A field investigation of the relationship between rotating shifts, sleep, mental health and physical activity of Australian paramedics
- Khan, Wahaj, Jackson, Melinda, Kennedy, Gerard, Conduit, Russell
- Authors: Khan, Wahaj , Jackson, Melinda , Kennedy, Gerard , Conduit, Russell
- Date: 2021
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 11, no. 1 (2021), p.
- Full Text:
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- Description: Paramedics working on a rotating shift are at an increased risk of developing chronic health issues due to continuous circadian rhythm disruption. The acute effects of shift rotation and objectively measured sleep have rarely been reported in paramedics. This study investigated the relationships between a rotating shift schedule and sleep (using actigraphy), subjective reports of sleepiness, mood, stress and fatigue. Galvanic Skin Response, energy expenditure and physical activity (BodyMedia SenseWear Armband) were also recorded across the shift schedule. Paramedics were monitored for a period of eight consecutive days across pre-shift, day shift, night shift, and 2 days off. Fifteen paramedics (M age = 39.5 and SD = 10.7 years) who worked rotational shifts experienced sleep restriction during night shift compared to pre-shift, day shift and days off (p < 0.001). Night shift was also associated with higher levels of stress (p < 0.05), fatigue (p < 0.05), and sleepiness (p < 0.05). One day off was related to a return to pre-shift functioning. Such shift-related issues have a compounding negative impact on an already stressful occupation with high rates of physical and mental health issues. Therefore, there is an urgent need to investigate methods to reduce rotating shift burden on the health of paramedics. This could be through further research aimed at providing recommendations for shift work schedules with sufficient periods for sleep and recovery from stress. © 2021, The Author(s).
- Authors: Khan, Wahaj , Jackson, Melinda , Kennedy, Gerard , Conduit, Russell
- Date: 2021
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 11, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Paramedics working on a rotating shift are at an increased risk of developing chronic health issues due to continuous circadian rhythm disruption. The acute effects of shift rotation and objectively measured sleep have rarely been reported in paramedics. This study investigated the relationships between a rotating shift schedule and sleep (using actigraphy), subjective reports of sleepiness, mood, stress and fatigue. Galvanic Skin Response, energy expenditure and physical activity (BodyMedia SenseWear Armband) were also recorded across the shift schedule. Paramedics were monitored for a period of eight consecutive days across pre-shift, day shift, night shift, and 2 days off. Fifteen paramedics (M age = 39.5 and SD = 10.7 years) who worked rotational shifts experienced sleep restriction during night shift compared to pre-shift, day shift and days off (p < 0.001). Night shift was also associated with higher levels of stress (p < 0.05), fatigue (p < 0.05), and sleepiness (p < 0.05). One day off was related to a return to pre-shift functioning. Such shift-related issues have a compounding negative impact on an already stressful occupation with high rates of physical and mental health issues. Therefore, there is an urgent need to investigate methods to reduce rotating shift burden on the health of paramedics. This could be through further research aimed at providing recommendations for shift work schedules with sufficient periods for sleep and recovery from stress. © 2021, The Author(s).
A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Family Practice Vol. 22, no. 1 (2021), p.
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- Description: Background: To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension. Methods: In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants’ stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period. Results: Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d =
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Family Practice Vol. 22, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension. Methods: In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants’ stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period. Results: Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d =
A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants
- Shahin, Wejdan, Kennedy, Gerard, Stupans, Ieva
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Exploratory Research in Clinical and Social Pharmacy Vol. 3, no. (2021), p. 100038-100038
- Full Text:
- Reviewed:
- Description: Knowledge and perceptions about chronic disease and medications play a crucial role in determining long-term treatment adherence to diseases such as hypertension. Exploring in depth the barriers and enablers to medication adherence in specific population subgroups such as Middle Eastern refugees and migrants in Australia is important. This may provide a better understanding of each of these groups' beliefs and knowledge and suggest strategies and interventions to improve medication adherence. This study aimed to understand Middle Eastern refugees' and migrants' experiences, perceptions, and knowledge about hypertension and to explore factors affecting medication adherence. In this study 15 participants who identified themselves as Middle Eastern refugees and migrants in Australia and had been diagnosed with hypertension were interviewed (migrants = 5, refugees =10) using semi-structured interviews. Recorded interviews were analysed using a thematic analysis framework and the findings were reported according to consolidated criteria for reporting qualitative research. Three key themes emerged from the interview analysis: (1) dealing with the illness in terms of understanding the symptoms and causes, self-managing of high blood pressure, and coping and acquaintance with the illness (2) beliefs, practices around medication adherence and the barriers and facilitators to taking medications regularly and (3) healthcare encounters represented by participants trust in healthcare providers. Differences were found between refugees and migrants relating to the understanding, control, and coping with hypertension, beliefs about medications, trust of healthcare providers, and taking medications as prescribed. There were also differences in the social context of the two groups. Understanding the factors that prevent adherence to hypertension in Middle Eastern refugees addressed the gap in the literature regarding refugees' beliefs and medication adherence. Future studies are recommended to assess the improvement in medication adherence in refugees by modifying their beliefs, attitude, and knowledge about medications and illness. In addition, healthcare providers should consider the differences between Middle Eastern refugees and migrants when providing the health advice that targets each of these population independently to ultimately improve their overall health and adherence to medications. Erratum: The publisher regrets that the section below was accidentally anonymized in the original published version of this article: “Ethical approval was obtained from (redacted) 60–19/22299”. This section should read: “Ethical approval was obtained from RMIT University Ethics Committee 60–19/22299”. The publisher would like to apologise for any inconvenience caused.
