ORCID Profile
0000-0002-4480-4188
Current Organisation
University of South Australia
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Publisher: Elsevier BV
Date: 06-2020
Publisher: Springer Science and Business Media LLC
Date: 08-02-2022
DOI: 10.1186/S13047-022-00515-W
Abstract: Non-medical prescribing is one healthcare reform strategy that has the potential to create health system savings and offer equitable and timely access to scheduled medicines. Podiatrists are well positioned to create health system efficiencies through prescribing, however, only a small proportion of Australian podiatrists are endorsed to prescribe scheduled medicines. Since scheduled medicines prescribed by Australian podiatrists are not subsidised by the Government, there is a lack of data available on the prescribing practices of Australian podiatrists. The aim of this research was to investigate the prescribing practices among Australian podiatrists and to explore barriers and facilitators that influence participation in endorsement. Participants in this quantitative, cross-sectional study were registered and practicing Australian podiatrists who were recruited through a combination of professional networks, social media, and personal contacts. Respondents were invited to complete a customised self-reported online survey, developed using previously published research, research team’s expertise, and was piloted with podiatrists. The survey contained three sections: demographic data including clinical experience, questions pertaining to prescribing practices, and barriers and facilitators of the endorsement pathway. Respondents ( n = 225) were predominantly female, aged 25–45, working in the private sector. Approximately one quarter were endorsed (15%) or in training to become endorsed (11%). Of the 168 non-endorsed respondents, 66% reported that they would like to undertake training to become an endorsed prescriber. The most common indications reported for prescribing or recommending medications include nail surgery (71%), foot infections 474 (88%), post-operative pain (67%), and mycosis (95%). The most recommended Schedule 2 medications were ibuprofen, paracetamol, and topical terbinafine. The most prescribed Schedule 4 medicines among endorsed podiatrists included lignocaine (84%), cephalexin (68%), flucloxacillin (68%), and amoxicillin with clavulanic acid (61%). Podiatrists predominantly prescribe scheduled medicines to assist pain, inflammatory, or infectious conditions. Only a small proportion of scheduled medicines available for prescription by podiatrists with endorsed status were reportedly prescribed. Many barriers exist in the current endorsement for podiatrists, particularly related to training processes, including mentor access and supervised practice opportunities. Suggestions to address these barriers require targeted enabling strategies.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Springer Science and Business Media LLC
Date: 12-12-2022
DOI: 10.1186/S13047-022-00589-6
Abstract: Lower extremity utations (LEAs) as a result of type 2 diabetes mellitus (T2DM) cause considerable morbidity, mortality, and burden on the healthcare system. LEAs are thought to be preventable, yet the rate of LEAs, particularly in Australia, has risen despite the availability of preventative healthcare services. Understanding patient’s perspectives of risk factors for LEAs may provide valuable insight into why many LEAs occur each year. The aim of this study was to explore patient’s perspectives of risk factors for LEAs as a result of T2DM. A qualitative descriptive methodology involving non-probability purposive s ling was used to recruit inpatients at a tertiary metropolitan hospital in South Australia. Semi-structured interviews were conducted, and data were transcribed verbatim. Data from the interviews were analysed using thematic analysis and the constant comparison approach. A total of 15 participants shared their perspectives of risk factors for lower extremity utations. Most (86%) of participants were male and Caucasian, with a median age of 66.4 years ranging from 44-80 years. The median duration of diabetes was 25.2 years, ranging from 12-40 years. More than half of the participants had undergone a previous utation with 86% being unemployed or retired and 73% living in metropolitan Adelaide. Two main themes emerged: competing priorities and awareness. Finance and family care were identified as subthemes within competing priorities. While subthemes in the context of awareness related to lack of awareness of risk, experiences with health care professionals and perspectives of disease severity. The findings from this research indicate that addressing risk factors for LEAs for patients with T2DM require a holistic and nuanced approach which considers in idual patient’s circumstances, and its influence on how risks are viewed and managed.
