ORCID Profile
0000-0002-0271-6702
Current Organisations
Monash University
,
University of South Australia
,
La Trobe University
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Neurosciences not elsewhere classified | Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology) | Psychology | Developmental Psychology and Ageing
Publisher: Wiley
Date: 10-07-2022
DOI: 10.1111/JSR.13680
Abstract: Habitual sleep duration and efficiency vary widely by age, gender, and racial/ethnic identity. Despite growing research on the importance of night‐to‐night, intrain idual variability (IIV) in sleep, few studies have examined demographic differences in sleep IIV. The present study describes typical sleep IIV overall and by demographics among healthy sleepers. Eight datasets of healthy sleepers ( N = 2,404 26,121 total days of sleep data) were synthesised to examine age, gender, and racial/ethnic identity differences in sleep IIV measured via diaries, actigraphy, and electroencephalography (EEG). Sleep IIV estimates included the intrain idual standard deviation (iSD), root mean square of successive differences (RMSSD), coefficient of variation (CV), and a validated Bayesian Variability Model (BVM). There was substantial IIV in sleep across measurement types (diary, actigraphy, EEG) for both sleep duration (iSD: 85.80 [diary], 77.41 [actigraphy], 67.04 [EEG] minutes RMSSD: 118.91, 108.89, 91.93 minutes CV: 19.19%, 19.11%, 18.57% BVM: 60.60, 58.20, 48.60 minutes) and sleep efficiency (iSD: 5.18% [diary], 5.22% [actigraphy], 6.46% [EEG] RMSSD: 7.01%, 7.08%, 8.44% CV: 5.80%, 6.27%, 8.14% BVM: 3.40%, 3.58%, 4.16%). Younger adults had more diary and actigraphy sleep duration IIV. Gender differences were inconsistent. White and non‐Hispanic/Latinx adults had less IIV in sleep duration and efficiency compared to racial/ethnic minority groups. Even among healthy sleepers, sleep varies widely from night‐to‐night. Like mean sleep, there also may be disparities in IIV in sleep by demographic characteristics. Study results help characterise normative values of sleep IIV in healthy sleepers.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.IJCARD.2016.06.284
Abstract: This study aimed to confirm, in a large, erse cohort of elite Stand-up Comedians and other entertainers, that there is an inverse association between comedic ability and longevity. This retrospective cohort study included 200 Stand-up Comedians (13% women), 113 Comedy Actors (17.5% women), and 184 Dramatic Actors (29.3% women) listed in the top 200 in each category in a popular online ranking website. Longevity within each group was examined adjusting for life expectancy by year of birth and within-group ranking score. Stand-up Comedians were younger than Comedy Actors (median birth year 1962 versus 1947: p<0.001) and Dramatic Actors (1962 versus 1946: p<0.001). Overall, 36/200 (18.0%), 33/114 (29.0%) and 56/184 (30.9%) of Stand-up Comedians, Comedy Actors and Dramatic Actors, respectively, had died (p=0.011). There was a significant gradient (p=0.011) in the age of death, with Stand-up Comedians dying at a younger age (67.1±21.3years) than their Comedy Actor (68.9±15.4years) and Dramatic Actor (70.7±16.6years) counterparts. Stand-up Comedians (38.9% versus 19.6%) were more likely to die prematurely compared to Dramatic Actors p=0.043, OR 1.98 95% CI 1.01 to 3.87). Independent of year of birth, for Stand-up Comedians alone, higher comedy rank was associated with shorter longevity (hazard ratio 0.938, 95% CI 0.880 to 0.999 for a 10-rank difference p=0.045). These data reaffirm an adverse relationship between comedic ability and longevity, with elite Stand-up Comedians more highly rated by the public more likely to die prematurely.
Publisher: Informa UK Limited
Date: 20-01-2021
Publisher: Elsevier BV
Date: 2023
Publisher: Oxford University Press (OUP)
Date: 07-10-2021
Abstract: Sleep problems are common during chemotherapy for breast cancer (BC). We evaluated whether combined brief cognitive behavioral and bright light therapy (CBT-I + Light) is superior to treatment as usual with relaxation audio (TAU+) for insomnia symptoms and sleep efficiency (primary outcomes). We randomized women receiving intravenous chemotherapy, stratified by tumor stage and insomnia severity index, to 6-week CBT-I + Light or TAU+. CBT-I + Light included 1 in-person session, 1 telephone call, 7 emails, and 20 min bright light (BL) each morning. TAU+ comprised usual treatment and two emails with relaxation audio tracks. Patient-reported outcomes were assessed at baseline, midpoint (week 3), post (week 6), and 3-month follow-up. Women (N = 101) were randomly assigned to CBT-I + Light or TAU+. The CBT-I + Light group showed significantly greater improvement in insomnia symptoms than the TAU+ group (−5.06 vs −1.93, p = .009 between-group effect size [ES] = .69). At 3-month follow-up, both groups were lower than baseline but did not differ from each other (between-group ES = .18, p = .56). CBT-I + Light had higher patient-reported sleep efficiency than TAU+ immediately after the start of intervention (p = .05) and significantly greater improvement in fatigue (between-group ES = .59, p = .013) and daytime sleep-related impairment (between-group ES = .61, p = .009) than the TAU+ group. CBT-I + Light had a clinically significant impact on insomnia and fatigue with moderate ESs. Results support offering cognitive behavioral therapy for insomnia and BL therapy during chemotherapy for BC to help manage sleep and fatigue. Australian New Zealand Clinical Trials Registry (anzctr.org.au/). Registration number: ACTRN12618001255279.
Publisher: Foundation for Open Access Statistic
Date: 2014
Publisher: Wiley
Date: 14-02-2022
DOI: 10.1111/JSR.13564
Abstract: The coronavirus disease 2019 (COVID‐19) pandemic resulted in significant increases in insomnia, with up to 60% of people reporting increased insomnia. However, it is unclear whether exposure to risk factors for the virus or worries about COVID‐19 are more strongly associated with insomnia. Using a three‐part survey over the course of the first 6 months of the pandemic, we evaluated associations between COVID‐19 exposures, COVID‐19 worries, and insomnia. We hypothesised that COVID‐19‐related worries and exposure to risk of COVID‐19 would predict increases in insomnia. Participants ( N = 3,560) completed a survey at three time‐points indicating their exposures to COVID‐19 risk factors, COVID‐19‐related worries, and insomnia. COVID‐19 worry variables were consistently associated with greater insomnia severity, whereas COVID‐19 exposure variables were not. COVID‐19 worries decreased significantly over time, and there were significant interactions between change in COVID‐19 worries and change in insomnia severity over time. In iduals who experienced increases in COVID‐19 worries also experienced increases in insomnia severity. Changes in worry during the COVID‐19 pandemic were associated with changes in insomnia worries about COVID‐19 were a more consistent predictor of insomnia than COVID‐19 exposures. Evidence‐based treatments targeting virus‐related worries may improve insomnia during this and future calamities.
Publisher: American Psychological Association (APA)
Date: 11-2018
DOI: 10.1037/HEA0000652
Publisher: Springer Science and Business Media LLC
Date: 20-05-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Informa UK Limited
Date: 2017
DOI: 10.2147/COPD.S123933
Publisher: American Medical Association (AMA)
Date: 11-11-2013
DOI: 10.1001/JAMAINTERNMED.2013.10261
Abstract: Physicians often perceive as futile intensive care interventions that prolong life without achieving an effect that the patient can appreciate as a benefit. The prevalence and cost of critical care perceived to be futile have not been prospectively quantified. To quantify the prevalence and cost of treatment perceived to be futile in adult critical care. To develop a common definition of futile care, we convened a focus group of clinicians who care for critically ill patients. On a daily basis for 3 months, we surveyed critical care specialists in 5 intensive care units (ICUs) at an academic health care system to identify patients whom the physicians believed were receiving futile treatment. Using a multivariate model, we identified patient and clinician characteristics associated with patients perceived to be receiving futile treatment. We estimated the total cost of futile treatment by summing the charges of each day of receiving perceived futile treatment and converting to costs. Prevalence of patients perceived to be receiving futile treatment. During a 3-month period, there were 6916 assessments by 36 critical care specialists of 1136 patients. Of these patients, 904 (80%) were never perceived to be receiving futile treatment, 98 (8.6%) were perceived as receiving probably futile treatment, 123 (11%) were perceived as receiving futile treatment, and 11 (1%) were perceived as receiving futile treatment only on the day they transitioned to palliative care. The patients with futile treatment assessments received 464 days of treatment perceived to be futile in critical care (range, 1-58 days), accounting for 6.7% of all assessed patient days in the 5 ICUs studied. Eighty-four of the 123 patients perceived as receiving futile treatment died before hospital discharge and 20 within 6 months of ICU care (6-month mortality rate of 85%), with survivors remaining in severely compromised health states. The cost of futile treatment in critical care was estimated at $2.6 million. In 1 health system, treatment in critical care that is perceived to be futile is common and the cost is substantial.
Publisher: SAGE Publications
Date: 15-01-2014
Abstract: A systematic review was conducted to examine the association between co-morbidity and physical performance in people with chronic obstructive pulmonary disease (COPD). MEDLINE, EMBASE, CINAHL, SCOPUS and Cochrane Central Register of Controlled Trials were searched from inception to end-February 2013, using keywords ‘COPD’, ‘exercise’, ‘physical activity’, ‘rehabilitation’, ‘co-morbidity’ and in idual co-morbid conditions. Studies reporting associations of co-morbidities in COPD with at least one objective measure of physical performance were included. Study quality was appraised using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Nine studies met inclusion criteria. Mean (standard deviation (SD)) STROBE score was 16 (3) (maximum score = 21). Four studies examined anxiety as a co-morbid condition three examined depression two examined obesity and two examined a range of conditions. Reduced physical performance was associated with higher Charlson score (odds ratio (OR) = 0.72, 95% confidence interval (CI) = 0.54–0.98), metabolic disease (OR = 0.58, 95% CI = 0.49–0.67), anxiety (OR = 0.37, 95% CI = 0.23–0.59) and osteoporosis (OR = 0.28, 95% CI = 0.11–0.70). Depression had minimal association with physical performance but was associated with higher dropout rates from pulmonary rehabilitation programmes. Obesity was negatively associated with baseline physical performance but not with change from an exercise intervention. The presence of co-morbid conditions in people with COPD may negatively affect physical performance and should be identified and accounted for analysis of interventions.
