Differences in anxiety, insomnia, and trauma symptoms in wildfire survivors from australia, canada, and the United States of America
- Authors: Isaac, Fadia , Toukhsati, Samia , Klein, Britt , Di Benedetto, Mirella , Kennedy, Gerard
- Date: 2024
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 21, no. 1 (2024), p.
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- Description: Many survivors of wildfires report elevated levels of psychological distress following the trauma of wildfires. However, there is only limited research on the effects of wildfires on mental health. This study examined differences in anxiety, depression, insomnia, sleep quality, nightmares, and post-traumatic stress disorder (PTSD) symptoms following wildfires in Australia, Canada, and the United States of America (USA). One hundred and twenty-six participants from Australia, Canada, and the USA completed an online survey. The sample included 102 (81%) women, 23 (18.3%) men, and one non-binary (0.8%) individual. Participants were aged between 20 and 92 years (M age = 52 years, SD = 14.4). They completed a demographic questionnaire, the Disturbing Dream and Nightmare Severity Index (DDNSI), Generalized Anxiety Disorder Questionnaire (GAD-7), the Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist (PCL-5). Results showed that participants from the USA scored significantly higher on the GAD-7 (p = 0.009), ISI (p = 0.003), and PCL-5 (p = 0.021) than participants from Australia and Canada. The current findings suggest a need for more international collaboration to reduce the severity of mental health conditions in Australia, Canada, and the USA. © 2023 by the authors.
Acupuncture for comorbid depression and insomnia in perimenopause : a feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial
- Authors: Zhao, Fei , Zheng, Zhen , Fu, Qiang-Qiang , Conduit, Russell , Xu, Hong , Wang, Hui-ru , Huang, Yu-Ling , Jiang, Ting , Zhang, Wen-Jing , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
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- Description: Background and objective: Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods: Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results: Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion: Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture. Copyright © 2023 Zhao, Zheng, Fu, Conduit, Xu, Wang, Huang, Jiang, Zhang and Kennedy.
Cognitive behavioral therapy-based treatments for insomnia and nightmares in adults with trauma symptoms : a systematic review
- Authors: Isaac, Fadia , Toukhsati, Samia , DiBenedetto, Mirella , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Current Psychology Vol. 42, no. 27 (2023), p. 23495-23505
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Development of a novel behavioral sleep medicine education workshop designed to increase trainee psychologists’ knowledge and skills in insomnia management
- Authors: Meaklim, Hailey , Rehm, Imogen , Junge, Moira , Monfries, Melissa , Kennedy, Gerard , Bucks, Romola , Meltzer, Lisa , Jackson, Melinda
- Date: 2023
- Type: Text , Journal article
- Relation: Behavioral Sleep Medicine Vol. 21, no. 6 (2023), p. 787-801
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- Description: Objectives: Despite the clear influence of poor sleep on mental health, sleep education has been neglected in psychology training programs. Here, we develop a novel behavioral sleep medicine (BSM) education workshop, the Sleep Psychology Workshop, designed for integration within graduate psychology programs. We also examined the potential efficacy and acceptability of the workshop to upskill trainee psychologists in sleep and insomnia management. Methods: The Sleep Psychology Workshop was developed using a modified Delphi Method. Eleven trainee psychologists completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the workshop, delivered as three, two-hour lectures (total of six hours). Sleep knowledge, attitudes, and practice assessments were completed pre-and post-intervention using the GradPsyKAPS Questionnaire. A focus group and 6-month follow-up survey captured feedback and qualitative data. Results: Trainees’ sleep knowledge quiz scores (% correct) increased from 60% to 79% pre- to post-workshop (p =.002). Trainees’ self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep disturbances increased, along with their confidence to manage insomnia (all p < .02). Participant feedback was positive, with 91% of trainees rating the workshop as “excellent” and qualitative data highlighting trainees developing practical skills in BSM. Six months post-intervention, 100% of trainees endorsed routinely asking their clients about sleep, with 82% reporting improvements in their own sleep. Conclusions: The Sleep Psychology Workshop is a potentially effective and acceptable introductory BSM education program for trainee psychologists, ready for integration within the graduate psychology curriculum. © 2023 Taylor & Francis Group, LLC.