Publisher: Elsevier BV
Date: 02-2021
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020895
Abstract: To describe objectively measured sleep characteristics in children aged 11–12 years and in parents and to examine intergenerational concordance of sleep characteristics. Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. Data were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns. Of the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years 88% mothers) and 1077 biological parent–child pairs. Survey weights were applied and statistical methods accounted for the complex s le design, stratification and clustering within postcodes. Parents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent–child concordance was quantified using Pearson’s correlation coefficients in unadjusted models and regression coefficients in adjusted models. The mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent–child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27). These normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent–child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.SLEH.2017.07.006
Abstract: Sleep is important for the physical, social and mental well-being of both children and adults. Over the years, there has been a general presumption that sleep will inevitably decline with the increase in technology and a busy 24-hour modern lifestyle. This narrative review discusses the empirical evidence for secular trends in sleep duration and the implications of these trends.
Publisher: SAGE Publications
Date: 02-11-2022
DOI: 10.1177/26350106221137896
Abstract: The purpose of the study was to determine the association between objective and self-report measures of sleep and cardiometabolic risk factors for type 2 diabetes. This study examines data on Australian adults, collected as part of the Child Health CheckPoint study. Sleep was examined in terms of actigraphy-derived sleep duration, timing, efficiency and variability and self-report trouble sleeping. Cardiometabolic risk factors for type 2 diabetes were examined in terms of body mass index and biomarkers of inflammation and dyslipidemia. Generalized estimating equations, adjusted for geographic clustering, were used to determine the association between measures of sleep and cardiometabolic risk factors. Complete case analysis was conducted for 1017 parents (87% mothers). Both objective and self-report measures of sleep were significantly but weakly associated with cardiometabolic risk factors. Both objective and self-report measures of sleep are significantly associated with cardiometabolic risk factors for type 2 diabetes. Self-report troubled sleep is associated with poorer cardiometabolic health, independent of actigraphy-derived sleep parameters.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SMRV.2019.04.011
Abstract: Sleep is essential for children's health and well-being. Characteristics of children's sleep such as sleep duration, timing, quality and variability are increasingly being associated with a wide range of health outcomes. The purpose of this study is to conduct a meta-review (systematic review of systematic reviews) to examine the relationship between sleep and health in children. A systematic search of four electronic databases (Medline, PsychInfo, Scopus, and Embase) was conducted to identify systematic reviews that examine the association between characteristics of children's sleep and health. Key findings, as well as areas in need of further research were synthesised descriptively. A total of 39 systematic reviews were identified for inclusion, covering areas of cognition, psychosocial health, cardiometabolic health, adiposity and other outcomes such as musculoskeletal pain. There is substantial and consistent evidence relating sleep duration to adiposity and emotional outcomes. The relationships between sleep quality and timing and blood lipids and glycaemic control merit further research. Links between sleep and metabolic syndrome in children appear to be weak and inconsistent. Key areas identified in need for further research included studies that objectively assess children's sleep and move beyond cross-sectional study designs and consider characteristics of sleep other than duration. It was also noted that covariates applied across studies varied considerably and the issue of residual confounding was raised in a number of reviews. Lastly, all reviews reported studies adopted a traditional approach of examining only one aspect of children's sleep. Systematic reviews support the notion that sleep is important for children's health. However, further studies that objectively assess sleep and consider characteristics of sleep other than duration and outcomes other than adiposity are needed. An understanding of sleep as a multidimensional construct and as a component of the 24-h d, is also needed to better understand the relationship between sleep and health in children.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.COLEGN.2012.07.003
Abstract: Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Researchers conducted non-participant observations (n = 9) of two hours duration across the 24 h period. Focus groups (n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008-2009. Two main problem areas were identified as impeding the nurses' ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.
