australia." Journal of the American Geriatrics Society 51, no. 11 (November 2003): 1533–38. http://dx.doi.org/10.1046/j.1532-5415.2003.51510.x.
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Byles, Julie, Jennifer Powers, Catherine Chojenta, and Penny Warner-Smith. "Older women in Australia: ageing in urban, rural and remote environments." Australasian Journal on Ageing 25, no. 3 (August 1, 2006): 151–57. http://dx.doi.org/10.1111/j.1741-6612.2006.00171.x.
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Kirkman, Maggie, and Jane Fisher. "Promoting older women’s mental health: Insights from Baby Boomers." PLOS ONE 16, no. 1 (January 12, 2021): e0245186. http://dx.doi.org/10.1371/journal.pone.0245186.
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Optimal mental health underpins full social participation. As people age, they confront personal and cultural challenges, the effects of which on mental health are not fully understood. The aim of this research was to learn from women of the Baby Boomer generation (born 1946–1964) what contributes to and hinders their mental health and wellbeing. Eighteen women participated in qualitative interviews (in English); data were analysed thematically. Participants were located across Australia in rural and urban areas; not all were born in Australia. They were diverse in education, employment status, and experiences of life and ageing. The women nominated as the main contributors to poor mental health in older women Illness and disability, Financial insecurity, Maltreatment, and Loss and grief. Contributors to good mental health were identified as Social interdependence, Feeling valued, Physical activity, Good nutrition, and Having faith or belief. Women’s accounts supplied other influences on mental health, both associated with the person (Personality and Intimate relationships and sex) and with society (Constructs of ageing, Gender, and Culture). Women also specified what they needed from others in order to improve their mental health as they aged: Public education about ageing, Purposeful roles for older women in society, Adequate services and resources, and Sensitive health care. In sum, older women wanted to be treated with respect and for their lives to have meaning. It is evident from these results that circumstances throughout life can have profound influences on women’s mental health in older age. Anti-discriminatory policies, informed and inclusive health care, and social structures that support and enhance the lives of girls and women at all ages will therefore benefit older women and increase the potential for their continuing contribution to society. These conclusions have implications for policy and practice in well-resourced countries.
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Majeed, Tazeen, Meredith Tavener, Xenia Dolja-Gore, Balakrishnan Nair, Catherine Chojenta, and Julie Byles. "Patterns of geriatric health assessment use among community dwelling older Australian women over a 14-year period." Journal of Health Services Research & Policy 24, no. 2 (April 2019): 100–107. http://dx.doi.org/10.1177/1355819618814561.
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Objective To assess which older Australian women had Medicare subsidized health assessments between 1999 and 2013. Methods This study used prospective, longitudinal survey data from the 1921 to 1926 birth cohort of Australian Longitudinal Study on Women’s Health (ALSWH) linked with Medicare Australia data on health services use. Over 11,000 Australian women were included in the study. Latent class analysis was used to identify assessment patterns over time, accounting for death, and based on three categories (‘no assessment’; ‘assessment; ‘deceased’) for each year between 1999 and 2013. Further analysis explored the impact of health and sociodemographic characteristics on class membership. Results Of the women included in the latent class analysis, 37% never had any assessment and the remainder had had at least one assessment. After a steady uptake from 1999 to 2003, there was decline in uptake from 2003 onwards. A six-class model with sufficient homogeneity and reliable estimation was selected to represent assessment patterns and mortality risk, labelled as: ‘high mortality’ rate with little chance for assessment (12.4%), ‘intermediate mortality, low assessment’ (14.1%), ‘later mortality/low assessment’ (13.1%), ‘later mortality, high assessment’ (7.0%), ‘low mortality, low assessment’ (31.8%), ‘low mortality, high assessment’ (21.6%). Older women with certain conditions (such as diabetes, depression, heart disease) were more likely to be in the low assessment groups, and women with difficulty managing on income were more likely to be in low assessment groups. Conclusion Distinct assessment and mortality patterns were seen, with many women not having assessment, in particular those who had certain health conditions, were taking 3+ medications, had difficulty in managing on income, needed help or were in respite care, and had caring responsibilities. The findings point to a need to promote these assessments among older women, and to reduce financial barriers, even within the context of a heavily subsidized health care system.
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Feldman, Susan, Julie Byles, Gita Mishra, and Jenny Powers. "The health and social needs of recently widowed older women in Australia." Australasian Journal on Ageing 21, no. 3 (September 2002): 135–40. http://dx.doi.org/10.1111/j.1741-6612.2002.tb00434.x.
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Cysique, Lucette A., Margaret P. Bain, Bruce J. Brew, and John M. Murray. "The burden of HIV-associated neurocognitive impairment in Australia and its estimates for the future." Sexual Health 8, no. 4 (2011): 541. http://dx.doi.org/10.1071/sh11003.
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Background The growing number of older individuals with HIV in Australia implies that the prevalence of dementia and additional HIV-associated neurocognitive disorders will increase. There are currently no estimates of the future burden of neurocognitive disease in this population. Methods: We estimated the number and age profile of people living with HIV to the end of 2009 using HIV/AIDS Registry data, and extrapolated these estimates to 2030. Prevalence of HIV-associated dementia (HAD) from 2005 to 2010 from a large Sydney hospital and cost estimates from the AIDS Dementia and HIV Psychiatry Service were used to estimate future HAD burden and costs. Results: Based on our calculations, the number of HIV-positive individuals in Australia will increase from 16 228 men and 1797 women in 2009 to 26 963 men and 5224 women in 2030, while the number of individuals aged 60+ years will increase from 1140 men and 78 women to 5442 men and 721 women, i.e. a 377% increase of older men and an 825% increase in older women. Based on a 7.8% (157/2004) HAD prevalence obtained from hospital data, individuals with HAD will increase in number from 1314 men and 143 women in 2009 to 2204 men and 421 women in 2030. An estimated 22 men and 2 women with non-HIV dementia in 2009 will increase to 104 men and 12 women by 2030. The annual cost of care will increase from ~$29 million in 2009 to $53 million in 2030, mostly for full-time residential care. Conclusions: Neurocognitive disorders will place an increasing burden on resources, especially as those living with HIV age. Because it is unclear if HAD is an increased risk factor for non-HIV dementia, our calculations may be conservative.
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Rayner, Jo-Anne, Karen Willis, and Charmaine Dennis. "Older Australian Women Use Complementary Fertility Care: A Practice Audit." Journal of Alternative and Complementary Medicine 18, no. 1 (January 2012): 6–7. http://dx.doi.org/10.1089/acm.2011.0687.