Disseminating sleep education to graduate psychology programs online : a knowledge translation study to improve the management of insomnia
- Authors: Meaklim, Hailey , Meltzer, Lisa , Rehm, Imogen , Junge, Moira , Monfries, Melissa , Kennedy, Gerard , Bucks, Romola , Graco, Marnie , Jackson, Melinda
- Date: 2023
- Type: Text , Journal article
- Relation: Sleep Vol. 46, no. 10 (2023), p.
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- Description: Study Objectives: Despite the negative impact of poor sleep on mental health, evidence-based insomnia management guidelines have not been translated into routine mental healthcare. Here, we evaluate a state-wide knowledge translation effort to disseminate sleep and insomnia education to graduate psychology programs online using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) evaluation framework. Methods: Using a non-randomized waitlist control design, graduate psychology students attended a validated 6-hour online sleep education workshop delivered live as part of their graduate psychology program in Victoria, Australia. Sleep knowledge, attitudes, and practice assessments were conducted pre- and post-program, with long-term feedback collected at 12 months. Results: Seven out of ten graduate psychology programs adopted the workshop (adoption rate = 70%). The workshop reached 313 graduate students, with a research participation rate of 81%. The workshop was effective at improving students’ sleep knowledge and self-efficacy to manage sleep disturbances using cognitive behavioral therapy for insomnia (CBT-I), compared to the waitlist control with medium-to-large effect sizes (all p < .001). Implementation feedback was positive, with 96% of students rating the workshop as very good-to-excellent. Twelve-month maintenance data demonstrated that 83% of students had used the sleep knowledge/skills learned in the workshop in their clinical practice. However, more practical training is required to achieve CBT-I competency. Conclusions: Online sleep education workshops can be scaled to deliver cost-effective foundational sleep training to graduate psychology students. This workshop will accelerate the translation of insomnia management guidelines into psychology practice to improve sleep and mental health outcomes nationwide. © The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society.
Identifying complementary and alternative medicine recommendations for anxiety treatment and care : a systematic review and critical assessment of comprehensive clinical practice guidelines
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Xu, Peijie , Conduit, Russell , Wang, Yan-Mei , Zhang, Wen-Jing , Wang, Hui-Ru , Yue, Li-Ping , Huang, Yu-Ling , Wang, Yin , Xu, Yan , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
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- Description: Background: Clinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs. Methods: Seven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively. Results: Ten CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind–body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John’s wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as “unclear, unambiguous, or uncertain”. No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism. Conclusion: Available guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694. Copyright © 2023 Zhao, Kennedy, Xu, Conduit, Wang, Zhang, Wang, Yue, Huang, Wang, Xu, Fu and Zheng.
Identifying complementary and alternative medicine recommendations for insomnia treatment and care : a systematic review and critical assessment of comprehensive clinical practice guidelines
- Authors: Zhao, Fei-Yi. Y. , Xu, Peijie , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Wang, Yan-Mei , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
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- Description: Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155. Copyright © 2023 Zhao, Xu, Kennedy, Conduit, Zhang, Wang, Fu and Zheng.
Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities
- Authors: Zhao, Fei-Yi , Xu, Peijie , Zheng, Zhen , Conduit, Russell , Xu, Yan , Yue, Li-Ping , Wang, Hui-Ru , Wang, Yan-Mei , Li, Yuan-Xin , Li, Chun-Yan , Zhang, Wen-Jing , Fu, Qiang-Qiang , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
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- Description: Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body–mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. “Inflammation,” “rating scale” and “psychological stress” were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body–mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced. Copyright © 2023 Zhao, Xu, Zheng, Conduit, Xu, Yue, Wang, Wang, Li, Li, Zhang, Fu and Kennedy.