Publisher: Oxford University Press (OUP)
Date: 10-2010
Publisher: Oxford University Press (OUP)
Date: 05-2011
Publisher: Elsevier BV
Date: 09-2020
Publisher: Springer Science and Business Media LLC
Date: 08-01-2013
DOI: 10.1038/IJO.2012.212
Abstract: To determine whether sleep timing behaviour is associated with energy intake and diet quality in children and adolescents. Cross-sectional analysis of nationally representative survey data. A total of 2200 participants of the 2007 Australian National Children's Nutrition and Physical Activity Survey aged 9-16 years with 2 days of food intake data, 4 days of use of time data and complete anthropometry. Participants were grouped into one of four sleep-wake behaviour categories: early bed-early rise (EE) early bed-late rise (EL) late bed-early rise (LE) and late bed-late rise (LL). The four categories were compared for body mass index (BMI) z-score, energy intake and diet quality assessed using the Dietary Guideline Index for Children and Adolescents. Analyses were adjusted for survey design, sociodemographic characteristics, sleep duration and physical activity level (PAL). In adjusted multivariate regression models with sleep timing behaviour group as the independent variable, the 'LL' category compared with the 'EE' category had a higher BMI z-score (β=0.20, 95% confidence interval (CI) 0.06 to 0.34, P=0.007), and lower diet quality (β=-4.0, 95% CI -5.7 to -2.3, P<0.001). Children and adolescents who went to bed late also had a higher intake of extra foods (that is, energy-dense, nutrient-poor foods) while those whom went to bed early consumed more fruit and vegetables. Energy intake was associated with sleep duration (β=-4.5 kJ, 95% CI -6.7 to -2.4, P<0.001), but not sleep timing behaviour. Late bedtimes and late wake up times are associated with poorer diet quality, independent of sleep duration, PAL and child and sociodemographic characteristics.
Publisher: Oxford University Press (OUP)
Date: 10-2011
DOI: 10.5665/SLEEP.1266
Publisher: Oxford University Press (OUP)
Date: 04-2013
DOI: 10.5665/SLEEP.2538
Publisher: SAGE Publications
Date: 05-12-2014
Abstract: Appropriate and timely foot self-care practices may prevent diabetes-related foot complications. However, self-care practices are often neglected, particularly by older adults. The purpose of this study was to conduct an integrative, systematic literature review of the psychosocial barriers and enablers of foot self-care practices among older adults diagnosed with diabetes. An integrative, systematic literature review and a deductive thematic analysis was conducted to determine psychosocial barriers and enablers of foot self-care practices among older adults. A total of 130 different studies were retrieved from the search strategy. From these, 9 studies were identified and included for review. Physical ability, perceived importance, patient knowledge, provision of education, social integration, risk status, and patient-provider communication were identified as key barriers and enablers of foot self-care. Participants at high risk of foot complications were found to perceive themselves at greater risk of complications, receive more education, and engage in better overall foot self-care practices compared to those at low risk of foot complications. Foot self-care practices appear underutilized as primary prevention measures by older adults and are instead adopted only once complications have already occurred. Likewise, facilitators of foot self-care practices, such as education, appear to be reserved for in iduals who have already developed foot complications. Health care professionals such as diabetes educators, podiatrists, and general practitioners may play an important role in the prevention of foot complications among older adults by recognizing, referring, and providing early education to older adults.
Publisher: Oxford University Press (OUP)
Date: 30-01-2021
Abstract: Sleep plays an important role in cardiometabolic health. Although the importance of considering sleep as a multidimensional construct is widely appreciated, studies have largely focused on in idual sleep characteristics. The association between actigraphy-derived sleep profiles and cardiometabolic health in healthy adults and children has not been examined. This study used actigraphy-measured sleep data collected between February 2015 and March 2016 in the Child Health CheckPoint study. Participants wore actigraphy monitors (GENEActiv Original, Cambs, UK) on their nondominant wrist for 7 days and sleep characteristics (period, efficiency, timing, and variability) were derived from raw actigraphy data. Actigraphy-derived sleep profiles of 1,043 Australian children aged 11–12 years and 1,337 adults were determined using K-means cluster analysis. The association between cluster membership and biomarkers of cardiometabolic health (blood pressure, body mass index, apolipoproteins, glycoprotein acetyls, composite metabolic syndrome severity score) were assessed using Generalized Estimating Equations, adjusting for geographic clustering, with sex, socioeconomic status, maturity stage (age for adults, pubertal status for children), and season of data collection as covariates. Four actigraphy-derived sleep profiles were identified in both children and adults: short sleepers, late to bed, long sleepers, and overall good sleepers. The overall good sleeper pattern (characterized by adequate sleep period time, high efficiency, early bedtime, and low day-to-day variability) was associated with better cardiometabolic health in the majority of comparisons (80%). Actigraphy-derived sleep profiles are associated with cardiometabolic health in adults and children. The overall good sleeper pattern is associated with more favorable cardiometabolic health.
