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A systemic review of the impact of wildfires on sleep disturbances

- Isaac, Fadia, Toukhsati, Samia, Benedetto, Mirella, Kennedy, Gerard

Authors: Isaac, Fadia , Toukhsati, Samia , Benedetto, Mirella , Kennedy, Gerard
Date: 2021
Type: Text , Journal article , Review
Relation: International Journal of Environmental Research and Public Health Vol. 18, no. 19 (2021), p.
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Description: Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compro-mise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings per-taining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63–72.5%) and nightmares (ranging between 33.3–46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associa-tions between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Anhedonia and anergia predict mortality in older Australians living in residential aged care

- Greenfield, L., Mathews, Stephanie, Toukhsati, Samia

Authors: Greenfield, L. , Mathews, Stephanie , Toukhsati, Samia
Date: 2022
Type: Text , Journal article
Relation: Aging and Mental Health Vol. 26, no. 3 (2022), p. 614-622
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Description: Objectives: Depression is common in older adults and is linked to morbidity and mortality. The aim of this study was to investigate whether specific symptoms of depression (dysphoria, anhedonia and anergia) predicted mortality in older Australian Aged Care residents. Methods: Eighty older adults (M = 83.16 ± 7.14) without cognitive impairment residing in 14 Residential Aged Care facilities located in Melbourne, Australia, completed the 15-item Geriatric Depression Scale—Short Form (GDS-15) and the Standardized Mini Mental State Examination. Residential Aged Care facilities provided the primary end-point of all-cause mortality at follow-up (M = 5.4 years ± 0.1). Results: Univariate Kaplan-Meier survival curves and Cox Proportional Hazards regression analyses were used to evaluate whether symptoms of depression predicted all-cause mortality, with known prognostic factors controlled. The results indicated that anhedonia (Hazard Ratio = 2.931 [95% CI 1.278–6.722], p =.011) and anergia (Hazard Ratio = 2.783 [95% CI 1.065–7.276], p =.037) were associated with almost a threefold increased risk of mortality in older adults living in RAC in adjusted analyses. Dysphoria did not predict mortality. Conclusions: These findings advance understanding of the mortality risks of anhedonia and anergia in an understudied population. Symptoms of anhedonia and anergia should be targeted for screening in older adults living in Aged Care to increase the detection and potential for referral to treatment for depressive presentation. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Animal Extinctions

- Toukhsati, Samia

Authors: Toukhsati, Samia
Date: 2017
Type: Text , Book chapter
Relation: Animals and Human Society Chapter 21 p. 499-518
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Description: Extinctions refer to the death of a single or multiple species (or taxon) and are common in the history of life on this planet. Using the fossil record, it has been estimated that 99.9% of the species that existed on earth is now extinct. Extinctions occur when a species fails to meet or adapt to changing environmental forces (such as global warming or cooling, habitat loss, destruction, or fragmentation) or when species origination is low, creating ecological niches for new, better adapted, species. This process of “background” extinction and new species evolution is natural, occurs continuously, and describes the way life diversified and radiated on this planet. However, when extinctions involve vast numbers of species and appear to occur around the same time in many different regions, as may be the case in modern times, they are termed “mass extinctions”; these are much less common, but greatly reduce species diversity. There is much debate and little consensus as to the cause and timescale of mass extinctions, generally referred to as the “Big Five” extinction events, which mark the point of transition to new geological epochs. This chapter will focus on the modern-day Holocene–Anthropocene extinction, which attributes the possible loss of up to 58,000 species per year to human activities.

Animals and Human Society

- Scanes, Colin, Toukhsati, Samia

Authors: Scanes, Colin , Toukhsati, Samia
Date: 2017
Type: Text , Book
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Description: Animals and Human Society provides a solid, scientific, research-based background to advance understanding of how animals impact humans. Animals have had profound effects on people from the earliest times, ranging from zoonotic diseases, to the global impact of livestock, poultry and fish production, to the influences of human-associated animals on the environment (on extinctions, air and water pollution, greenhouse gases, etc.), to the importance of animals in human evolution and hunter -gatherer communities.

Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure

- Toukhsati, Samia, Mathews, Stephanie, Sheed, A., Freijah, Isabella, Moncur, L., Cropper, P, Ha, F., Hare, David