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Hooper, Kaye D., Michael P. Pender, Penny M. Webb, and Pam A. McCombe. "Use of Traditional and Complementary Medical Care by Patients With Multiple Sclerosis in South-East Queensland." International Journal of MS Care 3, no. 1 (March 1, 2001): 13–28. http://dx.doi.org/10.7224/1537-2073-3.1.13.
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ABSTRACT Multiple sclerosis (MS) is a chronic disease that causes significant disability and dependence on health care. This study was performed to assess the use of traditional and complementary health care by 40 patients with clinically definite MS in South-East Queensland, Australia. Their clinical and personal details and use of traditional and complementary health care were recorded during interviews in the six-month study period from June 1996 to December 1996. All patients were under the care of a neurologist and a general practitioner. More than half (52.5%) of the patients used physiotherapy; among patients older than 40, use of physiotherapy reached 61%. Eighty percent of subjects were seen at the Multiple Sclerosis Society of Queensland, a charitable organization that delivers MS care. Thirty-three of 40 patients (82.5%) had used complementary therapy at some point; 93% of the women with MS had used this form of therapy. Older patients were less likely to use complementary therapy than were younger ones. Median cost to users of complementary therapy was $100 per month (Australian dollars). (Int J MS Care. 2001; 3(1): 13–28)
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Inacio, Maria C., Gillian Elizabeth Caughey, and Steve Wesselingh. "Registry of Senior Australians (ROSA): integrating cross-sectoral information to evaluate quality and safety of care provided to older people." BMJ Open 12, no. 11 (November 2022): e066390. http://dx.doi.org/10.1136/bmjopen-2022-066390.
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PurposeThe Registry of Senior Australians (ROSA) was established to evaluate aged care experiences in Australia. In this manuscript, we describe the ROSA framework, the two ROSA cohorts, highlights from research findings, and future plans.ParticipantsThe South AustralianROSA Prospective Cohort(August 2018–June 2020) enrolled 26 605 participants, of which 59.2% (N=15 745) are women, with a median age of 83 (interquartile range (IQR) 77–88). The NationalROSA Historical Cohort(January 2002–June 2020) includes 1 694 206 participants with an aged care eligibility assessment, of which 59.1% (N=1 001 705) are women and the median age is 78 (IQR 72–83).Findings to dateMost research using the ROSA has focused on dementia, service accessibility, quality and safety of care, falls and injuries and quality use of medicines. The ROSA has also examined the experience of individuals with highly prevalent and understudied conditions in aged care settings (eg, eye and mental health) and aspects of services (eg, built environment) and innovation (eg, mobile radiological services) that can affect older people’s health. Important learnings from the ROSA’s development include the significant resources and multidisciplinary expertise required for establishing this platform. Between 2018 and 2022, 43 academic publications, eight reports of the Australian Government Royal Commission into Aged Care Quality and Safety, and several reports to state health authorities and professional societies have used the ROSA.Future plansOur plans include to: (1) continue delivering high-quality evidence to support the improvement of ageing and aged care services; (2) influence and improve the quality of research in and for the aged care sector; (3) expand scope to facilitate examining aims in more depth; (4) include future aged care sector data collections within the ROSA; (5) inform best practices and innovate how consumer engagement occurs in research; (6) monitor and evaluate the impact of the 2021 Australian Aged Care Reforms.
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Eftekhari, P., P. Forder, and J. Byles. "Asthma Cycle of Care uptake among Australian older women with asthma." Internal Medicine Journal 46, no. 8 (August 2016): 990–91. http://dx.doi.org/10.1111/imj.13149.
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Bryson, Lois. "The Women's Health Australia Project and Policy Development." Australian Journal of Primary Health 4, no. 3 (1998): 59. http://dx.doi.org/10.1071/py98031.
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The Women's Health Australia (WHA) project plans to follow the health of a national sample of around 42,000 women who, in 1996, were in the age cohorts 18-22, 45-49 and 70-74. The multi-disciplinary research team adopts a social approach to health, focuses on biological, psychological, social and lifestyle factors and their relationship to physical health and emotional wellbeing, and is examining the use of, and satisfaction with, health care services. Base-line survey data highlight diversity and the need for health policy to tailor communications to the different age groups. In terms of general wellbeing and service appropriateness, the young are the most problematic, the mid cohort next, while older women indicate fewest problems. Young women experience the highest levels of stress, often suffer from tiredness and are over-concerned with their weight and shape. They are also most dissatisfied with GP services. Issues of employment and health are also central. In general employment is associated with good health, but strains are evident when there are family commitments. As employment becomes increasingly normalised for women, health policy must be mindful of these effects and the significant difficulties faced by a small group of women whose health precludes employment.
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Davis, Brooke, Bernadette Moore, and Dorothy Bruck. "The Meanings of Sleep: Stories from Older Women in Care." Sociological Research Online 12, no. 5 (September 2007): 225–34. http://dx.doi.org/10.5153/sro.1620.
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This paper analyses data from a two phase project which utilizes a mixed methods design to investigate the construct of ‘good’ and ‘poor’ sleep quality amongst older women in Australian residential care. Phase one of the study demonstrates the lack of congruence between quantitative measures of sleep behaviour and self categorizations by the participants as ‘good’ or ‘poor’ sleepers. This lack of congruence is explored in the second phase of the project where semi structured interviews investigate the process by which self categorizations emerge. Interview data ratifies the findings of phase one identifying that the process of self-categorization is not necessarily linked to sleep behaviours, as many of these phenomena such as nocturnal disruption, or early morning awakenings were similarly described by self-categorized ‘good’ and ‘poor’ sleepers. Rather, it appears that these women, through the process of upward and downward social comparison, construct ideas about ‘normal’ sleep, and it is this normative definition, rather than the sleep phenomena experienced, that the individual uses to provide a benchmark for their self-categorization of sleep quality.
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Bassett, Kimberley, Judith Gullifer, and Ramon L. Varcoe. "Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease." Ageing and Society 39, no. 12 (July 16, 2018): 2605–30. http://dx.doi.org/10.1017/s0144686x1800065x.
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AbstractThe population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeedmorelikely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.
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Craft, P. S., J. Buckingham, J. E. Dahlstrom, K. Beckmann, Y. Zhang, R. Stuart-Harris, G. Jacob, D. Roder, and N. Tait. "Variations in care for operable breast cancer and outcomes between rural and metropolitan centers in Australia." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e11517-e11517. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e11517.
