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Cognitive neuroscience | Biological psychology | Biological physics |
Publisher: Oxford University Press (OUP)
Date: 10-07-2023
Abstract: The unique requirements of shift work, such as sleeping and working at variable times, mean that current sleep hygiene guidelines may be inappropriate for shift workers. Current guidelines may also contradict fatigue management advice (e.g. advising against daytime napping). The present study utilized a Delphi methodology to determine expert opinion regarding the applicability of current guidelines for shift workers, the appropriateness of the term “sleep hygiene,” and develop tailored guidelines for shift workers. The research team reviewed current guidelines and existing evidence to draft tailored guidelines. Seventeen in idual guidelines, covering sleep scheduling, napping, sleep environment, bedtime routine, substances, light exposure, diet, and exercise were drafted. Experts from sleep, shift work, and occupational health fields (n = 155) were invited to review the draft guidelines using a Delphi methodology. In each round, experts voted on in idual guidelines, with 70% agreement considered consensus. Where consensus was not reached, written feedback from experts was discussed and incorporated into subsequent iterations. Of the experts invited, 68 (44%) agreed to participate, with 55 (35%) completing the third (final) round. Most experts (84%) agreed that tailored guidelines were required for shift workers. Consensus was reached on all guidelines after three rounds. One additional guideline (sleep inertia) and an introductory statement were developed, resulting in a final set of 18 in idual guidelines, termed “healthy sleep practices for shift workers.” This is the first study to develop tailored sleep hygiene guidelines for shift workers. Future research should investigate the acceptability and effectiveness of these guidelines amongst shift workers.
Publisher: Oxford University Press (OUP)
Date: 22-03-2013
DOI: 10.1093/AJE/KWS308
Abstract: Short (≤6 hours) and long (>9 hours) sleep durations are risk factors for mortality and morbidity. To investigate whether the prevalences of short and long sleep durations have increased from the 1970s to the 2000s, we analyzed data from repeated cross-sectional surveys of 10 industrialized countries (38 nationally representative time-use surveys n = 328,018 adults). Logistic regression models for each country were used to determine changes in the prevalence of short and long sleep durations over time, controlling for s ling differences in gender, age, number of weekend days included, and season of data collection. Over the periods covered by data, the prevalence of short sleep duration increased in Italy (adjusted odds ratio = 2.64, 95% confidence interval (CI): 2.41, 2.89) and Norway (adjusted odds ratio = 2.33, 95% CI: 1.77, 3.08) but decreased in Sweden, the United Kingdom, and the United States. The prevalence of long sleep duration increased in Australia (adjusted odds ratio = 1.14, 95% CI: 1.05, 1.25), Finland (adjusted odds ratio = 1.30, 95% CI: 1.14, 1.48), Sweden (adjusted odds ratio = 1.51, 95% CI: 1.35, 1.69), the United Kingdom (adjusted odds ratio = 2.03, 95% CI: 1.68, 2.46), and the United States (adjusted odds ratio = 1.50, 95% CI: 1.36, 1.65) but decreased in Canada and Italy. No changes were observed in Germany or the Netherlands. Limited increases in short sleep duration challenge the claim of increasingly sleep-deprived societies. Long sleep duration is more widespread than is short sleep duration. It has become more prevalent and thus should not be overlooked as a potential contributor to ill health.
Publisher: Oxford University Press (OUP)
Date: 15-09-2022
Abstract: Autonomic function is impaired in obstructive sleep apnea (OSA) and may mediate the association between OSA and cardiovascular risk. We investigated the effect of OSA therapy on autonomic function through a systematic review and meta-analysis of intervention studies. A systematic search using three databases (Medline, Embase, and Scopus) was performed up to December 9, 2020. Studies of OSA patients ≥ 18 years with autonomic function assessed before and after treatment with positive airway pressure, oral appliance, positional therapy, weight loss, or surgical intervention were included for review. Random effects meta-analysis was carried out for five groups of autonomic function indices. Risk of bias was assessed using the Cochrane Collaboration tool. Forty-three eligible studies were reviewed with 39 included in the meta-analysis. OSA treatment led to large decreases in muscle sympathetic nerve activity (Hedges’ g = −1.08 95% CI −1.50, −0.65, n = 8) and moderate decreases in catecholamines (−0.60 −0.94, −0.27, n = 3) and radio nucleotide imaging (−0.61 −0.99, −0.24, n = 2). OSA therapy had no significant effect on baroreflex function (Hedges’ g = 0.15 95% CI −0.09, 0.39, n = 6) or heart rate variability (0.02 −0.32, 0.36, n = 14). There was a significant risk of bias due to studies being primarily non-randomized trials. OSA therapy selectively improves autonomic function measures. The strongest evidence for the effect of OSA therapy on autonomic function was seen in reduced sympathetic activity as assessed by microneurography, but without increased improvement in parasympathetic function. OSA therapy may reduce the risk of cardiovascular disease in OSA through reduced sympathetic activity.
