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Nørmark LP, McAuliffe F, Maindal HT, O'Reilly S, Davies A, Burden C, Skinner TC, Vrangbæk K, Callander E. Protocol for cost-effectiveness analysis of a randomised trial of mHealth coaching (Bump2Baby and Me) compared with usual care for healthy gestational weight gain and postnatal outcomes in at-risk women and their offspring in the UK, Australia, Ireland and Spain. BMJ Open 2024; 14:e080823. [PMID: 38772891 PMCID: PMC11110546 DOI: 10.1136/bmjopen-2023-080823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/03/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION Gestational diabetes mellitus and overweight are associated with an increased likelihood of complications during birth and for the newborn baby. These complications lead to increased immediate and long-term healthcare costs as well as reduced health and well-being in women and infants. This protocol presents the health economic evaluation to investigate the cost-effectiveness of Bump2Baby and Me (B2B&Me), which is a health coaching intervention delivered via smartphone to women at risk of gestational diabetes. METHODS AND ANALYSIS Using data from the B2B&Me randomised controlled trial, this economic evaluation compares costs and health effects between the intervention and control group as an incremental cost-effectiveness ratio. Direct healthcare costs, costs of pharmaceuticals and intervention costs will be included in the analysis, body weight and quality-adjusted life-years for the mother will serve as the effect outcomes. To investigate the long-term cost-effectiveness of the trial, a Markov model will be employed. Deterministic and probabilistic sensitivity analysis will be employed. ETHICS AND DISSEMINATION The National Maternity Hospital Human Research and Ethics Committee was the primary approval site (EC18.2020) with approvals from University College Dublin HREC-Sciences (LS-E-20-150-OReilly), Junta de Andalucia CEIM/CEI Provincial de Granada (2087-M1-22), Monash Health HREC (RES-20-0000-892A) and National Health Service Health Research Authority and Health and Care Research Wales (HCRW) (21/WA/0022). The results from the analysis will be disseminated in scientific papers, through conference presentations and through different channels for communication within the project. TRIAL REGISTRATION NUMBER ACTRN12620001240932.
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Affiliation(s)
- Laura Pirhonen Nørmark
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark
| | - Fionnuala McAuliffe
- UCD Perinatal Research Centre, University College Dublin, Dublin, Ireland
- Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland
| | | | - Sharleen O'Reilly
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Anna Davies
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - Christy Burden
- University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Timothy C Skinner
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Karsten Vrangbæk
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark
| | - Emily Callander
- School of Public Health, University of Technology Sydney, Sydney, UK
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Booker LA, Mills J, Bish M, Spong J, Deacon-Crouch M, Skinner TC. Nurse rostering: understanding the current shift work scheduling processes, benefits, limitations, and potential fatigue risks. BMC Nurs 2024; 23:295. [PMID: 38685019 PMCID: PMC11057102 DOI: 10.1186/s12912-024-01949-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the organisation has a responsibility to make sure all reasonable measures are taken to reduce fatigue of staff. Therefore, it is important to assess what the current rostering processes is for staff responsible for creating the rosters for nurses. AIM The aims of the project were to understand (1) who creates the rosters and what the process is, (2) what training and knowledge these staff have in establishing rostering schedules that optimise the sleep and wellbeing of staff, and (3) what the benefits and limitations are of current rostering practices. METHODS Findings were generated through semi-structured interviews, using cluster coding to form categories. Twenty four nurses responsible for rostering staff were interviewed from three different sites in Victoria (one metropolitan and two regional/rural hospitals). Data was analysed using selected grounded theory methods with thematic analysis. RESULTS The common themes that came out of the interviews were that rostering staff were under prepared, unaware of fatigue and safety guidelines and polices from governing bodies and had not received any education or training before taking on the role. The most common rostering style was self-rostering, where staff could submit preferences. However, there were concerns about staff fatigue but were divided as to who should be responsible, with many saying it was up to staff to preference shifts that they could cope with. The final theme was cultural barriers to change. CONCLUSION While self-rostering resulted in staff having more freedom and flexibility, shift preferences may be influenced more so by a need to fit with lifestyle rather than to minimise fatigue and increase safety in the workplace. Greater consideration of the impact of shift work schedules on fatigue is required to ensure that the layers of clinical governance in health care organisations minimise the risk of occupation health and safety issues for employees delivering direct patient care.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, VIC, 3552, Australia.
- Institute for Breathing and Sleep, Austin Health, Melbourne, 3084, Australia.
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Jo Spong
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, 3084, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, VIC, 3552, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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Kasetti P, Husain NF, Skinner TC, Asimakopoulou K, Steier J, Sathyapala SA. Personality traits and pre-treatment beliefs and cognitions predicting patient adherence to continuous positive airway pressure: A systematic review. Sleep Med Rev 2024; 74:101910. [PMID: 38471433 DOI: 10.1016/j.smrv.2024.101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 01/09/2024] [Accepted: 02/12/2024] [Indexed: 03/14/2024]
Abstract
Adherence to Continuous Positive Airway Pressure (CPAP) for obstructive sleep apnoea (OSA) can be improved by behavioural interventions which modify patients' beliefs and cognitions about OSA, CPAP, and themselves. We have conducted the first systematic review of the literature on beliefs and cognitions held before starting treatment, and personality (which influences the former) that predict the decision to purchase or start CPAP, or CPAP adherence one month or more after CPAP initiation. A systematic search and screen of articles identified 21 eligible publications from an initial 1317. Quality assessment performed using an adapted Newcastle-Ottawa Scale demonstrated that 13 (62%) studies were poor quality and only seven (33%) were high quality. Eighteen factors, such as self-efficacy (confidence) in using CPAP and value placed on health predicted CPAP adherence; however, for only six (33%), utility as an intervention target is known, from calculation of individual predictive power. Studies did not use new behavioural frameworks effective at explaining adherence behaviours, nor did they interview patients to collect in-depth data on barriers and facilitators of CPAP use. Future studies cannot have these limitations if high quality evidence is to be generated for intervention development, which is currently sparse as highlighted by this review.