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e11517 Background: The causes of variation in breast cancer survival remain uncertain. Care provided to women with breast cancer may vary in relation to both the care setting and characteristics of the clinicians. Methods: To compare the outcomes of management of breast cancer treated in rural and metropolitan centers, a prospective audit of breast cancer in a region of Australia was undertaken. Over a nine-year observation period 2102 women with invasive breast cancer underwent potentially curative surgery. Treatments received, including systemic adjuvant therapy, were compared to contemporary guideline-based indicators. Breast cancer specific mortality was analyzed using Cox proportional hazards models. Results: Overall agreement of received treatment with the indicators was high. Women treated within rural centers were, however, much less likely to receive post operative radiotherapy after breast conserving surgery (86.4% vs. 97.0%; p<0.001). The overall recurrence rate, including distant metastases, for all women was 11.6%. Local or regional recurrence was more frequent in rural centers compared with metropolitan centers (4.1% versus 2.1%; p=0.05). Breast cancer mortality was increased in women with large tumors, high grade disease, and positive axillary lymph nodes. Non-compliance with treatment guidelines was associated with a trend towards increased breast cancer mortality (HR=1.55; p=0.056). After adjustment for these factors and patient age, undergoing surgery in rural centers was associated with increased breast cancer mortality (HR=1.84; p<0.001). Although women treated in rural centers were older, their cancer stage and tumour characteristics were similar to those of women treated in metropolitan centers. Non-cancer related mortality was elevated in women treated in rural centers compared with women travelling to a city for surgery (HR=2.08; p=0.005). Conclusions: Increased non-cancer related mortality in rural treated women suggests increased medical co-morbidity in this group, which may have influenced treatment choices and outcomes. Low rates of adjuvant radiotherapy were noted for women treated in rural centers. In addition, clinically significant differences in outcome, including breast cancer mortality, were observed. No significant financial relationships to disclose.
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Stanzel, Karin A., Karin Hammarberg, and Jane Fisher. "Primary healthcare providers' attitudes and beliefs about the menopause-related care needs of women who have migrated from low- and middle-income countries to Australia." Australian Journal of Primary Health 26, no. 1 (2020): 88. http://dx.doi.org/10.1071/py19132.
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Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.
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Hickey, M., G. Krikun, P. Kodaman, Frederick Schatz, C. Carati, and C. J. Lockwood. "Long-Term Progestin-Only Contraceptives Result in Reduced Endometrial Blood Flow and Oxidative Stress." Journal of Clinical Endocrinology & Metabolism 91, no. 9 (September 1, 2006): 3633–38. http://dx.doi.org/10.1210/jc.2006-0724.
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Abstract Context: Because of their safety and efficacy, long-term progestin-only contraceptives (LTPOCs) are well-suited for women with restricted access to health care. However, abnormal uterine bleeding (AUB) causes half of all users to discontinue therapy within 12 months. Endometria of LTPOC-treated patients display aberrant angiogenesis with abnormally enlarged, thin-walled, fragile blood vessels, inflammation, and focal hemorrhage. In this study, similar effects were observed with a new third-generation implantable LTPOC. Objective: We hypothesized that LTPOC reduces uterine and endometrial blood flow, leading to hypoxia/reperfusion, which triggers the generation of reactive oxygen species. The latter induce aberrant angiogenesis, causing AUB. Design: Endometrial perfusion was measured by laser-Doppler fluxmetry in women requesting LTPOCs. Endometrial biopsies were obtained for in vivo and in vitro experiments. Setting: The study was conducted in the Yale University School of Medicine and Family-Planning Center in Western Australia. Patients: Seven women 18 yr or older requesting implantable LTPOCs were recruited in Western Australia. Intervention: Women received etonorgestrel implants. Main Outcome: LTPOC treatment resulted in reduced endometrial perfusion and increased endometrial oxidative damage. Conclusions: We propose that LTPOCs result in hypoxia reperfusion, which leads to aberrant angiogenesis resulting in AUB.
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DiGiacomo, Michelle, Yutaka Hatano, Jane Phillips, Joanne Lewis, Amy P. Abernethy, and David C. Currow. "Caregiver characteristics and bereavement needs: Findings from a population study." Palliative Medicine 31, no. 5 (August 8, 2016): 465–74. http://dx.doi.org/10.1177/0269216316663855.
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Background: Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. Aim: We compared characteristics, expressed unmet needs and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age. Design: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care. Setting/participants: Participants were aged over 15 years, resided in households in South Australia and had someone close to them die from a terminal illness in the last 5 years. Results: Of the 1540 respondents who provided hands-on care for someone close at the end of life, 155 were widows/widowers. Bereaved spousal caregivers were more likely to be older, female, better educated, have lower incomes, less full-time work, English as second language, sought help with grief and provided more day-to-day care for longer periods. Spousal caregivers were less likely to be willing to take on caregiving again, less able to ‘move on’ with life and needed greater emotional support and information about illness and services. The only difference between widows and widowers was older age of spouse in women. Younger spousal caregivers perceived greater unmet emotional needs and were significantly less likely to be able to ‘move on’. Conclusion: Spousal caregivers are different from other caregivers, with more intense needs that are not fully met. These have implications for bereavement, health and social services.
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Haveric, Dzavid. "Muslim Memories in Victoria." Australian Journal of Islamic Studies 2, no. 3 (October 18, 2017): 20–39. http://dx.doi.org/10.55831/ajis.v2i3.55.
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There is no history of Islam in Australia without a history of Muslim communities; there is no history of these Muslim communities without the memories of Australian Muslims. Within Australia’s religiously pluralistic mosaic there is no history of the Muslim faith without sharing universal values with other faiths.
This paper is primarily based on empirical research undertaken in Victoria. It is a pioneering exploration of the building of multiethnic Muslim communities and interfaith relations from the 1950s to the 1980s. It is part of much broader research on the history of Islam in Australia. It is kaleidoscopic in its gathering of individual and family migrant memories from Muslims in all walks of life. It includes an older Muslim generation as well as those who came later, in subsequent waves. Muslim interviewees in the research were migrants of various ethnicities from Albania, Bosnia, Cyprus, Egypt, India, Indonesia, Jordan, Kosovo, Lebanon, Pakistan, Palestine, Sri Lanka, Syria, Turkey, Tanzania and Kenya. Muslim men and women are represented, and also those born in Australia. This research was enhanced by consulting Islamic and Christian archival sources.
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Brown, Wendy J., Richard Hockey, Annette J. Dobson, and Barbara Ainsworth. "Physical Activity, BMI and Health Care Costs in Mid-age and Older Australian Women." Medicine & Science in Sports & Exercise 38, Supplement (May 2006): S56. http://dx.doi.org/10.1249/00005768-200605001-01126.