Publisher: Informa UK Limited
Date: 19-05-2022
DOI: 10.1080/07420528.2022.2072224
Abstract: Effective management strategies for jetlag have largely been studied and evaluated through the lens of circadian science and biological rhythms. Jetlag is mostly self-managed by the in idual. The most effective strategies require in iduals to make behavioral changes to carefully alter sleep-wake schedules and time light exposure. However, travelers' perceptions, including their experiences, beliefs about jetlag/travel fatigue, and management expectations remain unclear. Therefore, the aim of this scoping review was to systematically synthesize the literature to understand what is currently known about travelers' perceptions of jetlag and travel fatigue. A literature search was conducted through EMBASE, PsycINFO, PubMed and Scopus generating 1164 results (2 articles known to authors), which were screened against our inclusion criteria. Twenty-two studies including data from 3952 participants were evaluated for its study design and traveler-centered outcome measures across the domains of: 1)
Publisher: Oxford University Press (OUP)
Date: 27-07-2022
Abstract: Intermittent hypoxia is a key mechanism linking Obstructive Sleep Apnea (OSA) to cardiovascular disease (CVD). Oximetry analysis could enhance understanding of which OSA phenotypes are associated with CVD risk. The aim of this study was to compare associations of different oximetry patterns with incident CVD in men and women with OSA. Sleep Heart Health Study data were used for analysis. n = 2878 Participants (51.8% female mean age 63.5 ± 10.5 years) with OSA (Apnea Hypopnea Index [AHI] ≥ 5 events/h) and no pre-existing CVD at baseline or within the first 2 years of follow-up were included. Four oximetry analysis approaches were applied: desaturation characteristics, time series analysis, power spectral density, and non-linear analysis. Thirty-one resulting oximetry patterns were compared to incident CVD using proportional hazards regression models adjusted for age, race, smoking, BMI, and sex. There were no associations between OSA oximetry patterns and incident CVD in the total s le or in men. In women, there were some associations between incident CVD and time series analysis (e.g. SpO2 distribution standard deviation, HR 0.81, 95% CI 0.68–0.96, p = 0.014) and power spectral density oximetry patterns (e.g. Full frequency band mean HR 0.75 95% CI 0.59–0.95 p = 0.015). Comprehensive comparison of baseline oximetry patterns in OSA found none were related to development of CVD. There were no standout in idual oximetry patterns that appear to be candidates for CVD risk phenotyping in OSA, but some showed marginal relationships with CVD risk in women. Further work is required to understand whether OSA phenotypes can be used to predict susceptibility to cardiovascular disease.
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: MDPI AG
Date: 14-04-2020
Abstract: Avoiding food before bedtime is a widely accepted sleep hygiene practice, yet few studies have assessed meal timing as a risk factor for disrupted sleep. This study examined the relationship between evening meal timing and sleep quality in young adults. A total of N = 793 participants (26% male) aged between 18 and 29 years responded to an online survey, which captured sociodemographic information, lifestyle variables, and sleep characteristics. Meal timing was defined as meals more than 3 h before or within 3 h of bedtime. The outcomes were as follows: one or more nocturnal awakenings, sleep onset latency of min, and sleep duration of ≤6 h. Logistic regression analyses showed that eating within 3 h of bedtime was positively associated with nocturnal awakening (OR = 1.61, 95% CI = 1.15–2.27) but not long sleep onset latency (1.24 0.89–1.73) or short sleep duration (0.79 0.49–1.26). The relationship remained significant after adjusting for potential confounders of ethnicity and body mass index (OR = 1.43, 95% CI = 1.00–2.04). Meal timing appears to be a modifiable risk factor for nocturnal awakenings and disrupted sleep. However, this is a preliminary cross-sectional study and highlights the need for additional research on the influence of the timing of food intake on sleep.