Publisher: Springer Science and Business Media LLC
Date: 11-04-2019
Publisher: Elsevier BV
Date: 04-2013
DOI: 10.1016/J.SLEEP.2013.01.002
Abstract: Questionnaires are widely used to determine children's sleep duration. While authors have been encouraged to move on from the question: 'how many hours of sleep do you usually get?', the validity of different reports remains unclear, and there do not appear to be any evidence-based recommendations for how to best enquire about children's sleep. Our study aims to determine the validity of subjective reports of children's sleep duration and if elements of phrasing influence the accuracy of reports. A systematic literature review was conducted to identify studies that report the subjective sleep duration of children ages five to 18years, inclusive. A thematic analysis was used to identify 'elements' of phrasing that may influence the accuracy of reports, and a descriptive analysis was conducted to determine the validity of subjective reports. Our review identified five elements of phrasing that may affect the accuracy of reports. These include, specifying sleep parameters that define sleep duration, the recall period, the day type, the method of data collection, and the respondent. The validity of subjective reports varied across studies and in accordance with identified elements of phrasing. Future studies that assess subjective reports of children's sleep should define sleep duration, the recall period, the days constituting schooldays and nonschooldays, the method of data collection, and the respondent of the questionnaire.
Publisher: Wiley
Date: 26-06-2017
DOI: 10.1111/APA.13917
Abstract: To examine secular trends in Australian children's actual sleep time as well as the perceived importance of sleep between 1985, 2004 and 2013. Secular trends in children's sleep and their perception of the importance of sleep across three time points 1985 (N = 401), 2004 (N = 450) and 2013 (N = 395) were examined according to socio-economic status (SES), age and sex. The children self-reported their bedtime, wake-up time and their perceived importance of sleep, among other questions. There were no significant differences in sleep duration between boys and girls in any of the survey years, nor were there differences in sleep duration between SES categories at any time point. Independent of survey year, age, sex and SES, there was a graded difference in sleep duration (minutes) across response categories for perceived importance of sleep. Overall, trends in the perceived importance of sleep appeared to match trends in actual sleep time, but not for all subgroups. This study indicates that the sleep duration of high SES Australian school children is returning to, or near to, baseline sleep duration observed in 1985, while the sleep duration of low SES Australian children has remained at low levels.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.SLEH.2018.05.004
Abstract: Sleep is important for the physical, social and mental well-being of both children and adults. In this paper, we discuss the need to consider sleep as a multidimensional construct and as a component of total 24-hour activity. First, we make a case for considering sleep as a multidimensional construct, whereby all characteristics of sleep (including duration, quality, timing, and variability) and their links with health are examined. Second, we argue that sleep should also be conceptualized as part of the daily spectrum of time-use, along with other types of activity. We propose novel statistical models, in particular compositional data analysis (CoDA), as appropriate analytical methods for a new sleep paradigm.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S12889-023-16277-4
Abstract: Obesity is a growing, global public health issue. This study aimed to describe the weight management strategies used by a s le of Australian adults examine the socio-demographic characteristics of using each strategy and examine whether use of each strategy was associated with 12-month weight change. This observational study involved a community-based s le of 375 healthy adults (mean age: 40.1 ± 5.8 years, 56.8% female). Participants wore a Fitbit activity monitor, weighed themselves daily, and completed eight online surveys on socio-demographic characteristics. Participants also recalled their use of weight management strategies over the past month, at 8 timepoints during the 12-month study period. Most participants (81%) reported using at least one weight management strategy, with exercise hysical activity being the most common strategy at each timepoint (40–54%). Those who accepted their current bodyweight were less likely to use at least one weight management strategy (Odds ratio = 0.38, 95% CI = 0.22–0.64, p 0.01) and those who reported being physically active for weight maintenance had a greater reduction in bodyweight, than those who did not (between group difference: -1.2 kg, p 0.01). The use of supplements and fasting were associated with poorer mental health and quality of life outcomes (p 0.01). The use of weight management strategies appears to be common. Being physically active was associated with greater weight loss. In iduals who accepted their current body weight were less likely to use weight management strategies. Fasting and the use of supplements were associated with poorer mental health. Promoting physical activity as a weight management strategy appears important, particularly considering its multiple health benefits.