Publisher: Wiley
Date: 19-06-2017
DOI: 10.1111/BJHP.12252
Abstract: Theories and research regarding cognitive and emotional processing during the experience of profound stressors suggest that the presence of intrusive thoughts and feelings predicts greater use of avoidance and that the use of avoidance paradoxically predicts more intrusions. However, empirical investigations of their purported bidirectional relationship are limited. This study presents a longitudinal investigation of the reciprocal relationship between intrusions and avoidance coping over a 6-month period in the year following breast cancer diagnosis. Breast cancer patients (N = 460) completed measures of cancer-related intrusions and avoidance at study entry, 3 months, and 6 months later (i.e., an average of 2, 5, and 8 months after diagnosis, respectively). Cross-lagged panel analyses revealed that intrusive thoughts, feelings, and images at study entry predicted greater avoidance 3 months later, and avoidance coping at study entry predicted intrusions 3 months later, controlling for the stability of intrusions and avoidance as well as time since diagnosis. Findings were not statistically significant for avoidance predicting intrusions, or vice versa, between the 3-month and the 6-month assessment period, during which they declined. These findings provide empirical support for the theoretical contention that avoidance and intrusive thoughts and emotions reciprocally influence one another following stressful events. Additionally, in the months shortly after breast cancer diagnosis, intrusions and avoidance are positively related. However, the relationships attenuate over time, which could indicate resolved cognitive and emotional processing of the cancer experience. Statement of contribution What is already known on this subject? Following stressful life events, in iduals often experience intrusive thoughts and feelings related to the event and they report avoidance of such reminders. Many studies demonstrate that greater intrusions predict more subsequent use of avoidance coping, and other studies show that greater use of avoidance predicts more intrusions. Their reciprocal relation has not been examined, however. What does this study add? This is the first examination of the concurrent, reciprocal influence of intrusions and avoidance. Findings suggest that accounting for the bidirectional influence of avoidance and intrusions best estimates hypothesized models. Higher intrusions and avoidance predicted each other for the first 3 months after study entry, but the relationship diminished 6 months after study entry, perhaps due to productive mental processing of the stress of breast cancer diagnosis and treatment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Publisher: Editorial Pontificia Universidad Javeriana
Date: 06-07-2018
DOI: 10.11144/JAVERIANA.UPSY17-3.PDPT
Abstract: Diabetic adolescents have poor metabolic control. We aimed to characterize the longitudinal association between the stress-related domains of emotional burden (EB), physician related-distress (PD), regimen-related distress (RD), diabetes-related interpersonal distress (ID), and hemoglobin glycosylated (HbA1c) trajectories among Type 1 diabetics Chilean adolescents. Thirty-two Type 1 diabetic adolescents (Mage=15.97 SD=3.45) were followed for one year. HbA1c was assessed at three time points, and a stress measure was obtained. Using a longitudinal growth curve modeling, a marginal overall negative linear trend was found in HbA1c (b = -0.23, p = 0.096). There was an interaction between time and PD (b = -0.33, p 0.05), and a main effect of EB, RD, and ID on HbA1c. Psychological stress domains predict metabolic control trajectories. Monitoring diabetes specific stress may be a useful tool to identify adolescents at risk for poor control, and interventions that reduce such stress might lead to better management of diabetes in adolescents.
Publisher: Research Square Platform LLC
Date: 19-07-2019
Abstract: Background Women with breast cancer experience a significantly higher prevalence of sleep disturbances and insomnia compared with the general population. The experience of persistent sleep disturbance places breast cancer patients at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment of sleep in this population is not standard and is often inadequately managed. This randomised controlled study will examine the effects of both Cognitive Behavioural Therapy for insomnia and sleep (CBT-I) and bright light therapy (BL) on the symptoms of insomnia, fatigue and mental health. Method/design Women diagnosed with breast cancer who are or will be receiving intravenous chemotherapy treatment at a major metropolitan cancer centre in Melbourne will be recruited (n=80). Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible participants will be randomised to the CBT+ intervention (CBT and BL) or relaxation audio enhanced treatment as usual (TAU+). The intervention group will receive one face-to-face session on sleep strategies, one telephone call, and seven email packages containing CBT-I based information and strategies. Participants will also wear Luminette light glasses for 20 minutes each morning for the six-week duration of the intervention. TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the 6 weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) measure. Data will also be collected on potential treatment moderators and mechanisms, and adherence to treatment. There will be 3-month follow-up measurements of fatigue, sleep-related impairment, sleep disturbance, depression, and anxiety. Discussion This is the first randomised controlled trial to combine CBT and BL for the treatment of sleep disturbances in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy dissemination.
Publisher: Springer Science and Business Media LLC
Date: 24-01-2022
DOI: 10.1038/S41598-022-05277-W
Abstract: This study examined whether resilience capacity moderates the association of daily perceived stress and affect with cortisol diurnal slope among relocated emerging adults. Relocated undergraduates ( N = 98 aged 18–25 years) were recruited from three groups: Resilient, Vulnerable, and Control. The Resilient group required Risky Family Questionnaire (RFQ) scores ≥ 29 and Brief Resilience Scale (BRS) scores ≥ 3.6. The Vulnerable group required RFQ scores ≥ 29 and BRS scores ≤ 3. The comparison Control group required RFQ scores ≤ 21 and T-scores 60 on PROMIS anxiety and depression symptoms. Mixed-effects models were used to test the unique associations of perceived stress, negative affect, and positive affect x group interactions (predictors) on diurnal cortisol slope (outcome) across 14 consecutive days. The Resilient group did not moderate the associations between daily stress or affect on cortisol diurnal slope. Instead, both the Resilient and Vulnerable groups with early family risk, showed a steeper diurnal slope unique to higher stress and a flatter slope unique to higher negative affect. Results suggest that riskier early family life was significantly associated with altered cortisol diurnal slope outcomes to stress (i.e., demand) and negative affect (i.e., distress). These associations were not attenuated by current resilience capacity.
Publisher: Research Square Platform LLC
Date: 19-02-2020
Abstract: Background: Women with breast cancer experience a significantly higher prevalence of sleep disturbances and insomnia compared with the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment of sleep in this population is not part of routine care, and often is managed inadequately. This randomised controlled trial will examine the combined effects of Cognitive Behavioural Therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue, and mental health. Method/design: Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne Australia will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 minutes each morning for the six-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the six weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) measure. Data will also be collected on potential treatment moderators and mechanisms, and adherence to treatment. There will be three-month follow-up measurements of fatigue, sleep-related impairment, sleep disturbance, depression, and anxiety. Discussion: This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbances in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12618001255279. Retrospectively registered on: 25/07/2018, recruitment began: 24/07/2018.
Publisher: Research Square Platform LLC
Date: 02-12-2019
Abstract: Background: Women with breast cancer experience a significantly higher prevalence of sleep disturbances and insomnia compared with the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment of sleep in this population is not part of routine care, and often is managed inadequately. This randomised controlled trial will examine the combined effects of Cognitive Behavioural Therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue, and mental health. Method/design: Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne Australia will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 minutes each morning for the six-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the six weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) measure. Data will also be collected on potential treatment moderators and mechanisms, and adherence to treatment. There will be three-month follow-up measurements of fatigue, sleep-related impairment, sleep disturbance, depression, and anxiety. Discussion: This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbances in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12618001255279. Retrospectively registered on: 25/07/2018, recruitment began: 24/07/2018.
Publisher: PeerJ
Date: 31-07-2018
DOI: 10.7717/PEERJ.5318
Abstract: Blinding is critical to clinical trials because it allows for separation of specific intervention effects from bias, by equalising all factors between groups except for the proposed mechanism of action. Absent or inadequate blinding in clinical trials has consistently been shown in large meta-analyses to result in overestimation of intervention effects. Blinding in dry needling trials, particularly blinding of participants and therapists, is a practical challenge therefore, specific effects of dry needling have yet to be determined. Despite this, dry needling is widely used by health practitioners internationally for the treatment of pain. This review presents the first empirical account of the influence of blinding on intervention effect estimates in dry needling trials. The aim of this systematic review was to determine whether participant beliefs about group allocation relative to actual allocation (blinding effectiveness), and/or adequacy of blinding procedures, moderated pain outcomes in dry needling trials. Twelve databases (MEDLINE, EMBASE, AMED, Scopus, CINAHL, PEDro, The Cochrane Library, Trove, ProQuest, trial registries) were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. Two independent reviewers performed screening, data extraction, and critical appraisal. Available blinding effectiveness data were converted to a blinding index, a quantitative measurement of blinding, and meta-regression was used to investigate the influence of the blinding index on pain. Adequacy of blinding procedures was based on critical appraisal, and subgroup meta-analyses were used to investigate the influence of blinding adequacy on pain. Meta-analytical techniques used inverse-variance random-effects models. The search identified 4,894 in idual publications with 24 eligible for inclusion in the quantitative syntheses. In 19 trials risk of methodological bias was high or unclear. Five trials were adequately blinded, and blinding was assessed and sufficiently reported to compute the blinding index in 10 trials. There was no evidence of a moderating effect of blinding index on pain. For short-term and long-term pain assessments pooled effects for inadequately blinded trials were statistically significant in favour of active dry needling, whereas there was no evidence of a difference between active and sham groups for adequately blinded trials. The small number and size of included trials meant there was insufficient evidence to conclusively determine if a moderating effect of blinding effectiveness or adequacy existed. However, with the caveats of small s le size, generally unclear risk of bias, statistical heterogeneity, potential publication bias, and the limitations of subgroup analyses, the available evidence suggests that inadequate blinding procedures could lead to exaggerated intervention effects in dry needling trials.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Frontiers Media SA
Date: 15-07-2014
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.RADI.2022.08.012
Abstract: The diagnosis of acute appendicitis remains challenging. This review determined the current diagnostic accuracy of CT and ultrasound for suspected acute appendicitis in adults. This systematic review adhered to the PRISMA for diagnostic test accuracy guidelines. A systematic search was undertaken in appropriate databases. Screening of potential titles and abstracts, full-text retrieval, methodological quality assessment using QUADAS, and data extraction was performed. Meta-analyses were performed for relevant subgroups, and sensitivity analysis was completed to account for outliers. GRADE was utilized to assess the certainty of findings. 31 studies evaluating CT, 10 evaluating US, and six evaluating both were included. Pooled sensitivity and specificity for CT was 0.972 [0.958, 0.981] and 0.956 [0.941, 0.967] respectively, and 0.821 [0.738, 0.882] and 0.859 [0.727, 0.933] for US, respectively. When analyzing subgroups based on the use of contrast enhancement, sensitivity and specificity was highest for CT with intravenous and oral contrast (0.992 [0.965, 0.998], 0.974 [0.936, 0.99]), compared to CT with intravenous contrast (0.955 [0.922, 0.974], 0.942 [0.916, 0.960]). Low-Dose CT produced comparable values (0.934 [0.885,0.963], 0.937 [0.911, 0.955]) relative to these subgroups and standard dose non-contrast CT (0.877 [0.774,0.937], 0.914 [0.827, 0.959]). US studies which excluded equivocal findings demonstrated significantly greater values than the remainder of US studies (p < 0.0001). The updated diagnostic test accuracies of CT, US and relevant subgroups should be implemented in light of factors such as dose, cost, and timing. For diagnosis of adult acute appendicitis: • CT with intravenous plus oral contrast enhancement yields statistically significantly greater diagnostic accuracy than CT with intravenous contrast alone. • Low-dose CT yields comparable sensitivity and specificity to standard-dose CT. • Ultrasound studies which exclude equivocal results may overinflate sensitivity and specificity.