Policies and initiatives/programs that promote health and self-care in asylum seekers living in high income countries : a narrative review
- Authors: Nkhoma, Gloria , Lim, Chiao , Kennedy, Gerard , Stupans, Ieva
- Date: 2023
- Type: Text , Journal article , Review
- Relation: International Journal of Human Rights in Healthcare Vol. 16, no. 4 (2023), p. 327-340
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- Description: Purpose: This paper aims to identify health-care entitlements that exist for asylum seekers with chronic non-communicable disease (CNCD) that promote their health and self-care, and to explore health policies, initiatives and programmes with the potential to foster self-care in this populace. Design/methodology/approach: Narrative review of literature conducted by searching EMBASE, CINAHL, WEB OF SCIENCE and PSYCINFO databases for articles published from 2010 to 2021. Included articles focussed on policies, programmes or initiatives with the potential to promote health in adult asylum seekers residing in high-income countries. Studies inclusive of other migrant groups such as undocumented migrants and those with mental health conditions were excluded. Eleven studies fitting the inclusion criteria were assessed against the study objectives. Findings: Free access to health-care services and pharmaceutical products, free access to food banks and supermarket model food banks, English and cooking lessons, community integration training sessions and culturally competent health-care workers were found to promote health and self-care. There is little research on self-care and health promotion in adult asylum seekers with CNCD. CNCDs represent high burden of disease in asylum seekers but have a low priority in reported research. Originality/value: This narrative review is the first to explicitly focus on asylum seekers in high-income countries with CNCD, excluding mental health conditions, and to explore initiatives, programmes and policies that enhance health promotion to facilitate self-care in this populace. © 2021, Emerald Publishing Limited.
Teaching and learning interventions designed to improve cultural competence in health profession students : a systematic review
- Authors: Nkhoma, Gloria , Lim, Chiao , Kennedy, Gerard , Stupans, Ieva
- Date: 2023
- Type: Text , Journal article
- Relation: The Internet Journal of Allied Health Sciences and Practice Vol. 21, no. 3 (2023), p.
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- Description: Purpose: Developing healthcare profession students’ cultural competency knowledge, skills and attributes is critical to meet the needs of culturally and linguistically diverse healthcare service consumers. The purpose of this systematic review was to identify effective cultural competence interventions for healthcare profession students. Methods: A systematic review of peer reviewed articles published from 2010-2021 using PRISMA guidelines was conducted by searching CINAHL, EMBASE, ERIC, PubMed, and Psych INFO databases. Article quality was assessed using the Evaluation Tool for Quantitative Research and Mixed Method Appraisal Tool. Results: The initial search identified 2,261 potentially relevant studies, 41 studies met the inclusion criteria in which intervention effectiveness was evaluated using a validated outcome measure pre- and post- intervention. Only one study used a non-self-report outcome measure. Out of the 41 studies, only eight studies employed randomisation in the method. Conclusion/Recommendations: This review evaluated effectiveness of cultural competence interventions and evaluation of the intervention using either self-report or non-self-report validated outcome measures at pre- and post-intervention exposure. Combining cultural competence teaching methods such as lectures with simulations, role-playing and community engagement with diverse populations enhanced cultural competence. Further studies are required to compare effective cultural competence teaching models and identify reliable non-self-report outcome measures to assess the effectiveness of interventions post-exposure. Comparing effective cultural competence teaching models that utilise reliable non-self-report outcome measures will be valuable for guiding the design of teaching and learning interventions directed towards cultural competence. Further research is also required to examine the duration of intervention efficacy and how to maintain efficacy post-intervention exposure. Findings from this review are important for designing and structuring of cultural competence curriculum for healthcare profession students and informing future research on cultural competence teaching. This review has identified that most evaluation tools and studies have been designed for the nursing discipline. There is need to design more cultural competence evaluation tools and studies for other healthcare disciplines such as pharmacy and physical therapy.
