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1.
BMC Infect Dis ; 21(1): 1, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33390160

RESUMO

BACKGROUND: Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA. METHODS: A systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger's and Begg's tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio. RESULTS: Of 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV. CONCLUSION: This review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings.


Assuntos
Infecções por HIV/epidemiologia , Desnutrição/epidemiologia , Tuberculose/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , África ao Sul do Saara/epidemiologia , Comorbidade , Infecções por HIV/mortalidade , Humanos , Morbidade , Prevalência , Tuberculose/etiologia
2.
Br J Nutr ; : 1-25, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33222703

RESUMO

Depression affects approximately 350 million people worldwide. Evidence suggests that diet plays an important role with the Mediterranean diet displaying promising preliminary results. Currently, most of the research is conducted on women and older adults however, the majority of mental illnesses occur before the age of 25. Men are less likely to seek help than women with only 13% of young men aged 15-24 seeking help for their mental health. Young men are hugely underrepresented in the current research which poses a significant issue. A 12-week randomised control trial will be conducted to examine the effect of a Mediterranean diet on the symptoms of depression in young men aged 18-25. Participants will be randomised to either follow a Mediterranean diet or receive the inactive control therapy befriending. Participants will attend 3 appointments at baseline, week 6 and week 12. The main outcome will be changes to the Becks depression Inventory score. This research aims to answer the question of whether diet can be used effectively in this population. This will be the first trial to examine the effect of a Mediterranean diet on the symptoms of depression in young men. This trial will help fill a significant research gap, contribute to the growing field of nutritional psychiatry, guide future research and inform advice given by clinicians to this specific demographic.

3.
Int J Clin Pract ; : e13821, 2020 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-33159830

RESUMO

This study explored the characteristics associated with the use of self-care products and practices by people rehabilitating from stroke. A cross-sectional sub-study of the Sax Institute's 45 and Up Study in which 1300 participants who had indicated a doctor had diagnosed them as having had a stroke were mailed a sub-study survey. The survey instrument included questionnaire items on demographics, self-care products and practices, health status and stroke status. The survey was completed by 576 (44.3%) of those eligible. At least one self-care product or practice was used by 39.9% of participants. Female participants were more likely than males to use self-care products (P ≤ .001) and self-care practices (P = .021). Self-care product use was higher amongst those with higher levels of fatigue (OR = 1.07) and/or those reporting slight (OR = 2.05) or moderate disability (OR = 2.28), compared with those who had no symptoms at all. As the burden of stroke survivorship increases because of improved acute stroke care in an ageing population, a stronger focus is needed by researchers, clinicians and policy makers on the self-care strategies used by stroke survivors and the ability for health professionals to appropriately support stroke survivors' in their rehabilitation and long-term management.

4.
BMC Complement Med Ther ; 20(1): 349, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208118

RESUMO

BACKGROUND: Australians report consulting with a naturopaths or herbalists to improve their wellbeing, yet little is known about the associations between these consultations and the patients' health behaviours. This cross-sectional study aimed to examine the relationship between health behaviour and consultations with naturopaths or herbalists in three age cohorts of Australian women. METHODS: Women aged 19-25 years, 31-36 years, and 62-67 years from the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behaviour; and whether they consulted with naturopath/herbalists in the last 12 months. Associations were analysed using multivariable logistic regression. RESULTS: A total of 9151 (19-25 years), 8200 (31-36 years) and 11,344 (62-67 years) women were included in the analysis. Between 7.3 and 11.9% of women reported to have consulted with naturopaths/herbalists in the last 12 months. Women of all cohorts consulting with naturopath/herbalist were less likely to smoke (19-25 yrs.: Odds Ratio [OR] 0.61; 31-36 years: OR 0.58; 62-67 years: OR 0.29), more likely to report at least moderate levels of physical activity (19-25 yrs.: OR 1.41; 31-36 years: OR 1.34; 62-67 years: OR 1.34), and the use of vegetarian diets(19-25 yrs.: OR 1.40; 31-36 years: OR 1.77; 62-67 years: OR 2.28), compared to women not consulting with naturopaths/herbalists. Women consulting with naturopaths/herbalists however were also more likely to have used marijuana (19-25 yrs.: OR 1.18; 31-36 years: OR 1.42), or illicit drugs in the last 12 months (19-25 yrs.: OR 1.24; 31-36 years: OR 1.40). CONCLUSIONS: Consultations with a naturopath or herbalist are associated with positive health behaviours that are protective of internationally important non-communicable diseases. Psychoactive drug use is also reported among women visiting a naturopath or herbalist. Further research is needed to understand the role naturopaths play in advising patients with regards to health and non-healthy behaviours.

