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Sociodemographic and behavioural correlates of social jetlag in Australian adults: results from the 2016 National Sleep Health Foundation Study
Get PDFThis manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/ which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 12 month embargo from date of publication (July 2018) in accordance with the publisher’s archiving policySocial jetlag is a term used to describe misalignment between biological and social time. Measured as the difference in sleep midpoints between work and free days, social jetlag has been associated with unhealthy lifestyle behaviours and adverse health outcomes. This study aimed to identify the prevalence of social jetlag, and its sociodemographic and behavioural correlates in 837 respondents who completed the Sleep Health Foundation Australia 2016 online survey. Binomial logistic regression models determined associations between social jetlag and self-reported lifestyle and work outcomes, excluding night, evening or rotating shift workers. One third (31.1%) of respondents experienced >1h of social jetlag. In analyses adjusted for sociodemographic variables associated with social jetlag (age, marital status, work status and metropolitan living plus the significant interaction term for age by metro living), social jetlag was associated with longer sleep duration on free days (OR = 2.8, CI = 1.9–4.1), evening preference (OR = 2.0, CI = 1.4–2.4), often staying up later than planned on work days (OR 1.9, CI = 1.3–2.9), and having a computer (OR = 1.7, CI = 1.2–2.4) or phone (OR = 1.6, CI = 1.1–2.4) in the bedroom and internet use in the hour before bed (OR = 1.7, CI 1.2–2.5). Almost twice as many working respondents with social jetlag reported going to work when they should have taken sick leave due to their state of health (OR = 1.9, CI = 1.3–3.0). In conclusion, social jetlag is prevalent in the Australian community and associated with bedtime technology use. Work attendance when in poor health is cause for concern in Australian day workers and requires further investigation.This research was funded by the Sleep Foundation of Australia. Dr Lang acknowledges the support the National Health and Medical Research Council of Australia for providing fellowship support
Solid Waste Management Solutions for a Rapidly Urbanizing Area in Thailand: Recommendations Based on Stakeholder Input
Get PDFThis article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Municipal solid waste is a significant problem, particularly in developing countries that lack sufficient infrastructure and useable land mass to process it in an appropriate manner. Some developing nations are experiencing a combination of issues that prevent proper management of solid waste. This paper reviews the management of municipal solid waste in northeast Thailand, using the Tha Khon Yang Sub-district Municipality (TKYSM) in Maha Sarakham Province as a case study. The combination of rapid population and economic growth and its associated affluence has led to an increase in the use of consumer items and a concomitant increase in the production of municipal solid waste. In the TKYSM there is pressure on local government to establish a suitable waste management program to resolve the escalating waste crisis. The aim of this study is to provide viable solutions to waste management challenges in the TKYSM, and potentially to offer guidance to other similar localities also facing the same challenges. It is well established that successful changes to waste management require an understanding of local context and consideration of specific issues within a region. Therefore, extensive community consultation and engagement with local experts was undertaken to develop an understanding of the particular waste management challenges of the TKYSM. Research methods included observations, one-on-one interviews and focus groups with a range of different stakeholders. The outcomes of this research highlight a number of opportunities to improve local infrastructure and operational capacity around solid waste management. Waste management in rural and urban areas needs to be approached differently. Solutions include: development of appropriate policy and implementation plans (based around the recommendations of this paper); reduction of the volume of waste going to landfill by establishing a waste separation system; initiation of a collection service that supports waste separation at source; educating the citizens of the municipality; and the local government staff, and for the local government to seek external support from the local temples and expertise from the nearby university.This research received no external funding
Hidden care: revelations of a case‐note audit of physical health care in a community mental health service
Get PDFThis manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/
which permits use, distribution and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 12 month embargo from date of publication (May 2018) in accordance with the publisher’s archiving policy.People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day‐to‐day practice. This study involved an audit of hardcopy and electronic clinical case‐notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow‐up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One‐way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case‐note records; however, because this information was ‘buried’ within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under‐reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers.Flinders University Faculty Gran
Agents of change: establishing quality improvement collaboratives to improve adherence to Australian clinical guidelines for dementia care
Get PDFThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Dissemination of clinical practice guidelines alone is insufficient to create meaningful change in clinical practice. Quality improvement collaborative models have potential to address the evidence-practice gap in dementia care because they capitalise on known knowledge translation enablers and incorporate optimal approaches to implementation. Non-pharmacological interventions focused on promoting independence are effective and favoured by people with dementia and their carers but are not routinely implemented. The objective of this translational project is to assess the impact of quality improvement collaboratives (QICs) on adherence to non-pharmacological recommendations from the Clinical Practice Guidelines for Dementia in Australia.