Teaching cultural competence to undergraduate pharmacy students using vignettes (case scenarios) as an innovative teaching intervention
- Authors: Nkhoma, Gloria , Lim, Chiao , Kennedy, Gerard , Stupans, Ieva
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Pharmacy Practice Vol. 31, no. 2 (2023), p. 225-229
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- Description: Objective: Cultural competence is instrumental in reducing health equities. Addressing cultural competence at higher education level in healthcare students lays a solid cultural competence foundation for professional practice. The use of vignettes as a teaching intervention was effective because it allowed the use of role-modelling in real-life situations. The study aimed to enhance cultural competence in undergraduate pharmacy students using a self-directed online interactive cultural competence module embedded with three vignettes (case scenarios). Method: This study was an exploratory longitudinal mixed method (survey and written feedback) study and used a convenience sample of 90 pharmacy students at an Australian University. Students' self-perceived transcultural self-efficacy was evaluated pre-and post-intervention using Jeffreys' Transcultural Self-Efficacy Tool (TSET) which is a validated outcome measure. Key findings: Vignettes were effective in teaching cultural competence as shown by significant (P < 0.0005) changes pre-to post-intervention in cognitive, practical and affective domains scores using TSET. The affective domain had the least positive mean score change. There was no significant association between any of the demographic factors such as age, gender or birthplace/parents' birthplace and changes in any of the three domains. Cronbach's alpha of >0.90 in all domains confirmed the test's internal consistency and reliability. Conclusions: The findings were indicative of the students' positive receptivity to learning cultural competence and that they had a well-developed understanding of cultural competence. Further research is needed to determine why most cultural competence teaching methods produce little or no meaningful change in enhancing the affective domain. © 2023 The Author(s). Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved.
The roles of depression, life control and affective distress on treatment attendance and perceived disability in chronic back pain sufferers throughout the duration of the condition
- Authors: Oraison, Humberto , Loton, Daniel , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 19 (2023), p.
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- Description: The aims of this study were to examine psychological factors that predict treatment seeking and disability over the total duration of experiencing back pain. A sample of 201 adults experiencing chronic back pain was recruited through health professionals and completed the Depression, Anxiety and Stress Scale (DASS), the Oswestry Back Pain Disability Questionnaire (ODQ), the McGill Pain Questionnaire (MPQ) and the life control and affective distress variables of the West Haven–Yale Multidimensional Pain Inventory (WHYMP), and participants disclosed the number of treatment sessions attended over the course of the illness. Depression, life control and affective distress were tested as indirect predictors of disability severity that were mediated by treatment attendance. Each unit increase in life control predicted attending nearly 30 more treatment sessions, each unit increase in affective distress predicted attending 16 fewer treatments and each unit increase in depression predicted 4 fewer treatments, together explaining 44% of variance in treatment seeking. The effects of life control and affective distress on disability were explained by treatment attendance, whereas depression retained a direct effect on disability. Treatment attendance had an effect on disability. The findings show that participants with lower life control and higher affective distress and depression had higher levels of pain and disability, in part due to due to their treatment-seeking behaviour. © 2023 by the authors.
Wearable obstacle avoidance electronic travel aids for blind and visually impaired individuals : a systematic review
- Authors: Xu, Peijie , Kennedy, Gerard , Zhao, Fei-Yi , Zhang, Wen-Jing , Van Schyndel, Ron
- Date: 2023
- Type: Text , Journal article
- Relation: IEEE Access Vol. 11, no. (2023), p. 66587-66613
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- Description: Background Wearable obstacle avoidance electronic travel aids (ETAs) have been developed to assist the safe displacement of blind and visually impaired individuals (BVIs) in indoor/outdoor spaces. This systematic review aimed to understand the strengths and weaknesses of existing ETAs in terms of hardware functionality, cost, and user experience. These elements may influence the usability of the ETAs and are valuable in guiding the development of superior ETAs in the future. Methods Formally published studies designing and developing the wearable obstacle avoidance ETAs were searched for from six databases from their inception to April 2023. The PRISMA 2020 and APISSER guidelines were followed. Results Eighty-nine studies were included for analysis, 41 of which were judged to be of moderate to high quality. Most wearable obstacle avoidance ETAs mainly depend on camera- and ultrasonic-based techniques to achieve perception of the environment. Acoustic feedback was the most common human-computer feedback form used by the ETAs. According to user experience, the efficacy and safety of the device was usually their primary concern. Conclusions Although many conceptualised ETAs have been designed to facilitate BVIs' independent navigation, most of these devices suffer from shortcomings. This is due to the nature and limitations of the various processors, environment detection techniques and human-computer feedback those ETAs are equipped with. Integrating multiple techniques and hardware into one ETA is a way to improve performance, but there is still a need to address the discomfort of wearing the device and the high-cost. Developing an applicable systematic review guideline along with a credible quality assessment tool for these types of studies is also required. © 2013 IEEE.