Publisher: BMJ
Date: 13-09-2013
Publisher: JMIR Publications Inc.
Date: 19-09-2023
DOI: 10.2196/47496
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2015
Publisher: Wiley
Date: 26-07-2017
DOI: 10.1002/PON.4472
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
DOI: 10.1097/SPV.0000000000000364
Abstract: A variety of pelvic organ prolapse (POP) surgeries are performed concomitant to midurethral sling (MUS) placement. It is unknown whether differing POP surgeries may affect stress urinary incontinence outcomes after MUS placement. We performed a retrospective cohort analysis of patients undergoing TVT obturator system in conjunction with a variety of POP repair (cystocele with mesh graft, cystocele with cadaveric fascia, colpocleisis, and sacrocolpopexy). Primary outcomes included validated measures of stress urinary incontinence (International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms), measured preoperatively and at 6 week, 1 year, and 2 years postoperatively. Secondary outcomes included validated questionnaire items focused on obstructive and irritative symptoms. Multivariate analyses using mixed-effects regressions were used to assess for differences in outcomes based on POP repair type. A total of 102 patients were identified for study analysis (cystocele with mesh graft, n = 45 cystocele with cadaveric fascia, n = 37 sacrocolpopexy, n = 16 colpocleisis, n = 4). Four patients undergoing colpocleisis were excluded from primary analysis given lack of sufficient cohort size. When adjusted for effects of covariates, significant improvements in primary and secondary outcomes were seen throughout follow-up in comparison with baseline. In general, multivariate analysis demonstrated no significant differences between surgeries when assessing primary and secondary outcomes. The only statistically significant difference in change over time comprised CM, which demonstrated superior improvement in International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (preoperative vs 2 year, P = 0.04). Regardless of POP surgery type, patients demonstrate improvements in validated SUI outcomes through 2 years. Multivariate analysis suggests that there is little difference in SUI outcomes after TVT obturator system across several different POP repair types.
Publisher: Wiley
Date: 03-08-2021
DOI: 10.1111/JPI.12757
Abstract: During the COVID‐19 pandemic, schools around the world rapidly transitioned from in‐person to remote learning, providing an opportunity to examine the impact of in‐person vs remote learning on sleep, circadian timing, and mood. We assessed sleep‐wake timing using wrist actigraphy and sleep diaries over 1‐2 weeks during in‐person learning (n = 28) and remote learning (n = 58, where n = 27 were repeat assessments) in adolescents (age M ± SD = 12.79 ± 0.42 years). Circadian timing was measured under a single condition in each in idual using salivary melatonin (Dim Light Melatonin Onset DLMO). Online surveys assessed mood (PROMIS Pediatric Anxiety and Depressive Symptoms) and sleepiness (Epworth Sleepiness Scale – Child and Adolescent) in each condition. During remote (vs in‐person) learning: (i) on school days, students went to sleep 26 minutes later and woke 49 minutes later, resulting in 22 minutes longer sleep duration (all P .0001) (ii) DLMO time did not differ significantly between conditions, although participants woke at a later circadian phase (43 minutes, P = .03) during remote learning and (iii) participants reported significantly lower sleepiness ( P = .048) and lower anxiety symptoms ( P = .006). Depressive symptoms did not differ between conditions. Changes in mood symptoms were not mediated by sleep. Although remote learning continued to have fixed school start times, removing morning commutes likely enabled adolescents to sleep longer, wake later, and to wake at a later circadian phase. These results indicate that remote learning, or later school start times, may extend sleep and improve some subjective symptoms in adolescents.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
Publisher: Springer Science and Business Media LLC
Date: 29-09-2015
Publisher: Oxford University Press (OUP)
Date: 17-04-2018
Abstract: Atrial fibrillation represents a substantial clinical and public health issue. The definitive impact of body mass index on prognosis of patients with chronic (persistent or permanent) atrial fibrillation remains undetermined. The purpose of this study was to investigate the association of body mass index with health outcomes (mortality and re-hospitalisation) of patients with chronic atrial fibrillation. Using data from the Standard versus Atrial Fibrillation spEcific managemenT strategY (SAFETY) trial (a randomised controlled trial of home-based, atrial fibrillation-specific disease management), we performed post-hoc analyses of mortality and re-hospitalisation outcomes during minimum 24-month follow-up according to baseline body mass index profile. Of 297 participants (mean age 71±11 years, 47% female, mean body mass index 29.6±6.7 kg/m 2 ), 35.0% of participants were overweight (body mass index 25.0–29.9 kg/m 2 ) and 43.1% were obese (body mass index≥30 kg/m 2 ). During follow-up, n=42 died including 16/65 (24.6%) classified as normal body mass index, 16/104 (15.4%) classified as overweight and 10/128 (7.8%) classified as obese. Increasing body mass index was not associated with increased mortality but was associated with re-hospitalisation due to cardiovascular disease with greater length-of-stay (odds ratio 1.05 95% confidence interval 1.00–1.09, p=0.032). Obese in iduals experienced increased unplanned admissions compared to overweight in iduals (incidence rate ratio 0.71 95% confidence interval 0.53–0.96, p=0.028), and increased cardiovascular-related (incidence rate ratio 0.58 95% confidence interval 0.39–0.86, p=0.007) and all-cause admissions (incidence rate ratio 0.63 95% confidence interval 0.45–0.89, p=0.008) compared to those classified as normal body mass index. Overweight and obesity were not associated with survival in patients with chronic atrial fibrillation but were associated with more frequent hospital care and prolonged stay.
Publisher: JMIR Publications Inc.
Date: 27-07-2022
DOI: 10.2196/36658
Abstract: Cancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind (CM) was developed as an internet-delivered intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. This protocol aims to provide an outline of the CanCope Study, a trial comparing the efficacy of a Unified Protocol–adapted internet-delivered intervention (CM) designed for cancer survivors compared with an active control condition—an internet-delivered healthy lifestyle intervention, CanCope Lifestyle (CL). The primary aim is to assess and compare the efficacy of both interventions in improving emotion regulation, anxiety and depressive symptoms, and quality of life. The secondary aims involve assessing the mechanisms of the CM intervention. This trial is a 2-arm randomized controlled trial that allocates cancer survivors to either CM or CL. Both interventions comprise 4 web-based modules and are expected to take participants at least 8 weeks to complete. Participants’ mental and physical health will be assessed via self-reported surveys at baseline (T0), between each module (T1, T2, and T3), immediately after the intervention (T4), and at 3-month follow-up (T5). The study aims to recruit 110 participants who have completed T4. The CanCope study began recruitment in September 2020. A total of 224 participants have been randomized to the CM (n=110, 49.1%) and CL (n=114, 50.9%) groups. This is one of the first trials to develop and investigate the efficacy of a web-based intervention for cancer survivors that specifically targets emotion regulation. Australian Clinical Trials ACTRN12620000943943 3z9cjsp DERR1-10.2196/36658
Publisher: Informa UK Limited
Date: 13-10-2015
DOI: 10.1080/08870446.2015.1094570
Abstract: This study aims to test experimentally whether coping strategies (approach- vs. avoidance-oriented coping) have differential effects under conditions of high or low stressor controllability. Undergraduates (62 women, 30 men) participated in a 2 × 2 experimental study where they were introduced to a fictitious disease (tisomerase enzyme deficiency) said to be either controllable or uncontrollable and an approach- or avoidance-oriented coping behaviour induction. Changes in positive and negative affect. A significant disease control x coping interaction on positive affect (f(2) = .07, p = .011) revealed that approach-coping condition participants had higher positive affect than avoidance-coping condition participants when disease control was high (d = .94, p = .003), but not when it was low (d = .11, p = .93). The experimental conditions did not significantly influence negative affect. Results demonstrate that disease control moderates the salubrious effects of approach-oriented coping on positive affect. For controllable, but not uncontrollable, health stressors, promoting problem-focused approach-oriented coping strategies may be recommended.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-05-2016
DOI: 10.1161/CIRCULATIONAHA.116.020730
Abstract: We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failure, as well, were recruited. Overall, 612 and 614 patients, respectively, were allocated to a home visit 7 to 14 days postdischarge by a cardiac nurse with follow-up and multidisciplinary support according to clinical need or standard management. The primary outcome of days-alive and out-of-hospital was examined on an intention-to-treat basis. During 1371 days (interquartile range, 1112–1605) of follow-up, 218 patients died and 17 917 days of hospital stay were recorded. In comparison with standard management, HBI patients achieved significantly prolonged event-free survival (90.1% [95% confidence interval, 88.2–92.0] versus 87.2% [95% confidence interval, 85.1–89.3] days-alive and out-of-hospital P =0.020). This reflected less all-cause mortality (adjusted hazard ratio, 0.67 95% confidence interval, 0.50–0.88 P =0.005) and unplanned hospital stay (median, 0.22 [interquartile range, 0–1.3] versus 0.36 [0–2.1] days/100 days follow-up P =0.011). Analyses of the differential impact of HBI on all-cause mortality showed significant interactions (characterized by U-shaped relationships) with age ( P =0.005) and comorbidity ( P =0.041) HBI was most effective for those aged 60 to 82 years (59%–65% of in idual trial cohorts) and with a Charlson Comorbidity Index Score of 5 to 8 (36%–61%). These data provide further support for the application of postdischarge HBI across the full spectrum of patients being hospitalized for chronic forms of heart disease. URL: www.anzctr.org.au . Unique identifiers: 12610000221055, 12608000022369, 12607000069459.
