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Bayes J, Bedaso A, Peng W, Adams J, Sibbritt D. The effect of polyphenols in post stroke adults: A systematic review of randomised controlled trials. Clin Nutr ESPEN 2023; 54:113-121. [PMID: 36963851 DOI: 10.1016/j.clnesp.2023.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/12/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND After a stroke, survivors are often left with significant disabilities and are at a greater risk of recurrent strokes. It is vital stroke survivors receive effective treatments to assist with rehabilitation and reduce risk factors for secondary stroke. Observational and preclinical studies have highlighted the promising role of polyphenols in these regards. METHODS A systematic review of original research which assessed the role of polyphenols on health outcomes in post stroke adults was conducted. PROQUEST, SCOPUS (Elsevier), MEDLINE (EBSCO), Embase and Cochrane Library databases were searched up to the 29th of October 2021. RESULTS A total of 9 studies met the full inclusion criteria and were included in this review. Several classes of polyphenols were assessed including hydroxybenzoic acids, stilbenes and flavonoids. Numerous health outcomes were assessed including vascular function, stroke disability, blood pressure, blood glucose and c-reactive protein. The majority of the studies included in this review (n = 8) note improvements in the polyphenol groups for at least one outcome measure. However, small sample sizes, short trial length and reporting bias prevent firm conclusions from being drawn. CONCLUSION This review provides promising preliminary evidence that polyphenols may be beneficial for post stroke adults, however, more research is required. To ensure reliable methodology and replication of results, future studies should include outcome statistics and effect sizes. Trials with a longer duration and large sample size should also be considered.
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Affiliation(s)
- J Bayes
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - A Bedaso
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - W Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - J Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - D Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Tilahune A, Peng W, Adams J, Sibbritt D. Social support and prenatal mental health problems: a systematic review and meta-analysis. Eur Psychiatry 2022. [PMCID: PMC9564965 DOI: 10.1192/j.eurpsy.2022.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental health problems. Providing social support is vital to reduce such risk. Objectives This systematic review and meta-analysis aimed at examining the relationship between social support and depression, anxiety and self-harm during pregnancy. Methods We searched observational studies from PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL databases. The Newcastle-Ottawa Scale tool was used for quality appraisal. The Q and the I² statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis. All the analysis was conducted using STATA. Results Sixty-seven studies with 64,449 pregnant women were part of the current review. Of the total 67 studies, 22 and 45 studies were included in the narrative analysis and meta-analysis, respectively. From the studies included in the narrative analysis, 20(91%) of them reported a significant association between social support and the risk of mental health problems (i.e. depression, anxiety, and self-harm). After adjusting for publication bias, the results of the random-effect model revealed low social support was significantly associated with antenatal depression (AOR: 1.18, 95% CI: 1.01, 1.41) and antenatal anxiety (AOR: 1.97, 95% CI: 1.34, 2.92). Conclusions Low social support was significantly associated with depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs to help reduce mental health problems amongst pregnant women. Disclosure No significant relationships.
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Tilahune A, Peng W, Adams J, Sibbritt D. The association between social support and antenatal depressive and anxiety symptoms among Australian women. Eur Psychiatry 2022. [PMCID: PMC9567406 DOI: 10.1192/j.eurpsy.2022.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital.
Objectives
This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women.
Methods
Our study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n=493). Depression and anxiety were assessed using the Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A binary logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms.
Results
After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR=4.75; 95% CI: 1.45, 15.66; p=0.010) and low social support (overall support) (AOR: 3.26, 95%CI: 1.05, 10.10, p=0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR=7.43; 95%CI: 1.75, 31.55; p=0.006).
Conclusions
Low emotional support and low affectionate support have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential.
Disclosure
No significant relationships.
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Peng W, Maguire J, Hayen A, Adams J, Sibbritt D. How to increase the value of self-reported health service data by using data linkage: a case study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments?
Methods
45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis.
Results
A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures.
Conclusions
Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants.
Key messages
Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.