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Tinashe, Dune, Stewart Jo., Tronc Wendy, Lee Vanessa, Mapedzahama Virginia, Firdaus Rubab, and Mekonnen Tensae. "Redefining Constructions of Sexuality and Sexual Wellbeing across Generations: Lessons from Ageing Aboriginal Women." International Journal of Social Science Studies 6, no. 3 (February 9, 2018): 40. http://dx.doi.org/10.11114/ijsss.v6i3.3014.
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This study explored how Indigenous women living in Australia understand, experience and construct sexuality within contexts dominated by revealed the impact of Eurocentric conceptualisations of gender, embodiment and intimacy. This project was informed by feminist methodology and collected data using semi-structured focus groups, which naturally took on the yarning method. The discussions, held on the Sunshine Coast in Queensland, were had with women aged 42 to 73 years, across three focus groups. The women primarily constructed sexuality within Australia’s history of colonisation, discrimination and prejudice against Indigenous people, the uptake of European values and their impact on Indigenous people over time and across generations. Self-esteem was a central feature across all major themes and described as integral to health constructions of sexuality and health relationships. Changes over time were characterised by the women’s commitment to instilling self-esteem in following generations as well as limitations to self-esteem resulting from discrimination. Socialising future generations to display and embrace intimacy was also central to a healthy construction of sexuality. The findings from this study reinforce that learning from Indigenous women about sexuality and ageing is key to enriching the evidence-base as well as health worker and researcher capacity while reinforcing the importance of self-care among Indigenous older women. Integrating such an approach with Indigenous women has the potential to increase the effectiveness and relevance of health promotion and wellbeing programmes aimed at older Indigenous women in the present and future.
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MCKENZIE, SAMANTHA J., JAYNE C. LUCKE, RICHARD L. HOCKEY, ANNETTE J. DOBSON, and LEIGH R. TOOTH. "Is use of formal community services by older women related to changes in their informal care arrangements?" Ageing and Society 34, no. 2 (September 28, 2012): 310–29. http://dx.doi.org/10.1017/s0144686x12000992.
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ABSTRACTThis paper examines how the relationships between the factors (predisposing, enabling and illness) of the 1973 Andersen framework and service use are influenced by changes in the caring role in older women of the 1921–26 cohort of the Australian Longitudinal Study on Women's Health. Outcome variables were the use of three formal community support services: (a) nursing or community health services, (b) home-making services and (c) home maintenance services. Predictor variables were survey wave and the following carer characteristics: level of education, country of birth, age, area of residence, ability to manage on income, need for care, sleep difficulty and changes in caring role. Carer changes were a significant predictor of formal service use. Their inclusion did not attenuate the relationship between the Andersen framework factors and service use, but instead provided a more complete representation of carers' situations. Women were more likely to have used support services if they had changed into or out of co-resident caring or continued to provide co-resident care for a frail, ill or disabled person, needed care themselves, and reported sleep difficulties compared with women who did not provide care. These findings are important because they indicate that support services are particularly relevant to women who are changing their caring role and who are themselves in need of care.
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Adams, Jon, Erica McIntyre, Amie Steel, Brenda Leung, Matthew Leach, and David Sibbritt. "The utilisation of public and private health care among Australian women with diabetes: Findings from the 45 and Up Study." PLOS ONE 16, no. 8 (August 12, 2021): e0255573. http://dx.doi.org/10.1371/journal.pone.0255573.
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Aim To describe the prevalence of health care utilisation and out-of-pocket expenditure associated with the management of diabetes among Australian women aged 45 years and older. Design Cross-sectional survey design. Methods The questionnaire was administered to 392 women (a cohort of the 45 and Up Study) reporting a diagnosis of diabetes between August and November 2016. It asked about the use of conventional medicine, complementary medicine (CM) and self-prescribed treatments for diabetes and associated out-of-pocket spending. Results Most women (88.3%; n = 346) consulted at least one health care practitioner in the previous 12 months for their diabetes; 84.6% (n = 332) consulted a doctor, 44.4% (n = 174) consulted an allied health practitioner, and 20.4% (n = 80) consulted a CM practitioner. On average, the combined annual out-of-pocket health care expenditure was AU$492.6 per woman, which extrapolated to approximately AU$252 million per annum. Of this total figure, approximately AU$70 million was spent on CM per annum. Conclusions Women with diabetes use a diverse range of health services and incur significant out-of-pocket expense to manage their health. The degree to which the health care services women received were coordinated, or addressed their needs and preferences, warrants further exploration. Limitations of this study include the use of self-report and inability to generalise findings to other populations.
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STONES, DAMIEN, and JUDITH GULLIFER. "‘At home it's just so much easier to be yourself’: older adults' perceptions of ageing in place." Ageing and Society 36, no. 3 (December 1, 2014): 449–81. http://dx.doi.org/10.1017/s0144686x14001214.
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ABSTRACTBy 2050, the number of people in Australia aged over 85 is expected to quadruple. Yet, from a socio-psychological research perspective, little is known about the experiences of people who continue to live at home during late old age (85 years and over), a period when challenging problems associated with ageing escalate and threaten to compromise independence. Utilising a qualitative methodology, the subjective lived experience of 23 very old adults (19 women, four men, with a mean age of 90.7 years, range 85–101 years) who live independently in rural Australia were elicited. The aims of the research were to understand their thoughts and feelings about ageing in place at home, and what psychological, social and practical adaptive strategies they employ to cope with difficulties encountered during very old age. In-depth interviews were analysed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases and interpretation of exemplars. Participants described how historical, cultural and environmental contexts shaped their everyday thoughts, activities and what was meaningful for them. The findings add to our understanding of the largely unnarrated lives of the very old, suggest a need for person-centred home-care assessment processes and aid significant others (family, friends and neighbours) to understand better what very old adults need to live independently.
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Dow, Briony, and Sue Malta. "People with Alzheimer's disease and their spouse-caregivers: differences in perceptions of sexual satisfaction?" International Psychogeriatrics 29, no. 2 (January 26, 2017): 181–83. http://dx.doi.org/10.1017/s1041610216002301.
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Older informal caregivers aged 65+ years account for 34% of all carers in the USA (Family Caregivers Alliance, 2016), 22% in England and Wales (Carers UK, 2015), and 24% in Australia (Deloitte Access Economics, 2015). For many older carers, this means looking after their spouse or intimate partner who in many cases has dementia (Donnellan et al., 2015). As the incidence of dementia increases, the need to understand the impact of caring on these intimate relationships becomes more vital, so the experiences of spousal caregivers can be anticipated, validated, and supported. It is also important to understand the gender differences in these care relationships, so that education and services can be tailored to meet the different needs of men and women caregivers. Sexual activity in later life is associated with both mental and physical health (Ganong and Larson, 2011; Anderson, 2013), and is therefore, important to maintain, perhaps even in the context of caring for someone with dementia.