Publisher: American Psychological Association (APA)
Date: 12-2015
DOI: 10.1037/A0039722
Publisher: JMIR Publications Inc.
Date: 24-03-2023
Abstract: common yet untested assumption of cognitive training in children is that activities should be adaptive, with difficulty adjusted to the in idual’s performance in order to maximize improvements on untrained tasks (known as transfer). Working memory training provides the ideal testbed to systematically examine this assumption as it is one of the most widely studied domains in the cognitive training literature, and is critical for children’s learning, including following instructions and reasoning. his trial aimed to examine children’s outcomes of working memory training using adaptive, self-select (child selects difficulty level) and stepwise (difficulty level increases incrementally) approaches to setting the difficulty of training activities compared to an active control condition immediately and 6 months post-intervention. While the aim is exploratory, we hypothesized that children allocated to a working memory training condition will show greater improvements: (1) on near transfer measures compared to intermediate and far transfer measures and (2) immediately post-intervention compared to 6 months post-intervention. his double-blinded, active-controlled, parallel-group randomized trial aimed to recruit 128 children aged 7 to 11 years from one metropolitan primary school in Melbourne. Following baseline testing, children were randomized into one of four conditions: adaptive, self-select or stepwise working memory training, or active control. An experimental intervention embedded in Minecraft was developed for teachers to deliver in class over two consecutive weeks (10 x 20-minute sessions). The working memory training comprised two training activities with processing demands similar to daily activities: backward span and following instructions. The control comprised creative activities. Pre- and post-intervention, children completed a set of working memory tests (near and intermediate transfer) and the Raven’s Standard Progressive Matrices (far transfer) to determine training outcomes, and motivation questionnaires to determine if motivations towards learning and the intervention were similar across conditions. Caregivers completed the ADHD Rating Scale-5 to measure their child’s attention (far transfer). Statistical analysis will include traditional null hypothesis significance testing and Bayesian methods to quantify evidence for both the null and alternative hypotheses. ata collection concluded in December 2022. Data is currently being processed and analyzed. his trial will determine whether the adaptive approach to setting the difficulty of training activities maximizes cognitive training outcomes for children. This trial has several strengths: adopts best practices for cognitive training studies (design, methods, analysis plan) uses a range of measures to detect discrete levels of transfer a 6 months post-intervention follow-up assessment appropriately powered and uses an experimental working memory training intervention based on current understanding of the cognitive mechanisms of training. Findings will inform future research and design of cognitive training interventions, and highlight the value of evidence-based principles of cognitive training. he Australian New Zealand Clinical Trials Registry, ACTRN12621000990820 www.anzctr.org.au/ACTRN12621000990820.aspx
Publisher: Informa UK Limited
Date: 07-2017
DOI: 10.2147/COPD.S111135
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.AMEPRE.2022.03.020
Abstract: This study aimed to systematically review and meta-analyze the relationship between resistance training and all-cause, cardiovascular disease, and cancer mortality. Systematic review and meta-analysis following PRISMA guidelines (International Prospective Register of Systematic Reviews Registration Number CRD42019136654) was conducted. MEDLINE (OVID), Embase, Emcare, SPORTDiscus, The Cochrane Library, and SCOPUS were searched from inception to June 6, 2021. Included studies reported resistance training as the exposure and all-cause mortality, cardiovascular disease‒specific mortality, and/or cancer-specific mortality as outcome/s. Only studies conducted among nonclinical adult populations (aged ≥18 years) and written in English were included. A total of 10 studies were included in the meta-analyses. Compared with undertaking no resistance training, undertaking any amount of resistance training reduced the risk of all-cause mortality by 15% (RR of 6 studies=0.85 95% CI=0.77, 0.93), cardiovascular disease mortality by 19% (RR of 4 studies=0.81 95% CI=0.66, 1.00), and cancer mortality by 14% (RR of 5 studies=0.86 95% CI=0.78, 0.95). A dose-response meta-analysis of 4 studies suggested a nonlinear relationship between resistance training and the risk of all-cause mortality. A maximum risk reduction of 27% was observed at around 60 minutes per week of resistance training (RR=0.74 95% CI=0.64, 0.86). Mortality risk reductions diminished at higher volumes. This systematic review and meta-analysis provides the strongest evidence to date that resistance training is associated with reduced risk of all-cause, cardiovascular disease, and cancer-specific mortality. More research is needed to determine whether any potential mortality benefits gained from resistance training diminish at higher volumes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2019
Publisher: University of Toronto Press Inc. (UTPress)
Date: 11-2021
Abstract: Purpose: This study reports on the prevalence and impact of pain in in iduals with different chronic respiratory diseases attending pulmonary rehabilitation (PR). Method: A retrospective review of medical records data was conducted for 488 participants who had attended a PR programme over a 2-year period. Data on pain and medication history taken from multidisciplinary medical records, together with participant demographics and PR outcomes, were extracted. We compared pain among participants with different types of chronic respiratory disease. Results: The overall prevalence of pain was 77%, with a significantly higher prevalence among in iduals with obstructive lung diseases (80%) compared with restrictive lung diseases (69% p = 0.04). Some participants (17%) who took pain medications did not discuss pain with their clinicians. The presence of pain and different reporting of pain did not have a negative impact on the PR programme completion rate ( p = 0.74), improvements in exercise capacity ( p = 0.51), or health-related quality of life (all four chronic respiratory disease questionnaire domains, p .05). Conclusions: The prevalence of pain is high among in iduals with chronic respiratory disease attending PR. The presence or absence of pain was not negatively associated with the programme completion rate or PR outcomes therefore, pain should not deter clinicians from referring patients to PR.
Publisher: BMJ
Date: 02-2018
Publisher: Springer Science and Business Media LLC
Date: 04-10-2022
DOI: 10.1007/S12529-021-10031-Z
Abstract: Daily activities are associated with affective experiences. A 24-h day can be separated into five mutually exclusive activity types: sleep, awake in bed, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LIPA), and sedentary behavior (SB). Most research has examined these activities independently and not collectively, yet increased time in one activity must be offset by decreasing other activities. Using compositional isotemporal substitution analyses, this study examined the associations between time spent in daily activities and affect, including both high and low arousal positive and negative affect. Across three separate studies, daily activities and affect were measured throughout 7-15 days (M Longer sleep duration at the expense of time awake in bed was associated with lower high arousal negative affect (e.g., nervousness, b = - 0.24, p = .007). More MVPA at the expense of LIPA or SB was associated with higher high arousal positive affect (e.g., happiness, b = 0.35, p = .027). Activity composition was not associated with low arousal positive or negative affect (all p ≥ .06). Associations between 24-h activity composition and affect differed based on types of activities, types of affect, and the interrelationships between activities within the composition. Findings can aid interventions to develop integrated guidance on the optimal activity patterns for mental health.
Publisher: Oxford University Press (OUP)
Date: 03-2015
DOI: 10.5665/SLEEP.4508
Publisher: Wiley
Date: 03-06-2021
DOI: 10.1111/RESP.14094
Publisher: European Respiratory Society (ERS)
Date: 2020
DOI: 10.1183/23120541.00343-2019
Abstract: Few studies have examined the contribution of life-course factors in explaining familial aggregation of chronic lung conditions. Using data from the 1958 British Birth Cohort, a life-course approach was used to examine whether, and how, exposure to risk factors through one's life explained the association between parental respiratory disease history and symptomatic airflow obstruction (AO). Cohort participants (n=6212) were characterised in terms of parental respiratory disease history and symptomatic AO at 45 years. Life-course factors ( e.g. smoking, asthma and early-life factors) were operationalised as life period-specific and cumulative measures. Logistic regression and path analytic models predicting symptomatic AO adjusted for parental respiratory disease history were used to test different life-course models (critical period, accumulation- and chain-of-risks models). While some life-course factors ( e.g. childhood passive smoking and occupational exposure) were in idually associated with parental respiratory disease history and symptomatic AO, asthma (OR 6.44, 95% CI 5.01–8.27) and persistent smoking in adulthood (OR 5.42, 95% CI 4.19–7.01) had greater impact on the association between parental respiratory disease history and symptomatic AO. A critical period model provided a better model fit compared with an accumulation-of-risk model and explained 57% of the effect of parental respiratory disease history on symptomatic AO. Adulthood asthma and smoking status explained around half of the effect of parental respiratory disease history on chronic obstructive pulmonary disease. Beyond smoking history, the combination of parental respiratory disease history and adulthood asthma may provide an opportunity for early diagnosis and intervention.
Publisher: Oxford University Press (OUP)
Date: 23-06-2017
DOI: 10.1093/SLEEP/ZSX109
Publisher: Cold Spring Harbor Laboratory
Date: 24-03-2021
DOI: 10.1101/2021.03.23.21254147
Abstract: Sleep problems are common during chemotherapy for breast cancer (BC). We evaluated whether combined brief cognitive behavioral and bright light therapy (CBT + ) is superior to treatment as usual with relaxation audio (TAU + ) for insomnia symptoms and sleep efficiency (primary outcomes). We randomized women receiving intravenous chemotherapy, stratified by tumor stage and insomnia severity index (ISI), to 6-weeks CBT + or TAU + . CBT + included one in-person session, one telephone call, seven emails, and 20 minutes bright light each morning. TAU + comprised usual treatment and two emails with relaxation audio tracks. Patient-reported outcomes were assessed at baseline, midpoint (week 3), post (week 6) and 3-month follow-up. Women ( N = 101) were randomly assigned to CBT + or TAU + . Insomnia symptoms declined significantly more from baseline to post with CBT + versus TAU + (−5.06 vs -1.93, P = .009 effect size [ES] = .69). At 3-month follow-up, both groups had improved insomnia symptoms but did not differ (ES = .18, P = .56). CBT + had higher patient-reported sleep efficiency than TAU + after the start of intervention ( P = .05) and more improvement in fatigue (ES = .59, P = .013) and daytime sleep-related impairment (ES = .61, P = .009) from baseline to post. CBT + had a clinically significant impact on insomnia and fatigue with moderate effect sizes. Results support offering cognitive behavioral therapy for insomnia and bright light therapy during chemotherapy for breast cancer to help manage sleep and fatigue. Registered with the Australian New Zealand Clinical Trials Registry ( anzctr.org.au/ ), Registration Number: ACTRN12618001255279 Poor sleep is prevalent after cancer diagnosis, especially during chemotherapy. Although cognitive behavioral therapy for insomnia (CBT-I) has been shown to be effective, including in cancer survivors, chemotherapy is unique with significant, ongoing, exogenous factors disrupting sleep (e.g., pain, nausea, and steroids used to manage side effects from chemotherapy). We showed statistically and clinically significant improvements in insomnia and fatigue symptoms in the CBT-I plus bright light therapy (CBT + ) treatment condition compared to the control in women receiving chemotherapy for stage 1–4 breast cancer. Waiting until cancer treatment completion may result in prolonging poor sleep and our findings suggest is not necessary. Future studies are needed to evaluate whether combined CBT + is superior to CBT-I or light alone.