- Authors: Shahin, Wejdan , Kennedy, Gerard , Stupans, Ieva
- Date: 2021
- Type: Text , Journal article
- Relation: Exploratory Research in Clinical and Social Pharmacy Vol. 3, no. (2021), p. 100038-100038
- Full Text:
- Reviewed:
- Description: Knowledge and perceptions about chronic disease and medications play a crucial role in determining long-term treatment adherence to diseases such as hypertension. Exploring in depth the barriers and enablers to medication adherence in specific population subgroups such as Middle Eastern refugees and migrants in Australia is important. This may provide a better understanding of each of these groups' beliefs and knowledge and suggest strategies and interventions to improve medication adherence. This study aimed to understand Middle Eastern refugees' and migrants' experiences, perceptions, and knowledge about hypertension and to explore factors affecting medication adherence. In this study 15 participants who identified themselves as Middle Eastern refugees and migrants in Australia and had been diagnosed with hypertension were interviewed (migrants = 5, refugees =10) using semi-structured interviews. Recorded interviews were analysed using a thematic analysis framework and the findings were reported according to consolidated criteria for reporting qualitative research. Three key themes emerged from the interview analysis: (1) dealing with the illness in terms of understanding the symptoms and causes, self-managing of high blood pressure, and coping and acquaintance with the illness (2) beliefs, practices around medication adherence and the barriers and facilitators to taking medications regularly and (3) healthcare encounters represented by participants trust in healthcare providers. Differences were found between refugees and migrants relating to the understanding, control, and coping with hypertension, beliefs about medications, trust of healthcare providers, and taking medications as prescribed. There were also differences in the social context of the two groups. Understanding the factors that prevent adherence to hypertension in Middle Eastern refugees addressed the gap in the literature regarding refugees' beliefs and medication adherence. Future studies are recommended to assess the improvement in medication adherence in refugees by modifying their beliefs, attitude, and knowledge about medications and illness. In addition, healthcare providers should consider the differences between Middle Eastern refugees and migrants when providing the health advice that targets each of these population independently to ultimately improve their overall health and adherence to medications. Erratum: The publisher regrets that the section below was accidentally anonymized in the original published version of this article: “Ethical approval was obtained from (redacted) 60–19/22299”. This section should read: “Ethical approval was obtained from RMIT University Ethics Committee 60–19/22299”. The publisher would like to apologise for any inconvenience caused.
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.
- Full Text:
- Reviewed:
- 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.
- 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.
- Full Text:
- Reviewed:
- 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.
Acupuncture : a promising approach for Comorbid depression and insomnia in perimenopause
- Zhao, Fei, Fu, Qiang-Aiang, Spencer, Sarah, Kennedy, Gerard, Conduit, Russell, Zhang, Wen-Jing, Zheng, Zhen
- Authors: Zhao, Fei , Fu, Qiang-Aiang , Spencer, Sarah , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article
- Relation: Nature and Science of Sleep Vol. 13, no. (2021), p. 1823-1863
- Full Text:
- Reviewed:
- Description: Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness. © 2021 Zhao et al.
- Authors: Zhao, Fei , Fu, Qiang-Aiang , Spencer, Sarah , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article
- Relation: Nature and Science of Sleep Vol. 13, no. (2021), p. 1823-1863
- Full Text:
- Reviewed:
- Description: Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness. © 2021 Zhao et al.