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Affiliation(s)
- W Peng
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - J Maguire
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - A Hayen
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - J Adams
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - D Sibbritt
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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Steel A, Wardle J, Frawley J, Adams J, Sibbritt D, Lauche R. Associations between complementary medicine utilisation and the use of contraceptive methods: Results of a national cross-sectional survey. Complement Ther Clin Pract 2018; 33:100-106. [PMID: 30396606 DOI: 10.1016/j.ctcp.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/24/2018] [Accepted: 09/08/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE This study examines the relationship between the use of complementary medicine (CM) interventions or consultations with CM practitioners and women's choice of contraceptive method. MATERIALS AND METHODS A secondary analysis of a cross-sectional survey of Australian Women aged 34-39 years from the Australian Longitudinal Study on Women's Health (ALSWH) was conducted. Associations between use of CM and contraception were analysed using Chi-squared tests and multivariate logistic regression. RESULTS Based on the responses from the included women (n = 7299), women who consulted a naturopath/herbalist were less likely to use implant contraceptives (OR 0.56; 95% confidence interval (CI) 0.33; 0.95). Those consulting a chiropractor (OR 1.54; 95%CI 1.05; 2.25) or an osteopath (OR 2.16; 95% CI 1.32; 3.54) were more likely to use natural contraception. CONCLUSION There may be a link between women's choice of contraceptive method and their use of CM, in particular, with CM practitioner consultations.
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Affiliation(s)
- A Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia; Office of Research, Endeavour College of Natural Health, Level 2, 269 Wickham Street, Fortitude Valley, QLD, 4006, Australia.
| | - J Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - J Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - J Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - D Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - R Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
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Akter T, Dawson A, Sibbritt D. The determinants of essential newborn care for home births in Bangladesh. Public Health 2016; 141:7-16. [PMID: 27932018 DOI: 10.1016/j.puhe.2016.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 07/22/2016] [Accepted: 08/06/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the association of sociodemographic, antenatal and delivery care factors with the essential newborn care (ENC) practices of neonates born at home in Bangladesh. STUDY DESIGN This study analyzed data of a cross-sectional survey-the Bangladesh Demographic and Health Survey, 2011. METHODS This analysis considered 3190 most recent live-born infants who were delivered at home within three years of the survey. Logistic regression models were used to identify the factors affecting the implementation of six ENC practices, namely using disinfected instruments to cut the umbilical cord, avoidance of application of any substances to the umbilical cord stump, immediate drying and wrapping of newborns, delayed bathing of newborns, and immediate initiation of breastfeeding. RESULTS Factors affecting ENC practices in Bangladesh are low parental education, low utilization of antenatal care services, the absence of skilled birth attendants, smaller size at birth, higher birth order and mother's age at birth. Regional factors also seem to considerably affect ENC practices. CONCLUSION There is ample scope to improve the coverage of ENC practices in Bangladesh. Health promotion programmes that target parents with low education and older mothers may help to build awareness of ENC practices. This investigation provides insight into the key determinants of ENC practices, which require consideration when scaling up ENC practices in low-income and lower middle-income countries.
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Affiliation(s)
- T Akter
- Faculty of Health, University of Technology, Sydney, Building 10, 235-253 Jones St, Ultimo, NSW 2007, Australia.
| | - A Dawson
- Faculty of Health, University of Technology, Sydney, Building 10, 235-253 Jones St, Ultimo, NSW 2007, Australia.
| | - D Sibbritt
- Faculty of Health, University of Technology, Sydney, Building 10, 235-253 Jones St, Ultimo, NSW 2007, Australia.
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Peng W, Liang H, Sibbritt D, Adams J. Complementary and alternative medicine use for constipation: a critical review focusing upon prevalence, type, cost, and users' profile, perception and motivations. Int J Clin Pract 2016; 70:712-22. [PMID: 27354244 DOI: 10.1111/ijcp.12829] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/24/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Complementary and alternative medicine (CAM) is increasingly used by those suffering from constipation. This paper reports the first critical integrative review of CAM use for people with constipation focusing upon the prevalence, type and cost of CAM use, as well as CAM users' profile, perception and motivations. METHODS A comprehensive search of international literature was conducted in MEDLINE, Academic Search Complete (EBSCO), and Allied and Complementary Medicine Database (AMED). The search was limited to original research peer-reviewed English language articles concerning CAM use for constipation published with an abstract and full text between 2005 and 2015. RESULTS A total of 35 papers met the inclusion criteria and were included in the review. The review shows approximately one in every three people suffering from constipation use CAM with herbal medicine the most commonly used CAM treatment for constipation and a large proportion of CAM use occurring concurrent with or in addition to conventional medical treatments. While early investigation suggests the cost of herbal medicine use in constipation care may be lower than that associated with the use other CAM modalities and conventional medications, this issue requires further research. CONCLUSIONS Although a high percentage of people with constipation using CAM consider these treatments effective, there remains a need for further in-depth examination of both patient and provider perspectives as well as communication and decision-making around CAM use for constipation to inform safe, effective and coordinated care for patients with constipation.