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Affiliation(s)
- P Kasetti
- Imperial College London, London, United Kingdom
| | - N F Husain
- Thames Valley Deanery, Oxford, United Kingdom
| | - T C Skinner
- La Trobe University, Melbourne, Australia; Copenhagen University, Denmark
| | | | - J Steier
- King's College London, London, United Kingdom; Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom
| | - S A Sathyapala
- Imperial College London, London, United Kingdom; Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom.
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Booker LA, Spong J, Hodge B, Deacon-Crouch M, Bish M, Mills J, Skinner TC. Differences in shift and work-related patterns between metropolitan and regional/rural healthcare shift workers and the occupational health and safety risks. Aust J Rural Health 2024; 32:141-151. [PMID: 38063243 DOI: 10.1111/ajr.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. DESIGN A cross-sectional study. SETTING An anonymous online survey of healthcare shift workers in Australia. PARTICIPANTS A total of 403 nurses, midwives and paramedics completed the survey. MAIN OUTCOME MEASURES Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. RESULTS Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. CONCLUSION Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Brad Hodge
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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Rey Velasco E, Demjén Z, Skinner TC. Digital empathy in behaviour change interventions: A survey study on health coach responses to patient cues. Digit Health 2024; 10:20552076231225889. [PMID: 38528968 PMCID: PMC10962034 DOI: 10.1177/20552076231225889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/14/2023] [Indexed: 03/27/2024] Open
Abstract
Introduction Digital health coaching interventions for behaviour change (BC) are effective in addressing various health conditions. Implementing these requires accurate descriptions of components and health coaches (HC) delivery methods, alongside understanding patients' perceptions of these interactions. The HC-patient relationship significantly influences BC outcomes. Here, empathy is an important driver that enables HCs to offer tailored advice that resonates with patients' needs, fostering motivation. Yet, defining and measuring empathy remains a challenge. In this study, we draw on various BC frameworks and Pounds' empathy appraisal approach to categorise HCs responses to patient cues and explore the interplay between empathy and BC. Methods Using a two-round survey, we collected responses from 11 HCs to 10 patient messages from the Bump2Baby and Me trial in a simulated interaction. We analysed 88 messages to identify empathic responses and behaviour change techniques. Results Patients' implicit empathy opportunities showed higher response rates than explicit ones. HCs prioritised positive reinforcement and employed various strategies to achieve similar objectives. The most common empathic response was 'Acceptance' for patients' implicit positive expressions of self-judgement. HCs emphasised relatedness-support and competence-promoting techniques for implicit negative feelings and judgements, such as 'Show unconditional regard' and 'Review behaviour goals', and 'Action planning and Problem-solving' techniques to address explicit negative appreciations and feelings. Conclusion The use of different techniques with the same objective highlights the complexity of BC interactions. Further research is needed to explore the impact of this variability on patient outcomes and programme fidelity.
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Affiliation(s)
- E Rey Velasco
- Liva Healthcare, Københavns Universitet Institut for Psykologi, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Kobenhavn, Denmark
| | - Z Demjén
- UCL Centre for Applied Linguistics, University College London, London, UK
| | - TC Skinner
- Department of Psychology, University of Copenhagen, Kobenhavn, Denmark
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Hernar I, Cooper JG, Nilsen RM, Skinner TC, Strandberg RB, Iversen MM, Graue M, Ernes T, Løvaas KF, Madsen TV, Lie SS, Richards DA, Ueland GÅ, Haugstvedt A. Diabetes Distress and Associations With Demographic and Clinical Variables: A Nationwide Population-Based Registry Study of 10,186 Adults With Type 1 Diabetes in Norway. Diabetes Care 2024; 47:126-131. [PMID: 37922320 PMCID: PMC10733651 DOI: 10.2337/dc23-1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/16/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To estimate diabetes distress prevalence and associations with demographic and clinical variables among adults with type 1 diabetes in Norway. RESEARCH DESIGN AND METHODS In this nationwide population-based registry study, the 20-item Problem Areas in Diabetes (PAID-20) questionnaire was sent to 16,255 adults with type 1 diabetes. Linear regression models examined associations of demographic and clinical variables with distress. RESULTS In total, 10,186 individuals (62.7%) completed the PAID-20, with a mean score of 25.4 (SD 18.4) and 21.7% reporting high distress. Respondents endorsed worrying about the future and complications as the most problematic item (23.0%). Female sex, younger age, non-European origin, primary education only, unemployment, smoking, continuous glucose monitoring use, more symptomatic hypoglycemia, reduced foot sensitivity, treated retinopathy, and higher HbA1c were associated with higher distress. CONCLUSIONS Diabetes distress is common among adults with type 1 diabetes and associated with clinically relevant factors, underlining that regular care should include efforts to identify and address distress.
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Affiliation(s)
- Ingvild Hernar
- Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - John G. Cooper
- Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Roy M. Nilsen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Timothy C. Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
- Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
| | - Ragnhild B. Strandberg
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Marjolein M. Iversen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Centre on Patient-Reported Outcomes Data, Haukeland University Hospital, Bergen, Norway
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tony Ernes
- Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Karianne F. Løvaas
- Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Tone V. Madsen
- Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Silje S. Lie
- Department of Health, VID Specialized University, Stavanger, Norway
| | - David A. Richards
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Grethe Å. Ueland
- Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway
- Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Speight J, Holmes-Truscott E, Garza M, Scibilia R, Wagner S, Kato A, Pedrero V, Deschênes S, Guzman SJ, Joiner KL, Liu S, Willaing I, Babbott KM, Cleal B, Dickinson JK, Halliday JA, Morrissey EC, Nefs G, O'Donnell S, Serlachius A, Winterdijk P, Alzubaidi H, Arifin B, Cambron-Kopco L, Santa Ana C, Davidsen E, de Groot M, de Wit M, Deroze P, Haack S, Holt RIG, Jensen W, Khunti K, Kragelund Nielsen K, Lathia T, Lee CJ, McNulty B, Naranjo D, Pearl RL, Prinjha S, Puhl RM, Sabidi A, Selvan C, Sethi J, Seyam M, Sturt J, Subramaniam M, Terkildsen Maindal H, Valentine V, Vallis M, Skinner TC. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol 2024; 12:61-82. [PMID: 38128969 DOI: 10.1016/s2213-8587(23)00347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.