Publisher: Oxford University Press (OUP)
Date: 07-07-2022
Abstract: To systematically determine subjective and objective outcome measures used to measure the efficacy of narcolepsy interventions in randomized controlled trials (RCTs) in adults and children and assess psychometric properties of patient-reported outcome measures (PROMs) used. We searched bibliographical databases and clinical trial registries for narcolepsy RCTs and extracted objective and subjective outcome measures. If PROMs were used, we searched for psychometric studies conducted in a narcolepsy population using bibliographical databases and appraised using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. In total, 80 different outcome measures were used across 100 RCTs. Epworth Sleepiness Scale (ESS) (n = 49) and Maintenance of Wakefulness Test (n = 47) were the most frequently used outcome measures. We found 19 validation studies of 10 PROMs in narcolepsy populations. There was limited evidence for validity or responsiveness of the ESS yet sufficient reliability (pooled ICC: 0.81–0.87). Narcolepsy Severity Scale (NSS) had sufficient reliability (pooled ICC: 0.71–0.92) and both adult and pediatric versions had sufficient discriminant validity (treated/untreated). Content validity was only evaluated in pediatric populations for ESS-CHAD and NSS-P and rated inconclusive. Quality of evidence of the psychometric studies for all scales ranged from very low to low. Although recognized by regulatory bodies and widely used as primary outcome measures in trials, there is surprisingly little evidence for the validity, reliability, and responsiveness of PROMs frequently used to assess treatment efficacy in narcolepsy. The field needs to establish patient-centered minimal clinically important differences for the PROMs used in these trials.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.SLEH.2017.11.006
Abstract: We aimed to evaluate the interaction of two key determinants of sleep health, quantity and quality, with physical, emotional, and social functioning, in the general population. Nationally-representative Australian cross-sectional study. General population. 14,571 people aged 15 or older in Household, Income and Labor Dynamics in Australia (HILDA) in 2013. The associations of sleep quality (good oor) in combination with mid-range (6-8 hours), short ( 8) sleep duration with functioning, determined from the SF-36, were evaluated using logistic regression adjusting for sociodemographic, relationships, health behaviors, obesity, pain, and mental and physical illness confounders. After adjusting for gender, and age, poor sleep quality in combination with short, mid-range and long sleep was associated with worse physical, emotional and social functioning. Pain and comorbid illness explained much of these associations, while attenuation from other covariates was minor. The associations of poor sleep quality with worse functioning remained after full adjustment regardless of sleep duration, while among people with good quality sleep, only those with long sleep duration reported poorer functioning. Poor sleep quality has robust associations with worse functioning regardless of total duration in the general population. There appears to be a substantial number of functional short sleepers with good quality sleep.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2023
DOI: 10.1007/S11096-023-01605-W
Abstract: In Australia, prescription melatonin became a ‘Pharmacist Only Medicine’ for people over 55 with insomnia from June 2021. However, little is known about pharmacists’ views on melatonin down-scheduling and perceived impacts on practice. To explore Australian community pharmacists’ views on and attitudes towards the down-scheduling of melatonin. A convenience s le of community pharmacists and pharmacy interns were recruited. Participants completed a survey capturing demographic and professional practice details, and rated their knowledge, beliefs and attitudes towards melatonin. This was followed by an online semi-structured interview. Interviews were guided by a schedule of questions developed using the Theoretical Domains Framework and explored the perceived role of melatonin, preparation/response to down-scheduling, practice changes and patient interactions. Interviews continued until data saturation and were digitally recorded, transcribed verbatim and analysed using the Framework Approach. Twenty-four interviews were conducted with community pharmacists (n = 19) and intern pharmacists (n = 5), all practicing in metropolitan areas. Pharmacists/intern pharmacists welcomed the increased accessibility of melatonin for patients. However, pharmacists perceived a disconnect between the guidelines, supply protocols and pack sizes with practice, making it difficult to monitor patient use of melatonin. The miscommunication of eligibility also contributed to patient-pharmacist tension when supply was denied. Importantly, most participants indicated their interest in upskilling their knowledge in melatonin use in sleep, specifically formulation differences and dosage titration. While pharmacists welcomed the down-scheduling of melatonin, several challenges were noted, contributing to pharmacist-patient tensions in practice. Findings highlight the need to refine and unify melatonin supply protocols and amend pack sizes to reflect guideline recommendations as well as better educating the public about the risk-benefits of melatonin.