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Affiliation(s)
- W Peng
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - H Liang
- Department of Anorectal Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - D Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - J Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Sibbritt D, Davidson P, Peng WB, Adams J, Hickman L. Hypertension: What are the self-care and health-care-seeking behaviours in women over time? J Hum Hypertens 2016; 30:783-787. [PMID: 27121442 DOI: 10.1038/jhh.2016.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/18/2016] [Accepted: 03/18/2016] [Indexed: 11/09/2022]
Abstract
The aim of this study was to estimate the prevalence and incidence of hypertension in women, and describe their self-care and health-seeking behaviours. This research was conducted as part of the Australian Longitudinal Study on Women's Health, a study comprising a nationally representative sample of Australian women in three age groups. The focus of this research is 14 099 women born in 1946-1951, who have been surveyed six times (1996-2010). Student t-tests were used to compare women who did or did not have hypertension by their health-care utilization. Longitudinal analyses were conducted using a Poisson generalized estimating equation model. The incidence of hypertension among this cohort during 1996 to 2010 ranged from 400 to 597 participants per survey, resulting in an increase in prevalence of hypertension from 20.9% in 1996 to 41.3% in 2010. For all survey periods, women with hypertension had a significantly higher average number of visits to doctors and allied health practitioners compared with women without hypertension (P<0.005). The use of complementary medicine (practitioners and self-prescribed treatments) by women with hypertension was significantly lower compared to women without hypertension (P<0.005). Over time, conventional health-care utilization was higher for women with hypertension compared with women without hypertension (adjusted RR=1.18; 95% CI: 1.14, 1.22; P<0.0001). Our findings show that women with hypertension are using a range of conventional and complementary and alternative medicine: with hypertensive women using more conventional medicine and less complementary and alternative medicine than non-hypertensive women. As such, health-care providers should communicate with their patients regarding their use of complementary and alternative medicine in their efforts to provide safe, effective and coordinate care.
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Affiliation(s)
- D Sibbritt
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - P Davidson
- Department Acute and Chronic Care, Johns Hopkins University, Baltimore, MD, USA
| | - W B Peng
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - J Adams
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - L Hickman
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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Steel A, Frawley J, Sibbritt D, Broom A, Adams J. The characteristics of women who use hypnotherapy for intrapartum pain management: Preliminary insights from a nationally-representative sample of Australian women. Complement Ther Med 2016; 25:67-70. [PMID: 27062951 DOI: 10.1016/j.ctim.2016.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/09/2016] [Accepted: 01/11/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This manuscript presents a preliminary examination of the characteristics of women who choose intrapartum hypnosis for pain management. DESIGN Cross-sectional analysis of 2445 women (31-36 years) from a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH), employing Fisher exact tests. SETTING Australia. MAIN OUTCOME MEASURES Use of intrapartum hypnosis, or hypnobirthing, for pain management during labour and birth. RESULTS Women using hypnobirthing were more likely to have consulted with an acupuncturist or naturopath, or attended yoga/meditation classes during pregnancy (p<0.0001). Use of CM products such as herbal medicines, aromatherapy oils, homoeopathy, herbal teas or flower essences (p<0.001) was also more common amongst these women. Women choosing hypnotherapy for intrapartum pain management less commonly identified as feeling safer knowing that an obstetrician is providing their care (p<0.001), and were more likely to labour in a birth centre or in a community centre (i.e. at home). CONCLUSIONS This analysis provides preliminary analysis into an as yet unexamined topic in contemporary maternity health service utilisation. The findings from this analysis may be useful for maternity health professionals and policy makers when responding to the needs of women choosing to use hypnotherapy for intrapartum pain management.
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Affiliation(s)
- A Steel
- Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, QLD 4006, Australia; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2006, Australia.
| | - J Frawley
- Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, QLD 4006, Australia; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2006, Australia
| | - D Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2006, Australia
| | - A Broom
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - J Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2006, Australia
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Akter T, Dawson A, Sibbritt D. What impact do essential newborn care practices have on neonatal mortality in low and lower-middle income countries? Evidence from Bangladesh. J Perinatol 2016; 36:225-30. [PMID: 26633143 DOI: 10.1038/jp.2015.181] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 08/25/2015] [Accepted: 10/19/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To assess the impact of essential newborn care (ENC) practices on the mortality of neonates delivered at home in Bangladesh. STUDY DESIGN This study used cross-sectional data from the 2011 Bangladesh Demographic and Health Survey. Adjusted logistic regression model was used to examine the effect of ENC practices on neonatal mortality based on 3190 live-born infants. RESULT Delayed bathing (72 h after delivery) significantly contributed to reducing neonatal mortality. A significant but counterintuitive relation was observed between the dry cord care and neonatal deaths. CONCLUSION Neonatal mortality may be reduced through emphasizing delayed bathing. Specific guidelines on the cleanliness of the fabric used to dry and wrap newborns, as well as emphasizing the use of clean delivery kits and initiation of immediate and exclusive breastfeeding, may improve neonatal outcomes. Further, the ENC guidelines in Bangladesh should include the application of topical antiseptics to the cord stump.