Authors: Toukhsati, Samia , Mathews, Stephanie , Sheed, A. , Freijah, Isabella , Moncur, L. , Cropper, P , Ha, F. , Hare, David
Date: 2020
Type: Text , Journal article
Relation: European Journal of Cardiovascular Nursing Vol. 19, no. 2 (2020), p.165-171
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Description: Background: Low confidence to exercise is a barrier to engaging in exercise in heart failure patients. Participating in low to moderate intensity exercise, such as the six-minute walk test, may increase exercise confidence. Aim: To compare the effects of a six-minute walk test with an educational control condition on exercise confidence in heart failure patients. Methods: This was a prospective, quasi-experimental design whereby consecutive adult patients attending an out-patient heart failure clinic completed the Exercise Confidence Scale prior to and following involvement in the six-minute walk test or an educational control condition. Results: Using a matched pairs, mixed model design (n=60; 87% male; Mage=58.87±13.16), we identified a significantly greater improvement in Total exercise confidence (F(1,54)=4.63, p=0.036, partial η2=0.079) and Running confidence (F(1,57)=4.21, p=0. 045, partial η2=0.069) following the six-minute walk test compared to the educational control condition. These benefits were also observed after adjustment for age, gender, functional class and depression. Conclusion: Heart failure patients who completed a six-minute walk test reported greater improvement in exercise confidence than those who read an educational booklet for 10 min. The findings suggest that the six-minute walk test may be used as a clinical tool to improve exercise confidence. Future research should test these results under randomized conditions and examine whether improvements in exercise confidence translate to greater engagement in exercise behavior. © The European Society of Cardiology 2019.

Higher long-term adherence to statins in rural patients at high atherosclerotic risk

- Peverelle, Matthew, Baradi, Arul, Paleri, Sarang, Lee, Yun, Sultani, Rohullah, Toukhsati, Samia, Hare, David, Janus, Edward, Wilson, Andrew

Authors: Peverelle, Matthew , Baradi, Arul , Paleri, Sarang , Lee, Yun , Sultani, Rohullah , Toukhsati, Samia , Hare, David , Janus, Edward , Wilson, Andrew
Date: 2019
Type: Text , Journal article
Relation: Journal of Clinical Lipidology Vol. 13, no. 1 (2019), p. 163-169
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Description: Background: Rural patients with atherosclerotic cardiovascular disease (ASCVD) experience greater cardiovascular morbidity and mortality than their urban counterparts. Statin therapy is a key component of ASCVD treatment. The extent to which there may be regional differences in long-term adherence to statins is unknown. Objective: To assess long-term rates of adherence to statins in a high-risk ASCVD cohort, and whether regional differences exist between rural and urban patients. Methods: Follow-up was conducted in patients who underwent coronary angiography at a single tertiary center between 2009 and 2013. Adherence was defined as consumption of prescribed statin ≥6 days per week. Patients were divided into remoteness areas (RAs), classified as RA1 (major city), RA2 (inner regional), and RA3 (outer regional) based on the Australian Standard Geographical Classification. Results: Five hundred twenty-five patients (69% male, mean age 64 ± 11 years) were followed-up after a median of 5.3 years. Baseline characteristics were similar between RAs. Overall adherence was 83%; however, rural patients were significantly more adherent to their statin therapy (80% in RA1, 83% in RA2, and 93% in RA3, P =.04). Living in RA3 independently predicted greater statin adherence than living in RA1 (odds ratio: 2.75, 95% CI: 1.1–7.8, P =.03). All-cause mortality was significantly higher in RA3 than other regional areas (6% RA1, 12% RA2, and 18% RA3, P =.01). Conclusions: Despite higher all-cause mortality, rural patients with ASCVD demonstrate significantly greater long-term adherence to statins than urban patients. Other factors, such as reduced access to health care and delayed diagnosis may explain the gap in outcomes between rural and urban patients.

Screening, referral and treatment of depression by Australian cardiologists

- Hare, David, Stewart, Andrew, Driscoll, Andrea, Mathews, Stephanie, Toukhsati, Samia

Authors: Hare, David , Stewart, Andrew , Driscoll, Andrea , Mathews, Stephanie , Toukhsati, Samia
Date: 2020
Type: Text , Journal article
Relation: Heart Lung and Circulation Vol. 29, no. 3 (2020), p. 401-404
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Description: Background: Depression is common in cardiovascular disease (CVD). Clinical practice guidelines recommend routine depression screening by cardiologists. The aim of the study was to undertake a national survey of Australian cardiologists’ clinical practice behaviours in relation to depression screening, referral, and treatment. Methods: The Cardiovascular Disease and Depression Questionnaire was sent to 827 eligible cardiologist members of Cardiac Society of Australia and New Zealand, of which a total of 524 were returned (63%). Results: Most Australian cardiologists do not routinely ask their patients about depression and only 3% routinely use depression screening instruments. Most cardiologists (>70%) think that General Practitioners (Primary Care Physicians) are primarily responsible for identifying and treating depression in CVD. Cardiologists, who understand the prognostic risks of depression in CVD and feel confident to identify and treat depression, were more likely to screen, refer and/or treat patients for depression. Conclusions: Australian cardiologists rarely use validated depression screening measures. Several brief instruments are available for use and can be easily integrated into routine patient care without taking additional consultation time. © 2019
Description: This work was supported by the Beyond Blue Victorian Centre of Excellence in Depression and Anxiety. Prof Andrea Driscoll was supported by a Heart Foundation Future Leader fellowship 100472 from the National Heart Foundation of Australia.