Publisher: Public Library of Science (PLoS)
Date: 12-11-2014
Publisher: Informa UK Limited
Date: 21-10-2022
DOI: 10.1080/00140139.2021.1980112
Abstract: Jetlag is largely self-managed by the in idual traveller. This paper explores the lived experiences of air travellers, their understanding of jetlag, and their perceptions of management strategies. 32 international travellers (mean age = 31, SD: 15 years 47% female, mean flight duration = 16, SD: 6 hours) were interviewed. Interviews were recorded, transcribed verbatim and analysed using the Framework Approach. Analysis of the qualitative data revealed three emergent themes: Travel beliefs and experiences
Publisher: Informa UK Limited
Date: 14-01-2020
DOI: 10.1080/07420528.2019.1704771
Abstract: Objective measures of circadian disruption are difficult to capture in a free-living environment hence the importance of validating subjective measures of jetlag. We aimed to assess the internal consistency of the 15-item Liverpool Jetlag Scale and its convergent and ergent validity with indicators of fatigue and anxiety in a large s le of air passengers. Online survey of passengers was conducted after travel on a range of long-haul flights. Jetlag was captured using the Liverpool scale, fatigue was measured using the Vitality subscale of the Short-Form Health Survey (SF-36), and the presence of anxiety or worry before, during, and after flight was self-reported. Inter-item correlations and Cronbach's alpha were calculated to assess the internal consistency of the scale. Exploratory factor analysis was used to examine whether the scale was consistent with one underlying construct of circadian disruption. Correlations between fatigue and anxiety (flying, situational, symptoms) with jetlag were used to assess convergent and ergent validity. Linear regression was used to determine the most important symptoms contributing to subjective jetlag rating. N = 460 passengers (57% female, mean age 50, SD 16 years) were surveyed. Cronbach's alpha indicated high internal reliability (alpha = 0.85). Jetlag was more strongly correlated with fatigue (rho = 0.47) than any type of anxiety (rho = 0.10-0.22). Exploratory factor analysis indicated responses were consistent with four factors: (i) fatigue/daytime impairment, (ii) sleep disturbance, (iii) changes in appetite and (iv) changes in bowel function. Regression analysis indicated that only changes in concentration, sleep time, fatigue, sleep quality and frequency of bowel motions were independent correlates of subjective jetlag (R
Publisher: MDPI AG
Date: 28-09-2021
Abstract: University students consistently report poor sleep. We conducted a before-and-after study to evaluate the impact of an online 10-week course on undergraduate students’ sleep knowledge, attitudes, and behaviours at 6-month follow-up. Data were collected via baseline course surveys (August–September 2020) and follow-up surveys distributed via email (February–March 2021). n = 212 students completed baseline surveys and n = 75 (35%) completed follow-up. Students retained to follow-up possessed higher baseline sleep knowledge and received higher course grades. At the 6-month follow-up, sleep knowledge had increased (mean score out of 5: 3.0 vs. 4.2, p 0.001). At baseline, 85% of students aimed to increase their sleep knowledge and 83% aimed to improve their sleep. At follow-up, 91% reported being more knowledgeable and 37% reported improved sleep. A novel Stages of Change item revealed that 53% of students’ attitudes towards their sleep behaviours had changed from baseline. There was a reduction in sleep latency at follow-up (mean 33.3 vs. 25.6 min, p = 0.015), but no change in the total Pittsburgh Sleep Quality Index score. In summary, completion of an online course led to increased sleep and circadian knowledge and changed sleep attitudes, with no meaningful change in sleep behaviours. Future interventions should consider components of behavioural change that go beyond the knowledge–attitudes–behaviour continuum.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.SLEH.2018.08.008
Abstract: Describe sleep duration in adult Sri Lankans and determine the bias and agreement of self-report and actigraphic assessments. Validation sub-study nested within the Colombo Twin and Singleton Study (2012-2015). Colombo, Sri Lanka. 175 adults with actigraphy, randomly selected from 3497 participants with self-reported sleep assessed in a population-based cohort. Self-reported sleep duration, ascertained by the Pittsburgh Sleep Quality Index (PSQI), was compared to a minimum of four days of actigraphy. Bias and agreement were assessed using the Bland-Altman method and a novel application of criterion cut-point analysis. Objective measurements of wake after sleep onset (WASO) and sleep efficiency were evaluated. Sri Lankans have short sleep duration averaging 6.4h (SD 1.5) self-reported and 6.0h (SD 0.9) actigraphically. Poor sleep quality was prevalent with an average WASO of 49 min., and sleep efficiency <85%. Bias was observed, with self-report consistently over-reporting sleep on average by 27.6 min (95% CI: -0.68, -0.24) compared to objective measures, but wide in idual variation in disagreement, ranging from over-reporting by 3.34h to under-reporting by 2.42h. A criterion cut-point method also failed to define agreed definitions of short and long sleep duration. Sleep in Sri Lankan adults, whether measured subjectively or objectively, is of short duration and suboptimal objective quality by High Income Country consensus standards. Given the high cardiometabolic morbidity in Sri Lanka and poor measurement agreement observed, this warrants further investigation and supports the need for culturally appropriate, reliable, and valid assessment for analytic epidemiology in non-Western settings.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.SMRV.2018.09.005