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Affiliation(s)
- T Akter
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - A Dawson
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - D Sibbritt
- Faculty of Health, University of Technology, Sydney, NSW, Australia
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Sibbritt D, Lui C, Kroll T, Adams J. Prevalence of Glucosamine and Omega-3 Fatty Acid Use and Characteristics of Users among Mid-Age Women: Analysis of a Nationally Representative Sample of 10,638 Women. J Nutr Health Aging 2016; 20:637-44. [PMID: 27273353 DOI: 10.1007/s12603-016-0721-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been a dramatic increase in the use of dietary supplements over the last few decades and both omega-3 fatty acids and glucosamine are two of the best-selling dietary supplements in many countries. An understanding of omega-3 fatty acids and glucosamine consumption is of significance to health care providers and for future health promotion activities. METHODS This research involved analysis of data collected from a nationally-representative sample of Australian women as part of the Australian Longitudinal Study on Women's Health (ALSWH). Participants' use of omega-3 fatty acids (FA), glucosamine, their demographics, health status and health care utilisation were measured. Analysis included logistic regression modelling. RESULTS Of the 10,638 women in the study, 26.8% reported use of omega-3 FA and 15.9% glucosamine. Women with osteoarthritis (OR=2.529; 95% CI: 2.190, 2.921), other arthritis (OR= 1.618; 95% CI: 1.375, 1.905), and joint pain (OR= 2.699; 95% CI: 2.305, 3.160) were more likely to use glucosamine (all p<0.001). In contrast, those with diabetes (OR= 0.471; 95% CI: 0.343, 0.646) or depression (OR= 0.764; 95% CI: 0.657, 0.887) were less likely to use glucosamine (both p<0.001). Women with osteoarthritis (OR=1.481; 95% CI: 1.297, 1.691) and joint pain (OR= 1.456; 95% CI: 1.306, 1.622) were more likely to use omega-3 FA (all p<0.001). CONCLUSIONS Substantial prevalence rates for use of glucosamine and omega-3 FA amongst mid-aged women highlights the need for health practitioners and policymakers to be mindful of the possible significant role of such supplement use as part of patient health-seeking behaviours.
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Affiliation(s)
- D Sibbritt
- Professor Jon Adams, Faculty of Health, University of Technology Sydney, Level 7, Building 10, 235 Jones Street, Broadway NSW 2007, Australia. Phone: +61 2 95144821,
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Frawley J, Sibbritt D, Broom A, Gallois C, Steel A, Adams J. Women's attitudes towards the use of complementary and alternative medicine products during pregnancy. J OBSTET GYNAECOL 2015; 36:462-7. [DOI: 10.3109/01443615.2015.1072804] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- J. Frawley
- University of Technology Sydney, Faculty of Health, Ultimo, Sydney, Australia
| | - D. Sibbritt
- University of Technology Sydney, Faculty of Health, Ultimo, Sydney, Australia
| | - A. Broom
- University of New South Wales, School of Social Sciences, Sydney, Australia
| | - C. Gallois
- Faculty of Social and Behavioural Science, University of Queensland, Brisbane, Australia
| | - A. Steel
- University of Technology Sydney, Faculty of Health, Ultimo, Sydney, Australia
- Endeavour College of Natural Health, Fortitude Valley, Brisbane, Australia
| | - J. Adams
- University of Technology Sydney, Faculty of Health, Ultimo, Sydney, Australia
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Wardle J, Adams J, Sibbritt D. Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia. HOMEOPATHY 2013; 102:199-206. [PMID: 23870380 DOI: 10.1016/j.homp.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 03/02/2013] [Accepted: 03/13/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). MATERIALS AND METHODS A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). RESULTS Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. CONCLUSIONS Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists.
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Affiliation(s)
- J Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW 2007, Australia.