Association between cognitive dysfunction and nocturnal peaks of blood pressure estimated from pulse transit time in obstructive sleep apnoea
- Authors: Alomri, Ridwan , Kennedy, Gerard , Wali, Siraj , Alhejaili, Faris , Zelko, Matthew , Robinson, Stephen
- Date: 2022
- Type: Text , Journal article
- Relation: Sleep Medicine Vol. 90, no. (2022), p. 185-191
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- Description: Background: Obstructive sleep apnoea (OSA) is characterised by recurrent episodes of partial or complete cessation of breathing during sleep and an increased effort to breathe. Patients with untreated OSA exhibit cognitive impairment that is only partly accounted for by hypoxia and sleep disruption, suggesting that other factors remain to be identified. OSA can involve repeated spikes of nocturnal blood pressure because of increased activity of the sympathetic nervous system during sleep. While high resting blood pressure is associated with cognitive dysfunction, it is not yet known whether peaks in nocturnal blood pressure are associated with cognitive impairment in OSA. Methods: A cohort of patients participated in overnight polysomnographic studies at a major sleep laboratory to investigate whether nocturnal elevations in blood pressure are associated with cognitive dysfunction in OSA. Nocturnal pulse transit time was measured as a surrogate for arterial blood pressure during sleep. Results: Of the 75 patients, 12 had no obstructive sleep apnoea, 26 had mild OSA, 18 moderate, and 19 severe OSA. The results revealed that systolic blood pressure peaks were associated with OSA severity, while diastolic blood pressure peaks were not. Peaks of nocturnal systolic blood pressure were independently associated with poorer performance on a test of visuospatial function, but not with impairments on tests of sustained attention, reaction time or autobiographical memory. Conclusion: The present findings indicate nocturnal peaks of systolic blood pressure that are substantially higher than normal daytime values may contribute to visuospatial dysfunction in OSA. © 2022 Elsevier B.V.
Competencies and training of health professionals engaged in health coaching : a systematic review
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2022
- Type: Text , Journal article
- Relation: Chronic Illness Vol. 18, no. 1 (2022), p. 58-85
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- Description: Objective: A systematic review was undertaken in order to evaluate the competencies of primary healthcare professionals who are engaged with health coaching patients with chronic health conditions. Methods: The databases CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched to identify peer reviewed papers referring to competencies of health professionals engaged in health coaching. Results: Nine key competencies that health professionals met and which resulted in successful patient outcomes from health coaching were identified. Comparisons of the core health coaching competencies to the competencies for coaches established by the International Coaching Federation and European Mentoring and Coaching Council showed considerable overlap. However, the comparison also reiterated the need for competencies specific to health coaches to be made explicit. Discussion: Health coaching has been shown to improve the health outcomes in patients with chronic health conditions. As such, there is a need to build an evidenced-based competency framework specific to health coaches. At present, the lack of a competency framework on which to base health coach training could significantly impact the outcomes of patients receiving health coaching. Practical implications include improving regulation and quality of health coaching, and more importantly, the health outcomes of patients receiving the service. © The Author(s) 2020.
Does the national competency standards framework for pharmacists in Australia support the provision of behaviour change interventions?
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2022
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 33, no. 2 (2022), p. 480-487
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- Description: Issue addressed: Australian pharmacists are increasingly moving towards the provision of patient-centred professional pharmacy services for chronic disease management. Some of these services are targeted towards improving patients’ health and wellbeing through the facilitation of patient-driven health behaviour change. This paper investigates whether the provision of behaviour change interventions by Australian pharmacists is adequately underpinned by the current competency framework. Methods: The foundation and behaviour change competences within each of the domains in the generic health behaviour change competency framework (GHBC-CF), was mapped to the Australian pharmacist competency framework. Results: Although the Australian competency framework underpins most of the foundation and behaviour change competences of the GHB-CF required to undertake low-intensity interventions, for medium to high-intensity interventions four specific task-related competences need to be addressed. These are F12 ‘Ability to recognise barriers to and facilitators of implementing interventions’, BC4 ‘ability to agree on goals for the intervention’, BC5 ‘capacity to implement behaviour change models in a flexible but coherent manner’ and BC6 ‘capacity to select and skilfully apply most appropriate intervention method’. Conclusion: Additional training is necessary if pharmacists aspire to provide behaviour change interventions for chronic disease management, in particular those that are complex as they involve changes to multiple health behaviours. So what?: The identification of these gaps is critical and can potentially be addressed in postgraduate training programs and as pharmacy curricula are updated. © 2021 Australian Health Promotion Association.