Methods
This project will employ an interrupted time-series design with process evaluation to assess the impact, uptake, feasibility, accessibility, cost, and sustainability of the QICs over 18 months. Thirty clinicians from across Australia will be invited to join the QICs to build their capacity in leading innovation in dementia care. Clinicians will participate in a training program and be supported to develop and implement a quality improvement project unique to their service context using plan-do-study-act cycles. Regular online meetings with their peers in the QIC will facilitate benchmarking and problem-solving. Clinicians will describe their practice via monthly checklists, and guideline adherence will be determined against a set of defined criteria. Phone interviews with up to 180 client dyads will be used to assess satisfaction with care and client outcomes. Clinician interviews and field note data will be used to explore implementation and costs. Involvement of people with dementia and carers will be embedded in the study design, conduct, and reporting, in addition to clinical and industry expertise.
Discussion
The quality of dementia care in Australia is largely dependent on the clinician involved and the extent to which they apply best available evidence in their practice. This study will determine the elements of this multifaceted implementation strategy that contributed to guideline adherence and client outcomes. The findings will inform future translational approaches to improving care and outcomes for people with dementia and their carers.Funding for this study is provided by the NHRMC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People (grant no. CDPC1327) and by the NHRMC National Institute for Dementia Research (grant no. 1135667). Both funding bodies peer reviewed the project but neither had any role in its design or data collection, analysis, or interpretation. Ian Cameron is supported by an Australian Health and Medical Research Council Senior Practitioner Fellowship. Kate Laver is supported by an Australian Health and Medical Research Council Dementia Research Development Fellowship
Mobile apps supporting healthy family meals: a systematic assessment
No full textThis abstract was prepared for the inaugural 'HDR Student Conference', Flinders University, November 2018. Copyright © the authorBackground: Modern families are facing conflicting demands on their time and resources, which may be at the detriment of child and family diet quality. Mobile apps have the potential to deliver innovative nutrition interventions by providing practical, behavioural support remotely, interactively and in context. This review aimed to identify and assess popular, commercially available mobile apps that offer support for the provision of healthy family food by 1) describing app scope and characteristics, 2) assessing app quality and 3) conducting a behavioural analysis of app content and features. Methods: Searches of commercial app stores between August-November 2017 identified apps addressing the food provision process. Apps were included if they were applicable to parents or families, written in English with a user rating of 4 stars. App quality was assessed using the Mobile App Rating Scale, app content and features were extracted and Behaviour Change Techniques (BCTs) identified. Results: Of 2881 apps screened, 51 (1.8%) were included for assessment, comprising 23 recipe/recipe manager apps, 12 meal planning apps, 10 shopping list apps, four family organizers and two food choice apps. Food choice and family organizer apps scored highest for app quality (mean+SD 3.5+0.6 out of 5), while most apps scored poorly for engagement. App features supporting healthy food provision included meal planners (n=26), shopping lists (n=44) and sharing app content (n=48). Behavioural support features mapped to relatively few BCTs (3.9+1.9 per app). Conclusions: Recipe/recipe manager apps, meal planning apps and family organizers with integrated meal planning and shopping lists, scored well for functionality and incorporated behavioural support features that could be used to address barriers to healthy food provision, although features were focused on planning behaviours. Recommendations: Future apps should prioritize features and content that improve app engagement quality
Discovering the Continuity of Care for Indonesian Children with HIV: Using Grounded Theory
No full textThis abstract was prepared for the inaugural 'HDR Student Conference', Flinders University, November 2018. Copyright © the authorBackgrounds The number of Indonesian children infected with human immunodeficiency virus (HIV) aged below 19 years old has cumulatively increased by 65.36% from 2011 to 2015. The government of Indonesia has developed and responded to a broad range of care policies and programs on managing this HIV epidemic. However, these care policies primarily focus on the adult, with little attention being paid to children. The objective of this presentation is to describe the methodological underpinning and the practical application of a constructivist grounded theory that is investigating the continuity of care for Indonesian children with HIV from the family and health care professional perspectives. Constructivist grounded theory is appropriate to explore the experiences, actions and events affecting the continuum of care provision for children with HIV in Indonesia. It implies a foundation of relativism and appreciates multiple truths or realities of subjectivism. This presentation will provide some background and give an overview of the constructivist grounded theory methods and process used, including data generation, initial coding, and memo-writing that adopts a mutual position between the researcher and the participants in the research process
An empowerment approach to supporting self-care management skills for people with Type 2 Diabetes Mellitus in Indonesia: Research proposal
No full textThis abstract was prepared for the inaugural 'HDR Student Conference', Flinders University, November 2018. Copyright © the authorAn empowerment approach to supporting self-care management skills for people with Type 2 Diabetes Mellitus in Indonesia: Research proposal. Background: Indonesia currently has 10.3 million people with Type 2 diabetes mellitus (T2DM) making it one of the top ten countries globally, with projections that the number will increase to 16.7 million by 2045. People with T2DM require support to manage their disease. Little is known about how patients with T2DM are supported by health care professionals (HCPs) in Indonesia. Previous studies on patient empowerment interventions have focused on the micro-level of providing patient health education with less involvement of care teams in designing interventions. Objectives: This study aims to explore the existing approaches used in the care of people with T2DM and propose a model of patient care framed by an empowerment approach. Methodology: A two phase single case study strategy will be used. Phase one will explore the existing T2DM care in supporting patients' self-care management skills across three levels of health care services. Data collection will comprise of direct observations of interactions between patients, their families and HCPs, a review of clinical guideline documents and health education programs, and interviews with patients, their families, and HCPs. Thematic data analysis will be conducted at this phase. Results from phase one will inform the phase two development of an alternative model of T2DM care in supporting patients' self-care management skills. Phase two will include focus groups with expert HCPs working with people with T2DM to seek consensus for a newly developed patient empowerment approach. Summary: This presentation will outline this case study proposal in detai
Finding My Way: results of a multicentre RCT evaluating a web-based self-guided psychosocial intervention for newly diagnosed cancer survivors
Get PDF“This is a post-peer-review, pre-copyedit version of an article published in Supportive Care in Cancer. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00520-018-4526-1”.