5.
Complement Ther Clin Pract ; 40: 101194, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32891274

RESUMO

BACKGROUND: The complexity of chronic conditions challenges health systems and patients. Patients with chronic conditions often consult complementary medicine (CM) practitioners. Optimal care of chronic conditions requires understanding of the characteristics and consultation behaviours of these patients. METHODS: Cross-sectional survey (n = 2025 adults), broadly representative of the Australian population. Measures included sociodemographics, health status and health service utilisation. Data from participants with chronic conditions were analysed. RESULTS: Of the 1314 participants reporting chronic conditions, 38.4% consulted a CM practitioner. Significant differences were observed between participants who did/did not consult CM practitioners, across all sociodemographics and some health status items. The most reported reason for consultation was to support wellbeing. Predictors of consultation were younger age, employment, and private health insurance coverage for CM, however, predictors varied by profession consulted. CONCLUSION: CM consultations amongst those with chronic conditions appear to be influenced by sociodemographic and economic factors, and quality of life needs.

6.
Nutrition ; 78: 110946, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32861952

RESUMO

OBJECTIVES: Currently 1 million Australians are living with depression each year, with an average of one in eight men experiencing the disorder. Studies have shown that individual nutrients, fruit and vegetable intake, polyphenols, and whole dietary patterns can have a positive effect on depressive symptoms. In particular, the Mediterranean diet has shown promising preliminary findings. The aim of this study was to assess the diet quality and knowledge of young men in relation to depressive symptoms. METHODS: This was a cross-sectional online survey. We collected data from 384 young Australian men between 18 and 25 y of age with diagnosed depression. Pearson's χ2 test was used for ordinal categorical variables. RESULTS: Dietary intake among this population was poor. Discretionary foods were consumed two to three times per week and included pizza (41%), fried potatoes such as French fries or hash browns (29%), and chocolate (25%). Roughly half of participants (47%) reported never consuming whole grains or legumes and only 9% said they eat vegetables twice or more per day. Healthy eating is perceived as both time consuming (82%) and expensive (70%). One-third (32%) of participants perceived their diet as having a major effect and 29% a slight effect on their mental health, with only 5% reporting that diet has no effect on their mental health. However, the majority of participants (84%) believe it is important or very important to eat an overall healthy diet and 77% reported being willing to change their diet if it would improve their symptoms of depression. CONCLUSIONS: These results highlighted the relatively poor diets of this population. This group of young men would greatly benefit from a quality diet such as the Mediterranean diet. The reported willingness to change their diets is encouraging and supports the viability of dietary intervention trials in this demographic. The dietary data presented in this study can be used to develop targeted interventions aimed at improving the diets of young men with depression.