Publisher: Wiley
Date: 21-07-2022
DOI: 10.1002/PON.5994
Abstract: The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's view of their masculinity. Searches were conducted across four databases (MEDline, PsycInfo, CINAHL Plus and Scopus) for articles published before April 2022 that included (1) TC and (2) masculinity. Two researchers independently rated studies for inclusion with a third resolving conflicts. Of the 6464 articles screened, 24 articles (10 quantitative and 14 qualitative) were included in the review. Articles were rated for quality and a narrative synthesis was performed. Overall, results indicated some men experience a shift in the way they relate to their sense of masculinity following diagnosis and treatment for TC. Being single and without children was related to the experience of negative masculinity‐related outcomes, possibly due to a compounding lack of relational support and being unable to conform to protector, provider traditions. Men who described testicle loss as symbolic of their diminished masculinity were also negatively impacted. However, recent, high‐quality literature on the topic using standardised masculinity measures was limited. Some men experience a reduced sense of masculinity after TC, however the impact of TC on masculinity remains person dependent. Further research using validated masculinity measures is required to uncover psycho‐social variables that may account for whether and how meaning is made between TC and its treatment and any subsequent impact on perceived masculinity. Such factors may better support these men in life beyond cancer. Systematic review registration: PROSPERO. International Prospective Register of Systematic Reviews: CRD42020185649.
Publisher: Cold Spring Harbor Laboratory
Date: 02-2021
DOI: 10.1101/2021.01.28.21250694
Abstract: Markedly elevated adverse mental health symptoms were widely observed early in the coronavirus disease 2019 (COVID-19) pandemic. Unlike the U.S., where cross-sectional data indicate anxiety and depression symptoms have remained elevated, such symptoms reportedly declined in the U.K., according to analysis of repeated measures from a largescale longitudinal study. However, nearly 40% of U.K. respondents (those who did not complete multiple follow-up surveys) were excluded from analysis, suggesting that survivorship bias might partially explain this discrepancy. We therefore sought to assess survivorship bias among participants in our longitudinal survey study as part of The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Survivorship bias was assessed 4,039 U.S. respondents who completed surveys including the assessment of mental health as part of The COPE Initiative in April 2020 and were invited to complete follow-up surveys. Participants completed validated screening instruments for symptoms of anxiety, depression, and insomnia. Survivorship bias was assessed for (1) demographic differences in follow-up survey participation, (2) differences in initial adverse mental health symptom prevalences adjusted for demographic factors, and (3) differences in follow-up survey participation based on mental health experiences adjusted for demographic factors. Adjusting for demographics, in iduals who completed only one or two out of four surveys had higher prevalences of anxiety and depression symptoms in April 2020 (e.g., one-survey versus four-survey, anxiety symptoms, adjusted prevalence ratio [aPR]: 1.30, 95% confidence interval [CI]: 1.08-1.55, P =0.0045 depression symptoms, aPR: 1.43, 95% CI: 1.17-1.75, P =0.00052). Moreover, in iduals who experienced incident anxiety or depression symptoms had higher odds of not completing follow-up surveys (adjusted odds ratio [aOR]: 1.68, 95% CI: 1.22-2.31, P =0.0015, aOR: 1.56, 95% CI: 1.15-2.12, P =0.0046, respectively). Our findings revealed significant survivorship bias among longitudinal survey respondents, indicating that restricting analytic s les to only respondents who provide repeated assessments in longitudinal survey studies could lead to overly optimistic interpretations of mental health trends over time. Cross-sectional or planned missing data designs may provide more accurate estimates of population-level adverse mental health symptom prevalences than longitudinal surveys.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.YPMED.2016.04.006
Abstract: Metabolic syndrome is a cluster of cardio-metabolic risk factors and is associated with increased mortality. There is no standard, validated way to assess the severity of aggregated metabolic syndrome risk factors. Cardiovascular and diabetes risk factor data came from two studies conducted in Australia from 2006 to 2010 in adults aged 18 or above. In medication free adults, sex-specific clinical thresholds and Principal Component Analysis were used to develop a formula to calculate a metabolic syndrome severity score (MetSSS). These scores were compared to scores derived using the same process in subgroups by sex, age, medication status, and time. We also examined the MetSSS in relation to other known risk factors. In 2125 adults (57.6±14.7years of age), the MetSSS ranged from 0 to 8.7 with a mean of 2.6. There were strong correlations (.95-.99) between the MetSSS in medication free adults and the MetSSS calculated from subgroups. MetSSS predicted medication initiation for hypertension, hyperlipidemia and hyperglycemia over six months (OR=1.31, 95% CI [1.00-1.70], per MetSSS unit, p=.043). Lower education, medication prescription, history of smoking and age were associated with higher MetSSS (all p<.05). Higher physical but not mental health quality of life was associated with lower MetSSS (p<.001). A standardized formula to measure cardio-metabolic risk factor severity was constructed and demonstrated expected relations with known risk factors. The use of the MetSSS is recommended as a measure of change within in iduals in cardio-metabolic risk factors and to guide treatment and management.
Publisher: Oxford University Press (OUP)
Date: 09-06-2023
Abstract: Insomnia is a disorder diagnosed based on self-reported sleep complaints. Differences between self-reported and sensor-based sleep parameters (sleep–wake state discrepancy) are common but not well-understood in in iduals with insomnia. This two-arm, parallel-group, single-blind, superiority randomized-controlled trial examined whether monitoring sleep using wearable devices and providing support for interpretation of sensor-based sleep data improved insomnia symptoms or impacted sleep–wake state discrepancy. A total of 113 (age M = 47.53 SD = 14.37, 64.9% female) in iduals with significant insomnia symptoms (Insomnia Severity Index(ISI) ≥10) from the community were randomized 1:1 (permuted block randomization) to receive 5 weeks (1) Intervention (n = 57): feedback about sensor-based sleep (Fitbit and EEG headband) with guidance for data interpretation and ongoing monitoring, and (2) Control (n = 56): sleep education and hygiene. Both groups received one in idual session and two check-in calls. The ISI (primary outcome), sleep disturbance (SDis), sleep-related impairment (SRI), depression, and anxiety were assessed at baseline and post-intervention. In total, 103 (91.2%) participants completed the study. Intention-to-treat multiple regression with multiple imputations showed that after controlling for baseline values, compared to the Control group (n = 51), the Intervention group (n = 52) had lower ISI (p = .011, d = 0.51) and SDis (p = .036, d = 0.42) post-intervention, but differences in SRI, depression, anxiety, and sleep–wake state discrepancy parameters (total sleep time, sleep onset latency, and wake after sleep onset) were not meaningful (P-values & .40). Providing feedback and guidance about sensor-based sleep parameters reduced insomnia severity and sleep disturbance but did not alter sleep–wake state discrepancy in in iduals with insomnia more than sleep hygiene and education. The role of sleep wearable devices among in iduals with insomnia requires further research. The Novel Insomnia Treatment Experiment (NITE): the effectiveness of incorporating appropriate guidance for sleep wearables in users with insomnia. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378452, Australia New Zealand Clinical Trials Registry: ACTRN12619001636145.
Publisher: JMIR Publications Inc.
Date: 06-02-2022
Abstract: ancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind was developed as an internet-delivered intervention adapted from the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. his protocol aims to provide an outline of The CanCope Study a randomized controlled trial comparing the efficacy of an UP-adapted internet-delivered intervention (CanCope Mind) designed for cancer survivors compared to an active control condition – an internet-delivered healthy lifestyle intervention (CanCope Lifestyle). The primary aim is to assess and compare the efficacy of both interventions in improving emotion regulation, anxiety and depressive symptoms, and quality of life. The secondary aims involve assessing the mechanisms of the CanCope Mind intervention. ancer survivors will be recruited and randomized to either CanCope Mind or CanCope Lifestyle. Both interventions comprise four online modules and are expected to take participants at least eight weeks to complete. Participants’ mental and physical health will be assessed via self-reported surveys at baseline (T0), between each module (T1, T2, T3), post-intervention (T4), and at three-months follow-up (T5). The study aims to recruit 110 participants who have completed T4. he CanCope Study began recruitment in September 2020. As of December 2021, 224 participants have been randomized and 116 have completed the post-intervention survey (T4). Data collection for all timepoints is expected to be finalized by May 2022. his will be one of the first trials to develop and investigate the efficacy of an online intervention for cancer survivors that specifically targets emotion regulation. CTRN12620000943943
Publisher: Center for Open Science
Date: 17-12-2021
Abstract: Study Objectives: Habitual sleep duration and efficiency vary widely by age, gender, and racial/ethnic identity. Despite growing research on the importance of night-to-night, intrain idual variability (IIV) in sleep, few studies have examined demographic differences in sleep IIV. The present study describes typical sleep IIV overall and by demographics among healthy sleepers. Methods: Eight international data sets of healthy sleepers (N = 2404 26,121 total days of sleep data) were synthesized to examine age, gender, and racial/ethnic identity differences in sleep IIV measured via diaries, actigraphy, and electroencephalography. Sleep IIV estimates included the intrain idual standard deviation (iSD), root mean square of successive differences (RMSSD), coefficient of variation (CV), and a validated Bayesian Variability Model (BVM). Results: Sleep duration and efficiency varied widely from night-to-night within people (duration iSD: 67.04–85.80 minutes duration RMSSD: 91.93–118.91 minutes duration CV: 18.57–19.19% duration BVM: 48.60–60.60 minutes efficiency iSD: 5.18–6.46%, efficiency RMSSD: 7.01–8.44% efficiency CV: 5.80–8.14% efficiency BVM: 3.40–4.16%). Different metrics of IIV were strongly correlated for sleep duration (rs .58–.97) and sleep efficiency (rs .53–1.00). Younger adults had more IIV in diary and actigraphy sleep duration. Gender differences were inconsistent. White and non-Hispanic/Latinx adults had less IIV in sleep duration and efficiency compared to racial/ethnic minority groups. Conclusions: Even among healthy sleepers, sleep varies widely from night-to-night. Like mean sleep, there also may be disparities in IIV in sleep by demographic characteristics. Study results help characterize normative values of sleep IIV in healthy sleepers.