Acupuncture as an independent or adjuvant management to standard care for perimenopausal depression : a systematic review and meta-analysis
- Zhao, Fei, Fu, Qiang-Qiang, Kennedy, Gerard, Conduit, Russell, Zhang, Wen-Jing, Zheng, Zhen
- Authors: Zhao, Fei , Fu, Qiang-Qiang , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone. Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed. Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01]. Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD. © Copyright © 2021 Zhao, Fu, Kennedy, Conduit, Zhang and Zheng.
- Authors: Zhao, Fei , Fu, Qiang-Qiang , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone. Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed. Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01]. Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD. © Copyright © 2021 Zhao, Fu, Kennedy, Conduit, Zhang and Zheng.
Acupuncture for comorbid depression and insomnia in perimenopause : a feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial
- Zhao, Fei, Zheng, Zhen, Fu, Qiang-Qiang, Conduit, Russell, Xu, Hong, Wang, Hui-ru, Huang, Yu-Ling, Jiang, Ting, Zhang, Wen-Jing, Kennedy, Gerard
- 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.
- Full Text:
- Reviewed:
- 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.
- 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.
- Full Text:
- Reviewed:
- 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.
- Alomri, Ridwan, Kennedy, Gerard, Wali, Siraj, Alhejaili, Faris, Zelko, Matthew, Robinson, Stephen
- 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
- Full Text: false
- Reviewed:
- 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.
Association between nocturnal activity of the sympathetic nervous system and cognitive dysfunction in obstructive sleep apnoea
- Alomri, Ridwan, Kennedy, Gerard, Wali, Siraj, Alhejaili, Faris, Robinson, Stephen
- Authors: Alomri, Ridwan , Kennedy, Gerard , Wali, Siraj , Alhejaili, Faris , Robinson, Stephen
- Date: 2021
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 11, no. 1 (2021), p. 11990-11990.
- Full Text:
- Reviewed:
- Description: Obstructive sleep apnoea (OSA) is associated with repetitive breathing obstructions during sleep. These episodes of hypoxia and associated arousals from sleep induce physiological stress and nocturnal over-activation of the sympathetic nervous system (SNS). One consequence of OSA is impairment in a range of cognitive domains. Previous research into cognitive impairment in OSA have focussed on intermittent hypoxia and disrupted sleep, but not nocturnal over-activation of the SNS. Therefore, we investigated whether nocturnal over-activity of the SNS was associated with cognitive impairments in OSA. The extent of nocturnal SNS activation was estimated from heart rate variability (HRV), pulse wave amplitude (PWA) and stress response biomarkers (cortisol and glucose levels). OSA severity was significantly associated with PWA indices and the HRV low frequency/ high frequency ratio (p < 0.05). Morning blood glucose levels were significantly associated with the duration of a blood oxygen saturation (SaO2) < 90% (p < 0.01). PWA and HRV were significantly associated with the time taken to perform a task involving visuospatial functioning (p < 0.05), but not with impairments in sustained attention, reaction time or autobiographical memory. These results suggest that the visuospatial dysfunction observed in people with OSA is associated with increased nocturnal activity of the SNS. © 2021, The Author(s).
- Authors: Alomri, Ridwan , Kennedy, Gerard , Wali, Siraj , Alhejaili, Faris , Robinson, Stephen
- Date: 2021
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 11, no. 1 (2021), p. 11990-11990.
- Full Text:
- Reviewed:
- Description: Obstructive sleep apnoea (OSA) is associated with repetitive breathing obstructions during sleep. These episodes of hypoxia and associated arousals from sleep induce physiological stress and nocturnal over-activation of the sympathetic nervous system (SNS). One consequence of OSA is impairment in a range of cognitive domains. Previous research into cognitive impairment in OSA have focussed on intermittent hypoxia and disrupted sleep, but not nocturnal over-activation of the SNS. Therefore, we investigated whether nocturnal over-activity of the SNS was associated with cognitive impairments in OSA. The extent of nocturnal SNS activation was estimated from heart rate variability (HRV), pulse wave amplitude (PWA) and stress response biomarkers (cortisol and glucose levels). OSA severity was significantly associated with PWA indices and the HRV low frequency/ high frequency ratio (p < 0.05). Morning blood glucose levels were significantly associated with the duration of a blood oxygen saturation (SaO2) < 90% (p < 0.01). PWA and HRV were significantly associated with the time taken to perform a task involving visuospatial functioning (p < 0.05), but not with impairments in sustained attention, reaction time or autobiographical memory. These results suggest that the visuospatial dysfunction observed in people with OSA is associated with increased nocturnal activity of the SNS. © 2021, The Author(s).