7.
J Bodyw Mov Ther ; 24(3): 29-37, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32826002

RESUMO

OBJECTIVES: Massage is a popular form of health care used among women, yet little is known about the characteristics of women who use massage therapy and the rationale for its use. This study reports the prevalence and characteristics of young and middle-aged Australian women who consulted a massage therapist. DESIGN: The study analysed data from the Australian Longitudinal Study on Women's Health; a nationally-representative sample of Australian women. The data from 7,993 young, and 9,102 middle-aged women were included in the analyses and massage use was compared against measures of health status, health care utilisation, and demographics. RESULTS: Prevalence of consultation with a massage therapist in the previous 12 months was 42.4% in young women and 25.2% in middle-aged women. Women who consulted a massage therapist were more likely to consult other complementary medicine practitioners and/or use self-prescribed complementary medicine. Both young and middle-aged women were more likely to consult a massage therapist if they experienced musculoskeletal problems; however less likely, with chronic disease such as diabetes and hypertension. CONCLUSION: Despite large numbers of young and middle-aged Australian women consulting a massage therapist, no Australian studies investigate the prevalence of massage consultations and report correlations with characteristics relevant to demographic, health status and health service data. Our findings highlight the need for further investigation of women's choices relevant to the use of massage therapy. Such research could shape the future of women's health care by providing insight into women's decision making around massage therapy, conventional treatment and healthcare utilisation.

8.
J Hum Hypertens ; 34(12): 833-840, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32541665

RESUMO

Hypertension is a common condition worldwide that significantly increases morbidity and mortality rates in the older population. A number of treatment options are available to control blood pressure. The purpose of this study was to assess the use of health services and self-care amongst people with hypertension and to estimate the out-of-pocket expenses associated with such health care use. A sub-study of the 45 and Up Study was conducted amongst 1300 individuals who had earlier reported a clinical diagnosis of hypertension in 2017. A total of 753 (57.9%) individuals with hypertension returned a completed questionnaire. In the last 12 month, for their hypertension management, 84% of participants consulted a doctor, 19% of them consulted an allied health practitioner and 9% of them consulted a complementary medicine practitioner. The average total out-of-pocket expenditure for hypertension-related health care was Australian $461.8 per annum, with an estimated Australian $941 million per annum if extrapolated to all Australians aged 55 years and over with hypertension. Older people with hypertension use a wide range of health services to control their blood pressure including conventional medicine, allied health and complementary medicine practitioners as well as various self-care practices. A substantial amount of out-of-pocket expenditure has been spent on hypertension care annually. Given the global health and economic burden of hypertension, there is an urgent need for more research exploring cost-effective management(s) for hypertensive patients.

9.
J Asthma ; : 1-9, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32155089

RESUMO

Objective: This study aims to describe the prevalence of health care utilization (including conventional medicine, self-care and complementary medicine treatments) for the management of asthma by women aged 45 years and over and their associated out-of-pocket expenditure.Methods: A self-reported mail survey of 375 Australian women, a cohort of the national 45 and Up Study, reporting a clinical diagnosis of asthma. The women were asked about their use of health care resources including conventional medicine, complementary medicine, and self-prescribed treatments for asthma and their associated out-of-pocket spending. Spearman's correlation coefficient, student's t-test and chi-square test were used as appropriate. Population level costs were created by extrapolating the costs reported by participants by available national prevalence data.Results: Survey respondents (N = 375; response rate, 46.9%) were, on average, 67.0 years old (min 53, max 91). The majority (69.1%; n = 259) consulted at least one health care practitioner in the previous 12 months for their asthma. Most of the participants (n = 247; 65.9%) reported using at least one prescription medication for asthma in the previous 12 months. The total out-of-pocket expenditure on asthma treatment for Australian women aged 50 years and over is estimated to be AU$159 million per annum.Conclusions: The breadth of conventional and complementary medicine health care services reported in this study, as well as the range of treatments that patients self-prescribe, highlights the challenges of coordinating care for individuals living with asthma.