Publisher: Cambridge University Press (CUP)
Date: 09-09-2023
DOI: 10.1017/S0033291722002616
Abstract: Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms. This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4–12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores ] were included severe medical sychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI ( or ⩾14) and infant age ( or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models. 114 participants (CBT = 39, LDT = 36, TAU = 39 M age = 32.20 ± 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes −2.01 and −1.52 respectively, p 0.001) from baseline to post-intervention compared to TAU improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p 0.001) but not LDT ( p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea no others reported adverse events. Therapist-assisted CBT and LDT were feasible during the first postpartum year data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.
Publisher: Oxford University Press (OUP)
Date: 19-04-2023
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.SLEEP.2021.10.012
Abstract: Theoretical models argue that coping reduces stress responses, yet no studies have tested whether coping moderates the prospective stress effects on sleep in daily life. This study tested if coping moderates the stress-sleep association using a daily, intensive longitudinal design across 7-12 days. 326 young adults (M Within-person problem-focused and emotional-approach coping moderated the within-person stress effects on actigraphic total-sleep-time (both p = 0.02) higher stress predicted shorter total-sleep-time only during high use of problem-focused or emotional-approach coping (both p = 0.01). Between-person avoidance moderated the between-person stress effect on actigraphic total-sleep-time (p = 0.04) higher stress predicted shorter total-sleep-time for high avoidance coping (p = 0.02). Within-person emotional-approach coping buffered the between-person stress effect on actigraphic sleep efficiency (p = 0.02) higher stress predicted higher sleep efficiency for high emotional-approach coping (p = 0.04). This study showed that daily coping moderates the effects of evening stress on sleep that night. More efforts to cope with stress before bedtime had a short-term cost of shorter sleep that night. However, high use of emotional-approach coping buffered the impact of stress to promote sleep efficiency.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2020
DOI: 10.1186/S13063-020-4196-4
Abstract: Women with breast cancer experience a significantly higher prevalence of sleep disturbance and insomnia than the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment for sleep in this population is not part of routine care and is often managed inadequately. This randomised controlled trial will examine the combined effects of cognitive behavioural therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue and mental health. Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne, Australia, will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio-enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 min each morning for the 6-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the 6 weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT, and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS). Data will also be collected on potential treatment moderators and mechanisms and adherence to treatment. There will be 3-month follow-up measurements of insomnia symptoms, fatigue, sleep-related impairment, sleep disturbance, depression and anxiety. This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbance in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation. Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618001255279 . Retrospectively registered on 25 July 2018.
Publisher: SAGE Publications
Date: 2019
Abstract: To systematically review randomized controlled trials that compared the effectiveness of different types of exercise on the symptom of fatigue in in iduals with chronic obstructive pulmonary disease (COPD). MEDLINE, EMBASE, EMcare, PsychINFO, and Cochrane library were searched from inception to October 2018. Studies were included if in iduals with COPD were randomized into two or more physical exercise interventions that reported fatigue. Of the 395 full-texts reviewed, 17 studies were included. Fifteen studies reported the impact of exercise on health-related quality of life with fatigue as a subdomain. Reduction in fatigue was observed following endurance, resistance, or a combination of both exercises. There was no significant difference between continuous and interval training ( n = 3 studies, pooled standardized mean difference (SMD) = −0.17, 95% CI = −0.47, 0.12, p = 0.25) or between endurance and resistance training ( n = 3 studies, SMD = −0.35, 95% CI = −0.72, 0.01, p = 0.07) on fatigue in people with COPD. Fatigue reduction is not usually a primary outcome of exercise interventions, but it is frequently a secondary domain. The type of exercise did not influence the impact of exercise on fatigue, which was reduced in endurance, resistance, or a combination of both exercises, enabling clinicians to personalize training to match targeted outcomes.
Publisher: Cambridge University Press (CUP)
Date: 21-01-2018
DOI: 10.1017/S1478951517001122
Abstract: Although the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivity is a complex multifactorial phenomenon influenced by internal and external factors that ultimately influences engagement in psychosocial support in bereavement. This study explored factors that influence receptivity to bereavement support from palliative care services in rural, regional, and remote Western Australia. The study comprised a qualitative descriptive research design using semistructured interviews with 24 bereaved in iduals, nine palliative care health professionals, and four Aboriginal Health Professionals. Participants were recruited via palliative care services in country Western Australia. Interviews were transcribed verbatim and thematically analyzed. Findings revealed that a range of in idual, social, and geographical factors influence receptivity to bereavement support and can impact on utilization of bereavement support services. Receptivity provides a frame of reference to enhance understanding of factors influencing engagement in psychosocial support in bereavement. Receptivity promotes a shift of service provider perspectives of effective supportive care to consumer-centric reasons for engagement.
Publisher: American Chemical Society (ACS)
Date: 18-09-2020
Publisher: Oxford University Press (OUP)
Date: 2023
DOI: 10.1093/SLEEPADVANCES/ZPAD012
Abstract: Insomnia is common in the general population and is diagnosed based on self-reported sleep complaints. There is a frequent discrepancy between objectively recorded and self-reported sleep (sleep–wake state discrepancy), especially in in iduals with insomnia. Although sleep–wake state discrepancy is well-documented in the literature, it is not well understood. This protocol describes the methodology of a randomized control study, which will examine whether providing monitoring and feedback about objectively recorded sleep with support for interpretation of sleep–wake state discrepancy improves insomnia symptoms and will explore the potential mechanisms of change. Participants are 90 in iduals with insomnia symptoms (Insomnia Severity Index [ISI] ≥10). Participants will be randomized to one of two conditions: (1) Intervention: feedback about objectively recorded sleep (actigraph and optional electroencephalogram headband) with guidance for data interpretation, (2) Control: sleep hygiene session. Both conditions will involve in idual sessions and two check-in calls. The primary outcome is ISI score. Secondary outcomes include sleep-related impairment, symptoms of anxiety and depression, and other sleep and quality of life measures. Outcomes will be assessed using validated instruments at baseline and post-intervention. With increasing number of wearable devices that measure sleep, there is a need to understand how sleep data provided by these devices could be utilized in the treatment of insomnia. Findings from this study have the potential to better understand sleep–wake state discrepancy in insomnia and uncover new approaches to supplement current insomnia treatment.
Publisher: AACN Publishing
Date: 31-08-2015
DOI: 10.4037/AJCC2015476
Abstract: Nurses and physicians often describe critical care that is not expected to provide meaningful benefit to a patient as futile, and providing treatments perceived as futile is associated with moral distress. To explore concordance of physicians' and nurses' assessments of futile critical care. A focus group of clinicians developed a consensus definition of "futile" critical care. Daily for 3 months, critical care physicians and nurses in a health care system identified patients perceived to be receiving futile treatment. Assessments and patients' survival were compared between nurses and physicians. Nurses and physicians made 6254 shared assessments on 1086 patients. Nurses and physicians assessed approximately the same number of patients as receiving futile treatment (110 for nurses vs 113 for physicians, P = .82) however, concordance was low as to which patients were assessed as receiving futile treatment (κ = 0.46). The 110 patients categorized by nurses as receiving futile treatment had lower 6-month mortality than did the 113 patients so assessed by physicians (68% vs 85%, P = .005). Patients who were assessed as receiving futile treatment by both providers were more likely to die in the hospital than were patients assessed as receiving futile treatment by the nurse alone (76% vs 32%, P < .001) or by the physician alone (76% vs 57%, P = .04). Interprofessional concordance on provision of critical care perceived to be futile is low however, joint predictions between physicians and nurses were most predictive of patients' outcomes, suggesting value in collaborative decision making.
Publisher: Oxford University Press (OUP)
Date: 14-10-2019
DOI: 10.1093/SLEEP/ZSZ250
Abstract: Stress is associated with poor and short sleep, but the temporal order of these variables remains unclear. This study examined the temporal and bi-directional associations between stress and sleep and explored the moderating role of baseline sleep complaints, using daily, intensive longitudinal designs. Participants were 326 young adults (Mage = 23.24 ± 5.46), providing & ,500 nights of sleep altogether. Prospective total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were measured using actigraphy and sleep diaries. Perceived stress was reported three times daily between: 11:00–15:00, 15:30–19:30, and 20:00–02:00. Sleep complaints were measured at baseline using the PROMIS sleep disturbance scale. Within- and between-person sleep and stress variables were tested using cross-lagged multilevel models. Controlling for covariates and lagged outcomes, within-person effects showed that higher evening stress predicted shorter actigraphic and self-reported TST (both p & .01). Conversely, shorter actigraphic and self-reported TST predicted higher next-day stress (both p & .001). Longer self-reported SOL and WASO (both p & .001), as well as lower actigraphic (p & .01) and self-reported SE (p & .001), predicted higher next-day stress. Between-person effects emerged only for self-reported TST predicting stress (p & .01). No significant results were found for the moderating role of baseline sleep complaints. Results demonstrated bi-directional relations between stress and sleep quantity, and a consistent direction of worse sleep quantity and continuity predicting higher next-day stress. Results highlighted within-in idual daily variation as being more important than between-in idual differences when examining sleep and daytime functioning associations.
Publisher: Wiley
Date: 19-10-2022
DOI: 10.1111/JSR.13506
Abstract: Nurses experience poor sleep and high stress due to demanding work environments. Night shift work is common among nurses and may exacerbate stress-sleep associations. We examined bidirectional associations between daily stress and sleep, and moderation by recent shift worker status and daily work schedule among nurses. Participants were 392 nurses (92% female 78% White, mean age = 39.54, SD = 11.15) who completed 14 days of electronic sleep diaries and actigraphy. They simultaneously completed assessments of daily stress and work schedule upon awakening (day shift vs. night shift [work between 9 p.m.-6 a.m.] vs. off work). Participants were classified as recent night shift workers if they worked at least one night shift during the past 14 days (n = 101 26%). In the entire s le, greater daily stress predicted shorter self-reported total sleep time and lower self-reported sleep efficiency that night. Shorter self-reported and actigraphy total sleep time and lower self-reported sleep efficiency predicted higher next-day stress. Compared with recent night shift workers, day workers reported higher stress after nights with shorter total sleep time. Stress-sleep associations mostly did not vary by nurses' daily work schedule. Sleep disturbances and stress may unfold in a toxic cycle and are prime targets for tailored interventions among nurses. Night shift workers may be less susceptible to the effects of short sleep on next-day stress. Research is needed to understand the short- and long-term effects of shift work and address the unique sleep challenges nurses face.