Competencies and training of health professionals engaged in health coaching : a systematic review
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2022
- Type: Text , Journal article
- Relation: Chronic Illness Vol. 18, no. 1 (2022), p. 58-85
- Full Text: false
- Reviewed:
- 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.
- Meaklim, Hailey, Rehm, Imogen, Junge, Moira, Monfries, Melissa, Kennedy, Gerard, Bucks, Romola, Meltzer, Lisa, Jackson, Melinda
- 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
- Full Text: false
- Reviewed:
- 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.
Differential associations of hypoxia, sleep fragmentation, and depressive symptoms with cognitive dysfunction in obstructive sleep apnea
- Alomri, Ridwan, Kennedy, Gerard, Wali, Siraj, Ahejaili, Faris, Robinson, Stephen
- Authors: Alomri, Ridwan , Kennedy, Gerard , Wali, Siraj , Ahejaili, Faris , Robinson, Stephen
- Date: 2021
- Type: Text , Journal article
- Relation: Sleep Vol. 44, no. 4 (2021), p.
- Full Text:
- Reviewed:
- Description: Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors. © Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
- Authors: Alomri, Ridwan , Kennedy, Gerard , Wali, Siraj , Ahejaili, Faris , Robinson, Stephen
- Date: 2021
- Type: Text , Journal article
- Relation: Sleep Vol. 44, no. 4 (2021), p.
- Full Text:
- Reviewed:
- Description: Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors. © Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
Does the modality used in health coaching matter? A systematic review of health coaching outcomes
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Patient Preference and Adherence Vol. 14, no. (2020), p. 1477-1492
- Full Text:
- Reviewed:
- Description: Objective: The purpose of this review was to evaluate the modalities (e.g., face-to-face, telephone or electronic) of pharmacist health coaching providing the greatest improvement in patient outcomes, to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists. Methods: This systematic review followed the PRISMA guidelines. CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched (2000–2019). Included articles were reviewed for the modality used to health coach, the training provided, and the outcomes. Results: Twelve papers met the eligibility criteria. A majority of studies included involved a combination of modalities of pharmacist health coaching. Four papers referred to face-toface sessions, and one study used telephone coaching. In each paper, coaching led to an improvement in clinical and non-clinical health outcomes. Conclusion: The training provided to health coaches varied and in some cases was not reported. Inconsistencies in reports led to difficulties when comparing study outcomes. Therefore, conclusions about the modality providing the greatest improvement in patient outcomes and the most pragmatic health coaching modality are not possible. Studies that document the training, the modality, the outcomes and the cost benefits of coaching by pharmacists are warranted to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists. © 2020 Singh et al.
- Authors: Singh, Harjit , Kennedy, Gerard , Stupans, Ieva
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Patient Preference and Adherence Vol. 14, no. (2020), p. 1477-1492
- Full Text:
- Reviewed:
- Description: Objective: The purpose of this review was to evaluate the modalities (e.g., face-to-face, telephone or electronic) of pharmacist health coaching providing the greatest improvement in patient outcomes, to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists. Methods: This systematic review followed the PRISMA guidelines. CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched (2000–2019). Included articles were reviewed for the modality used to health coach, the training provided, and the outcomes. Results: Twelve papers met the eligibility criteria. A majority of studies included involved a combination of modalities of pharmacist health coaching. Four papers referred to face-toface sessions, and one study used telephone coaching. In each paper, coaching led to an improvement in clinical and non-clinical health outcomes. Conclusion: The training provided to health coaches varied and in some cases was not reported. Inconsistencies in reports led to difficulties when comparing study outcomes. Therefore, conclusions about the modality providing the greatest improvement in patient outcomes and the most pragmatic health coaching modality are not possible. Studies that document the training, the modality, the outcomes and the cost benefits of coaching by pharmacists are warranted to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists. © 2020 Singh et al.
Does the national competency standards framework for pharmacists in Australia support the provision of behaviour change interventions?
- Singh, Harjit, Kennedy, Gerard, Stupans, Ieva
- 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
- Full Text:
- Reviewed:
- 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.
- 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
- Full Text:
- Reviewed:
- 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.