Abstract: Jetlag is a combination of travel fatigue and circadian misalignment resulting from air travel across time zones. Routinely recommended interventions based on circadian science include timely exposure to light and darkness (scheduled sleep), but the real-world effectiveness of these and other non-circadian strategies is unknown. We systematically reviewed the evidence for non-pharmacological interventions for jetlag. PubMed, EMBASE, Scopus, and Web of Science were searched. Studies reviewed 1) involved human participants undergoing air travel with a corresponding shift in the external light-dark cycle 2) administered a non-pharmacological intervention 3) had a control or comparison group and 4) examined outcomes such as jetlag symptoms, sleep, cognitive hysical performance, mood, fatigue, or circadian markers. Thirteen studies used light exposure, physical activity, diet, chiropractic treatment, or a multifaceted intervention to counteract jetlag. Nine studies found no significant change in the outcomes, three reported mixed findings, and one was positive. The null findings are likely due to poorly designed circadian interventions and neglect of contributors to travel fatigue. Higher quality studies that schedule darkness as well as light, in the periods before, during, and after flight are needed to reduce the circadian component of jetlag. Interventions should also address the stressors that contribute to travel fatigue.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.SMRV.2011.07.003
Abstract: Little evidence exists to support the common assertion that adult sleep duration has declined. We investigated secular trends in sleep duration over the past 40 years through a systematic review. Systematic search of 5 electronic databases was conducted to identify repeat cross-sectional studies of sleep duration in community-dwelling adults using comparable s ling frames and measures over time. We also attempted to access unpublished or semi-published data sources in the form of government reports, theses and conference proceedings. No studies were excluded based on language or publication date. The search identified 278 potential reports, from which twelve relevant studies were identified for review. The 12 studies described data from 15 countries from the 1960s until the 2000s. Self-reported average sleep duration of adults had increased in 7 countries: Bulgaria, Poland, Canada, France, Britain, Korea and the Netherlands (range: 0.1-1.7 min per night each year) and had decreased in 6 countries: Japan, Russia, Finland, Germany, Belgium and Austria (range: 0.1-0.6 min per night each year). Inconsistent results were found for the United States and Sweden. There has not been a consistent decrease in the self-reported sleep duration of adults from the 1960s to 2000s. However, it is unclear whether the proportions of very short and very long sleepers have increased over the same period, which may be of greater relevance for public health.
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA11.10302
Abstract: To determine whether sleep duration of Australian adults has declined over recent years. Analysis of nationally representative data from repeated cross-sectional time-use surveys conducted in 1992, 1997 and 2006. Private households in Australia. Respondents aged 15 years and over (N = 21 195) who completed time-use diaries over two consecutive days. Change in sleep duration by sociodemographic group. Mean sleep duration was 8 h 20 min in 1992, 8 h 33 min in 1997, and 8 h 30 min in 2006 (SEM for all years, 1 min). After adjustment for s ling during weekends and different seasons, there was no significant change in sleep duration from 1992 to 2006 (adjusted difference, 2 min 95% CI, -2 to 5 min P = 0.33). The only significant decreases in sleep duration were observed in people aged 65 years and over (adjusted difference, 12 min 95% CI, 4-19 min P < 0.001), people with no income (adjusted difference, 17 min 95% CI, 7-27 min P = 0.001) and male carers (adjusted difference, 31 min 95% CI, 9-53 min P = 0.002), although people in these groups reported over 8 h sleep on average. Most Australian adults were not sleeping less in 2006 than they did in 1992. Public health concerns over declining sleep duration do not appear to be warranted. Investigation of possible changes in quality of sleep is required.