Knowledge about, attitude toward, and practice of complementary and alternative medicine among nursing students : a systematic review of cross-sectional studies
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Cleary, Sonja , Conduit, Russell , Zhang, Wen-Jing , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 10, no. (2022), p.
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- Description: Background: The globally growing demand for complementary and alternative medicine (CAM) has attracted educators' attention to integrate CAM into conventional nursing programs. This systematic review aimed to understand the status quo of nursing students (NSs)' overall rated knowledge of, attitude/belief toward, and practice/previous use or experience (KAP) of CAM in surveys, given these factors may influence NSs' receptivity to CAM curricula, and may be of value in guiding the development of effective teaching strategies. Methods: Formally published cross-sectional quantitative studies investigating the primary outcome of KAP toward CAM by NSs were searched for from eight databases from their inception through to 28 April 2022. PRISMA 2020 guidelines were followed. Results: Twenty-six studies were included for analysis, 25 of which were judged to be of moderate to high quality. Despite limited and poorly informed knowledge of CAM therapies, the majority of NSs generally viewed them in a positive light. Furthermore, NSs usually reported an interest in further learning, and supported and welcomed the integration of CAM curricula, at least as elective modules, into existing nursing programs. Lack of evidence was perceived as a major barrier to the use or integration of CAM. Mass media and the internet were the main sources via which NSs access CAM information. Measurement of KAP in all included studies was via self-designed questionnaires/scales or adapted from previously developed questionnaires/scales. Conclusions: The need for integrating and strengthening CAM curricula into current nursing education is identified. Besides theoretical knowledge and matched clinical placement, skills training in literature searching and evidence-based practice are advised to be included in the curricula design. The experiential learning mode is strongly recommended for delivering specific CAM modalities. In addition, a standard instrumentation for determining NSs' KAP toward CAM should be designed and examined for use in different cultural settings. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=300602, identifier: PROSPERO CRD42022300602. Copyright © 2022 Zhao, Kennedy, Cleary, Conduit, Zhang, Fu and Zheng.
Psychological interventions to improve sleep in young adults : a systematic review and meta-analysis of randomized controlled trials
- Authors: Kodsi, Ali , Bullock, Ben , Kennedy, Gerard , Tirlea, Loredana
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Behavioral Sleep Medicine Vol. 20, no. 1 (2022), p. 125-142
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- Description: Introduction: The effects of impaired sleep on the wellbeing of young adults are profound, and the adverse outcomes for mental health are well documented in the research literature. Objective: This systematic review and meta-analysis aimed to identify, summarize, and synthesize the available evidence from randomized-controlled trials (RCTs) investigating psychological interventions aimed at improving sleep and related secondary outcomes such as anxiety and depression in healthy young adults. Method: Nine electronic databases (Cochrane Central Registry of Controlled Trials [CENTRAL], PubMed, Scopus, PsycNET, CINHAL, INFORMIT, Web of Science [Science and Social Citation Index], OpenSigle and EMBASE) were searched, returning 54 full-text papers for assessment, with 13 studies meeting inclusion criteria for the meta-analysis. Results: A random effects meta-analysis showed that the combined effect of all interventions was moderate (ES = −0.53, 95% CIs [- 0.69, −0.36], p < .01), reflecting the efficacy of psychological interventions at improving sleep scores at post-intervention. Subgroup analyses of individual interventions showed that cognitive-behavioral interventions improved sleep (ES = −0.67, 95% CIs [−0.77, −0.57], p <.01) and secondary outcomes for anxiety (ES = −0.35, 95% CIs [−0.56, −0.15], p <.01) and depression (ES = −0.41, 95% CIs [−0.70, −0.13], p <.01) at post-intervention. Conclusion: The results of the current review support the implementation of cognitive and behavioral interventions for sleep among young adults experiencing both sleep and comorbid mental health problems. © 2021 Taylor & Francis Group, LLC.
