Acupuncture used by one in 10 Aussie women
Acupuncture is used by around one in 10 Aussie women aged 34–39 years and around one in 16 women aged 62–67 years, according to data from 17 000 women participating in the Australian Longitudinal Study on Women’s Health, published in Acupuncture in Medicine. The research, from the Australian Research Centre for Complementary and Integrative Medicine at the University of Technology Sydney, also found that women with chronic conditions, including arthritis, low iron, chronic fatigue syndrome and endometriosis, were more likely to use Chinese medicine and acupuncture. Other interesting outcomes were that among users of both treatments, those from the young cohort were more likely to have private health insurance and reside in urban areas, while non-smokers were significant users within the middle-aged group. Survey subjects who were married or in a de facto relationship were less likely to use Chinese medicine compared with their single counterparts, while those with private health insurance were 1.65 times more likely to use the treatment compared with those without. A large proportion of users of Chinese medicine from the young cohort had been diagnosed with endometriosis, low iron levels, anxiety disorder and chronic fatigue syndrome. Report co-author Professor Jon Adams commented: “It is important that all involved … be mindful of the complementary treatment options that may be popular among women. Critical public health has a key role to play in ensuring this important area of health and health care receives sufficient rigorous and scientific scrutiny”.
Screening of all pregnancies could cut pre-term births
Australian experts writing in the Australian and New Zealand Journal of Obstetrics and Gynaecology have recommended that all pregnancies should be screened to detect women who have a short cervix and may be at risk of pre-term birth. The length of a woman’s cervix mid-pregnancy can be used to predict the likelihood of pre-term birth, but universal screening of all pregnancies is not common. The authors, from the University of Western Australia, the University of Adelaide and the South Australian Health and Medical Research Institute, wrote that most cases of pre-term birth occur with no prior history. Given that there are treatments available to reduce the risk once it is identified, they wrote that there is a clear role for routine cervical length (CL) screening as part of the regular pregnancy ultrasound examinations. “A public health campaign to inform all care providers about the recommended manner of screening and the treatment options available should be implemented and imaging staff should be appropriately trained. Additionally, women need to be advised correctly about the benefits and risks of CL screening in order for them to make an informed decision about screening and treatment.”
Training needed to increase use of long-acting reversible contraceptives
Australia’s abortion rates are among the highest in the developed world, and around 30% of pregnancies are unintended. Although long-acting reversible contraceptives (LARCs) are known to reduce the rate of unintended pregnancies, they have a very low uptake in Australia. A roundtable meeting involving researchers from Monash University, Family Planning NSW, the Australasian Menopause Society, Marie Stopes International Australia, Monash Medical Centre and the University of Sydney Medical School discussed a range of impediments to LARC use, including lack of familiarity with LARCs, deficits in GPs trained to insert and remove the devices and poor education in LARCs for GPs. They also suggested that nurses should be trained to perform the LARC insertions, as well as having rapid referral pathways and policy changes to assist more women broadly. Published in the Australian and New Zealand Journal of Obstetricians and Gynaecologists, the discussion group came up with a set of strategies that promote LARC uptake and may therefore reduce Australia’s high unintended pregnancy rate. Those strategies included enhancing GP education to minimise barriers to optimal prescribing practices (such as structured learning activities, improved access to quality information, counselling and prescribing tools and practical training on insertions and removals); providing women with clear, factual information; doing an in-depth examination of relevant international data to inform and improve outcomes in Australia by identifying best practice models, provider perspectives and contributory factors to higher LARC uptake and lower abortion rates; changing the policy and health system; and implementing a collaborative approach.
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