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
This author accepted manuscript is made available following 12 month embargo from date of publication (November 2018) in accordance with the publisher’s archiving policyPurpose
This multicentre randomised controlled trial examined the efficacy of Finding My Way (FMW), a 6-week/6-module online self-guided psychotherapeutic intervention for newly diagnosed curatively treated cancer survivors, in reducing cancer-related distress and improving quality of life compared to an online attention control.
Methods
Participants were randomised on a 1:1 ratio using a gender-stratified block design to intervention (n = 94) or attention control (n = 97), and were blinded to condition. Assessments were completed at baseline (T0), post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Mixed model repeated measures analyses examined differences between groups for cancer-specific distress (primary outcome) and general distress, quality of life (QoL), coping, and health service utilisation (secondary outcomes).
Results
While both groups reported reduced cancer-specific and general distress over time, between-group differences were not significant. Intervention participants reported lower total health service utilisation and supportive care utilisation post-intervention than controls (total HS use: between-group mean difference = − 1.07 (− 1.85 to − 0.28); supportive care use: between-group mean difference = − 0.64 (− 1.21 to − 0.06)) and significantly higher emotional functioning at 3 months (between-group mean difference = 7.04 (0.15 to 13.9)). At 6 months, the supportive care utilisation finding reversed (between-group mean difference = 0.78 points (0.19 to 1.37). Across remaining QoL and coping outcomes, no significant group differences emerged.
Conclusions
While both groups experienced reductions in distress, between-group differences were not significant. This contrasts with the significantly improved emotional functioning observed in FMW participants at 3 months and the short-term reductions in health service utilisation. Long-term increases in supportive care service utilisation suggest FMW only met needs while being actively used
Turbo thin film continuous flow production of biodiesel from fungal biomass
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available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/ which permits use, distribution and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 24 month embargo from date of publication (November 2018) in accordance with the publisher’s archiving policyDirect biodiesel production from wet fungal biomass may significantly reduce production costs, but there is a lack of fast and cost-effective processing technology. A novel thin film continuous flow process has been applied to study the effects of its operational parameters on fatty acid (FA) extraction and FA to fatty acid methyl ester (FAME) conversion efficiencies. Single factor experiments evaluated the effects of catalyst concentration and water content of biomass, while factorial experimental designs determined the interactions between catalyst concentration and biomass to methanol ratio, flow rate, and rotational speed. Direct transesterification (DT) of wet Mucor plumbeus biomass at ambient temperature and pressure achieved a FA to FAME conversion efficiency of >90% using 3 wt/v % NaOH concentration, if the water content was ≤50% (w/w). In comparison to existing DT methods, this continuous flow processing technology has an estimated 90–94% reduction in energy consumption, showing promise for up-scaling.Eko K. Sitepu gratefully acknowledges funding through the Australian Award Scholarship. The authors acknowledge funding of the project through the Australian Research Council and the Government of South Australia
Mitochondrial haplogroups in an Australian and British Caucasian diabetic sample with and without retinopathy
No full textCopyright (C) Ebony Liu & Flinders University - Made available per CC BY-NC-ND: Creative Commons-Attribution-Noncommercial-No Derivatives 3.0 AUThe dataset has information on approximately 3000 de-identified individuals. Information includes: mitochondrial haplogroup as determined by genotyping and Haplogrep, demographic and clinical information such as diabetic retinopathy grading. Data is expressed in numbers. Unless otherwise specified in the headings, -9 means unknown, 1 means no and 2 means yes. Further details regarding the methodology can be found in our manuscript Mitochondrial haplogroups are not associated with diabetic retinopathy in a large Australian and British Caucasian sample published by Scientific Reports 2018