Publisher: Oxford University Press (OUP)
Date: 16-11-2020
DOI: 10.1093/SLEEP/ZSZ200
Abstract: Poor sleep patterns in older adults are associated with chromosomal telomere shortening, a marker of cellular senescence. However, studies have relied on self-reported sleep characteristics, with few data for younger in iduals. We investigated whether sleep measured via actigraphy was cross-sectionally associated with telomere length in children and midlife adults. A population-based s le of 1874 11–12 year olds and midlife adults (mean age 44 years, SD 5.1) had biological and physical assessments at centers across Australia in 2015–2016. Sleep characteristics, including duration, onset, offset, day-to-day variability, and efficiency, were derived from actigraphy. Relative telomere length (T/S ratio) was measured by quantitative polymerase chain reaction on genomic DNA from peripheral blood. Multivariable regression models estimated associations, adjusting for prespecified confounders. Both sleep and telomere data were available for 728 children and 1070 adults. Mean (SD) T/S ratio was 1.09 (0.55) in children and 0.81 (0.38) in adults. T/S ratio was not predicted by sleep duration (β 0.04, 95% confidence interval [CI] −0.02 to 0.09, p = .16, children β −0.004, 95% CI −0.03 to 0.02, p = .70, adults) or most other sleep metrics. The only exception was a weak association between later sleep timing (the midpoint of sleep onset and offset) and longer telomeres in adults (β 0.03, 95% CI 0.01 to 0.06, p = .01). Objective sleep characteristics show no convincing associations with telomere length in two largely healthy populations up to at least midlife. Sleep–telomere associations may be a late-life occurrence or may present only with a trigger such as presence of other morbidities.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2012
Abstract: There is a common belief that children are not getting enough sleep and that children’s total sleep time has been declining. Over the century, many authors have proposed sleep recommendations. The aim of this study was to describe historical trends in recommended and actual sleep durations for children and adolescents, and to explore the rationale of sleep recommendations. A systematic literature review was conducted to identify recommendations for children’s sleep requirements and data reporting children’s actual total sleep time. For each recommendation identified, children’s actual sleep time was determined by identifying studies reporting the sleep duration of children of the same age, gender, and country in the same years. Historical trends in age-adjusted recommended sleep times and trends in children’s actual sleep time were calculated. A thematic analysis was conducted to determine the rationale and evidence-base for recommendations. Thirty-two sets of recommendations were located dating from 1897 to 2009. On average, age-specific recommended sleep decreased at the rate of –0.71 minute per year. This rate of decline was almost identical to the decline in the actual sleep duration of children (–0.73 minute per year). Recommended sleep was consistently ∼37 minutes greater than actual sleep, although both declined over time. A lack of empirical evidence for sleep recommendations was universally acknowledged. Inadequate sleep was seen as a consequence of “modern life,” associated with technologies of the time. No matter how much sleep children are getting, it has always been assumed that they need more.