Health beliefs and chronic illnesses of refugees : a systematic review
- Shahin, Wejdan, Stupans, Ieva, Kennedy, Gerard
- Authors: Shahin, Wejdan , Stupans, Ieva , Kennedy, Gerard
- Date: 2021
- Type: Text , Journal article
- Relation: Ethnicity and Health Vol. 26, no. 5 (2021), p. 756-768
- Full Text: false
- Reviewed:
- Description: Objective: To evaluate beliefs, and attitudes about health of refugees with chronic conditions such as diabetes mellitus type 2, hypertension, chronic obstructive pulmonary disease, and posttraumatic stress disorder and the consequent effects on self-care in comparison to resident populations. Design: A systematic review methodology was used. PubMed, Embase, PsycINFO and CINAHL databases were searched for relevant articles. The main terms analysed were health beliefs, chronic conditions and refugee populations. From 844 articles, 45 were retained for further assessment, and finally 5 met the inclusion criteria. Results: Differences in the health beliefs, attitudes and self-care management approaches of refugees compared to resident populations were identified in two studies. The remaining three papers did not make comparisons between the refugees and the resident population, nor did they specifically explore the refugees’ health beliefs. Of the five studies, three were carried out in Sweden and two in the US. Refugees who have poorer mental and physical health as well as higher prevalence of chronic diseases than the populations among which they resettle seem to lack the knowledge about their illness, symptoms and self-management and thus are less able to control their chronic conditions. Conclusion: The findings highlighted the deficiency in the literature of studies which examine health beliefs and attitudes of minority groups such as refugees who have chronic conditions. The findings also gave insight to the need for a distinctive understanding of refugee health and the management of chronic conditions in comparison to other non-refugee migrant groups. Further research is needed to fully understand the differences between refugees and local populations in terms health beliefs, chronic disease and self-management. © 2018 Informa UK Limited, trading as Taylor & Francis Group.
Identifying complementary and alternative medicine recommendations for insomnia treatment and care : a systematic review and critical assessment of comprehensive clinical practice guidelines
- Zhao, Fei-Yi. Y., Xu, Peijie, Kennedy, Gerard, Conduit, Russell, Zhang, Wen-Jing, Wang, Yan-Mei, Fu, Qiang-Qiang, Zheng, Zhen
- 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.
- Full Text:
- Reviewed:
- 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.
- 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.
- Full Text:
- Reviewed:
- 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.
Knowledge about, attitude toward, and practice of complementary and alternative medicine among nursing students : a systematic review of cross-sectional studies
- Zhao, Fei-Yi, Kennedy, Gerard, Cleary, Sonja, Conduit, Russell, Zhang, Wen-Jing, Fu, Qiang-Qiang, Zheng, Zhen
- 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.
- Full Text:
- Reviewed:
- 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.
- 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.
- Full Text:
- Reviewed:
- 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.
- Meaklim, Hailey, Abbott, Jo-Anne, Kennedy, Gerard, Murray, Greg, Klein, Britt, Rehm, Imogen
- Authors: Meaklim, Hailey , Abbott, Jo-Anne , Kennedy, Gerard , Murray, Greg , Klein, Britt , Rehm, Imogen
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Psychologist Vol. 54, no. 3 (2019), p. 225-234
- Full Text: false
- Reviewed:
- Description: Objectives: This study examined the feasibility of delivering an online cognitive behavioural therapy for insomnia intervention (Sleep-e) within an Australian public hospital outpatient insomnia clinic. Method: This study was conducted as an open trial pilot study. Fifty-two patients waiting for clinic treatment were invited to participate, with ten commencing and six completing the 7-week internet intervention. Participants completed a battery of questionnaires regarding their demographic information, sleep and insomnia symptoms, and provided feedback about the program. Exclusion criteria were minimal, and the study allowed for participants to have other health, psychiatric, and sleep disorder co-morbidities. Results: Post-program satisfaction results suggested that Sleep-e was easy to use; participants were satisfied with it; and found it beneficial in improving sleep. Paired samples t tests for the intention-to-treat sample indicated reductions in participants' insomnia severity (p = 0.02) and sleep onset latency (p = 0.04) from pre- to post-program. However, a larger sample is needed to generalise the results to the wider population. Conclusion: The findings support Sleep-e as a helpful treatment for insomnia in a public hospital outpatient population for at least a subgroup of patients. However, significant lessons were learned regarding the importance of educating health care providers and patients about novel models of internet service delivery. Potential models of adaptive or blended stepped-care are discussed to facilitate program implementation. Future research should identify how to implement internet interventions more effectively in public health settings to take advantage of their potential to improve clinical efficiency.