Publisher: European Respiratory Society (ERS)
Date: 10-2019
DOI: 10.1183/23120541.00264-2019
Abstract: The presence of comorbid conditions could impact performance in pulmonary rehabilitation (PR) programmes. We aimed to compare the comorbidity prevalence among those with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) and evaluate the impact on PR response. We performed a retrospective cohort study, recording comorbidities for all patients with COPD or ILD referred to PR. Participants were classified as responders to PR if they met the minimal important difference for exercise capacity and health-related quality of life (HRQoL). The prevalence of comorbidities and impact on PR outcomes were compared by lung disease and by sex using a univariate analysis and multivariate logistic regression. The mean number of comorbidities was similar among those with COPD (3.3±2.1, n=242) and ILD (3.2±1.9, n=66) (p .05). Females had a higher number of comorbidities than males in both COPD (p=0.001) and ILD (p=0.017) populations. Circulatory (64%) and endocrine/metabolic (45%) conditions were most common in COPD. In ILD, digestive (55%) and circulatory (53%) comorbidities were most prevalent. In people with ILD, those over 65 years, with musculoskeletal/connective tissue disease or circulatory disease were less likely to obtain meaningful improvements in exercise capacity. There was no impact of comorbidities on exercise capacity in COPD or on HRQoL in ILD. The majority of patients with COPD or ILD enrolled in PR programmes have multiple comorbidities that may affect improvements in exercise capacity. PR programmes may be less effective for older adults with ILD and comorbid circulatory or musculoskeletal disease.
Publisher: Informa UK Limited
Date: 04-2019
DOI: 10.1080/07347332.2019.1590491
Abstract: Emotional awareness and acceptance of emotion are associated with improved health in breast cancer (BC) patients. Art therapy (AT) uses visual art-making for expression and communication and has been shown to reduce psychological and physical symptoms in in iduals with cancer. A major objective of AT is to encourage increases in emotion processing however, few studies examine these changes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2016
Publisher: American Psychological Association (APA)
Date: 12-2019
DOI: 10.1037/EMO0000487
Publisher: Oxford University Press (OUP)
Date: 09-12-2017
DOI: 10.1093/SLEEP/ZSW067
Abstract: Research has extensively examined the relationship between adolescents' mental health and average sleep duration/quality. Using rigorous methodology, this study characterized adolescents' objective sleep intrain idual variability (IIV) and examined its role on mood beyond the effects of their respective in idual mean (IIM) values. One hundred forty-six community-dwelling adolescents (47.3% male) aged 16.2 ± 1.0 (M ± SD) years wore an actigraph that assessed bedtime, risetime, time-in-bed (TIB), and sleep onset latency (SOL) throughout a 15-day vacation with relatively unconstrained sleep opportunity. Self-report sleep quality (SSQ), negative mood (MOOD), and other covariates were assessed using questionnaires. For each sleep variable, in iduals' mean values (IIM) and IIV were used to simultaneously predict MOOD with SSQ as a mediator. Models were estimated in a Bayesian IIV framework both linear and quadratic effects of the IIM and IIV were examined. Longer and more variable TIB, as well as more variable SOL (but not mean SOL), were associated with poorer SSQ (ps < .01), which in turn, was associated with more negative MOOD (ps < .05). The indirect effect of SOL IIV was curvilinear, such that as SOL became more variable, the deteriorating effect of high SOL IIV accelerated. Neither bedtime nor risetime IIV was significantly associated with SSQ or MOOD. During relatively unconstrained sleep opportunity, more variable TIB and SOL were associated with more negative mood, mediated by poorer perceived sleep quality. Significant effects of IIV were over and above that of mean values, suggesting that unique aspects of sleep IIV are relevant to how adolescents perceive sleep quality and their mood.
Publisher: Informa UK Limited
Date: 19-01-2018
Publisher: Informa UK Limited
Date: 05-08-2013
Publisher: Center for Open Science
Date: 21-03-2022
Abstract: Background: A myriad of modifiable cognitive and behavioural factors influence adolescent sleep. Using an intense longitudinal design, we investigated adolescents’ perceptions of factors facilitating (i.e., facilitators) and hindering (i.e., barriers) sufficient and good quality sleep in their everyday life.Methods: 205 (54.2% female, 64.4% non-white) Year 10-12 adolescents (Mage = 16.9 ± 0.9) completed daily morning surveys and wore actigraphs over 2 school-weeks and 2 subsequent vacation-weeks (5162 total observations). Daily morning surveys assessed self-reported sleep and use of 8 facilitators and 6 barriers of sleep from the previous night. Linear mixed-effects models examined the contribution of facilitators/barriers to actigraphy and self-reported total sleep time (TST) and sleep onset latency (SOL), controlled for age, sex, race, place of birth, and study day. School/non-school day status was included as a moderator.Results: Seven facilitators and two barriers were endorsed by & % of adolescents as frequently (≥50% nights) helping reventing them from achieving good sleep. Overall, facilitators or barriers explained 1-5% (p-values & .001) of unique variance above and beyond the covariates. Facilitators, predicting longer TST and shorter SOL, were following body cues, managing thoughts and emotions, creating good sleep environment, avoiding activities interfering with sleep, and bedtime planning (only TST on school nights). Barriers, predicting shorter TST and longer SOL, were pre-bed thoughts and emotions, unconducive sleep environment, activities interfering with sleep, inconsistent routines, and other household members’ activities. Conclusions: Adolescents use a range of sleep facilitating behaviours and a number of factors prevent sufficient and good quality sleep in their everyday life. These factors are predictive of their sleep duration and onset latency and require further research to understand their functions and clinical implications.
Publisher: Wiley
Date: 12-07-2023
DOI: 10.1111/BJHP.12679
Abstract: This trial assessed the efficacy of an emotion‐focused, modular, Internet‐delivered adaptation of the Unified Protocol (UP) in improving cancer survivors' emotion regulation strategies. A two‐arm randomized controlled trial (1:1) was used to compare the efficacy of two Internet‐based interventions: UP‐adapted CanCope Mind (CM) and lifestyle‐focused active control CanCope Lifestyle (CL). N = 224 cancer survivors randomized to CM or CL were assessed at baseline, between‐modules, at post‐intervention and 3‐month follow‐up on emotion regulation outcomes targeted by each CM module (Module 1: beliefs about emotions Module 2: mindfulness Module 3: cognitive reappraisal skills, catastrophizing, refocus on planning Module 4: experiential avoidance). Primary analyses were intention‐to‐treat linear regressions using Fisher randomization tests for p ‐values and intervals were used to compare groups with standardized mean difference (SMD) effect sizes. CanCope Mind participants ( n = 61 completers) experienced moderate‐to‐large improvements (SMDs from .44–.88) across all outcomes at post‐intervention. CM's effects were larger than CL's ( n = 75 completers) immediately post‐intervention and at 3‐month follow‐up for beliefs about emotions, mindfulness, cognitive reappraisals and experiential avoidance (all p's .05). CM experienced greater improvements in catastrophizing immediately post‐intervention, with a trending effect at follow‐up. However, we could not reject the null hypothesis of identical between‐group effects for refocusing on planning both immediately post‐intervention and at follow‐up. Exploratory analyses revealed inconsistent between‐module effects. In its entirety, CM is a promising intervention for improving and maintaining cancer survivors' adaptive emotion regulation, especially for mindfulness and experiential avoidance. This may have important clinical implications for promoting cancer survivors’ emotional functioning and general well‐being.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.SMRV.2015.06.003
Abstract: Features of an in idual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intrain idual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.
Publisher: Wiley
Date: 23-08-2021
DOI: 10.1002/PON.5787
Abstract: CanCope is an internet‐delivered, cognitive‐behavioural intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Four separate pilot studies evaluated each of CanCope’s modules for (1) feasibility and participant satisfaction, and changes in (2) module‐specific outcomes, and (3) global measures of emotion dysregulation and anxiety and depressive symptoms, from pre‐to‐post module delivery. Eligible cancer survivors self‐selected into one two‐week online module designed to improve a specific aspect of emotion regulation ([1] understanding emotions, [2] mindfulness of emotions, [3] cognitive reappraisals, [4] challenging emotion‐driven behaviours). Across modules, post‐intervention surveys were completed by 17‐19 participants, (58.1%‐90.5% completion rate for participants who received the intervention). Each module was feasible and participants reported high satisfaction. Moderate‐to‐large pre‐to‐post effect sizes in mean differences were observed in module‐specific target outcomes ( p’s 0.05). Emotion dysregulation significantly decreased across modules 1 to 3 ( p’s 0.05) with a non‐significant decrease for module 4 ( p = 0.13). Anxiety symptoms significantly decreased across all modules ( p’s 0.05). Depressive symptoms significantly decreased across modules 1 and 3 ( p’s 0.05), with non‐significant decreases across modules 2 ( p = 0.08) and 4 ( p = 0.06). Each CanCope module demonstrated promise in targeting emotion regulation skills and supporting the mental health of cancer survivors. Randomised controlled trials are required to test the efficacy of CanCope as an intervention in its entirety.