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Aljadani H, Sibbritt D, Patterson A, Collins C. Diet quality does not predict six-year weight changes in mid-age women from Australian Longitudinal Study on Women's Health. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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15
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Steel A, Sibbritt D, Adams J, Daley J. P04.80. Navigating the divide: women's engagement with conventional and complementary medicine in pregnancy. BMC Complement Altern Med 2012. [PMCID: PMC3373792 DOI: 10.1186/1472-6882-12-s1-p350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Frawley J, Sibbritt D, Adams J, Steel A, Wardle J, Broom A, Lui C, Murthy V. OA16.04. Women’s sources of information for CAM use during pregnancy. BMC Complement Altern Med 2012. [PMCID: PMC3373324 DOI: 10.1186/1472-6882-12-s1-o65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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17
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Vempati R, Dunn J, Cottingham P, Sibbritt D, Adams J. P04.81. Mapping the natural health landscape: New Zealand-based CAM professionals survey. Altern Ther Health Med 2012. [PMCID: PMC3373877 DOI: 10.1186/1472-6882-12-s1-p351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Murthy V, Sibbritt D, Adams J, Broom A. P05.64. The role of self-discovery in women’s integration of CAM into their model of health care: qualitative data from a cohort study of 3,731 women. Altern Ther Health Med 2012. [PMCID: PMC3373924 DOI: 10.1186/1472-6882-12-s1-p424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Steel A, Diezel H, Sibbritt D, Adams J. OA13.03. Promoting safe and integrated maternity care through interprofessional education. Altern Ther Health Med 2012. [PMCID: PMC3373336 DOI: 10.1186/1472-6882-12-s1-o51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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20
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Beatty LJ, Adams J, Sibbritt D, Wade TD. Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: a prospective longitudinal investigation. Complement Ther Med 2011; 20:61-9. [PMID: 22305250 DOI: 10.1016/j.ctim.2011.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 07/11/2011] [Accepted: 09/27/2011] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES While several cross-sectional studies have examined psychological correlates of complementary and alternative medicine (CAM) use and cancer, few prospective longitudinal investigations have been reported. This study examined whether CAM use moderated distress and quality of life (HRQoL) from pre- to post-cancer. DESIGN A prospective longitudinal national cohort design. SETTING Participants were 718 mid-aged women from the Australian longitudinal study on women's health who did not have cancer at survey 1, but who subsequently developed cancer. For each participant, three waves of data were extracted: the wave prior to diagnosis ('pre'), at diagnosis ('cancer'), and after cancer ('post'). MAIN OUTCOME MEASURES CAM use was measured by the question 'in the past 12 months have you consulted an alternative health practitioner'. Distress was measured by perceived stress (PSS) and depression (CES-D 10), HRQoL was measured by physical and mental health functioning (SF-36). RESULTS CAM use significantly moderated the change over time in stress [F(561)=3.09, p=0.04], depression [F(494)=3.14, p=0.04], but not HRQoL. CAM-users were significantly more stressed than non-users pre-cancer (p<0.05), but there were no significant differences at subsequent surveys. CAM-users were significantly less depressed post-cancer compared to non-users (p<0.05). CONCLUSIONS Findings indicated that CAM users may be more psychologically vulnerable than non-users with respect to stress, with CAM acting as an effective psychological, but not HRQoL, intervention.
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Affiliation(s)
- L J Beatty
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
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21
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Mitchell GK, Girgis A, Jiwa M, Sibbritt D, Burridge LH. A tool to assess lay cancer carers' changing needs in general practice. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Steinsbekk A, Adams J, Sibbritt D, Johnsen R. Complementary and alternative medicine practitioner consultations among those who have or have had cancer in a Norwegian total population (Nord-Trøndelag Health Study): prevalence, socio-demographics and health perceptions. Eur J Cancer Care (Engl) 2010; 19:346-51. [PMID: 19686272 DOI: 10.1111/j.1365-2354.2008.01049.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Steinsbekk
- Department of Public Health and General Practice Norwegian University of Science and Technology (NTNU), Trondheim, MTFS, Trondheim, Norway
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23
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Broom A, Wijewardena K, Sibbritt D, Adams J, Nayar K. The use of traditional, complementary and alternative medicine in Sri Lankan cancer care: Results from a survey of 500 cancer patients. Public Health 2010; 124:232-7. [DOI: 10.1016/j.puhe.2010.02.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 12/08/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Abstract
BACKGROUND Comprehensive antenatal psychosocial assessment of mothers prior to the birth is established in many regions. While the influence of fathers on infant and maternal well-being is also recognised as commencing before birth, the early identification of needs among expectant fathers has not been addressed. METHODS The current study surveyed fathers attending antenatal classes in public and private hospitals (n=307) in New South Wales, Australia, using psychosocial questions derived from the questions commonly asked in assessments of mothers. RESULTS The most frequent responses suggest that fathers, at the time of the birth, have needs in regard to their ability to cope with the stresses of new parenthood and the skills and knowledge to care for their new baby. LIMITATIONS Conclusions from the study are limited in their application to the population of expectant fathers by the low response rate and the low numbers of low-income, ethnic-background, and indigenous fathers in the sample. CONCLUSION Assessment of fathers by psychosocial questions similar to mothers is advised to detect fathers who may require assistance and parenting education for fathers in infant care.