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Affiliation(s)
- Jane Speight
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Elizabeth Holmes-Truscott
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Renza Scibilia
- Diabetogenic, Melbourne, VIC, Australia; JDRF International, New York, NY, USA
| | - Sabina Wagner
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Victor Pedrero
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
| | - Sonya Deschênes
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Kevin L Joiner
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ingrid Willaing
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Institute of Public Health, Department of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Katie M Babbott
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bryan Cleal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jane K Dickinson
- Department of Health Studies & Applied Educational Psychology, Teachers College Columbia University, New York, NY, USA
| | - Jennifer A Halliday
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Eimear C Morrissey
- Health Behavior Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Giesje Nefs
- Department of Medical Psychology, Radboudumc, Nijmegen, Netherlands; Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands; Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Shane O'Donnell
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | - Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bustanul Arifin
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | - Emma Davidsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Kamlesh Khunti
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Karoline Kragelund Nielsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Tejal Lathia
- Department of Endocrinology, Apollo Hospitals, Navi Mumbai, India
| | | | | | - Diana Naranjo
- Department of Pediatrics, Division of Endocrinology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Suman Prinjha
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts & Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Chitra Selvan
- Department of Endocrinology, Ramaiah Medical College, Bengaluru, India
| | - Jazz Sethi
- The Diabesties Foundation, Ahmedabad, India
| | - Mohammed Seyam
- Faculty of Medicine, Al-Quds University, Abu Dis, Palestine
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Mythily Subramaniam
- Institute of Mental Health Singapore, Singapore; Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Helle Terkildsen Maindal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Booker LA, Wilson D, Spong J, Fitzgibbon C, Deacon-Crouch M, Lenz KE, Skinner TC. Maternal Circadian Disruption from Shift Work and the Impact on the Concentration of Melatonin in Breast Milk. Breastfeed Med 2024; 19:33-39. [PMID: 38150529 DOI: 10.1089/bfm.2023.0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Background and Objective: Melatonin in breast milk exhibits a 24-hour circadian rhythm, present in nighttime breast milk but nearly undetectable in daytime breast milk. Shift work can disrupt the circadian timing of individuals, evident in changes in melatonin in saliva and urine samples. However, it is unknown whether these changes are also reflected in breast milk from a shift working mother. The aim of this study was to investigate whether maternal circadian rhythm disturbance from shift work impacts the melatonin concentration in breast milk. Materials and Methods: Breast milk and saliva samples were collected from 11 shift working mothers at four timepoints across five consecutive days. This included during their day shift or nonworkdays to act as a control, night shift, subsequent night shifts and postnight shift. Where possible, pre- and postfeed collections were also undertaken. Samples were grouped into four-time intervals: 12-6:30 am, 7-11:30 am, 12-6:30 pm, 7-11:30 pm, and melatonin levels (picogram per milliliter) in the breast milk and saliva samples were analyzed. Results: There was a significant decrease in breast milk melatonin (p = 0.026) at the 12-6:30 am time interval on subsequent night shifts, compared with control days. However, there was no overall time and shift type interaction effect (p = 0.70). In addition, no observed difference in melatonin levels was found in saliva samples, or when comparing pre- and postfeed breast milk. Breast milk melatonin however was found to be significantly higher compared with saliva (p > 0.001), at all but one time interval. Conclusion: The findings suggest that there is a potential effect of maternal circadian rhythm disruption from shift work on breast milk melatonin levels. This is an important step in exploring the role of maternal circadian timing and the effect on breast milk composition. Expansion of this research and exploration of other circadian rhythm misalignment sleep disorders on breast milk is highly recommended.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Danielle Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Katrin E Lenz
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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Booker LA, Fitzgerald J, Mills J, Bish M, Spong J, Deacon‐Crouch M, Skinner TC. Sleep and fatigue management strategies: How nurses, midwives and paramedics cope with their shift work schedules-a qualitative study. Nurs Open 2024; 11:e2099. [PMID: 38268269 PMCID: PMC10803889 DOI: 10.1002/nop2.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/07/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
AIMS To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift work. DESIGN A single case study with embedded units. METHODS Twenty-seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022. RESULTS Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long-term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations. CONCLUSION This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessary information, training and guidance to staff on how to reduce fatigue risk is required. PATIENT OR PUBLIC CONTRIBUTION This study involved healthcare shift workers in semi-structured interviews. Data gathered from a previous survey that participants were involved in helped shape the interview topics and the study design.