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Ford, Margot. "Language Nests in New Zealand. Implications for the Australian Aboriginal and Torres Strait Islander Context." Australian Journal of Indigenous Education 24, no. 2 (1996): 15–19. http://dx.doi.org/10.1017/s1326011100002416.
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In the past ten years there has been an increasing interest in early childhood education in Aboriginal communities, particularly for 4-year-olds and under. The reasons for this are varied. One of the main reasons is the existence of the Community Development Employment Project (CDEP) where Aboriginal people in remote communities receive the equivalent of the unemployment benefit in exchange for work and training, usually four hours per day for five days. Other larger communities, for example Yuendemu or Maningrida in the Northern Territory, have considerable numbers of people studying, often at Batchelor College, and therefore some type of support is needed to take care of their young children. Increasingly Aboriginal people are taking on professional jobs in communities — teachers, health care workers and office administrators. All these factors are leading to a need to re-evaluate traditional forms of child care, which in these changing times is putting an unacceptable burden on older women and the extended family generally. Other pertinent reasons are the need for a more cohesive strategy to pass on cultural knowledge, to support language maintenance and language revival and support very young mothers who need the support of older women with more experience.
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Rahman, Mijanur, Jimmy T. Efird, and Julie E. Byles. "Patterns of aged care use among older Australian women: A prospective cohort study using linked data." Archives of Gerontology and Geriatrics 81 (March 2019): 39–47. http://dx.doi.org/10.1016/j.archger.2018.11.010.
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Farquhar, Cynthia M., Zhuoyang Li, Sarah Lensen, Claire McLintock, Wendy Pollock, Michael J. Peek, David Ellwood, et al. "Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study." BMJ Open 7, no. 10 (October 2017): e017713. http://dx.doi.org/10.1136/bmjopen-2017-017713.
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ObjectiveEstimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes.DesignCase–control study.SettingSites in Australia and New Zealand with at least 50 births per year.ParticipantsCases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls.MethodsData were collected using the Australasian Maternity Outcomes Surveillance System.Primary and secondary outcome measuresIncidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death).ResultsThe incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%).Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation.
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Pilotto, Alberto, Nicola Veronese, Julia Daragjati, Alfonso J. Cruz-Jentoft, Maria Cristina Polidori, Francesco Mattace-Raso, Marc Paccalin, et al. "Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study." Journals of Gerontology: Series A 74, no. 10 (October 17, 2018): 1643–49. http://dx.doi.org/10.1093/gerona/gly239.
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Abstract Background Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79–6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70–20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.
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Patterson, Amanda J., Anne F. Young, Jennifer R. Powers, Wendy J. Brown, and Julie E. Byles. "Relationships between nutrition screening checklists and the health and well-being of older Australian women." Public Health Nutrition 5, no. 1 (February 2002): 65–71. http://dx.doi.org/10.1079/phn2001205.
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AbstractObjectives:To examine associations between nutrition screening checklists and the health of older women.Design:Cross-sectional postal survey including measures of health and health service utilisation, as well as the Australian Nutrition Screening Initiative (ANSI), adapted from the Nutrition Screening Initiative (NSI).Setting:Australia, 1996.Subjects:In total, 12 939 women aged 70–75 years randomly selected as part of the Australian Longitudinal Study on Women's Health.Results:Responses to individual items in the ANSI checklist, and ANSI and NSI scores, were associated with measures of health and health service utilisation. Women with high ANSI and NSI scores had poorer physical and mental health, higher health care utilisation and were less likely to be in the acceptable weight range. The performance of an unweighted score (TSI) was also examined and showed similar results. Whereas ANSI classified 30% of the women as ‘high-risk’, only 13% and 12% were classified as ‘high-risk’ by the NSI and TSI, respectively. However, for identifying women with body mass index outside the acceptable range, sensitivity, specificity and positive predictive values for all of these checklists were less than 60%.Conclusions:Higher scores on both the ANSI and NSI are associated with poorer health. The simpler unweighted method of scoring the ANSI (TSI) showed better discrimination for the identification of ‘at risk’ women than the weighted ANSI method. The predictive value of individual items and the checklist scores need to be examined longitudinally.
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Kalisch Ellett, Lisa M., Nicole L. Pratt, Mhairi Kerr, and Elizabeth E. Roughead. "Antipsychotic polypharmacy in older Australians." International Psychogeriatrics 30, no. 4 (November 10, 2017): 539–46. http://dx.doi.org/10.1017/s1041610217001934.
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ABSTRACTBackground:Antipsychotics are commonly used, and the rate of use is highest, among those aged 65 years or over, where the risk of adverse events is also high. Up to 20% of younger adults use more than one antipsychotic concurrently; however there are few studies on the prevalence of antipsychotic polypharmacy in older people. We aimed to analyze antipsychotic use in elderly Australians, focusing on the prevalence of antipsychotic polypharmacy and the use of medicines to manage adverse events associated with antipsychotics.Methods:A cross-sectional study was conducted using Australian Department of Veterans’ Affairs (DVA) administrative claims data for the period 1 March 2014 to 30 June 2014. Veterans dispensed at least one antipsychotic medicine during the study period was included. We determined the number of participants dispensed antipsychotic polypharmacy and the number of participants dispensed medicines to manage antipsychotic side effects.Results:There were 7,412 participants with a median age of 86 years. Fifty-one percent (n=3,784) were women and 48% (n=3,569) lived in residential aged-care. Fifty one participants (0.7%) were dispensed anticholinergic medicines indicated for the management of antipsychotic-associated extrapyramidal movement disorders and eight (0.1%) were dispensed medicines for the management of hyperprolactinemia. Five percent of participants (n=365) received dual antipsychotics. Dual antipsychotic users were more likely to be under the care of a psychiatrist or to have had a mental health hospitalization than those using a single antipsychotic.Conclusions:Antipsychotic polypharmacy occurred in one in 20 elderly persons, indicating that there is room for improvement in antipsychotic use in elderly patients.
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Rahman, Md Mijanur, and Julie E. Byles. "Trajectories of Long-Term Residential Care Needs Among Older Australian Women: A Cohort Study Using Linked Data." Journal of the American Medical Directors Association 21, no. 6 (June 2020): 786–92. http://dx.doi.org/10.1016/j.jamda.2019.08.019.