P092 improving postgraduate psychology students’ sleep and insomnia knowledge with a sleep education workshop
- Meaklim, H., Meltzer, L., Junge, M., Rehm, I., Monfries, M., Kennedy, Gerard, Bucks, R., Jackson, M.
- Authors: Meaklim, H. , Meltzer, L. , Junge, M. , Rehm, I. , Monfries, M. , Kennedy, Gerard , Bucks, R. , Jackson, M.
- Date: 2021
- Type: Text , Journal article
- Relation: Sleep advances. Vol. 2, no. Supplement_1 (2021), p. A51-A51
- Full Text:
- Reviewed:
- Description: Abstract Introduction Trainee psychologists receive limited sleep and insomnia education during postgraduate study. This study examined the delivery of a sleep psychology training workshop for postgraduate psychology students and examined changes in sleep knowledge from pre- to post-workshop. Methods A 6-hour Sleep Psychology Workshop was delivered to postgraduate psychology students around Victoria. Online pre- and post-workshop questionnaires were used to evaluate changes in sleep psychology knowledge and collect feedback on the workshop. Results The participants were 187 students (82% female, M age = 32), most of whom were in their 5th year of psychology training (69%) and had not received any sleep education during their postgraduate studies at the date of the intervention (77%). Students’ sleep knowledge significantly improved after workshop completion (pre: 56% vs. post: 80% correct), t(107)= -21.41, p < .001. Students provided positive feedback about the workshop, with 96% rating the workshop as excellent/very good and 86% reporting that they would recommend the workshop to other postgraduate students. Overall, 94% of students agreed/strongly agreed that the sleep psychology workshop improved their confidence to manage sleep disturbances in their future psychology practice. Discussion Postgraduate psychology students require sleep and insomnia education. This study demonstrates that students’ sleep psychology knowledge can improve after a 6-hour sleep education and training workshop and provides initial positive feedback about the benefits of sleep and insomnia education for postgraduate students.
- Authors: Meaklim, H. , Meltzer, L. , Junge, M. , Rehm, I. , Monfries, M. , Kennedy, Gerard , Bucks, R. , Jackson, M.
- Date: 2021
- Type: Text , Journal article
- Relation: Sleep advances. Vol. 2, no. Supplement_1 (2021), p. A51-A51
- Full Text:
- Reviewed:
- Description: Abstract Introduction Trainee psychologists receive limited sleep and insomnia education during postgraduate study. This study examined the delivery of a sleep psychology training workshop for postgraduate psychology students and examined changes in sleep knowledge from pre- to post-workshop. Methods A 6-hour Sleep Psychology Workshop was delivered to postgraduate psychology students around Victoria. Online pre- and post-workshop questionnaires were used to evaluate changes in sleep psychology knowledge and collect feedback on the workshop. Results The participants were 187 students (82% female, M age = 32), most of whom were in their 5th year of psychology training (69%) and had not received any sleep education during their postgraduate studies at the date of the intervention (77%). Students’ sleep knowledge significantly improved after workshop completion (pre: 56% vs. post: 80% correct), t(107)= -21.41, p < .001. Students provided positive feedback about the workshop, with 96% rating the workshop as excellent/very good and 86% reporting that they would recommend the workshop to other postgraduate students. Overall, 94% of students agreed/strongly agreed that the sleep psychology workshop improved their confidence to manage sleep disturbances in their future psychology practice. Discussion Postgraduate psychology students require sleep and insomnia education. This study demonstrates that students’ sleep psychology knowledge can improve after a 6-hour sleep education and training workshop and provides initial positive feedback about the benefits of sleep and insomnia education for postgraduate students.
Perceived barriers and enablers to physical activity participation in people with alopecia areata : a constructivist grounded theory study
- Rajoo, Yamuna, Wong, J., Raj, I., Kennedy, Gerard
- Authors: Rajoo, Yamuna , Wong, J. , Raj, I. , Kennedy, Gerard
- Date: 2020
- Type: Text , Journal article
- Relation: BMC Psychology Vol. 8, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Background: Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions. Methods: The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved. Results: The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance. Conclusion: The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model. © 2020, The Author(s).
- Authors: Rajoo, Yamuna , Wong, J. , Raj, I. , Kennedy, Gerard
- Date: 2020
- Type: Text , Journal article
- Relation: BMC Psychology Vol. 8, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Background: Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions. Methods: The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved. Results: The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance. Conclusion: The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model. © 2020, The Author(s).