10.
Sci Rep ; 10(1): 846, 2020 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-31964999

RESUMO

Both the Osteopathic Research Innovation Network (ORION) and the Osteopathy Research Connect-New Zealand (ORC-NZ) are practice-based research networks (PBRNs) recently established in Australia and New Zealand. This paper highlights the profile of the osteopaths participating in each PBRN in order to encourage and facilitate further related research in osteopathy. All registered osteopaths in Australia and New Zealand were invited to participate in the ORION and ORC-NZ PBRNs, respectively. This paper presents practice and sociodemographic characteristics of the osteopaths that elected to join the PBRN in their country. A total of 253 registered osteopaths in New Zealand (48.7%) agreed to join ORC-NZ while 992 registered osteopaths in Australia (44.5%) joined ORION. Membership of both PBRNs reflect national geographical spread, and diverse personal and practice characteristics. Combined membership of both PBRNs represents 45.3% of all registered osteopaths in Australasia and 7.7% of the global osteopathic profession. The PBRNs, independently and in combination, hold much potential to advance the evidence-base and capacity of osteopathy research. Both ORION and ORC-NZ PBRNs are powerful, innovative resources available to other interested parties to help conduct further osteopathy research in Australia and New Zealand.

11.
Complement Ther Med ; 48: 102276, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31987260

RESUMO

OBJECTIVES: The aim of this study is to a) investigate the headache features and level of headache severity, chronicity, and disability found within a chiropractic patient population and b) to ascertain if patient satisfaction with headache management by chiropractors is associated with headache group or reason for consulting a chiropractor. DESIGN AND SETTING: Consecutive adult patients with a chief complaint of headache participated in an online cross-sectional survey (n = 224). Recruitment was via a randomly selected sample of Australian chiropractors (n = 70). Headache features were assessed using International Classification of Headache Disorders criteria and level of headache disability measured using the Headache Impact Test instrument. RESULTS: One in four participants (n = 57; 25.4%) experienced chronic headaches and 42.0% (n = 88) experienced severe headache pain. In terms of headache features, 20.5% (n = 46) and 16.5% (n = 37) of participants had discrete features of migraine and tension-type headache, respectively, while 33.0% (n = 74) had features of more than one headache type. 'Severe' levels of headache impact were most often reported in those with features of mixed headache (n = 47; 65.3%) and migraine (n = 29; 61.7%). Patients who were satisfied or very satisfied with headache management by a chiropractor were those who were seeking help with headache-related stress or to be more in control of their headaches. CONCLUSION: Many with headache who consult chiropractors have features of recurrent headaches and experience increased levels of headache disability. These findings may be important to other headache-related healthcare providers and policymakers in their endeavours to provide coordinated, safe and effective care for those with headaches.


Assuntos
Cefaleia/terapia , Manipulação Quiroprática/métodos , Adolescente , Adulto , Idoso , Estudos Transversais , Avaliação da Deficiência , Feminino , Cefaleia/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Inquéritos e Questionários , Adulto Jovem
12.
Eur J Clin Nutr ; 74(6): 945-952, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31758163

RESUMO

BACKGROUND/OBJECTIVES: We previously demonstrated that fruit and vegetable consumption, was associated with less weight gain over 6 years in young women for all body mass index (BMI) categories. This study evaluated the relationship between diet quality and 6-year weight change, in Australian women initially in the healthy weight range (≥18.5 BMI <25 kg/m2) at baseline. SUBJECTS/METHODS: A total of 4083 young women (27-31 years) in the healthy weight range (≥18.5 BMI <25 kg/m2) enroled in the Australian Longitudinal study on Women's Health (ALSWH) were analysed. Diet quality was measured by the Australian Recommended Food Score (ARFS) and the Fruit and Vegetable Index (FAVI) using dietary data derived from a validated food frequency questionnaire. Weight change was calculated as the difference between baseline and 6-year follow-up weight (kg). Multiple linear regression models were used to analyse the association between baseline ARFS and FAVI and 6-year weight change. RESULTS: At baseline, mean diet quality was low for both indices [ARFS (maximum 72) = 29.9 and FAVI (maximum 333) = 94.2] and women gained 3.7 kg of weight during 6 years of follow-up. Regression modelling revealed that every one point increase over 6 years in either the ARFS or FAVI score was associated with statistically significantly less weight gain over 6 years, although the amount was small (33 and 12 g, respectively). CONCLUSIONS: Higher diet quality predicts lower prospective weight gain in young women however, further research is needed over a longer follow-up period and in diverse population groups.