Publisher: CSIRO Publishing
Date: 05-04-2022
DOI: 10.1071/AH21156
Abstract: Objective Parliamentary inquiries into health-related issues empower everyday Australians to contribute to the development and reform of health policy. We explored how patient and family/carers concerns are translated by this process, using a less well-known disease, narcolepsy, as an ex le. Methods Written submissions made to the Parliamentary Inquiry into Sleep Health Awareness in Australia 2018 by self-identified patients or family/carers with narcolepsy (n = 13) were extracted and thematically analysed using the Framework Approach. Each submission was systematically coded and abstracted into emergent themes before being evaluated against the final policy recommendations. Results Although patients and their family/carers prioritised issues that affected their daily lives (i.e. mental health sequela, workplace accommodations), the policy recommendations in the report focused mainly on issues of healthcare infrastructure, funding and engagement. Our analysis highlighted several barriers that patients and their family/carers face when contributing to this part of healthcare policy formation. Conclusions Our findings suggest that the parliamentary inquiry process in its current form is not an ideal vehicle by which patients and family/carers can contribute or influence healthcare policy. Despite calling for submissions from patients and their family/carers, the final report and subsequent health policy recommendations made by the inquiry do not appear to be patient-centric or reflective of the submissions written by these stakeholders. Increased transparency, development of processes to balance stakeholder priorities and improved accessibility for stakeholders to participate are needed if health-related parliamentary inquiries are to produce healthcare policy that ultimately meets the needs of patients and family/carers.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Wiley
Date: 04-08-2017
DOI: 10.1111/AJO.12674
Abstract: As age is not modifiable, pregnancy risk information based on age alone is unhelpful for older women. To determine severe morbidity/mortality rates for women aged ≥35 years according to maternal profile based on parity, pre-existing medical conditions and prior pregnancy complications, and to assess the independent contribution of age. Population-based record-linkage study using NSW hospitalisation and birth records 2006-2012. Maternal and perinatal mortality/morbidity were assessed for non-anomalous singleton births to women aged ≥35 years. For 117 357 pregnancies among 99 375 women aged ≥35 years, the median age at delivery was 37 years (range 35-56 years), including: 35 652 (30.4%) multiparae without pre-existing medical or obstetric complications, 33,058 (28.2%) nulliparae without pre-existing medical conditions and 30 325 (25.8%) multiparae with prior pregnancy complications. Maternal and perinatal mortality/morbidity varied by maternal profile with ranges of 0.9-3.5% and 2.4-11.9%, respectively. For nulliparae, each five-year increase in age did not contribute significantly to maternal risk after controlling for medical conditions (adjustedodds ratio 1.08, 95% CI 0.93-1.25), but did confer perinatal risk (1.14 1.05-1.25). For multiparae, each five-year increase in age beyond 35 years was independently associated with adverse maternal (1.23 1.09-1.39) and perinatal outcomes (1.23 1.09-1.39). For women aged ≥35 years, presence of medical conditions conferred a greater risk for morbidity/mortality than age itself. For multiparous women, the effects of medical and obstetric history were additive. The contribution of maternal age to adverse outcomes in pregnancies without significant medical and obstetric history is modest.
Publisher: Informa UK Limited
Date: 21-09-2020
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA10.10976
Abstract: Patients with cardiovascular disease may be especially prone to the adverse effects of complementary medicines.
Publisher: Wiley
Date: 07-11-2022
DOI: 10.1111/JSR.13772
Abstract: Social jetlag is the discrepancy between socially determined sleep timing on workdays and biologically determined sleep timing on days free of social obligation. Poor circadian timing of sleep may worsen sleep quality and increase daytime sleepiness in obstructive sleep apnea (OSA). We analysed de‐identified data from 2,061 participants (75.2% male, mean [SD] age 48.6 [13.4] years) who completed Sleep Apnea Global Interdisciplinary Consortium (SAGIC) research questionnaires and underwent polysomnography at 11 international sleep clinic sites. Social jetlag was calculated as the absolute difference in the midpoints of sleep between weekdays and weekends. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Linear regression analyses were performed to estimate the association between social jetlag and daytime sleepiness, with consideration of age, sex, body mass index, ethnicity, insomnia, alcohol consumption, and habitual sleep duration as confounders. Of the participants, 61.5% had h of social jetlag, 27.5% had 1 to h, and 11.1% had ≥2 h. Compared to those with h of social jetlag, those with ≥2 h of social jetlag had 2.07 points higher ESS (95% confidence interval [CI] 0.77–3.38, p = 0.002), and those with 1 to h of social jetlag had 0.80 points higher ESS (95% CI 0.04–1.55, p = 0.04) after adjustment for potential confounding. Interaction with OSA severity was observed social jetlag appeared to have the greatest effect on daytime sleepiness in mild OSA. As social jetlag exacerbates daytime sleepiness in OSA, improving sleep timing may be a simple but novel therapeutic target for reducing the impact of OSA.