Publisher: American Psychological Association (APA)
Date: 10-2018
DOI: 10.1037/CCP0000328
Publisher: Elsevier
Date: 2016
Publisher: Center for Open Science
Date: 14-09-2020
Abstract: Study Objectives: To examine bi-directional, temporal associations between daily sleep and affect under naturally constrained (school) and unconstrained (vacation) sleep opportunities, while simultaneously incorporating both valence (positive versus negative) and arousal (high versus low) dimensions of affect. Methods: Sleep and affect were measured over 2 weeks of school and 2 weeks of vacation in 205 adolescents (54.1% females, Mage=16.9 years), providing 5231 days of data. Total sleep time (TST) and sleep efficiency were measured using actigraphy and sleep diary. High- and low-arousal positive and negative affect (PA, NA) were self-reported each afternoon. Between- and within-person sleep-affect associations were tested using cross-lagged, multilevel models. Lagged outcome, day of the week, study day, and sociodemographics were controlled.Results: Bi-directional associations between self-report sleep and affect were found on the between-person level: longer self-report TST associated with lower high and low arousal NA. Higher high arousal PA associated with longer actigraphy TST between-persons, but predicted shorter same-night actigraphy TST within-persons. Results did not differ between school and vacation. Significant within-person random effects demonstrate in idual differences in daily sleep-affect associations. Conclusions: Associations differed based on sleep measurement and affect dimensions, highlighting the complex relationship between sleep and affect. Strong between-person associations between self-report sleep and affect suggest that improving either sleep or mood may benefit the other. Although overall high arousal PA was protective of sleep duration, on a day-to-day basis, higher-than-usual high arousal PA may reduce sleep duration on nights it is experienced. Further research needs to identify causes of in idual differences in sleep-affect associations.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2014
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.JPEDS.2018.06.036
Abstract: To identify distinct language trajectories of children born very preterm and full term from 2 to 13 years of age and examine predictors for the identified trajectories. A cohort of 224 children born very preterm and 77 full term controls recruited at birth were followed up at ages 2, 5, 7, and 13 years. The number of distinct language trajectories was examined using latent growth mixture modeling allowing for linear and quadratic time trends. Potential predictors in the neonatal period (eg, birth group, sex, and medical risk) and at 2 years (ie, social risk and use of allied health services) for the language trajectories were tested using multinomial logistic regression. Five distinct language trajectories were identified across childhood: stable normal (32% of study cohort), resilient development showing catch-up (36%), precocious language skills (7%), stable low (17%), and high-risk (5%) development. The very preterm group was 8 times more likely to have a language trajectory that represented poorer language development compared with full term controls (very preterm, 40% full term, 6%). Greater social risk and use of allied health services were associated with poorer language development. Variable language trajectories were observed, with a substantial proportion of children born very preterm exhibiting adverse language development. These findings highlight the need for monitoring language skills in children born very preterm before school entry and across middle childhood.
Publisher: Oxford University Press (OUP)
Date: 15-10-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
DOI: 10.1097/PSY.0000000000000395
Abstract: Allostatic load (AL) represents cumulative wear-and-tear on the body and is operationalized as a multisystem index of biomarkers. Allostatic load is associated with morbidities and mortality, leading to a growing body of literature that uses AL as an outcome in its own right. Psychosocial resources (PSRs), such as mastery and social support, may influence health outcomes in part via AL, and the current review seeks to characterize the relations between PSRs and AL. A systematic review was conducted by searching PubMed, CINAHL Plus, PsycINFO, Scopus, and Embase for studies examining the relation between PSR(s) and AL in humans. From 1,417 abstracts screened, 60 full-text articles were reviewed, and 24 studies met inclusion criteria. Mixed evidence exists for a relationship between PSRs and AL. Most (14/24) studies used a cross-sectional design, and only one study investigated whether a PSR predicted change in AL. Compared to cross-sectional studies, longitudinal studies were more likely to report a significant relationship (8/14 versus 8/10, respectively). Studies with statistically significant main or moderated effects had larger s le sizes than those reporting null effects. Whether a study reported a significant main or moderated relationship did not differ by whether psychological (8/11) or social (10/16) resources were assessed. Evidence for a relationship between PSRs and AL is equivocal, and obtained significant relationships are generally small in magnitude. Gaps in the current literature and directions for future research are discussed. Longitudinal studies are needed that repeatedly assess PSRs and AL.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.DIABRES.2017.02.030
Abstract: Diabetes care is principally applied in the primary care setting whereby we examined trends in glycaemic levels and goals and estimated avoidable glycaemic burden. We retrieved glycated haemoglobin (HbA Average age of patients was 62.1±15.1years (47.1% women). HbA Amid considerable improvements, many treated patients still do not attain HbA
Publisher: Oxford University Press (OUP)
Date: 02-08-2019
DOI: 10.1093/PTJ/PZZ111
Abstract: Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling. The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials. Twelve databases were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index). The search identified 4894 in idual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding. Trials were clinically and methodologically erse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial. Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.
Publisher: Hindawi Limited
Date: 11-03-2014
DOI: 10.1002/DA.22256
Publisher: Frontiers Media SA
Date: 07-05-2015
Publisher: Hindawi Limited
Date: 12-12-2013
DOI: 10.1002/DA.22216
Publisher: Springer Science and Business Media LLC
Date: 24-08-2022
DOI: 10.1007/S00520-022-07305-X
Abstract: Cancer-related fatigue (CRF) is a common and debilitating consequence of cancer and its treatment. Numerous supportive care interventions have been developed to alleviate CRF however, the ersity of outcome measures used to assess CRF limits comparability of findings. We aimed to evaluate the content and psychometric properties of measures used to assess CRF in interventions targeting fatigue, to inform the selection of suitable measures in future research. Included measures were identified from a systematic review of interventions targeting CRF. General characteristics of each measure were extracted, and item content was assessed against domains specified by the National Comprehensive Cancer Network (NCCN) definition of CRF. Psychometric properties were evaluated against COnsensus-based Standards for the selection of heath Measurement INstruments (COSMIN) criteria. Of 54 measures identified, 25 met inclusion criteria. Seventeen were fatigue-specific and eight a fatigue subscale or single item within a broader measure. Only 14 (56%) were specifically developed for cancer populations. Content coverage according to the NCCN CRF definition ranged from 0 to 75%. Evidence for fulfilment of COSMIN criteria in cancer populations ranged from 0 to 93%, with only five measures meeting 70% of the COSMIN criteria. The Piper Fatigue Scale-Revised had good content coverage, but did not comprehensively address COSMIN criteria. The EORTC-FA12 and FACIT/FACT-F had excellent psychometric properties, with each capturing different aspects of fatigue. Ultimately, the choice of CRF measure should be guided by the research question and the CRF domains most relevant to the particular research context.
Publisher: Center for Open Science
Date: 28-01-2021
Abstract: Study Objectives: To describe trajectories of daily perceived sleep need (PSNeed) and sleep deficit across 28 consecutive days, and examine if cumulative sleep deficit predicts next-day affect.Methods: Daily sleep and affect were measured over 2 weeks of school and 2 weeks of vacation in 205 adolescents (54.1% females, Mage = 16.9 years). Each day, participants wore actigraphs and self-reported the amount of sleep needed to function well the next day (i.e., perceived sleep need), sleep duration, and high- and low-arousal positive and negative affect (PA, NA). Cumulative actigraphy and diary sleep deficit were calculated as the weighted average of the difference between PSNeed and sleep duration over the past 3 days. Cross-lagged, multilevel models were used to test cumulative sleep deficit as a predictor of next-day affect. Lagged affect, day of the week, study day, and sociodemographics were controlled.Results: PSNeed was lower early in the school week, before increasing in the second half of the week. Adolescents accumulated sleep deficit across school days and reduced it during weekends. During weekends and vacations, adolescents’ self-reported, but not actigraphy sleep duration, met PSNeed. Higher cumulative actigraphy sleep deficit predicted higher next-day high arousal NA higher cumulative diary sleep deficit predicted higher NA (regardless of arousal), and lower low arousal PA the following day.Conclusions: Adolescents experienced sustained cumulative sleep deficit across school days. Non-school nights appeared to be opportunities for reducing sleep deficit. Trajectories of sleep deficit during vacation suggested recovery from school-related sleep restriction.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: Oxford University Press (OUP)
Date: 14-01-2016
DOI: 10.1007/S12160-015-9763-7
Abstract: Few studies examine whether dispositional approach and avoidance coping and stressor-specific coping strategies differentially predict physical adjustment to cancer-related stress. This study examines dispositional and situational avoidance and approach coping as unique predictors of the bother women experience from physical symptoms after breast cancer treatment, as well as whether situational coping mediates the prediction of bother from physical symptoms by dispositional coping. Breast cancer patients (N = 460) diagnosed within the past 3 months completed self-report measures of dispositional coping at study entry and of situational coping and bother from physical symptoms every 6 weeks through 6 months. In multilevel structural equation modeling analyses, both dispositional and situational avoidance predict greater symptom bother. Dispositional, but not situational, approach predicts less symptom bother. Supporting mediation models, dispositional avoidance predicts more symptom bother indirectly through greater situational avoidance. Dispositional approach predicts less symptom bother through less situational avoidance. Psychosocial interventions to reduce cancer-related avoidance coping are warranted for cancer survivors who are high in dispositional avoidance and/or low in dispositional approach.
Publisher: Oxford University Press (OUP)
Date: 29-07-2021
Abstract: To describe trajectories of daily perceived sleep need and sleep debt, and examine if cumulative perceived sleep debt predicts next-day affect. Daily sleep and affect were measured over two school weeks and two vacation weeks (N = 205, 54.1% females, M ± SDage = 16.9 ± 0.87 years). Each day, participants wore actigraphs and self-reported the amount of sleep needed to function well the next day (i.e. perceived sleep need), sleep duration, and high- and low-arousal positive and negative affect (PA, NA). Cumulative perceived sleep debt was calculated as the weighted average of the difference between perceived sleep need and sleep duration over the past 3 days. Cross-lagged, multilevel models were used to test cumulative sleep debt as a predictor of next-day affect. Lagged affect, day of the week, study day, and sociodemographics were controlled. Perceived sleep need was lower early in the school week, before increasing in the second half of the week. Adolescents accumulated perceived sleep debt across school days and reduced it during weekends. On weekends and vacations, adolescents self-reported meeting their sleep need, sleeping the amount, or more than the amount of sleep they perceived as needing. Higher cumulative actigraphy sleep debt predicted higher next-day high arousal NA higher cumulative diary sleep debt predicted higher NA (regardless of arousal), and lower low arousal PA the following day. Adolescents experienced sustained, cumulative perceived sleep debt across school days. Weekends and vacations appeared to be opportunities for reducing sleep debt. Trajectories of sleep debt during vacation suggested recovery from school-related sleep restriction. Cumulative sleep debt was related to affect on a daily basis, highlighting the value of this measure for future research and interventions.
Location: United States of America
Location: United States of America
Start Date: 06-2019
End Date: 12-2024
Amount: $558,824.00
Funder: Australian Research Council
View Funded Activity