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Self-care interventions that reduce hospital readmissions in patients with heart failure; towards the identification of change agents

- Toukhsati, Samia, Jaarsma, Tiny, Babu, Abraham, Driscoll, Andrea, Hare, David

Authors: Toukhsati, Samia , Jaarsma, Tiny , Babu, Abraham , Driscoll, Andrea , Hare, David
Date: 2019
Type: Text , Journal article , Review
Relation: Clinical Medicine Insights: Cardiology Vol. 13, no. (2019), p. 1-8
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Description: Unplanned hospital readmissions are the most important, preventable cost in heart failure (HF) health economics. Current professional guidelines recommend that patient self-care is an important means by which to reduce this burden. Patients with HF should be engaged in their care such as by detecting, monitoring, and managing their symptoms. A variety of educational and behavioural interventions have been designed and implemented by health care providers to encourage and support patient self-care. Meta-analyses support the use of self-care interventions to improve patient self-care and reduce hospital readmissions; however, efficacy is variable. The aim of this review was to explore methods to achieve greater clarity and consistency in the development and reporting of self-care interventions to enable ‘change agents’ to be identified. We conclude that advancement in this field requires more explicit integration and reporting on the behaviour change theories that inform the design of self-care interventions and the selection of behaviour change techniques. The systematic application of validated checklists, such as the Theory Coding Scheme and the CALO-RE taxonomy, will improve the systematic testing and refinement of interventions to enable ‘change agent/s’ to be identified and optimised.

The relationship between phobic anxiety and 2-year readmission after Acute Coronary Syndrome : What is the role of heart rate variability?

- O'Neil, Adrienne, Taylor, Barr, Hare, David, Thomas, Emma, Toukhsati, Samia, Oldroyd, John, Scovelle, Anna, Oldenburg, Brian

Authors: O'Neil, Adrienne , Taylor, Barr , Hare, David , Thomas, Emma , Toukhsati, Samia , Oldroyd, John , Scovelle, Anna , Oldenburg, Brian
Date: 2019
Type: Text , Journal article
Relation: Journal of Affective Disorders Vol. 247, no. (2019), p. 73-80
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Description: Objective: Phobic anxiety is a risk factor for poor prognosis following Acute Coronary Syndrome (ACS). A psychophysiological marker of vagal function, autonomic dysfunction may play a critical role in this relationship. The aim of the study was two-fold: to assess whether phobic anxiety was characterised by autonomic dysfunction (heart rate variability) in the short (1-month) and longer term (12-months) following ACS, and (ii) to quantify the extent to which HRV parameters modified the effect of phobic anxiety on all-cause hospital readmission over 2 years. Methods: The ADVENT study followed 416 ACS patients. At 1-month following discharge (T0), phobic anxiety and autonomic functioning were assessed using the Crown Crisp Index (CCI) and 11 indices of heart rate variability (HRV), respectively. HRV was measured again at 12-months (T1) (n = 359). Hospital readmission (all cause) was derived from an audit of hospital records by two medically trained research fellows. Generalised linear modelling (GLM) was used to first determine the association between CCI score at T0 and HRV parameters at T0 and T1. Binary logistic regression was used to measure the relationship between CCI scores and readmission (yes/no) and the extent to which HRV parameters modified this effect. Results: CCI scores were associated with 7 of the 11 indices of HRV: Average RR (ms), SDRR (ms), RMSSD (ms), SDSD (ms), pRR50 (%), LF Powers (ms2) and HF Powers (ms2) at T0 but not T1. CCI scores at T0 significantly predicted likelihood of readmission to hospital in the subsequent 2 year period. No parameter of HRV at T0 modified this effect. Limitations: We were unable to provide adjudicated major adverse coronary events outcome data, or account for changes in medication adherence, diet or physical activity. Conclusions: While phobic anxiety is associated with both reduced vagal function in the short term after an ACS event and 2 year all cause readmission, HRV does not appear to be the pathway by which phobic anxiety drives this outcome.

Wandering cats : Attitudes and behaviors towards cat containment in Australia

- Toukhsati, Samia, Young, Emily, Bennett, Pauleen, Coleman, Grahame

Authors: Toukhsati, Samia , Young, Emily , Bennett, Pauleen , Coleman, Grahame
Date: 2012
Type: Text , Journal article
Relation: Anthrozoos Vol. 25, no. 1 (2012), p. 61-74
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Description: Cat containment is a prominent cat management issue in Australia that provokes strong, and sometimes opposing, points of view. The aim of this study was to explore beliefs and attitudes towards containment in cat owner and non-owner groups, and to examine cat containment practices in owners. A random sample of 424 Victorian residents was recruited to complete the Community Attitudes towards Companion Animals Survey by telephone interview. The results showed that, of 142 cat owners, 80% contained their cat to a property at night but only 41.2% contained their cat to a property during the day. For cat owners, beliefs about the importance of cat containment were related to concerns regarding the protection of cats from injury and the protection of native wildlife. Beliefs relating to the importance of cat containment most strongly predicted containment practices. Conversely, findings from non-owners revealed that support for containment was generally linked to concerns regarding protection for wildlife and protection of community members from harm or nuisance behaviors. These findings indicate broad support for cat containment and suggest that education relating to the advantages of suitably enriched containment to protect cats from injury would be worthwhile in regions with cat curfews in place. © ISAZ 2012.

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