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Gill, Gerard, Kate Blackmore, Dominic P Geraghty, and Des FitzGerald. "The impact of residential socio-economic profile on medical service utilisation and nursing home attendance claims by older Australians." Australian Journal of Primary Health 10, no. 3 (2004): 137. http://dx.doi.org/10.1071/py04058.
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In other developed countries, older persons in deprived personal circumstances make increased use of primary care and nursing homes compared with those less disadvantaged. The influence of living in a more deprived area on the use of these services by older residents has not been so well studied. This study appraises if older Australians living in more disadvantaged locations have similar increased service usage. Retrospective analyses of fee-for-service data from 1 October 2001 to 30 September 2002 for all Medicare and Department of Veterans? Affairs claimants aged 77 years and over, not admitted to residential aged care, were undertaken. Data were analysed by age, gender and quartile of disadvantage of postcode of residence as categorised by the Australian Bureau of Statistics 1996 Census Index of Relative Socio-economic Disadvantage. The main outcome measures were: mean number of claims for general practitioner primary medical care (GP) services; longer GP consultations; specialist consultations; rate of GP health assessments; and, first claims for GP nursing home attendances. Mean number of claims for GP primary medical care services generally decreased as the disadvantage of postcode increased. Men aged 77-79 years were an exception, with no difference in the mean across quartiles of disadvantage. The mean number of claims for longer primary care consultations and all specialist consultations also decreased as the disadvantage of postcode increased. Claims for GP health assessments were more frequent as the disadvantage of the residential postcode increased. Claim rates for first nursing home attendance items by men did not differ across the range of disadvantage. This lack of difference was also seen for women aged 77-79 years. Claims for first nursing home attendance items by women aged 80 or more years decreased as the disadvantage of postcode increased. This study concluded that there are fewer claims for medical and nursing home services by older Australians living in more disadvantaged postcodes. Whether this represents under-provision of medical care leading to sub-optimal health outcomes needs further examination.
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Ward, Paul R., Sara Javanparast, and Carlene Wilson. "Equity of colorectal cancer screening: which groups have inequitable participation and what can we do about it?" Australian Journal of Primary Health 17, no. 4 (2011): 334. http://dx.doi.org/10.1071/py11055.
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The National Bowel Cancer Screening Program (NBCSP) offers population-based screening for colorectal cancer (CRC) across Australia. The aims of this paper were to highlight the inequities in CRC screening in South Australia (SA) and the system-related barriers and enablers to CRC screening from the perspective of participants identified as having inequitable participation. First, de-identified data for the SA population of the NBCSP were statistically analysed and then mapped. Second, 117 in-depth interviews were conducted with culturally and linguistically diverse (CALD) groups, Indigenous and Anglo-Saxon Australians. Participation rates in the NBCSP were geographically and statistically significantly different (P < 0.0001) on the basis of gender (higher for women), age (higher for older people) and socioeconomic status (higher for more affluent people). The main system-related barriers were the lack of awareness of CRC or CRC screening within these groups, the problems with language due to most of the information being in English and the lack of recommendation by a doctor. This study revealed that inequity exists in the NBCSP participation in SA, and we identified both barriers and facilitators to CRC screening that require action at the level of both policy and practice. There is a large role in primary health care of both recommending CRC screening and facilitating equitable participation.
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South, Sandra H. "Australian Association of Gerontology Position Paper: Older women who are experiencing, or at risk of, homelessness." Australasian Journal on Ageing 38, no. 1 (December 5, 2018): 66–68. http://dx.doi.org/10.1111/ajag.12601.
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Lind, Kimberly E., Mikaela L. Jorgensen, Leonard C. Gray, Andrew Georgiou, and Johanna I. Westbrook. "Anti-osteoporosis Medication Use in a High Fracture-Risk Population: Contemporary Trends in Australian Residential Aged Care Facilities." Health Services Insights 12 (January 2019): 117863291985211. http://dx.doi.org/10.1177/1178632919852111.
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Osteoporotic fractures impose substantial morbidity and mortality among older adults. Undertreatment is an ongoing concern; treatment rates declined following reports of adverse effects of guideline-recommended bisphosphonates, but new antiresorptives have since become available. Our goal was to identify contemporary trends in osteoporosis treatment guideline adherence in a high fracture-risk population. We conducted a secondary data analysis using electronic health record data of adults aged ⩾65 years from 68 residential aged care facilities in Australia during 2014-2017 (n = 9094). Using medication administration data, we identified antiresorptive (bisphosphonates and denosumab) and vitamin D supplement use among residents with osteoporosis. Regression was used to evaluate temporal trends, and resident and facility characteristics associated with antiresorptive use and vitamin D use. In 2014, 34% of women and 42% of men with osteoporosis used antiresorptives; this decreased 8 percentage points by 2017. Antiresorptive use was higher among those with a history of fracture and lower in the last year of life. Denosumab use increased but did not substitute for the continued decline in bisphosphonate use. Vitamin D was consistently used by more than 60% of residents and was higher among those with fracture history. Greater attention to the treatment of osteoporosis treatment rates among this high fracture-risk population is warranted.
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Byles, Julie. "Over the Hill and Picking up Speed: Older Women of the Australian Longitudinal Study on Women's Health." Australasian Journal on Ageing 18 (December 1999): 55–62. http://dx.doi.org/10.1111/j.1741-6612.1999.tb00891.x.
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Henson, Connie, Boe Rambaldini, Bronwyn Carlson, Monika Wadolowski, Carol Vale, and Kylie Gwynne. "A new path to address health disparities: How older Aboriginal & Torres Strait Islander women use social media to enhance community health (Protocol)." DIGITAL HEALTH 8 (January 2022): 205520762210844. http://dx.doi.org/10.1177/20552076221084469.
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Background Digital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research. Objective This paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies. Methods This mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs. Conclusions Privileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.
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Peterson, Candida C. "The Accuracy of Older and Younger Australians' Understanding of Mental Health and Aging." International Journal of Aging and Human Development 36, no. 2 (March 1993): 129–38. http://dx.doi.org/10.2190/fehx-80mj-2uwl-7ph5.
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Inadequacies in contemporary mental health care for elderly individuals may come about partly through ignorance of both positive aspects of mental health in old age (e.g., the responsiveness of older clients to psychotherapy) and the negative aspects (e.g., elderly men's unusually high suicide risk). A quiz measuring knowledge of both kinds was administered to a total of 250 Australian men and women aged seventeen to eighty-one years who were either retired, employed, housewives, or university students. As hypothesized, the retired group scored lowest on the quiz, with no significant differences among younger students versus non-students. Age was found to be a more important mediator of the retired group's low scores than gender, living with an older person, or self-definition as retired versus employed or a housewife. A previous finding of higher scores by Australians than by U.S. undergraduates in an aging course was also replicated and extended to older nonstudent groups. Implications of these findings for mental health services for elderly individuals and for educational interventions to improve understanding of mental health in older age groups were considered.