The health coaching competency gap – Analysis of pharmacist competency frameworks from Australia, Canada, New Zealand the United Kingdom and the United States of America
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Leva
- Date: 2022
- Type: Text , Journal article
- Relation: Health and Social Care in the Community Vol. 30, no. 4 (2022), p. e921-e932
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- Description: The traditional competency frameworks for coaches, the International Coaching Federation (ICF) and the European Mentoring and Coaching Council (EMCC) disregard the differences in expertise required among the diverse professions that may provide coaching. A recent systematic review has identified competencies specific to health professionals who health coach. There are increasing workload pressures in primary care; pharmacists can potentially shift to the greater provision of health promotion services, such as health coaching. The provision of such services needs to be underpinned by competency frameworks, which support the role of pharmacists as health coaches. This analysis identifies the competency gaps for pharmacists if they are to take on the role of health coaching. The enabling competencies of health coaches were compared to the competency frameworks of pharmacists from Australia (AUS), Canada (CAN), New Zealand (NZ), the United Kingdom (UK) and the United States of America (USA). Correlations between the international pharmacist competency frameworks and the competencies enabling health coaching showed that entry to practice pharmacists from AUS, CAN and NZ all require training enabling the health coaching competency ‘demonstrates confidence’, whereas competency frameworks for pharmacists from both the UK and the USA included all competencies required to health coach. Although pharmacists from the countries examined had most of the competencies required to health coach, gaps within the international pharmacist competency frameworks were apparent, university curricula addressing these gaps would equip entry to practice pharmacists with the knowledge and understanding to confidently provide emerging professional pharmacy services such as health coaching. © 2021 John Wiley & Sons Ltd.
The importance of setting and therapeutic relationships when delivering chiropractic care to those living with disadvantage
- Authors: Marthick-Hone, Dan , Doyle, Aunty , Kennedy, Gerard , Vindigni, Dein , Polus, Barbara
- Date: 2022
- Type: Text , Journal article
- Relation: Chiropractic and Manual Therapies Vol. 30, no. 1 (2022), p.
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- Description: Background: Chiropractic is a mostly privatised health profession within Australia, with people experiencing disadvantage typically having limited access due to financial barriers. However, some universities within Australia offer community outreach clinics where students provide chiropractic care to people living with disadvantage. This demographic experiences higher rates of chronic conditions including musculoskeletal complaints and requires subsidisation to access privatised care. This need also offers opportunity for the chiropractic profession to work within community healthcare teams. A mixed-methods observational study was used to investigate how the unique setting of a student chiropractic community clinic may influence the experience and outcomes of those who attend. Methods: Three patient-reported outcome measures (PROMs) investigated client outcomes: Measure Yourself Medical Outcome Profile (MYMOP); European Five Domain Five Level Quality of Life Questionnaire (EQ-5D-5L); and the Patient Enablement Instrument. The PROMs data were analysed descriptively and inferentially. Interviews were conducted with clients who had received chiropractic care, chiropractic students, clinical supervisors and staff of the centre. Interview data were coded using thematic analysis, and themes were formed using Bronfenbrenner’s socio-ecological systems framework and non-participant observations. Results: Thirty-seven participants completed baseline PROMs and 17 completed follow-ups after four treatments. Seventy-two percent of participants nominated their primary complaint as chronic. Significant change was noted in general health and wellbeing for the MYMOP, pain and disability for the EQ-5D-5L and index scores for the EQ-5D-5L suggested improved health and wellbeing. Most clients experienced higher levels of enablement post treatment. Twelve participants were interviewed (four were clients), with five themes emerging from the interview data. Clients reported their lived experiences impacted their health problems and attending the clinic offered benefits beyond improvement of pain and disability. Conclusions: Interview data suggested that these benefits were due to a combination of therapy, the setting and the relationships formed within that setting. Complementing this, PROM data suggested clients experienced better levels of health and wellbeing and decreased levels of pain and disability. Findings indicated that people who experienced disadvantage may receive broader benefits from attending community centres offering chiropractic care. Services such as chiropractic may be complementary in meeting the healthcare needs of those experiencing disadvantage. © 2022, The Author(s).