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Affiliation(s)
- Lauren A. Booker
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
| | - Jarrah Fitzgerald
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melissa Deacon‐Crouch
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Timothy C. Skinner
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Department of Psychology, Centre for Health and SocietyUniversity of CopenhagenCopenhagenDenmark
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Schipp J, Hendrieckx C, Braune K, Knoll C, O'Donnell S, Ballhausen H, Cleal B, Wäldchen M, Lewis DM, Gajewska KA, Skinner TC, Speight J. Psychosocial Outcomes Among Users and Nonusers of Open-Source Automated Insulin Delivery Systems: Multinational Survey of Adults With Type 1 Diabetes. J Med Internet Res 2023; 25:e44002. [PMID: 38096018 PMCID: PMC10755653 DOI: 10.2196/44002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 06/10/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Emerging research suggests that open-source automated insulin delivery (AID) may reduce diabetes burden and improve sleep quality and quality of life (QoL). However, the evidence is mostly qualitative or uses unvalidated, study-specific, single items. Validated person-reported outcome measures (PROMs) have demonstrated the benefits of other diabetes technologies. The relative lack of research investigating open-source AID using PROMs has been considered a missed opportunity. OBJECTIVE This study aimed to examine the psychosocial outcomes of adults with type 1 diabetes using and not using open-source AID systems using a comprehensive set of validated PROMs in a real-world, multinational, cross-sectional study. METHODS Adults with type 1 diabetes completed 8 validated measures of general emotional well-being (5-item World Health Organization Well-Being Index), sleep quality (Pittsburgh Sleep Quality Index), diabetes-specific QoL (modified DAWN Impact of Diabetes Profile), diabetes-specific positive well-being (4-item subscale of the 28-item Well-Being Questionnaire), diabetes treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire), diabetes distress (20-item Problem Areas in Diabetes scale), fear of hypoglycemia (short form of the Hypoglycemia Fear Survey II), and a measure of the impact of COVID-19 on QoL. Independent groups 2-tailed t tests and Mann-Whitney U tests compared PROM scores between adults with type 1 diabetes using and not using open-source AID. An analysis of covariance was used to adjust for potentially confounding variables, including all sociodemographic and clinical characteristics that differed by use of open-source AID. RESULTS In total, 592 participants were eligible (attempting at least 1 questionnaire), including 451 using open-source AID (mean age 43, SD 13 years; n=189, 41.9% women) and 141 nonusers (mean age 40, SD 13 years; n=90, 63.8% women). Adults using open-source AID reported significantly better general emotional well-being and subjective sleep quality, as well as better diabetes-specific QoL, positive well-being, and treatment satisfaction. They also reported significantly less diabetes distress, fear of hypoglycemia, and perceived less impact of the COVID-19 pandemic on their QoL. All were medium-to-large effects (Cohen d=0.5-1.5). The differences between groups remained significant after adjusting for sociodemographic and clinical characteristics. CONCLUSIONS Adults with type 1 diabetes using open-source AID report significantly better psychosocial outcomes than those not using these systems, after adjusting for sociodemographic and clinical characteristics. Using validated, quantitative measures, this real-world study corroborates the beneficial psychosocial outcomes described previously in qualitative studies or using unvalidated study-specific items.
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Affiliation(s)
- Jasmine Schipp
- The Australian Centre for Behavioural Research in Diabetes, Carlton, Australia
- Section for Health Services Research, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christel Hendrieckx
- The Australian Centre for Behavioural Research in Diabetes, Carlton, Australia
- School of Psychology, Deakin University, Burwood, Australia
| | - Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Dedoc Labs GmbH, Berlin, Germany
| | - Christine Knoll
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Shane O'Donnell
- School of Sociology & School of Medicine, University College Dublin, Dublin, Ireland
| | - Hanne Ballhausen
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Dedoc Labs GmbH, Berlin, Germany
| | - Bryan Cleal
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Mandy Wäldchen
- School of Sociology & School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Carlton, Australia
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Carlton, Australia
- School of Psychology, Deakin University, Burwood, Australia
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11
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Booker LA, Fitzgibbon C, Spong J, Deacon-Crouch M, Wilson DL, Skinner TC. Rapid Versus Slow Cooling Pasteurization of Donor Breast Milk: Does the Cooling Rate Effect Melatonin Reduction? Breastfeed Med 2023; 18:951-955. [PMID: 38100440 DOI: 10.1089/bfm.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Background and Objective: There is a question as to whether melatonin levels in breast milk are impacted by the cooling rate postpasteurization. Past research that has used in the Australian donor bank's breast milk Holder Pasteurization technique has reported varying findings regarding melatonin levels postpasteurization. Where breast milk was cooled slowly, a significant reduction in breast milk melatonin levels was observed. Conversely, where a rapid cooling method was used, there was no significant reduction in melatonin levels. The aim of this study was to investigate whether the cooling process between the different pasteurization techniques impact on melatonin levels in breast milk postpasteurization. Materials and Methods: Twenty-seven nighttime breast milk samples were collected, with each sample divided into three; one remained unpasteurized, one was pasteurized and rapidly cooled to 4°C, and the other was pasteurized and cooled slowly to 4°C. Results: Melatonin levels were significantly reduced in both the rapidly cooled and slow cooled breast milk samples when compared to their unpasteurized counterpart (p < 0.001). There was no significant difference in melatonin levels between the two cooling methods (p = 0.91). Conclusion: This study showed that both the rapid and cooling pasteurization processes had a similar reduction in melatonin levels in breast milk. However, even after pasteurization melatonin was still present. Therefore, it is recommended that donor banks still take into consideration circadian timing hormones such as melatonin and the time of day breast milk is expressed.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Danielle L Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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12
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DeCosta P, Skinner TC, Sørensen JL, Topperzer MK, Grabowski D. Young children's perspectives on treatment and care: A qualitative study using narrative and play-based interviewing. J Pediatr Nurs 2023; 73:211-220. [PMID: 37862851 DOI: 10.1016/j.pedn.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023]
Abstract
PURPOSE To explore young children's (age 3-6 years) own experiences and perceptions of treatment and care when living with a chronic illness. DESIGN AND METHODS The study employed a qualitative research design using a narrative and play-based interview approach. Individual face-to-face, narrative and play-based interviews were conducted with eight young children age 3-6 years with type 1 diabetes or cystic fibrosis. The play sessions took place at the home of the children and were video recorded. Interpretative phenomenological analysis was used to analyse the data and frame the study. RESULTS Our analysis identified six main themes: 1. Children understood illness through their bodily experience of treatment and care, 2. Children's experience of care and treatment ranged from a feeling of powerlessness to a sense of agency, 3. Children depended on their parents to provide comfort, advocacy and protection, 4. Children's perceptions of treatment and care were inherently related to their experiences of familiarity, interpersonal relationships and trust, 5. Children with type 1 diabetes did not perceive that they played an active role during consultations, and 6. Children associated medical treatment with receiving tangible rewards or positive feedback. CONCLUSION Children expressed a need to feel safe and build agency. They experienced this through participation and interpersonal relationships with healthcare professionals. PRACTICE IMPLICATIONS We should prioritize the establishment and implementation of age-appropriate psychosocial care practices that support young children in participating, forming relationships, and building trust.