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Bowden, Jocelyn L., Rod Lamberts, David J. Hunter, Luciano Ricardo Melo, and Kathryn Mills. "Community-based online survey on seeking care and information for lower limb pain and injury in Australia: an observational study." BMJ Open 10, no. 7 (July 2020): e035030. http://dx.doi.org/10.1136/bmjopen-2019-035030.
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ObjectivesMusculoskeletal pain is a leading cause of disability globally. In geographically and socioeconomically diverse countries, such as Australia, care seeking when someone experiences musculoskeletal pain is varied and potentially influenced by their individual characteristics, access to practitioners or perceived trustworthiness of information. This study explored how consumers currently access healthcare, how well it is trusted and if sociodemographic factors influenced healthcare utilisation.DesignAnonymous online observational survey.SettingAustralia.ParticipantsA convenience sample of 831 community-based individuals (18+ years).Outcome measuresDescriptive analyses and generalised estimating equations were used to quantify healthcare-seeking behaviours, sources and trust of health information for (A) first-contact practitioners, (B) medical practitioners, and (C) other sources of information.ResultsOf the 761 respondents, 73% were females, 54% resided in capital cities. 68% of respondents had experienced pain or injury in more than one lower limb joint. Despite this, more than 30% of respondents only sought help when there had not been natural resolution of their pain. Physiotherapists had the highest odds of being seen, asked and trusted for healthcare information. The odds of seeking care from general practitioners were no higher than seeking information from an expert website. Older individuals and women exhibited higher odds of seeking, asking and trusting health information.ConclusionIntelligible and trustworthy information must be available for consumers experiencing lower limb pain. Individuals, particularly younger people, are seeking information from multiple, unregulated sources. This suggests that healthcare professionals may need to invest time and resources into improving the trustworthiness and availability of healthcare information to improve healthcare quality.
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Robinson, Penelope J., Robin J. Bell, Alfred Lanzafame, Catherine Kirby, Andrew Weekes, Leon Piterman, and Susan R. Davis. "The prevalence of vitamin D deficiency and relationship with fracture risk in older women presenting in Australian general practice." Australasian Journal on Ageing 32, no. 3 (July 25, 2011): 177–83. http://dx.doi.org/10.1111/j.1741-6612.2011.00553.x.
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Sambrook, P. N., J. S. Chen, L. M. March, I. D. Cameron, R. G. Cumming, S. R. Lord, J. Schwarz, and M. J. Seibel. "Serum Parathyroid Hormone Is Associated with Increased Mortality Independent of 25-Hydroxy Vitamin D Status, Bone Mass, and Renal Function in the Frail and Very Old: A Cohort Study." Journal of Clinical Endocrinology & Metabolism 89, no. 11 (November 1, 2004): 5477–81. http://dx.doi.org/10.1210/jc.2004-0307.
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Abstract Very frail older people constitute an increasing proportion of the aging population and often have vitamin D deficiency and impaired renal function. Primary hyperparathyroidism has been associated with increased mortality, but it is unclear whether secondary hyperparathyroidism is associated with increased mortality independent of renal function and vitamin D status. This study aimed to examine the effect of vitamin D deficiency and secondary hyperparathyroidism on mortality in frail older people after accounting for renal function and general measures of health. We evaluated 842 subjects (182 men with a mean age of 81.9 yr and 660 women with a mean age of 86.2 yr) living in residential aged care facilities in Sydney, Australia in a prospective, cohort study. Over a mean duration of follow-up of 31 months, 345 subjects died. Baseline serum 25-hydroxy vitamin D, serum PTH, and bone ultrasound attenuation were significantly associated with mortality in univariate and multivariate analyses (for PTH, a hazard ratio of 1.39 for time to death) after correcting for age and gender. In multivariate analyses that corrected for health status, nutritional status, and renal function, PTH remained a significant predictor of mortality but not 25-hydroxy vitamin D or bone ultrasound attenuation. Serum PTH appears to be associated with increased mortality in the frail elderly independent of vitamin D status, renal function, bone mass, and measures of general health. The mechanism of this effect requires further investigation.
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Vedi, Aditi, Richard Mitchell, Cecelia Oswald, Glenn M. Marshall, Toby Trahair, and David S. Ziegler. "Increased Use of Allogeneic Transplant in CR2 Improves the Outcome for Children with Acute Myeloid Leukaemia." Blood 126, no. 23 (December 3, 2015): 2521. http://dx.doi.org/10.1182/blood.v126.23.2521.2521.
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Abstract Improvements in Outcome for Paediatric de novo Acute Myeloid Leukaemia Aditi Vedi1,2, Richard Mitchell1, Cecelia Oswald1, Glenn Marshall1,2, Toby Trahair1, David S Ziegler1,2 1Kids Cancer Centre, Sydney ChildrenÕs Hospital, Randwick, NSW, Australia, 2 School of Women and Children's Health, University of New South Wales, Randwick, NSW, Australia ABSTRACT The treatment for paediatric acute myeloid leukaemia (AML) has not changed significantly over the past 3 decades, yet outcomes have improved with cure rates increasing from 30% to over 50% of all newly diagnosed children over this period. This improvement in survival has been attributed to both treatment intensification and improved supportive care over the decades, although the precise impact of each remains unknown. Our group has retrospectively analysed a unique cohort of patients with de novo AML diagnosed in childhood (n=276), all treated with the same chemotherapy protocol over a 25-year period from 1986-2012. The contemporary cohort (2000-12), compared to historical cohorts (1986-99) had significantly improved overall survival (OS, 75% vs. 50%, p = 0.01), lower disease related mortality (38% vs. 19%, p = 0.02) and were significantly more likely to receive allogeneic transplant after relapse (SCT, 73% vs. 12%, p <0.0001). Allogeneic transplant post relapse was associated with a significantly improved survival across the entire cohort (OS 50% for allogeneic SCT vs. 12% for autologous or none, p<0.0001). There was no significant difference between the contemporary and historical cohorts in treatment related mortality (13% vs. 7%, p = 0.42) or relapse rates after induction (50% in older cohort vs. 40% in recent era, p=0.25), suggesting consistency of induction treatment efficacy and toxicity across the two periods. This data suggests improved survival in paediatric AML in the modern era has predominantly resulted from increased use of allogeneic SCT after relapse rather than from improved supportive care and is independent of chemotherapy intensification. Disclosures No relevant conflicts of interest to declare.
