Association between consultations with complementary/alternative medicine practitioners and menopause-related symptoms: a cross-sectional study.

OBJECTIVES: To examine the associations between consultations with complementary and alternative medicine (CAM) practitioners and menopause-related symptoms. METHODS: A cross-sectional survey of a nationally representative sample of 10 011 women aged 59-64 years from the Australian Longitudinal Study on Women's Health, conducted in 2010. Women, including those with hysterectomy, oophorectomy and natural menopause, were asked about their consultations with a range of CAM practitioners and menopause-related symptoms experienced. RESULTS: Acupuncturists were more likely to be consulted by women with hysterectomy experiencing night sweats (odds ratio, OR = 2.21), but were less likely to be consulted by those experiencing hot flushes (OR = 0.53). Acupuncturists were also more likely to be consulted by women with oophorectomy (OR = 3.11) and natural menopausal women (OR = 1.57) experiencing back pain. Massage therapists were more likely to be consulted by women with oophorectomy experiencing back pain (OR = 1.98), women with hysterectomy experiencing anxiety (OR = 1.52), and natural menopausal women experiencing back pain (OR = 1.54) and/or anxiety (OR = 1.29). Naturopaths/herbalists were more likely to be consulted by women with oophorectomy experiencing leaking urine (OR = 2.08). Chiropractors/osteopaths were more likely to be consulted by women across all menopausal status experiencing back pain (OR = 2.52, 2.31 and 2.25 for women with oophorectomy, hysterectomy and natural menopause, respectively). CONCLUSIONS: There are substantial levels of CAM practitioners' consultations amongst menopausal women, with a range of menopause-related symptoms associated with the use of specific CAM practitioner modalities. It is important that health-care providers are mindful of CAM practitioner use in order to ensure safe, effective and coordinated treatment and support for menopausal women in their care.

A critical review of traditional Chinese medicine use amongst women with menopausal symptoms.

OBJECTIVES: To provide the first critical review of traditional Chinese medicine (TCM) use amongst symptomatic menopausal women, drawing upon work examining the perspectives of both TCM users and TCM practitioners. METHODS: A search was conducted in three English-language databases (MEDLINE, CINAHL and AMED) and three Chinese-language databases (CNKI, VIP and CBM Disc) for 2002-2013 international peer-reviewed articles reporting empirical findings of TCM use in menopause. RESULTS: A total of 25 journal articles reporting 22 studies were identified as meeting the review inclusion criteria. Chinese herbal medicine appears to be the most common therapy amongst symptomatic menopausal women, and vasomotor symptoms and emotional changes are the most frequent symptoms for which TCM is sought. However, evidence regarding the prevalence of TCM use and users' profile in menopause is limited. Existing studies are of varied methodological quality, often reporting low response rate, extensive recall bias and a lack of syndrome differentiation. CONCLUSIONS: This review provides insights for practitioners and health policy-makers regarding TCM care to symptomatic menopausal women. More nationally representative studies are required to rigorously examine TCM use for the management of menopausal symptoms. Syndrome differentiation of menopausal women is an area which also warrants further attention.

Weight catch-up and achieved schooling at 18 years of age in Brazilian males.

OBJECTIVE: To assess the relationship between weight catch-up in infancy and achieved schooling at 18 years of age in Brazilian males. SUBJECTS: All newborn infants in the city's hospitals were enrolled in 1982; 78.8% (2250) of all male participants were located at age 18 years when enrolling in the national army. RESULTS: According to the Brazilian school calendar, 18-year-olds should be attending the 11th grade, but school failure was very common and 78.5% of all subjects had failed at least once. The average achieved schooling was 7.7 years (s.d.=2.3). After controlling for possible confounding variables, birthweight was positively associated with achieved schooling. With respect to postnatal growth, weight gain in the first 20 months was associated with increased schooling. Among SGA infants who caught-up in weight, achieved schooling was 1.3 higher. Data from a cross-sectional survey in the same population suggest that such a difference corresponds to a 25% difference in adult income levels. CONCLUSION: The study showed that early weight catch-up is associated with achieved schooling. The beneficial effects of early weight gain should be balanced against its potential harms.

Validation of a 28 day interval between discharge and readmission for emergency readmission rates.

For the majority of studies on hospital readmission rates, a readmission is deemed to have occurred if a patient was admitted within 28 days of the previous discharge date. This time period, however, has rarely been justified clinically or statistically and certainly not in Australia. In examining the patterns of readmissions to NSW public acute hospitals, this study provides statistical support for the use of a 28 day interval for total readmissions. The same finding applies to the four admission categories of medical, surgical, paediatrics, and obstetrics and gynaecology.

Readmissions of day-only patients in NSW acute hospitals.

Day-only admissions have increased substantially over the last decade. With the increase in numbers, it is necessary to consider the quality of care of the patients undergoing a day-only admission. The readmission rate can be used as one such guide to quality of care. For several large Sydney hospitals, the percentage of patients readmitted was consistent across all lengths of stay (approximately 9%). When considering those type of admissions that are more suited to day surgery units, the readmission rate was 4.4%. This is suggestive of conservative selection criteria for day surgery unit patients.

Trends and projections for day only admissions in NSW acute hospitals.

The rapid increase in the number of day only admissions during the last decade has led to an increased awareness of this type of hospital admission. Health planners are now interested in which procedures are causing the increase in the day only activity and how best to accommodate it in the future. To address these issues, routinely collected hospital data were used to analyse trends in day only admissions and to extrapolate future demand via regression models. The results suggest that day only admissions will constitute 45% of all admissions to NSW acute hospitals by the year 2001. Detailed review of patient caseloads suggest that 13.5% of all patients will be potentially treatable through day surgery units, as opposed to general wards, by 2001. Assuming 80% of these potential patients actually do get treated in day surgery units, then the workload generated could be accommodated within 30 day surgery facilities.