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Affiliation(s)
- Patricia DeCosta
- Department of Prevention, Health Promotion & Community Care, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Timothy C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
| | - Jette Led Sørensen
- Juliane Marie Centre & Mary Elizabeths Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martha Krogh Topperzer
- Juliane Marie Centre & Mary Elizabeths Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen, Denmark
| | - Dan Grabowski
- Department of Prevention, Health Promotion & Community Care, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
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13
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Booker LA, Hodge B, Skinner TC. Rethinking the distribution of sleep services: discrepancy of obstructive sleep apnoea in rural compared with metropolitan men in Australia - a large national survey. Rural Remote Health 2023; 23:7704. [PMID: 37700451 DOI: 10.22605/rrh7704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Geographical location is increasingly recognised as a contributor to health inequity, with barriers including travel distances and a shortage of healthcare services. Individuals living in rural areas are known to have increased illness and comorbidities. Obstructive sleep apnoea (OSA) is one such illness. OSA is a condition where a person repeatedly pauses breathing while asleep due to their airways becoming wholly or partially blocked, and it is associated with various chronic diseases. Exploration into the effects of these barriers on OSA is limited. This study explores the proportion of diagnosed and undiagnosed OSA in men living in rural compared to metropolitan areas. METHODS This was a cross-sectional, secondary analysis of the Australian Ten to Men dataset. The present study looked at men aged over 18 years diagnosed with OSA in their lifetime from wave 2 (n=10 513) and wave 3 (n=7262) of the dataset. Wave 2 data were collected between November 2015 and May 2016, and wave 3 between July 2020 and February 2021. RESULTS In wave 2, a higher proportion of rural men were diagnosed with OSA than metropolitan men (OR, 1.47, 95%CI 1.22-1.78, p<0.001), but not regional men. In addition, a significantly higher proportion of men in rural areas were at risk for OSA than metropolitan men (37.7% v 32.6%, p<0.0001). However, men living rurally were older, had higher BMI and lower socioeconomic status. Location was no longer a significant predictor of OSA after controlling for age, BMI and socioeconomic status. In wave 3, rate of diagnosis of OSA during the lifetime was no longer significantly associated with location (p=0.057) or being diagnosed with OSA in the previous 12 months (p=0.062). CONCLUSION This study highlights the need to ensure adequate services in rural areas, given the higher proportion of men diagnosed with, or at risk of, OSA in rural areas. OSA is also associated with an increase risk of comorbidities such as heart disease, hypertension and diabetes, which are diseases also seen more prevalently in rural men. Rethinking the distribution of healthcare services will go some way to addressing this problem.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Vic., Australia; and Institute for Breathing and Sleep, Austin Health, Melbourne, Vic., Australia
| | - Brad Hodge
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Vic., Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Vic., Australia; and Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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14
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Holloway EE, Gray S, Halliday J, Harrap B, Hines C, Skinner TC, Speight J, Hendrieckx C. Feasibility and acceptability of 'low-intensity mental health support via a telehealth-enabled network' for adults with type 1 and type 2 diabetes: the LISTEN pilot study. Pilot Feasibility Stud 2023; 9:133. [PMID: 37501203 PMCID: PMC10373371 DOI: 10.1186/s40814-023-01367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND This study examined the feasibility and acceptability of the low-intensity mental health support via telehealth-enabled network (LISTEN) intervention, for adults with diabetes, facilitated by diabetes health professionals (HPs). METHODS LISTEN training. Three HPs participated in three half-day online workshops and applied their learnings during training cases (maximum four). Competency was assessed with a validated tool and achieved 'satisfactory' ratings for three consecutive sessions. LISTEN pilot. A single-group, pre-post study (up to four LISTEN sessions) with online assessments at baseline, post-intervention, and 4-week follow-up. Eligible participants were adults with type 1 or type 2 diabetes, with diabetes distress, but excluded if they had moderate/severe depressive and/or anxiety symptoms. Feasibility was assessed via recruitment and session completion rates. Acceptability was assessed with post-intervention self-report data. Changes in diabetes distress and general emotional well-being from baseline (T1) were explored at post-intervention (T2) and at 4-week follow-up (T3). RESULTS Two HPs achieved competency (median training case sessions required: 7) and progressed to deliver LISTEN in the pilot study. In the pilot, N = 16 adults (Med [IQR] age: 60 [37-73] years; 13 women) with diabetes participated (median sessions per participant: 2). Twelve participants (75%) completed the post-intervention assessment (T2): 92% endorsed the number of sessions offered as 'just right', 75% felt comfortable talking with the HP, and 67% were satisfied with LISTEN. Perceived limitations were the structured format and narrow scope of problems addressed. Diabetes distress scores were lower post-intervention. CONCLUSIONS This pilot demonstrates the feasibility of training HPs to deliver LISTEN, and the acceptability and potential benefits of LISTEN for adults with diabetes. The findings highlight adaptations that may enhance the delivery of, and satisfaction with, LISTEN that will be tested in a hybrid type 1 effectiveness-implementation trial.
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Affiliation(s)
- Edith E Holloway
- School of Psychology, Deakin University, Geelong, VIC, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia.
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Shikha Gray
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
| | - Jennifer Halliday
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Benjamin Harrap
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, VIC, Australia
| | | | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
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15
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Perrin BM, Diacogiorgis D, Sullivan C, Gerrard J, Skinner I, Skinner TC, Nawaratne R, Alahakoon D, Kingsley MIC. Habitual Physical Activity of People with or at Risk of Diabetes-Related Foot Complications. Sensors (Basel) 2023; 23:5822. [PMID: 37447670 DOI: 10.3390/s23135822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
Regular physical activity is an important component of diabetes management. However, there are limited data on the habitual physical activity of people with or at risk of diabetes-related foot complications. The aim of this study was to describe the habitual physical activity of people with or at risk of diabetes-related foot complications in regional Australia. Twenty-three participants with diabetes from regional Australia were recruited with twenty-two participants included in subsequent analyses: no history of ulcer (N = 11) and history of ulcer (N = 11). Each participant wore a triaxial accelerometer (GT3X+; ActiGraph LLC, Pensacola, FL, USA) on their non-dominant wrist for 14 days. There were no significant differences between groups according to both participant characteristics and physical activity outcomes. Median minutes per day of moderate-to-vigorous physical activity (MVPA) were 9.7 (IQR: 1.6-15.7) while participants recorded an average of 280 ± 78 min of low-intensity physical activity and 689 ± 114 min of sedentary behaviour. The sample accumulated on average 30 min of slow walking and 2 min of fast walking per day, respectively. Overall, participants spent very little time performing MVPA and were largely sedentary. It is important that strategies are put in place for people with or at risk of diabetes-related foot complications in order that they increase their physical activity significantly in accordance with established guidelines.