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FALAGAS, M. E., P. K. KOLETSI, E. BASKOUTA, P. I. RAFAILIDIS, G. DIMOPOULOS, and D. E. KARAGEORGOPOULOS. "Pandemic A(H1N1) 2009 influenza: review of the Southern Hemisphere experience." Epidemiology and Infection 139, no. 1 (October 5, 2010): 27–40. http://dx.doi.org/10.1017/s0950268810002037.
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SUMMARYWe sought to systematically review the published literature describing the epidemiological aspects of the first wave of pandemic A(H1N1) 2009 influenza in the Southern Hemisphere. Fifteen studies were included in this review, originating from South America, Australia or New Zealand, and Africa. Across the different studies, 16·8–45·3% of the laboratory-confirmed cases were admitted to hospital, and 7·5–26·0% of these cases were admitted to intensive care units (ICUs). The fatality rate was 0·5–1·5% for laboratory-confirmed cases in 6/8 studies reporting specific relevant data, and 14·3–22·2% for cases admitted to ICUs in 5/7 studies, respectively. In 4/5 studies the majority of laboratory-confirmed cases were observed in young and middle-aged adults, the percentage of older adults increased the higher the level of healthcare the cases received (e.g. laboratory confirmation, hospitalization or ICU admission) or for fatal cases. Many of the cases had no prior comorbidity, including conditions identified as risk factors for seasonal influenza. Pregnant women represented 7·4–9·1% and 7·1–9·1% of unselected laboratory-confirmed cases and of those admitted to ICUs, respectively. Obesity and morbid obesity were more commonly reported as the level of healthcare increased.
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Rossen, Larissa, Delyse Hutchinson, Judy Wilson, Lucinda Burns, Steve Allsop, Elizabeth Elliott, Sue Jacobs, Jacqui Macdonald, Craig Olsson, and Richard Mattick. "Maternal Bonding through Pregnancy and Postnatal: Findings from an Australian Longitudinal Study." American Journal of Perinatology 34, no. 08 (February 17, 2017): 808–17. http://dx.doi.org/10.1055/s-0037-1599052.
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Background Mother-infant bonding provides the foundation for secure attachment through the lifespan and organizes many facets of infant social-emotional development, including later parenting. Aims To describe maternal bonding to offspring across the pregnancy and postnatal periods, and to examine a broad range of sociodemographic and psychosocial predictors of the maternal-offspring bond. Methods Data were drawn from a sample of 372 pregnant women participating in an Australian population-based longitudinal study of postnatal health and development. Participants completed maternal bonding questionnaires at each trimester and 8 weeks postnatal. Data were collected on a range of sociodemographic and psychosocial factors. Results Bonding increased significantly through pregnancy, in quality and intensity. Regression analyses indicated that stronger antenatal bonding at all time points (trimesters 1 through 3) predicted stronger postnatal bonding. Older maternal age, birth mother being born in a non-English speaking country, mother not working full time, being a first-time mother, breast-feeding problems, and baby's crying behavior all predicted poorer bonding at 8 weeks postpartum. Conclusion These novel findings have important implications for pregnant women and their infant offspring, and for health care professionals working in perinatal services. Importantly, interventions to strengthen maternal-fetal bonding would be beneficial during pregnancy to enhance postnatal bonding and infant health outcomes.
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Birch, Elisa, and Alison Preston. "The Australian labour market in 2019." Journal of Industrial Relations 62, no. 3 (March 16, 2020): 341–64. http://dx.doi.org/10.1177/0022185620909147.
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1 This article provides an overview of the key features of the labour market in 2019, with historical data providing insight into recent trends. In 2019, the female labour force participation rate reached an all-time high of 61.3%, 10 percentage points lower than the male rate. Disaggregated analysis shows this growth stems from rising participation amongst older women. This, in turn, is underpinned by a growth in feminised sectors of the labour market, notably the Health Care and Social Assistance sector. Since 2000 this sector has contributed 22.6% to total employment growth and at 2019 accounted for 13.5% of the Australian workforce. There has also been a growth in part-time and casual employment over recent years, with the latter now accounting for 25% of all employees. These are concerning developments, with estimates showing that 58.6% of casuals are not guaranteed a minimum number of hours of work in their job. The article notes that wages growth remains below that required to stimulate employment growth, and that a continued focus on conventional labour market indicators has the potential to lead to misguided policy formulation.
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Lo, T. K. T., L. Parkinson, M. Cunich, and J. Byles. "Factors associated with the health care cost in older Australian women with arthritis: an application of the Andersen's Behavioural Model of Health Services Use." Public Health 134 (May 2016): 64–71. http://dx.doi.org/10.1016/j.puhe.2015.11.018.
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Garrett, Cameryn C., Henrietta Williams, Louise Keogh, Qazi W. Ullah, Fabian Kong, and Jane S. Hocking. "Is there a role for practice nurses in increasing the uptake of the contraceptive implant in primary care?: survey of general practitioners and practice nurses." Sexual Health 13, no. 3 (2016): 241. http://dx.doi.org/10.1071/sh15229.
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Background: Uptake of long-acting reversible contraception (LARC) in Australia is low. With appropriate training, practice nurses (PNs) in general practice clinics could help increase LARC uptake. Methods: General practitioners (GPs) and PNs completed a postal survey to assess contraceptive implant knowledge and attitudes towards PNs providing contraception counselling and inserting the contraceptive implant. χ2 tests were used to detect differences between GPs and PNs. Unadjusted odds ratios (OR) for the association between demographic characteristics and knowledge and attitudes towards the contraceptive implant were calculated for GPs and PNs separately. Results: Four hundred and sixty-eight GPs and 1142 PNs participated. GPs had greater knowledge about LARC than PNs (59% vs 33%; P < 0.01). A similar proportion of GPs and PNs (70%) agreed that PNs could become involved in contraceptive counselling. Among GPs, urban-based GPs were less likely to agree that their clinic would be supportive of the PN inserting the implant (OR = 0.6; 95% CI: 0.4–0.9). Among PNs, older PNs (OR = 0.5; 95% CI: 0.4–0.7) were less likely to agree that the clinic would support PNs inserting the contraceptive implant, but those with Pap test training were more likely to agree (OR = 2.1; 95% CI: 1.5–3.0). Conclusions: This study found high levels of acceptability for PNs to provide contraceptive counselling and insertion of the contraceptive implant. Further research is needed to evaluate the impact of potential interventions that equip PNs with the skills to consult women about contraception and insert the contraceptive implant on LARC uptake.