***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To compare the characteristics of complementary and alternative medicine ( CAM ) users and non-users among Australian women . DESIGN Cross-sectional postal question naire conducted during 1996 , forming the baseline survey of the Australian Longitudinal Study on Women 's Health . PARTICIPANTS Women aged 18 - 23 years ( n = 14 779 ) , 45 - 50 years ( n = 14 099 ) and 70 - 75 years ( n = 12 939 ) , r and omly selected from the Health Insurance Commission data base , with over-sampling of women from rural and remote areas of Australia . MAIN OUTCOME MEASURES Consultation with an alternative health practitioner in the 12 months before the survey . RESULTS Women in the mid-age cohort were more likely to have consulted an alternative health practitioner in the previous year ( 28 % ) than women in the younger cohort ( 19 % ) or older cohort ( 15 % ) . In all age groups , CAM users were more likely than CAM non-users to reside in non-urban areas , to report poorer health , have more symptoms and illness , and be higher users of conventional health services . CONCLUSIONS Women in non-urban Australia are more likely to use CAM but do so in in parallel with conventional health services This prospect i ve cohort study examined the health-seeking behaviour of patients diagnosed with genital warts and vulvodynia who presented to Manly Sexual Health Service from March to June 2000 . A self-administered question naire was used to assess patients ' perceptions of their condition and their use of complementary therapies .  Thirty-seven patients with genital warts and 26 patients with vulvodynia participated in the study . The use of at least one  complementary health product or method  was reported by 59 % of patients with genital warts and 96 % of vulvodynia patients ( P < 0.001 ) . Having received conflicting information and being worried about the condition was significantly associated with visits to complementary health providers . Acknowledgement of this search for complementary therapies and open discussion can help patients make informed decisions and to avoid drug interactions , and should ultimately lead to better patient care We know little about older adults ' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient – provider communication and medical decision making . Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making . Survey research was conducted using r and om digit dialing of Florida residents ' l and line telephones . The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information . Study respondents were 225 older adults ( age range = 50−92 years , M = 68.9 , SD = 10.4 ) , which included users ( n = 105 ) and nonusers ( n = 119 ) of online health information . Users and nonusers differed in frequency and types of health sources sought . Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale . This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making This study aim ed to examine the factors associated with  Chinese medicine use amongst a sample of 10,287 Australian women aged 56 - 61 years . Data was obtained from a cross-sectional postal question naire conducted in 2007 , this being the fifth survey of the Australian Longitudinal Study on Women 's Health . This representative sample of 10,287 women was r and omly selected from the Health Insurance Commission ( Medicare ) data base . The outcome measure was the use of Chinese medicine in the previous 12 months . The predictive factors included demographics , health status measures and health service utilization measures . Statistical analyses included univariate chi-square and ANOVA tests and backward stepwise multiple logistic regression modelling . The use of Chinese medicine amongst women aged 56 - 61 years appears to be strongly influenced by their country of birth , consultation with a range of CAM practitioners , and the use of some self-prescribed CAM . Interestingly , severe tiredness was the only symptom or diagnosis that predicted Chinese medicine use . Given the substantial prevalence of Chinese medicine use and the finding that the use of Chinese medicine is heavily integrated alongside the use of many other CAM and conventional treatments , it is imperative for the safety of patients that health professionals ( across complementary and conventional healthcare ) fully recognise the possible Chinese medicine use amongst their practice population s. In order to help inform relevant practice and policy development it is also important that future research further examining women 's decision-making , motivations and evaluations regarding Chinese medicine use considers such issues within the context of broader CAM and conventional health care utilization BACKGROUND Over 80 % of rheumatoid arthritis ( RA ) patients have used some type of  complementary medicine ( CM ) at some time . Little is known about RA patients ' perceptions of the efficacy , hazards and costs associated with CM use relative to physician-prescribed medicine . These data may be helpful in better underst and ing patients ' needs and in improving their care . AIMS To determine the prevalence and features of  CM use among RA patients attending a community-based private rheumatology practice .  CM was defined as treatment that was initiated by the patient , excluding treatment that had been prescribed or specifically recommended by their doctor . telephone-administered question naire was used to survey a stratified r and om sample of 200 RA patients who had attended the practice within the preceding year . The main outcome measures were : ( i )  CM use in the past year , ( ii ) patient expenditure on CM , ( iii ) patients ' perceptions of CM and ( iv ) characteristics of patients using CM .  RESULTS One hundred and six patients responded ( response rate 53 % ) and 101 completed the interview . Seventy-four patients ( 73.3 % ) had used some form of CM in the past year . There were 68 ( 67.3 % ) patients who had utilized complementary therapies and 32 patients ( 31.7 % ) who had consulted a complementary practitioner for their RA . The most commonly used treatments were dietary ( 64 instances ) and behavioural/cognitive therapies ( 45 instances ) . Prescription medicine was considered more beneficial than either form of CM , and users and non-users of CM held a similar perception of the efficacy of prescription medicine . The median amount spent on RA treatment per month was $ A7 ( range 0 - 91 ) for complementary treatments , $ A26 ( 1 - 270 ) for complementary practitioners and $ A7 ( 0 - 80 ) for prescription medicine . Women were more likely to have consulted a CM practitioner ( OR = 1.5 ; 95 % CI : 1.2 - 1.9 ) , as were patients who were not receiving a pension ( OR = 1.7 ; 95 % CI : 1.1 - 2.6 ) . CONCLUSIONS This study confirmed that  CM use is prevalent among RA patients attending a community-based private rheumatology practice . Despite lesser perceived benefit , patients spent at least as much money on  CM  as they did on prescription medicine . These findings suggest that there are other factors motivating the use of alternative treatments OBJECTIVE This study aim ed to identify the health conditions and symptoms that predicted dietary and health supplement use in older Australians . DESIGN Almost 2,500 Australians aged 65 years and over were r and omly selected from the 2000 Australian Electoral Commission roll . All states and territories were proportionally represented in the sample . Data were obtained using a self-administered postal survey . SUBJECTS Approximately 1,200 individuals ( 51 % males and 49 % females ) aged between 65 - 98 years completed the survey . RESULTS At the time of survey , 43 % ( n=548 ) reported using some form of supplement . Supplement use was significantly associated with gender ( female ) and chronic musculoskeletal ailments such as arthritis , osteoporosis and generalised back or neck problems . A diagnosis of hypertension or a heart condition were significant barriers to supplement use in this sample . The most common potential drug-supplement interaction was between calcium supplements and antihypertensives . CONCLUSION Older supplement users may be of the opinion that supplements offer relief from the pain and suffering associated with their medical problems . If so , current supplement patterns would indicate that they are misguided . Nurses have an important role to play in encouraging older individuals to disclose their use of supplements to all health professionals involved in their continuing care OBJECTIVE In the course of performing systematic review s on the prevalence of low back and neck pain , we required a tool to assess the risk of study bias . Our objectives were to ( 1 ) modify an existing checklist and ( 2 ) test the final tool for interrater agreement . STUDY DESIGN AND SETTING The final tool consists of 10 items addressing four domains of bias plus a summary risk of bias assessment . Two research ers tested the interrater agreement of the tool by independently assessing 54 r and omly selected studies .  Interrater agreement overall and for each individual item was assessed using the proportion of agreement and Kappa statistic . RESULTS Raters found the tool easy to use , and there was high interrater agreement : overall agreement was 91 % and the Kappa statistic was 0.82 ( 95 % confidence interval : 0.76 , 0.86 ) . Agreement was almost perfect for the individual items on the tool and moderate for the summary assessment . CONCLUSION We have addressed a research gap by modifying and testing a tool to assess risk of study bias . Further research may be useful for assessing the applicability of the tool across different conditions This study aim ed to identify the prevalence and types of complementary and alternative medications ( CAMs ) used by women during menopause and explore potential associations between CAM use and menopausal symptoms . Analysis was undertaken with 886 r and omly selected menopausal women aged 47 - 67 years who participated in a postal question naire on the menopause experience . The prevalence of CAM use was relatively high ( 82.5 % ) , with nutrition most commonly cited ( 67 % ) , followed by phytoestrogens ( 56 % ) , herbal therapies ( 41 % ) , and CAM medications ( 25 % ) . Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17 - 23 % more likely to report anxiety ( p = .019 ) or vasomotor symptoms ( p = .013 ) . Women who used herbal therapies ( p = .009 ) or phytoestrogens ( p = .030 ) were 13 - 16 % more likely to experience vasomotor symptoms . Women who used nutrition were 18 % more likely to experience anxiety ( p = .049 ) . These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices Background . There is evidence of asthma patients using complementary and alternative medicine ( CAM ) . This article reports the findings of the first ever longitudinal study of CAM use among women with asthma from a large nationally representative sample . Methods . A longitudinal analysis of question naires completed in 1996 , 2000 , 2003 , and 2006 as part of the Australian Longitudinal Study on Women 's Health . The cohort began with 14,701 r and omly selected young women ( aged 18–22 years ) .  CAM use was defined as a consultation with a range of complementary practitioners in the 12 months prior to each survey . Statistical analyses included the use of generalized estimating equations . Results . Over the 10-year period , approximately 26 % of the women were asthmatic . Asthmatic women were significantly more likely to use CAM  ( 19 % , 22 % , and 36 % for surveys 2–4 , respectively ) than non-asthmatic women ( 15 % , 20 % , and 32 % for surveys 2–4 , respectively ) .  CAM use increased as time since asthma diagnosis increased . However , only the increase in consultations with a naturopath/herbalist remains statistically significant when the CAM modalities are considered individually alongside asthma status . The longitudinal model suggests that women with asthma are 1.13 ( 95 % CI : 1.05–1.21 ) times more likely to consult with a CAM practitioner ( p < .001 ) . The study also shows that CAM users have a higher dissatisfaction with conventional healthcare services and consultations when compared to CAM non-users . Conclusion . These findings suggest that women with asthma may turn to CAM after conventional care fails to adequately address their healthcare needs OBJECTIVE To investigate the use of and expenditure on 17 of the most popular forms of complementary and alternative medicine ( CAM ) by adult Australians , sociodemographic characteristics of CAM users , and communication between  CAM users and their doctors . METHODS In May-June 2005 , a sample of 1067 adults , 18 years and older , from all Australian states and territories , was recruited by r and om-digit telephone dialing and interviewed about their CAM use in the previous 12 months . RESULTS In the 12-month period , 68.9 % ( 95 % CI : 66.1%-71.7 % ) of those interviewed used at least one of the 17 forms of CAM  and 44.1 % ( 95 % confidence interval : 41.1%-47.1 % ) visited a CAM practitioner . The estimated number of visits to CAM practitioners by adult Australians in the 12-month period ( 69.2 million ) was almost identical to the estimated number of visits to medical practitioners (  
    Output:
    
Results The findings indicate a correlation between CM users and gender , with reports of a higher rate of use from females compared to males .
Female CM users are more likely to be middle-aged with a higher education and higher annual income in comparison to female non-CM users .
An association between resident location and use of CM disciplines was also identified with reports of rural residents utilising manual therapies more frequently compared to urban residents .
CM users are more likely to seek  CM services for a range of chronic conditions including diseases identified as National Health Priority Areas by the Australian Government .
Conclusions This article provides the first comprehensive review examining the nature of CM use in Australia .