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Affiliation(s)
- Byron M Perrin
- La Trobe Rural Health School, La Trobe University, Bendigo 3552, Australia
- Holsworth Research Initiative, La Trobe University, Bendigo 3550, Australia
| | | | - Courtney Sullivan
- La Trobe Rural Health School, La Trobe University, Bendigo 3552, Australia
- Holsworth Research Initiative, La Trobe University, Bendigo 3550, Australia
| | - James Gerrard
- Central Australian Aboriginal Congress, Mparntwe (Alice Springs) 0870, Australia
| | - Isabelle Skinner
- La Trobe Rural Health School, La Trobe University, Bendigo 3552, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo 3552, Australia
| | - Rashmika Nawaratne
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora 3086, Australia
| | - Damminda Alahakoon
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora 3086, Australia
| | - Michael I C Kingsley
- La Trobe Rural Health School, La Trobe University, Bendigo 3552, Australia
- Holsworth Research Initiative, La Trobe University, Bendigo 3550, Australia
- Department of Exercise Sciences, University of Auckland, Auckland 1023, New Zealand
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16
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Booker LA, Lenz KE, Spong J, Deacon-Crouch M, Wilson DL, Nguyen TH, Skinner TC. High-Temperature Pasteurization Used at Donor Breast Milk Banks Reduces Melatonin Levels in Breast Milk. Breastfeed Med 2023. [PMID: 37257176 DOI: 10.1089/bfm.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background and Objective: Donor human milk banks are used when breast milk directly from mothers is unavailable or insufficient. Breast milk contains melatonin, which exhibits a 24-hour pattern. Melatonin promotes sleep onset and is barely detected in daytime milk but rises in the evening and peaks early in the morning. Melatonin supports the development of an infant's own circadian rhythm and is important for neurodevelopment. Currently, donor banks pasteurize breast milk using a Holder Pasteurization (HoP) technique where breast milk is treated at a high temperature (+62°) for 30 minutes before cooling to eliminate any pathogens before it is given to infants. It is not known how the pasteurization process affects the melatonin levels in breast milk. The aim of this study was to investigate whether the pasteurization process reduces melatonin levels in breast milk. Materials and Methods: Ten night-time breast milk samples were collected and each divided into two groups; one group remained unpasteurized and the other group was pasteurized using the HoP technique. Results: Melatonin levels between the unpasteurized and pasteurized groups were compared. Results showed that there was a significant reduction after pasteurization (mean ± standard deviation = 51.92 pg/mL ± 19.54 versus 39.66 pg/mL ± 13.05, p = 0.01). Conclusions: It is important to understand that pasteurization can reduce melatonin levels in breast milk because this hormone is considered important to support the neurodevelopment of infants, especially those born preterm. Further focus on the effect of pasteurization techniques on melatonin in donor breast milk is warranted.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Katrin E Lenz
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Rural Department of Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Rural Department of Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Danielle L Wilson
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Trang H Nguyen
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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17
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Holloway EE, Gray S, Mihalopoulos C, Versace VL, Le Gautier R, Chatterton ML, Hagger V, Halliday J, Henshaw K, Harrap B, Manallack S, Black T, Van Bruggen N, Hines C, O'Neil A, Skinner TC, Speight J, Hendrieckx C. Low-Intensity mental health Support via a Telehealth Enabled Network for adults with diabetes (LISTEN): protocol for a hybrid type 1 effectiveness implementation trial. Trials 2023; 24:350. [PMID: 37221629 DOI: 10.1186/s13063-023-07338-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/29/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs). METHODS A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes (N = 454) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN-a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between-group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes. DISCUSSION It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required. TRIAL REGISTRATION This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on 1 February, 2022.
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Affiliation(s)
- Edith E Holloway
- School of Psychology, Deakin University, Geelong, VIC, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
- Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Shikha Gray
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Vincent L Versace
- School of Medicine, Deakin Rural Health, Deakin University, Warrnambool, VIC, Australia
| | - Roslyn Le Gautier
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Virginia Hagger
- Institute for Health Transformation, Deakin University, Geelong, Australia
- School of Nursing & Midwifery, Deakin University, Burwood, VIC, Australia
| | - Jennifer Halliday
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | | | - Benjamin Harrap
- School of Medicine, Deakin Rural Health, Deakin University, Warrnambool, VIC, Australia
| | - Sarah Manallack
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | | | | | - Adrienne O'Neil
- IMPACT Institute, Deakin University, Geelong, VIC, Australia
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Department of Psychology, La Trobe University, Victoria, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, Australia
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18
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Bardram JE, Cramer-Petersen C, Maxhuni A, Christensen MVS, Bækgaard P, Persson DR, Lind N, Christensen MB, Nørgaard K, Khakurel J, Skinner TC, Kownatka D, Jones A. DiaFocus: A Personal Health Technology for Adaptive Assessment in Long-Term Management of Type 2 Diabetes. ACM Trans Comput Healthcare 2023; 4:1-43. [DOI: 10.1145/3586579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 02/08/2023] [Indexed: 07/25/2023]
Abstract
Type 2 diabetes (T2D) is a large disease burden worldwide and represents an increasing and complex challenge for all societies. For the individual, T2D is a complex, multi-dimensional, and long-term challenge to manage, and it is challenging to establish and maintain good communication between the patient and healthcare professionals. This article presents DiaFocus, which is a mobile health sensing application for long-term ambulatory management of T2D. DiaFocus supports an
adaptive
collection of physiological, behavioral, and contextual data in combination with ecological assessments of psycho-social factors. This data is used for improving patient-clinician communication during consultations. DiaFocus is built using a generic data collection framework for mobile and wearable sensing and is highly extensible and customizable. We deployed DiaFocus in a 6-week feasibility study involving 12 patients with T2D. The patients found the DiaFocus approach and system useful and usable for diabetes management. Most patients would use such a system, if available as part of their treatment. Analysis of the collected data shows that mobile sensing is feasible for longitudinal ambulatory assessment of T2D, and helped identify the most appropriate target users being early diagnosed and technically literate T2D patients.