13.
Nutr Metab Cardiovasc Dis ; 30(2): 223-232, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-31767421

RESUMO

BACKGROUND AND AIMS: Most studies measure baseline diet quality exclusively and hence the impact of longitudinal changes in dietary intake in relation to weight change is not considered. Therefore, this study aimed to examine whether change in diet quality over nine-years was associated with weight change over the same period in mid-age Australian women. METHODS AND RESULTS: Healthy mid-age (45-49 years) women from the Australian Longitudinal study on Women's Health (ALSWH) were eligible a valid total energy intake (TEI) was reported at baseline (n = 2381), determined using Goldberg cut-offs. Diet quality was measured by the Australian Recommended Food Score (ARFS) using data derived from a validated food frequency questionnaire. Multiple linear regressions were used to evaluate relationships between change in diet quality and weight in mid-age women (n = 1999). Women in the highest tertile of ARFS change improved diet quality [mean ± SD] [7 ± 4 points], while those in the lowest [-9 ±5 points] and middle [-1±2 points] tertiles had worse diet quality at follow-up. Overall, mean weight gain was 2.3 ± 7.2 kg over nine years. Those in the highest tertile of ARFS change gained significantly less weight, compared to the lowest tertile; ß = -1.2 kg [95% CI: -2.31, -0.11; p = 0.03] after adjustment for changes in confounders and baseline weight, baseline ARFS, and total energy intake. CONCLUSIONS: Improving diet quality could be an important strategy for promoting modest weight loss and potentially contribute to preventing weight gain in mid-age women, which is important for metabolic health.


Assuntos
Trajetória do Peso do Corpo , Dieta Saudável , Valor Nutritivo , Obesidade/prevenção & controle , Comportamento de Redução do Risco , Ganho de Peso , Fatores Etários , Austrália/epidemiologia , Inquéritos sobre Dietas , Ingestão de Energia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/fisiopatologia , Prevalência , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores de Tempo
14.
Womens Health Issues ; 30(1): 35-40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31727443

RESUMO

OBJECTIVE: Depression is a common comorbidity in patients with cardiovascular conditions. This study aims to assess the association between comorbid depression and health-promoting behavior in middle-aged and older Australian women with hypertension or heart disease. METHODS: Data are from a subset of 45 and Up Study participants with diagnosed chronic illness (n = 1,925). Health behaviors including smoking status, alcohol consumption, and physical activity were assessed. Associations of depression with health behaviors in women with hypertension or heart disease were analyzed using unadjusted and adjusted (for chronic conditions and demographic measures) logistic regression models. RESULTS: A total of 666 women with hypertension and 220 women with heart disease were included in the analysis. In adjusted analyses, women with hypertension and comorbid depression were 2.36 (95% confidence interval, 1.02-5.46) times more likely to be risky or high-risk drinkers and 55% (adjusted odds ratio, 0.45; 95% confidence interval, 0.27-0.73) less likely to be highly physically active, compared with women without depression. Women with heart disease and comorbid depression were 65% (adjusted odds ratio, 0.35; 95% confidence interval, 0.12-0.95) less likely to be highly physically active, compared with women without depression. CONCLUSIONS: This study provides the first data indicating that depression may be a barrier to health-promoting behavior in middle-aged and older women with hypertension or heart disease. Given that physical inactivity and risky alcohol consumption are important risk factors for aggravation of cardiologic conditions, health-promoting behaviors should be specifically targeted in the treatment of women with comorbid depression.