Publisher: Wiley
Date: 25-02-2022
DOI: 10.1002/HPJA.462
Abstract: To describe the need for high school sleep education from the perspective of undergraduate university students. Undergraduate students who completed an online course on sleep and circadian health were surveyed 6 months after course completion. Students were asked whether a similar course would have benefited them as high school students, and about the need for sleep education in high schools. Thematic analysis of this qualitative data was carried out. Eighty‐nine students who had attended 71 unique high schools provided responses. Eight‐one per cent thought they would have benefitted from a similar course during high school and identified domains of sleep knowledge particularly relevant to high school students. They cited environmental barriers to healthy sleep present during high school and believed that sleep education could improve students’ lifestyle, sleep and performance. Nineteen per cent of students said they would not have benefited, because they perceived sleeping patterns during high school to be nonmodifiable or believed that previous sleep education was sufficient. Of the respondents who did not think students would benefit, 53% would still tell their high school principal that there was a need for sleep education. The findings support the need for engaging sleep education for high school students. Future studies should examine the perspectives of students in high school directly, rather than undergraduate students who have already shown an interest in sleep health. Sleep health is missing from the Australian school curriculum. Online courses may be an engaging method of promoting sleep and circadian health to high school students.
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: Informa UK Limited
Date: 09-11-2022
DOI: 10.1080/14760584.2022.2143350
Abstract: Identifying health behaviors associated with adverse events following immunization (AEFI) could identify intervention targets for AEFI prevention. University employees receiving an influenza vaccination (n = 1301) completed a series of online surveys for health behaviors including sleep, exercise, dietary intake, and smoking habits, and emotional state (baseline), and for indications of AEFI (three days post-vaccination) and influenza-like illness (ILI) symptoms (fortnightly follow-up for 4 months). 29.9% of participants reported an AEFI and 46.0% reported experiencing ILI during follow-up. Multivariate logistic regression revealed usual sleep duration was associated with AEFI (odds ratio 1.20, 95% confidence interval 1.03-1.41), increasing with each hour of sleep. ILI was associated with reporting AEFI (1.70, 1.24-2.33), increasing BMI (1.03, 1.00-1.06) and survey response frequency (1.13, 1.04-1.22), and decreased with better usual sleep quality (0.96, 0.92-1.00) and with increasing age (0.98, 0.96-1.00). Sex stratification revealed no significant predictors of AEFI for either sex in women, experiencing AEFI increased likelihood of ILI (1.88, 1.25-2.85) and in men, survey completion frequency increased ILI likelihood (1.19, 1.05-1.36). Our study suggests modifying health behaviors would not alter AEFI risk and reactogenicity may signal weaker immunogenicity but confirmation through objective measures is warranted.
Publisher: Springer Science and Business Media LLC
Date: 28-09-2023
Publisher: Mary Ann Liebert Inc
Date: 02-0012
Abstract: Disclosure of personal information is believed to be more frequent in online compared to offline communication. However, this assumption is both theoretically and empirically contested. This systematic review examined existing research comparing online and offline self-disclosure to ascertain the evidence for current theories of online communication. Studies that compared online and offline disclosures in dyadic interactions were included for review. Contrary to expectations, disclosure was not consistently found to be greater in online contexts. Factors such as the relationship between the communicators, the specific mode of communication, and the context of the interaction appear to moderate the degree of disclosure. In relation to the theories of online communication, there is support for each theory. It is argued that the overlapping predictions of each theory and the current state of empirical research highlights a need for an overarching theory of communication that can account for disclosure in both online and offline interactions.
