Helen Gramotnev

Transitions into and out of caregiving: Health and social characteristics of mid-age Australian women

Family caregiving is frequently associated with significant levels of physical, emotional and financial strain. This article examines the health effects of transitions into and out of caregiving in middle age. We conducted a secondary analysis of data from the Australian Longitudinal Study on Womens Health (ALSWH) to examine changes in caregiving status among middle-aged women over a 3-year period, and the correlates and outcomes of these changes. A total of 9,555 middle-aged Australian women were categorised according to caregiving status at two surveys 3 years apart, as Continuing (2.7%); Stopped (4.9%); Started (3.0%); and Never caregivers (89.4%). Analyses at each time point show poorer physical and emotional health, health service use, health behaviours and lower engagement in the paid workforce among all three caregiver groups, indicating that middle-aged women who are, have been, or will become family caregivers are in poorer health than women who do not have these roles. Middle-aged women in poor health tend to be selected into caregiving, probably because they are less engaged with the paid workforce. Poor health and disengagement from the paid workforce continue even when caregiving stops. Health care providers should be particularly conscious of the needs of middle-aged caregivers, who are likely to be in poor health even before they take on the role.

Motherhood plans among young Australian women: who wants children these days?

Fertility rates in the developed world have been below replacement level for 25 years, and it is often assumed that this results from deliberate, unconstrained individual choice. Data from 7448 childless women aged 22 to 27, participating in the Australian Longitudinal Study on Women’s Health, indicate that 9 per cent aspire to childlessness, with 72 per cent wanting 1 or 2 children and 19 per cent more. Differences in psychological functioning disappear after adjustment for socioeconomic variables. Women wanting 1 or 2 children also want paid work, while those wanting many children generally have traditional aspirations. Policy-makers need to consider strategies that support women to negotiate motherhood and paid work.

Predictors and outcomes of early motherhood in the australian longitudinal study on women's health

Abstract Early motherhood is identified as a social problem, and having children at an early age is assumed to lead to psychological distress, welfare dependence and socioeconomic disadvantage. Analysis of responses from 9,689 young participants in the Australian Longitudinal Study on Womens Health was used to examine predictors and outcomes of early motherhood in Australia. Survey 1 (1996, aged 18 – 23) and Survey 2 (2000, aged 22 – 27), were used to categorize women as Childless, Existing Mothers (before Survey 1) and New Mothers (became mothers before Survey 2). Multivariate logistic regressions provided comparisons on sociodemographics, gynaecological variables, psychological wellbeing and health behaviours. Survey 1 data show that Existing Mothers experience socioeconomic disadvantages and unhealthy lifestyles. However, those who will go on to become mothers earlier than their peers already experience similar disadvantages. Further, the Survey 2 data show that, when these pre-existing disadvantages are controlled for, the additional deficits experienced by early mothers are relatively minor. Social disadvantage predisposes women to become mothers early, and to adopt unhealthy behaviours. However, young Australian women cope well with the challenges of early motherhood. In the longer term, unhealthy lifestyles and low education may lead to ill health and disadvantage, but early motherhood is not the initiator of this trajectory.

A phase II randomised double-blind placebo-controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: a herbal medicine preparation for the management of symptoms of benign prostatic hypertrophy.

OBJECTIVE The aim of the clinical trial was to evaluate the efficacy and safety of ProstateEZE Max, an orally dosed herbal preparation containing Cucurbita pepo, Epilobium parviflorum, lycopene, Pygeum africanum and Serenoa repens in the management of symptoms of medically diagnosed benign prostate hypertrophy (BPH). DESIGN This was a short-term phase II randomized double-blind placebo controlled clinical trial. SETTING The trial was conducted on 57 otherwise healthy males aged 40-80 years that presented with medically diagnosed BPH. INTERVENTION The trial participants were assigned to receive 3 months of treatment (1 capsule per day) with either the herbal preparation (n = 32) or a matched placebo capsule (n = 25). OUTCOME MEASURES The primary outcome measure was the international prostate specific score (IPSS) measured at baseline, 1, 2 and 3 months. The secondary outcomes were the specific questions of the IPSS and day-time and night-time urinary frequency. RESULTS There was a significant reduction in IPSS total median score in the active group of 36% as compared to 8% for the placebo group, during the 3-months intervention (p < 0.05). The day-time urinary frequency in the active group also showed a significant reduction over the 3-months intervention (7.0-5.9 times per day, a reduction of 15.6% compared to no significant reduction change for the placebo group (6.2-6.3 times per day) (p < 0.03). The night-time urinary frequency was also significantly reduced in the active group (2.9-1.8, 39.3% compared to placebo (2.8-2.6 times, 7%) (p < 0.004). CONCLUSION The herbal preparation (ProstateEZE Max) was shown to be well tolerated and have a significant positive effect on physical symptoms of BPH when taken over 3 months, a clinically significant outcome in otherwise healthy men.