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Affiliation(s)
| | | | - Alban Maxhuni
- Technical University of Denmark, Kgs. Lyngby, DK, Denmark
| | | | - Per Bækgaard
- Technical University of Denmark, Kgs. Lyngby, DK, Denmark
| | - Dan R. Persson
- Technical University of Denmark, Kgs. Lyngby, DK, Denmark
| | - Nanna Lind
- Steno Diabetes Center Copenhagen, Herlev, DK, Denmark
| | | | | | | | | | | | - Allan Jones
- Roche Diabetes Care GmbH, Mannheim, DE, Germany
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19
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Booker LA, Spong J, Deacon-Crouch M, Skinner TC. Preliminary Exploration into the Impact of Mistimed Expressed Breast Milk Feeding on Infant Sleep Outcomes, Compared to Other Feeding Patterns. Breastfeed Med 2022; 17:853-858. [PMID: 36137055 DOI: 10.1089/bfm.2022.0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background and Objective: The presence and fluctuation of melatonin in breast milk during the night and day may be providing sleep timing information to infants, thereby supporting/enabling the development of their own circadian cycle. If this is the case, then it is important that infants consume breast milk according to the time of day it is produced. However, breast milk is not always consumed at the "right" time. The aim of this study was to investigate whether consuming mistimed expressed breast milk impacts infant sleep compared with other feeding types. Methods: A total of 329 mothers completed an online anonymous survey. Mothers were grouped into one of five groups; direct breastfed only, formula only, express mistimed, express-timed, and combined breastfed/formula fed. Results: Cross-sectional analysis showed mistimed expressed breast milk was significantly associated with delayed sleep onset of the infant (p < 0.001), but direct breastfed infants had significantly more awakenings at night (p < 0.001). Conclusions: The findings from this study suggest a potential effect of mistimed expressed breast milk consumption on an infant's circadian rhythm, affecting some aspects of their sleep. This is an important first step in exploring mistimed feeding on infant sleep outcomes and provides preliminary evidence that warrants future research.
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Affiliation(s)
- Lauren A Booker
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.,Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Rural Department Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.,Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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20
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Huhndt A, Chen Y, O’Donnell S, Cooper D, Ballhausen H, Gajewska KA, Froment T, Wäldchen M, Lewis DM, Raile K, Skinner TC, Braune K. Barriers to Uptake of Open-Source Automated Insulin Delivery Systems: Analysis of Socioeconomic Factors and Perceived Challenges of Caregivers of Children and Adolescents With Type 1 Diabetes From the OPEN Survey. Front Clin Diabetes Healthc 2022; 3:876511. [PMID: 36992765 PMCID: PMC10012142 DOI: 10.3389/fcdhc.2022.876511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/04/2022] [Indexed: 01/15/2023]
Abstract
BackgroundAs a treatment option for people living with diabetes, automated insulin delivery (AID) systems are becoming increasingly popular. The #WeAreNotWaiting community plays a crucial role in the provision and distribution of open-source AID technology. However, while a large percentage of children were early adopters of open-source AID, there are regional differences in adoption, which has prompted an investigation into the barriers perceived by caregivers of children with diabetes to creating open-source systems.MethodsThis is a retrospective, cross-sectional and multinational study conducted with caregivers of children and adolescents with diabetes, distributed across the online #WeAreNotWaiting online peer-support groups. Participants—specifically caregivers of children not using AID—responded to a web-based questionnaire concerning their perceived barriers to building and maintaining an open-source AID system.Results56 caregivers of children with diabetes, who were not using open-source AID at the time of data collection responded to the questionnaire. Respondents indicated that their major perceived barriers to building an open-source AID system were their limited technical skills (50%), a lack of support by medical professionals (39%), and therefore the concern with not being able to maintain an AID system (43%). However, barriers relating to confidence in open-source technologies/unapproved products and fear of digital technology taking control of diabetes were not perceived as significant enough to prevent non-users from initiating the use of an open-source AID system.ConclusionsThe results of this study elucidate some of the perceived barriers to uptake of open-source AID experienced by caregivers of children with diabetes. Reducing these barriers may improve the uptake of open-source AID technology for children and adolescents with diabetes. With the continuous development and wider dissemination of educational resources and guidance—for both aspiring users and their healthcare professionals—the adoption of open-source AID systems could be improved.