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1111/J.1753-6405.2012.00845.X
Abstract: To determine the extent to which insomnia poses an independent burden on in idual function and healthcare use in Australia. Cross-sectional data from 8,841 respondents and representative of the Australian population aged 16 to 85 in the 2007 National Mental Health and Wellbeing Survey were analysed. Insomnia was defined as 'sleeping only in short bursts and being awake most of the night' during the past week. This measure was validated against common epidemiological indicators of insomnia. Associations between insomnia, disability and healthcare consumption were explored using multivariate logistic regression. Insomnia was reported by 5.6% of adults and was associated with older age, female gender, pain and psychological distress. Controlling for these and other a priori confounders, insomnia was associated with greater odds of (Adjusted Odds Ratio 95% CI): disability days (1.62 1.20-2.18), difficulties in daily activities (1.60 1.10-2.31), life dissatisfaction (2.34 1.11-4.93), use of sleep medication (1.78 1.12-2.82) and a higher number of visits to general practitioners (1.57 1.06-2.33). Insomnia was not significantly associated with the use of medications for mental health (1.17 0.82-1.67), hospital admissions (1.31 0.82-1.67), the use of complementary and alternative medicine (1.10 0.73-1.67) or unmet need for healthcare (1.22 0.84-1.77). One in twenty adult Australians experience a level of insomnia that is independently associated with impairments in functioning and increased use of healthcare. Increasing public and clinician awareness of the impact of insomnia, and promotion of available insomnia treatments may be warranted.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 26-04-2012
Abstract: Complementary and alternative medicine (CAM) may offer benefits as well as risks to people with cardiovascular disease. Understanding the prevalence and the nature of CAM use will encourage beneficial CAM therapies, prevent potential herb-drug interactions and foster communication between patients and physicians. A systematic search of eight bibliographic databases was conducted for studies that investigated CAM use in patients with cardiovascular diseases. Two independent reviewers selected relevant abstracts and evaluated the quality of included studies. Twenty-seven studies were included. Prevalence of CAM use in cardiac patients ranged from 4% - 61%. Biologically-based therapies usage ranged from 22% to 68%. Herbal medicines were used by between 2% and 46%. A large proportion of patients did not inform medical practitioners about their CAM use and up to 90% of treating physicians did not discuss CAM use with their patients. CAM use in patients with cardiovascular disease appears common. The findings suggest that the effects of CAM on medical management of cardiovascular disease may be overlooked and that patient-physician communication need to be strengthened.
Publisher: Wiley
Date: 09-02-2017
DOI: 10.1111/AOGS.13086
Abstract: There is a lack of information on long-term outcomes by mode of delivery for term breech presentation. We aimed to compare childhood mortality, cerebral palsy, hospitalizations, developmental, and educational outcomes associated with intended vaginal breech birth (VBB) with planned cesarean section. Population birth and hospital records from New South Wales, Australia, were used to identify women with non-anomalous pregnancies eligible for VBB during 2001-2012. Intended mode of delivery was inferred from labor onset and management. Death, hospital, and education records were used for follow up until 2014. Cox proportional hazards regression and modified Poisson regression were used for analysis. Of 15 281 women considered eligible for VBB, 7.7% intended VBB, 74.2% planned cesarean section, and intention was uncertain for 18.1%. Intended VBB did not differ from planned cesarean section on infant mortality (Fisher's exact p = 0.55), childhood mortality (Fisher's exact p = 0.50), cerebral palsy (Fisher's exact p = 1.00), hospitalization in the first year of life [adjusted hazard ratio (HR) 1.04 95% CI 0.90-1.20], hospitalization between the first and sixth birthdays (HR 0.92 95% CI 0.82-1.04), being developmentally vulnerable [adjusted relative risk (RR) 1.22 95% CI 0.48-1.69] or having special needs status (RR 0.95 95% CI 0.48-1.88) when aged 4-6, or scoring more than 1 standard deviation below the mean on tests of reading (RR 1.10 95% CI 0.87-1.40) and numeracy (RR 1.04 95% CI 0.81-1.34) when aged 7-9. Planned VBB confers no additional risks for child health, development or educational achievement compared with planned cesarean section.
Publisher: Hindawi Limited
Date: 2011
DOI: 10.1155/2011/632829
Abstract: Systematic search of bibliographic databases was conducted to describe the prevalence of dietary supplement use in cardiac patients. Included for review were studies that investigated supplement use in people with cardiovascular risk factors or proven cardiovascular disease. Databases searched were Medline, EMBASE, CINAHL, AMED, Meditext, H& S and IPA. Over five hundred articles were retrieved and twenty studies met the criteria for this review. Dietary supplements were taken by a median 36% (interquartile range: 26–42%) of cardiac patients 36% (IQR 18–43%) reported taking a vitamin/mineral supplement and 12% (IQR 7–21%) used herbal supplements. Many users indicated that supplements were taken specifically for heart health and 16–64% of users reported using supplements alongside prescription medications. However 39–95% of treating physicians were unaware of patients’ supplement use. Dietary supplement use in patients with cardiovascular disease appears common, as does the concurrent use of supplements with prescription medicines. This information is often not communicated to doctors and treating physicians may need to be more proactive in asking about supplement use.
No related organisations have been discovered for Yu Sun Bin.
Start Date: 07-2023
End Date: 06-2026
Amount: $790,276.00
Funder: Australian Research Council
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