Publisher: Wiley
Date: 23-02-2023
DOI: 10.1111/JSR.13855
Abstract: Micronutrients, particularly amino acids, are thought to play an important role in sleep regulation and maintenance. While tryptophan is a known predictor of sleep, less is known about branched‐chain amino acids (BCAAs), which compete with tryptophan for transport across the blood–brain barrier. The aim of this study was to determine the association between BCAAs and actigraphy‐derived sleep duration, timing and efficiency, and self‐reported trouble sleeping. This study examined data on children and adults collected as part of the Child Health CheckPoint study. Linear mixed models, adjusted for geographic clustering, were used to determine the association between BCAAs and sleep characteristics. Complete‐case analysis was conducted for 741 children aged 11–12 years old (51% females) and 941parents (87% mothers). While BCAAs were significantly associated with children's sleep duration, timing and self‐reported trouble sleeping, no associations were observed in adults, in fully adjusted models. In children, higher levels of BCAAs are associated with shorter sleep duration, delayed sleep timing, and more frequent reports of trouble sleeping.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.SLEH.2018.02.004
Abstract: Sleep recommendations are widely used to guide communities on children's sleep needs. Following recent adjustments to guidelines by the National Sleep Foundation and the subsequent consensus statement by the American Academy of Sleep Medicine, we undertook a systematic literature search to evaluate the current evidence regarding relationships between objectively measured sleep duration and cognitive function in children aged 5 to 13 years. Cognitive function included measures of memory, attention, processing speed, and intelligence in children aged 5 to 13 years. Keyword searches of 7 databases to December 2016 found 23 meeting inclusion criteria from 137 full articles reviewed, 19 of which were suitable for meta-analysis. A significant effect (r = .06) was found between sleep duration and cognition, suggesting that longer sleep durations were associated with better cognitive functioning. Analyses of different cognitive domains revealed that full/verbal IQ was significantly associated with sleep loss, but memory, fluid IQ, processing speed and attention were not. Comparison of study sleep durations with current sleep recommendations showed that most children studied had sleep durations that were not within the range of recommended sleep. As such, the true effect of sleep loss on cognitive function may be obscured in these s les, as most children were sleep restricted. Future research using more rigorous experimental methodologies is needed to properly elucidate the relationship between sleep duration and cognition in this age group.
Publisher: Springer Science and Business Media LLC
Date: 23-06-2023
DOI: 10.1038/S41746-023-00856-1
Abstract: Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sleep, published before 1 September 2022. Outcomes were total physical activity, steps, moderate-to-vigorous physical activity (MVPA), fruit and vegetable consumption, sleep quality and sleep duration. Standardised mean differences (SMD) were calculated to compare intervention effects. Subgroup analyses were conducted to assess chatbot type, intervention type, duration, output and use of artificial intelligence. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment tool. Nineteen trials were included. S le sizes ranged between 25–958, and mean participant age ranged between 9–71 years. Most interventions ( n = 15, 79%) targeted physical activity, and most trials had a low-quality rating ( n = 14, 74%). Meta-analysis results showed significant effects (all p 0.05) of chatbots for increasing total physical activity (SMD = 0.28 [95% CI = 0.16, 0.40]), daily steps (SMD = 0.28 [95% CI = 0.17, 0.39]), MVPA (SMD = 0.53 [95% CI = 0.24, 0.83]), fruit and vegetable consumption (SMD = 0.59 [95% CI = 0.25, 0.93]), sleep duration (SMD = 0.44 [95% CI = 0.32, 0.55]) and sleep quality (SMD = 0.50 [95% CI = 0.09, 0.90]). Subgroup analyses showed that text-based, and artificial intelligence chatbots were more efficacious than speech/voice chatbots for fruit and vegetable consumption, and multicomponent interventions were more efficacious than chatbot-only interventions for sleep duration and sleep quality (all p 0.05). Findings from this systematic review and meta-analysis indicate that chatbot interventions are efficacious for increasing physical activity, fruit and vegetable consumption, sleep duration and sleep quality. Chatbot interventions were efficacious across a range of populations and age groups, with both short- and longer-term interventions, and chatbot only and multicomponent interventions being efficacious.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2012