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Affiliation(s)
- R Fletcher
- Family Action Centre, University of Newcastle, Newcastle, New South Wales, Australia.
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25
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Duke J, McEvoy M, Sibbritt D, Guest M, Smith W, Attia J. Vibrotactile threshold measurement for detecting peripheral neuropathy: defining variability and a normal range for clinical and research use. Diabetologia 2007; 50:2305-12. [PMID: 17846743 DOI: 10.1007/s00125-007-0813-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Accepted: 07/23/2007] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS We aimed to define normal ranges for vibration sense as measured by vibratory perception thresholds (VPTs) using biothesiometry. METHODS We performed biothesiometry in a community-dwelling sample of 901 people aged 55 to 85 years who did not have diabetes. We quantitated the variation between repeat measures using analysis of variance and Bland-Altman plots. We also plotted the age- and sex-specific reference ranges. RESULTS We found small but statistically significant differences between repeat measures using the ascending and descending method of limits. Statistically higher vibration thresholds were noted on the right arm and leg compared with the left. Significantly higher vibration thresholds were also seen in men vs women for both lower limbs. We also defined sex-specific reference intervals (normal ranges) for biothesiometry for older persons and quantitated the increase in vibration threshold with increasing age. CONCLUSIONS/INTERPRETATION For reliability, it may be sufficient to obtain the average of two ascending measures separated by at least 1 min in just the right hand or right foot, since this is usually the one with the higher threshold. Although identical reference ranges can be used for men and women for the upper limb, there are significant differences in the lower limbs. The major determinant of VPT is age: we have established age-specific norms for VPT testing for adults between 55 and 85 years of age.
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Affiliation(s)
- J Duke
- Centre for Clinical Epidemiology and Biostatistics, David Maddison Building, University of Newcastle, Newcastle, New South Wales, Australia
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26
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Adams J, Sibbritt D, Young AF. Consultations with a naturopath or herbalist: the prevalence of use and profile of users amongst mid-aged women in Australia. Public Health 2007; 121:954-7. [PMID: 17606282 DOI: 10.1016/j.puhe.2007.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Revised: 02/09/2007] [Accepted: 03/15/2007] [Indexed: 11/15/2022]
Affiliation(s)
- J Adams
- Epidemiology and Social Medicine Division, School of Population Health, University of Queensland, Rm 333, Public Health Building, Herston Rd, Herston, Qld. 4006, Australia.
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27
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Li M, Dibley MJ, Sibbritt D, Yan H. Factors associated with adolescents' overweight and obesity at community, school and household levels in Xi'an City, China: results of hierarchical analysis. Eur J Clin Nutr 2007; 62:635-43. [PMID: 17440524 DOI: 10.1038/sj.ejcn.1602757] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify personal and environmental factors associated with adolescent overweight and obesity in Xi'an city, China. SUBJECTS/METHODS A total of 1804 adolescents from 30 junior high schools in six districts in Xi'an City. Community, school, household and individual characteristics were self reported by parents, school doctors and students. Factors associated with adolescent overweight and obesity were identified using a hierarchical logistic regression. RESULTS In all adolescents, after adjustment for age and gender, factors significantly associated with overweight and obesity were: living in urban districts (odds ratio (OR): 4.0, 95% confidence interval (CI): 2.7-6.0); limited use of school sports facilities (OR: 1.7, 95% CI: 1.1-2.6); wealthy households (OR: 1.7, 95% CI: 1.1-2.6); parental restrictions on purchasing snacks (OR: 1.5, 95% CI: 1.03-2.0); having an overweight/obese parent (OR: 1.8, 95% CI: 1.3-2.5); having soft drinks more than four times per week (OR: 1.6, 95% CI: 1.02-2.5) and not fussy about foods (OR: 1.7, 95% CI: 1.2-2.2). Eating sweets was negatively associated with overweight/obesity (OR: 0.6, 95% CI: 0.4-0.9). Separate gender analyses revealed that in boys, low physical activity (OR: 2.0, 95% CI: 1.1-3.8) and higher energy intake (OR: 1.8, 95% CI: 1.1-2.9) were also associated with overweight/obesity. In girls, less school sports meetings (OR: 2.3, 95% CI: 1.3-4.0); parental decisions about eating fast foods (OR: 1.8, 95% CI: 1.1-2.9) and availability of home video games (OR: 1.7, 95% CI: 1.1-2.5) were also significant. CONCLUSIONS Preventive strategies for adolescent overweight and obesity in Xi'an should address the community and school environments to reinforce behavioral change. Gender differences also need to be considered when planning interventions.