Assuntos
Depressão/epidemiologia , Comportamentos Relacionados com a Saúde , Cardiopatias/epidemiologia , Hipertensão/epidemiologia , Fumar/efeitos adversos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Austrália/epidemiologia , Doença Crônica , Comorbidade , Depressão/etiologia , Depressão/psicologia , Feminino , Cardiopatias/psicologia , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Adv Nutr ; 11(3): 602-615, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31687743

RESUMO

Depression is a mood disorder which currently affects 350 million individuals worldwide. Recently, research has suggested a protective role of diet for depression. The Mediterranean-style dietary pattern has been highlighted in several systematic reviews as a promising candidate for reducing depressive symptoms. It has been speculated that this could be due to the high polyphenol content of foods commonly found in the diet. Therefore, the aim of this review was to assess the effects of polyphenols found in a Mediterranean diet on the symptoms of depression. A systematic literature review was conducted of original research which assessed the role of polyphenols on the symptoms of depression in humans. The following databases were searched: PROQUEST, SCOPUS (Elsevier), MEDLINE (EBSCO), CINAHL, and EMBase, up to 18 February, 2019. The inclusion criteria consisted of both observational and experimental research in adults aged 18-80 y that assessed depression scores in relation to polyphenol intake. A total of 37 studies out of 12,084 met the full inclusion criteria. Of these, 17 were experimental studies and 20 were observational studies. Several different polyphenols were assessed including those from tea, coffee, citrus, nuts, soy, grapes, legumes, and spices. Twenty-nine of the studies found a statistically significant effect of polyphenols for depression. This review has found both an association between polyphenol consumption and depression risk, as well as evidence suggesting polyphenols can effectively alleviate depressive symptoms. The review uncovered gaps in the literature regarding the role of polyphenols for depressive symptoms in both young adults and men. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42019125747.

16.
J Aging Health ; 32(5-6): 472-480, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30819022

RESUMO

Objective: To test the association between sleeping problems and multiple epidemiological factors among women over 50 with a chronic condition. Method: The Medical Outcomes Study Sleep Scale (MOS-SS) was employed to measure sleep problems among 1,925 participants with chronic conditions who also responded to questions about health service use, self-care and demographics. Results: About 43% of women reported sleeping problems. Women were more likely to have a sleeping problem if they reported some difficulties with available income, odds ratio (OR) = 1.61; 95% confidence interval (CI): [1.27, 2.04]; p < .005, or were struggling with available income (OR = 2.84; 95% CI: [2.04, 3.96]; p < .005). Women were less likely to have sleeping problems if they were highly physically active (OR = .63; 95% CI: [0.51, 0.79]; p < .005). Discussion: Medical professionals should be aware of the significant risk of sleeping problems among mid-age and older women with chronic health conditions, particularly those who have financial concerns, are sedentary, or are not highly physically active.


Assuntos
Doença Crônica/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Exercício Físico , Feminino , Humanos , Renda , Pessoa de Meia-Idade , New South Wales/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Saúde da Mulher
17.
BMJ Open ; 9(10): e029192, 2019 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-31662359

RESUMO

OBJECTIVE: To compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home. DESIGN: A population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised χ2 tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance. SETTING: All eight Australian states and territories. PARTICIPANTS: Women with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks' gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home. MAIN OUTCOME MEASURES: Mode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death). RESULTS: Compared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth. CONCLUSIONS: This is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.


Assuntos
Entorno do Parto/estatística & dados numéricos , Mortalidade Perinatal , Resultado da Gravidez/epidemiologia , Adulto , Austrália/epidemiologia , Centros de Assistência à Gravidez e ao Parto , Salas de Parto , Feminino , Humanos , Recém-Nascido , Armazenamento e Recuperação da Informação , Modelos Logísticos , Masculino , Gravidez , Estudos Retrospectivos
18.
Medicina (Kaunas) ; 55(10)2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31554323

RESUMO

Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention.