The clinical efficacy of a bovine lactoferrin/whey protein Ig-rich fraction (Lf/IgF) for the common cold: A double blind randomized study

OBJECTIVE The aim of the study was to determine if a bovine lactoferrin/whey protein Ig-rich fraction (Lf/IgF) combination was effective in reducing the number of colds and in turn improving symptom recovery in a cohort of males and females that reported frequently contracting a cold. DESIGN A double blind randomized placebo-controlled clinical trial. SETTING One-hundred and twenty-six participants matched by age, BMI, dietary and physical parameters with self-reported frequent upper respiratory tract symptoms and infections were randomly assigned to receive 600 mg of Lf/IgF or a placebo daily for 90 days. MAIN OUTCOME MEASURES AND RESULTS A total of 90 participants (47 receiving the active and 43 placebo) completed the 90 day trial and 15 completed 45 days participation (6 in the active and 9 in the placebo group). The total number of colds recorded over the study period was 48 for the treatment group versus 112 for the placebo group (p < 0.001). The significant trend was retained when the data was corrected for medications returned (p < 0.001) and for guessing treatment allocations (p < 0.001). Non-parametric analysis demonstrated that the total number of cold-associated symptoms reported by participants that received Lf/IgF was significantly less than those in the placebo group (p < 0.05). Also, total days sick with a cold and cold severity were reduced over the clinical trial period for Lf/IgF over placebo, but the trend was not significant. CONCLUSIONS These findings demonstrate that the Lf/IgF combination significantly decreased the incidence of colds and the cumulative number of cold-related symptoms over placebo. This therapeutic combination may be indicated for the prevention of colds and its most common symptoms in the general population when administered as a preventative supplement.

The Life Control Scale: Validation with a Population Cohort of Middle-Aged Australian Women

BackgroundThe concept of perceived control is central to many theories of physical and emotional well-being. However, existing measures are lengthy and generally focus on job control. In epidemiological research, brief measures and those which can be applied across entire populations are needed. Among women in particular, a substantial minority have no paid work, while most also have major unpaid family commitments which may affect well-being through their effect on control. Thus, we evaluated the six-item Life Control Scale (Bobak, Soc Sci Med. 47:269–79, 1998) with a population-based sample of middle-aged women.MethodA population-based sample of 11,223 women aged 50 to 55, participating in the Australian Longitudinal Study on Women’s Health, completed the Life Control Scale as part of an omnibus survey of health and psychosocial factors.ResultsThe scale was demonstrated to be unifactorial and internally reliable and to show the expected relationships with several measures of socioeconomic position, physical health, and mental health.ConclusionThe Life Control Scale is brief, valid, and broadly applicable in epidemiological research.

Predictors and correlates of coping well with early motherhood in the Australian Longitudinal Study on Women's Health

Abstract Women who become mothers at an early age are characterised by socio-economic disadvantage and unhealthy lifestyles; however, some cope extremely well. This paper describes Australian women who become mothers at an early age, in order to identify factors that predict coping. The younger cohort of the Australian Longitudinal Study of Womens Health was used to identify 1064 young women who became mothers between Survey 1 and Survey 2. These women were categorised on the basis of the Mental Health Index of the SF-36 as having High, Normal or Low mental health. Survey 1 data were used to examine predictors, and Survey 2 data to examine correlates, of mental health. Surprisingly, few socio-demographic or health-related variables predict level of coping with early motherhood. Women who would have High mental health as mothers were likely to be in paid work, had few symptoms, and had low levels of stress. They were least likely to have a history of miscarriage and most likely to use contraception. There were no significant effects for other socio-demographic factors, or health-related behaviours. In the longer term, however, all young mothers may suffer an increasing level of disadvantage and distress relative to their peers.