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Affiliation(s)
- M Li
- Department of Public Health, School of Medicine, Xi'an Jiaotong University, Xi'an, China
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Abstract
Complementary and alternative medicine (CAM) is now a significant practice issue for those delivering cancer care with a range of CAM being utilized by a significant number of patients with cancer. While various studies have explored the prevalence of CAM use among cancer patients, little is currently known about naturopathy/herbalism use by patients with cancer in Australia. This paper reports the prevalence of naturopath/herbalist consultations among mid-aged Australian women with cancer. The research was conducted as part of the Australian Longitudinal Study on Women's Health, with the data for this analysis coming from the third survey of 11,202 women aged 50-55, conducted in 2001. For all cancers combined, 15.7% of women with cancer were found to consult a naturopath/herbalist. Mid-aged women with cancer were found to be more likely to consult a naturopath/herbalist than mid-aged women without cancer. Naturopathy/herbalism consultations appear to be utilized by the women with cancer alongside and as a supplement to conventional health services. Given the prevalence of consultations with herbal therapists/naturopaths among mid-aged women with cancer in Australia, it is important that physicians and others involved in cancer patient care and management are informed and educated about naturopathy/herbalism and its use among their patients.
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Affiliation(s)
- J Adams
- Centre for Clinical Epidemiology and Biostatistics, School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, Newcastle, Australia.
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29
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Casey MG, Adams J, Sibbritt D. An examination of the prescription and dispensing of medicines by Western herbal therapists: a national survey in Australia. Complement Ther Med 2006; 15:13-20. [PMID: 17352967 DOI: 10.1016/j.ctim.2005.10.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2004] [Revised: 08/24/2005] [Accepted: 10/18/2005] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To describe the patterns of prescription and dispensing of herbal medicines employed by Western herbal practitioners in Australia. DESIGN A national postal survey sent to all full members of the National Herbalist Association of Australia (NHAA). SETTING Nationwide clinics of professional herbal practitioners in Australia. MAIN OUTCOME MEASURES Measures of medicinal use were collected including aspects of prescription, formulation, dispensing and preparation forms of medicines used. The practitioners were asked if they dispensed their own medicines, about the form of herbal preparations used, aspects of formulation and dosages. RESULTS The predominant prescription by most Western herbal practitioners in Australia is individualised herbal formulae rather than the use of single herbs. Traditional preparations of herbals such as teas and powders are used but liquid herbal extracts are most commonly dispensed. These liquid medicines are in the form of highly concentrated fluid extracts in ratios of 1:1 or 1:2, herb material to liquid. Pre-formulated tablets or capsules made by herbal manufacturers are being incorporated into modern practice but most prescriptions are individualised liquid formulae prepared and dispensed, from the clinic dispensary, after patient consultation. In addition to internal prescriptions, topical creams, pessaries, douches, gargles, eyebaths and poultices or washes are still incorporated into treatments. Although there is variation in used dosage ranges, the predominant system is that of pharmacologically active doses of highly concentrated fluid extracts. CONCLUSION The professional prescription of Western herbal medicines is different to commercial usage. As opposed to pre-formulated tablets, or use of single herbals, the vast majority of Western herbalists in Australia construct individualised herbal formulations for their patients after consultation. The preferred form of administration of these prescriptions is as highly concentrated liquid herbal extracts in pharmacologically active doses.
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Affiliation(s)
- M G Casey
- Centre for Clinical Epidemiology and Biostatistics, School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, Level 3 DMB, Royal Newcastle Hospital, Newcastle 2300, Australia.
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Hope-Allan N, Adams J, Sibbritt D, Tracy S. The use of acupuncture in maternity care: a pilot study evaluating the acupuncture service in an Australian hospital antenatal clinic. ACTA ACUST UNITED AC 2004; 10:229-32. [PMID: 15519940 DOI: 10.1016/j.ctnm.2004.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper outlines an exploratory study charting the circumstances of use and patient perspectives regarding the acupuncture service offered in an antenatal clinic at an Australian public hospital. Study participants were recruited from women attending the antenatal clinic. Upon completion of their course of acupuncture treatment, 52 women were given a questionnaire, of which 37 (71%) were completed and returned. Of the 37 women who attended the acupuncture clinic, 18 (49%) had previously used at least one form of complementary medicine/therapy. The most common reason for treatment was physiological symptoms including back pain, symphysis pubis dysfunction and sciatica. All 37 women stated that the acupuncture improved their well-being and this finding was statistically significant (P<0.001). These findings are offered as a means of identifying potential issues for future investigation in this under-researched area.