Assuntos
Terapias Complementares , Comportamentos Relacionados com a Saúde , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Estados Unidos , Adulto Jovem
19.
Chiropr Man Therap ; 27: 33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31404389

RESUMO

Background: The diagnosis of primary headaches assists health care providers in their decision-making regarding patient treatment, co-management and further evaluation. Chiropractors are popular health care providers for those with primary headaches. The aim of this study is to examine the clinical management factors associated with chiropractors who report the use of primary headache diagnostic criteria. Methods: A cross-sectional survey was distributed between August and November 2016 to a random sample of Australian chiropractors who are members of a practice-based research network (n = 1050) who had reported 'often' providing treatment for patients with headache disorders to report on practitioner approaches to headache diagnosis, management, outcome measures and multidisciplinary collaboration. Multiple logistic regression was conducted to assess the factors that are associated with chiropractors who report using International Classification of Headache Disorders (ICHD) primary headache diagnostic criteria. Results: With a response rate of 36% (n = 381), the majority of chiropractor's report utilising ICHD primary headache diagnostic criteria (84.6%). The factors associated with chiropractors who use ICHD primary headache diagnostic criteria resulting from the regression analysis include a belief that the use of ICHD primary headache criteria influences the management of patients with primary headaches (OR = 7.86; 95%CI: 3.15, 19.60); the use of soft tissue therapies to the neck/shoulders for tension headache management (OR = 4.33; 95%CI: 1.67, 11.19); a belief that primary headache diagnostic criteria are distinct for the diagnosis of primary headaches (OR = 3.64; 95%CI: 1.58, 8.39); the use of headache diaries (OR = 3.52; 95%CI: 1.41, 8.77); the use of ICHD criteria improves decision-making regarding primary headache patient referral/co-management (OR = 2.35; 95%CI: 1.01, 5.47); referral to investigate a headache red-flag (OR = 2.67; 95%CI: 1.02, 6.96) and not referring headache patients to assist headache prevention (OR = 0.16; 95%CI: 0.03, 0.80). Conclusion: Four out of five chiropractors managing headache are engaged in the use of primary headache diagnostic criteria. This practice is likely to influence practitioner clinical decision-making around headache patient management including their co-management with other health care providers. These findings call for a closer assessment of headache characteristics of chiropractic patient populations and for further enquiry to explore the role of chiropractors within interdisciplinary primary headache management.


Assuntos
Transtornos da Cefaleia/diagnóstico , Adulto , Austrália , Quiroprática , Estudos Transversais , Feminino , Transtornos da Cefaleia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
20.
Complement Ther Med ; 45: 172-178, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331556

RESUMO

BACKGROUND: Approximately one in four adults do not meet the World Health Organisation physical activity recommendations. While health promotion (i.e., physical activity) is common within chiropractic settings, little is known about chiropractors discussing this public health issue with their patients. The aim of our study is to examine the prevalence and characteristics of Australian chiropractors who frequently discuss patient physical activity. METHODS: A national cross-sectional survey of chiropractors focusing upon practitioner characteristics, practice settings and clinical management characteristics. Regression analyses were conducted on 1924 survey respondents to identify factors associated with practitioners who frequently discuss physical activity with patients. RESULTS: Eighty-five percent of Australian chiropractors reported 'often' discussing physical activity as part of their patient management. The strongest factors associated with chiropractors who frequently discuss physical activity obtained from the multivariate analysis include: often discussing occupational health and safety (odds ratio [OR] = 6.10; 95%CI: 3.88, 9.59), often discussing diet/nutrition (OR = 4.56; 95%CI: 3.12, 6.66), often discussing smoking/drugs/alcohol (OR = 4.41; 95%CI: 2.06, 9.40), often use of specific exercise therapy/rehabilitation/injury taping (OR = 3.76; 95%CI: 2.62, 5.39) and often caring for athletes or sports people (OR = 2.18; 95%CI: 1.56, 3.06) within their practice setting. CONCLUSION: Discussing physical activity is a frequent feature of patient management among most chiropractors in Australia. The association between these practitioners and discussion of other costly public health burdens could suggest chiropractors have a valuable role to play in chronic disease prevention. Given the growing need for practitioner-led promotion of patient physical activity further research examination of the role and contribution of chiropractors in promoting this important public health topic among patients and communities is needed.


Assuntos
Quiroprática/estatística & dados numéricos , Exercício Físico/fisiologia , Promoção da Saúde/estatística & dados numéricos , Adulto , Austrália , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Prevalência , Inquéritos e Questionários
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