Publisher: Oxford University Press (OUP)
Date: 04-2012
DOI: 10.2522/PTJ.20110013
Abstract: The generation of research can be likened to the production of consumer goods, with a producer (the study authors and funders), a product (the study and publications arising from it), and consumers (those who read and cite the published study). The aim of this study was to use bibliometric indexes to track changes in the producers, products, and consumers of the journal Physical Therapy from 1945 through 2010. An analysis of published manuscripts (excluding letters, editorials, corrections, commentaries, and book reviews) in Physical Therapy was performed using a reliable bibliometric audit tool. Articles were s led every 3 months and at 5-year intervals over a 65-year period. Information relating to authorship, the research methods used, and citation patterns was collected. Data were analyzed descriptively. There have been substantial shifts in the nature of research published over the last 65 years in Physical Therapy. In 1945, the typical paper was anecdotal and authored by 1.4 American authors (working in hospitals), and consisted of 4 pages and 4 references. In 2010, the typical paper used a cross-sectional survey or randomized controlled trial design, with 4.6 multinational authors (working in universities), and consisted of 12 pages and 49 references. Findings are specific to the articles published in Physical Therapy that were s led in this bibliometric analysis. The changes seen in the research published in Physical Therapy mirror the shifts that have occurred in other industries: increasing quantification, standardization, collaboration, and internationalization. These trends are likely to continue in the future.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.SLEEP.2015.02.534
Abstract: The present study investigated the effectiveness of a school-based sleep education programme in improving key sleep behaviours, sleep knowledge, and sleep hygiene. A cross-sectional cluster-randomised controlled trial with two groups (Intervention and Control) and three assessment time points [baseline, immediately post intervention (6 weeks post baseline) and follow-up (18 weeks post baseline)] was employed. A total of 296 students (mean age = 12.2 ± 0.6 years 59% female) from 12 schools in Adelaide, South Australia, were recruited, with 149 participants in the Intervention group and 147 in the Control group. The intervention consisted of four classroom lessons delivered at weekly intervals, followed by a group project on sleep topics, which students presented at a parental information evening. Sleep patterns were assessed objectively (actigraphy, n = 175) and subjectively (time-use recall, n = 251) at three time points. Sleep knowledge and sleep hygiene (n = 296) were also measured. Generalised estimating equations were used to compare changes in the Intervention and Control groups. The programme increased time in bed by 10 min (p = 0.03) for the Intervention group relative to the Control group, due to a 10-min delay in wake time (p = 0.00). These changes were not sustained at follow-up. There was no impact on sleep knowledge or sleep hygiene. Investment in the sleep health of youth through sleep education is important but changes to sleep patterns are difficult to achieve. More intensive programmes, programmes with a different focus or programmes targeting different age groups may be more effective.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.SMRV.2011.03.005
Abstract: Sleep deficits are associated with a wide range of detrimental physical and mental health outcomes. There is concern that children are not getting enough sleep, and that sleep duration has been declining. However, evidence is sparse. A systematic review of world literature was conducted to locate studies reporting the sleep duration of children aged 5-18 years. Monte Carlo simulation was used to generate pseudodata from summary data, which were combined with raw data and analysed by linear regression of sleep duration on year of measurement at the age × sex × day type × country level. Data were available on 690,747 children from 20 countries, dating from 1905 to 2008. From these data, 641 regressions were derived. The s le-weighted median rate of change was -0.75 min nightly per year, indicating a decrease of more than 1 h per night over the study period. Rates of change were negative across age, sex and day type categories, but varied according to region, with Europe, the USA, Canada and Asia showing decreases and Australia, the UK and Scandinavia showing increases. Over the last 103 years, there have been consistent rapid declines in the sleep duration of children and adolescents.
No related grants have been discovered for Lisa Matricciani.