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Affiliation(s)
- N Hope-Allan
- Hornsby Ku-ring-gai Hospital, New South Wales, Australia
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31
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Abstract
In this paper we identify the need for further research exploring the relationship between complementary and alternative medicine (CAM) use and women's health. We offer our personal thoughts on the direction such future research might take outlining a number of research domains (type of CAM consumption, longitudinal analysis of women's use of CAM, cross-cultural analysis of women's CAM consumption, reasons for women's CAM consumption). We hope that this brief paper helps inspire greater research attention upon what we believe to be a well deserving sub-field of study within the social science of CAM.
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Affiliation(s)
- J Adams
- Centre for Clinical Epidemiology and Biostatistics, School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, Newcastle, Australia.
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32
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Dunkley EJC, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003; 96:635-42. [PMID: 12925718 DOI: 10.1093/qjmed/hcg109] [Citation(s) in RCA: 552] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There are difficulties with the diagnosis of serotonin toxicity, particularly with the use of Sternbach's criteria. AIM To improve the criteria for diagnosing clinically significant serotonin toxicity. DESIGN Retrospective analysis of prospectively collected data METHODS We studied all patients admitted to the Hunter Area Toxicology Service (HATS) following an overdose of a serotonergic drug from January 1987 to November 2002 (n = 2222). Main outcomes were: diagnosis of serotonin toxicity by a clinical toxicologist, fulfillment of Sternbach's criteria and treatment with a serotonin receptor (5-HT(2A)) antagonist. A learning dataset of 473 selective serotonin reuptake inhibitor (SSRI)-alone overdoses was used to determine individual clinical features predictive of serotonin toxicity by univariate analysis. Decision rules using CART analysis were developed, and tested on the dataset of all serotonergic overdose admissions. RESULTS Numerous clinical features were associated with serotonin toxicity, but only clonus (inducible, spontaneous or ocular), agitation, diaphoresis, tremor and hyperreflexia were needed for accurate prediction of serotonin toxicity as diagnosed by a clinical toxicologist. Although the learning dataset did not include patients with life-threatening serotonin toxicity, hypertonicity and maximum temperature > 38 degrees C were universal in such patients; these features were therefore added. Using these seven clinical features, decision rules (the Hunter Serotonin Toxicity Criteria) were developed. These new criteria were simpler, more sensitive (84% vs. 75%) and more specific (97% vs. 96%) than Sternbach's criteria. DISCUSSION These redefined criteria for serotonin toxicity should be more sensitive to serotonin toxicity and less likely to yield false positives.
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Affiliation(s)
- E J C Dunkley
- School of Medical Practice and Population Health, University of Newcastle, Newcastle, NSW, Australia
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Sibbritt D, Gibberd R. The annual variation in activity and funding for acute public hospitals in NSW, 1988-89 to 1992-93. AUST HEALTH REV 1995; 19:52-67. [PMID: 10157537 DOI: 10.1071/ah960052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Casemix-based funding was introduced into the Victorian health system without an assessment of the annual variation in inpatient activity. Before undertaking such a funding reform, it would be appropriate to determine the level of annual variation in inpatient activity for individual hospitals that could be attributable to chance or random variation. If the annual random variation is not accounted for, then casemix-based funding may actually lead to inefficiencies. For this study, hospital inpatient activity and funding data for 120 acute public hospitals from New South Wales for the years 1988-89 to 1992-93 were used to estimate the standard deviation of the annual random variation in activity and gross operating payment. Through linear regression, estimates of the standard deviation of random variation about the underlying trend were obtained for each hospital. The results showed that, depending on the size of the hospital, total diagnosis related group cost weights have a standard deviation in the range of 2 to 16 per cent of total activity, whilst gross operating payment has an equivalent standard deviation that ranges from 1 to 10 per cent annually. The magnitude of the variation would suggest that funding of hospitals should either be based on average activity over several years or based on bands of activity in order to reduce the potential random variation in funding levels.
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Affiliation(s)
- D Sibbritt
- Department of Statistics, University of Newcastle, Australia
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34
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Fahey P, Sibbritt D. Statistical tools for understanding variation: the allocation of operating suite time. J Qual Clin Pract 1994; 14:177-86. [PMID: 7711997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Australian hospitals are becoming increasingly familiar with the 'new' tools for continuous quality improvement. In particular, many are becoming increasingly competent in establishing and supporting quality improvement teams for process evaluation and improvement. The main problems with such teams now seems to arise in relation to the analysis and interpretation of data on the process. This paper provides an example of the types of analyses and interpretations required of today's quality improvement practitioner in health care.
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Affiliation(s)
- P Fahey
- Department of Statistics, University of Newcastle, Callaghan, NSW, Australia
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