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Affiliation(s)
- Antonia Huhndt
- Department of Paediatric Endocrinology and Diabetes, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Yanbing Chen
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Ireland
| | - Shane O’Donnell
- School of Sociology, University College Dublin, Belfield, Ireland
| | - Drew Cooper
- Department of Paediatric Endocrinology and Diabetes, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Hanne Ballhausen
- Department of Paediatric Endocrinology and Diabetes, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- #dedoc° Diabetes Online Community, Dedoc Labs GmbH, Berlin, Germany
| | - Katarzyna A. Gajewska
- #dedoc° Diabetes Online Community, Dedoc Labs GmbH, Berlin, Germany
- Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Timothée Froment
- #dedoc° Diabetes Online Community, Dedoc Labs GmbH, Berlin, Germany
| | - Mandy Wäldchen
- School of Sociology, University College Dublin, Belfield, Ireland
| | | | - Klemens Raile
- Department of Paediatric Endocrinology and Diabetes, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Timothy C. Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
- La Trobe University, Bendigo, Australia
| | - Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Institute of Medical Informatics, Charité—Universitätsmedizin Berlin, Berlin, Germany
- *Correspondence: Katarina Braune,
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21
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Speight J, Baptista S, Lee C, Sher L, Skinner TC, Brown A. The Social and Emotional Well-being of Indigenous Peoples Living With Diabetes: A Systematic Review Protocol. Front Clin Diabetes Healthc 2022; 3:902395. [PMID: 36992776 PMCID: PMC10012064 DOI: 10.3389/fcdhc.2022.902395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022]
Abstract
IntroductionGlobally, Indigenous people have a greater incidence and earlier onset of diabetes than the general population and have higher documented rates of emotional distress and mental illness. This systematic review will provide a synthesis and critical appraisal of the evidence focused on the social and emotional well-being of Indigenous peoples living with diabetes, including prevalence, impact, moderators, and the efficacy of interventions.MethodsWe will search MEDLINE Complete, EMBASE, APA PsycINFO, and CINAHL Complete from inception until late April 2021. Search strategies will include keywords related to Indigenous peoples, diabetes, and social and emotional well-being. All abstracts will be rated independently by two researchers against specified inclusion criteria. Eligible studies will report social and emotional well-being data for Indigenous people with diabetes, and/or report on the efficacy of interventions designed to address social and emotional well-being in this population. For each eligible study, quality will be rated using standard checklists to appraise each study’s internal validity, to be determined based on study type. Any discrepancies will be resolved through discussions and consultation with other investigators as needed. We expect to present a narrative synthesis of the evidence.DiscussionThe findings of the systematic review will enable greater understanding of the impact of relationships between diabetes and emotional well-being among Indigenous peoples to inform research, policy and practice. The findings will be accessible to Indigenous people affected by diabetes through a summary published in plain language on our research centre’s website.Systematic Review RegistrationPROSPERO registration number: CRD42021246560.
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Affiliation(s)
- Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Shaira Baptista
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Shaira Baptista,
| | - Christopher Lee
- First Nations Diabetes consumer and advocate, Melbourne, VIC, Australia
| | - Louisa Sher
- Library, Deakin University, Geelong, VIC, Australia
| | - Timothy C. Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- LaTrobe University, Melbourne, VIC, Australia
| | - Alex Brown
- College of Health & Medicine, Australian National University, Canberra, ACT, Australia
- Telethon Kids Institute, Perth, WA, Australia
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22
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Booker LA, Cordon EL, Pedersen HS, Fosgerau CF, Egerton S, Chan CKY, Skinner TC. Different Behavior-Change Messaging Techniques Do Not Increase Customers' Hand Sanitization Adherence During the COVID-19 Pandemic: A Natural Behavioral Study. Front Psychol 2022; 13:876131. [PMID: 35756219 PMCID: PMC9218524 DOI: 10.3389/fpsyg.2022.876131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hand hygiene is an integral public health strategy in reducing the transmission of COVID-19, yet the past research has shown hand hygiene practices among the public is sub-optimal. This study aimed to (1) quantify hand sanitization rates among the public to minimize the transmission of COVID-19 and (2) evaluate whether different public health messaging, based on various behavior-change theories influences hand hygiene behavior in a natural setting. Methods An observational, naturalistic study design was used with real-time customer activity data recorded against hand sanitizer usage in a regional hardware store. Primary outcome from the study was to measure the usage ratio by counting the amount of activity versus usage of hand sanitizer per hour against individual messages based on their behavioral change technique (BCT). Results There was no significant difference between the baseline message and any of the intervention messages [F(16,904) = 1.19, p = 0.279] or between BCT groups [F(3,906) = 1.33, p = 0.263]. Post hoc tests showed no significant difference between messages (social comparison, p = 0.395; information, p = 1.00; and action planning, p = 1.00). Conclusion This study showed that even during a pandemic, hand hygiene usage rates in a public setting were similar to the past studies and that compliance did not shift dependent on the public message displayed. This raises questions on whether requirements imposed on businesses to provide hand sanitizer to patrons are an ineffective and maybe an unnecessary economic burden. A measured approach to risk and behavioral analysis surrounding the use of hand sanitizer in a pandemic is suggested as a better approach to inform public policy on the value of hand sanitizer.
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Affiliation(s)
- Lauren A Booker
- La Trobe Rural Health School, La Trobe University, Melbourne, VIC, Australia
| | - Emma L Cordon
- La Trobe Rural Health School, La Trobe University, Melbourne, VIC, Australia
| | - Hanne Sæderup Pedersen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
| | | | - Simon Egerton
- Department of Computer Science and Information Technology, La Trobe University, Melbourne, VIC, Australia
| | - Carina K Y Chan
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Timothy C Skinner
- La Trobe Rural Health School, La Trobe University, Melbourne, VIC, Australia.,Department of Psychology, Centre for Health, and Society, University of Copenhagen, Copenhagen, Denmark
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23
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Schipp J, Skinner TC, Holloway E, Scibilia R, Langstrup H, Speight J, Hendrieckx C. 'We're all on the same team'. Perspectives on the future of artificial pancreas systems by adults in Australia with type 1 diabetes using open-source technologies: A qualitative study. Diabet Med 2022; 39:e14708. [PMID: 34599617 DOI: 10.1111/dme.14708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/22/2021] [Accepted: 09/29/2021] [Indexed: 11/27/2022]
Abstract
AIMS An emerging group of people with type 1 diabetes are not waiting for commercial solutions, choosing to manage their condition with open-source artificial pancreas systems (APS). Our aim was to explore their perspectives on the future of APS. METHODS Semi-structured telephone interviews were conducted (in Australia, October 2018 to January 2019) with 23 adults with type 1 diabetes currently using open-source APS. Interviews were recorded, transcribed and analysed thematically. RESULTS Participants described five key features of open-source APS they value: compatibility, user-led design, customisability, ability to evolve faster and community-driven. They attributed the success of the open-source APS movement to benefits they derive from these features: choice, solutions that meet their needs, ownership, staying one step ahead and real-time support. They expressed hope that future commercial products and healthcare would benefit from their learnings and from collaboration with the open-source APS community. CONCLUSIONS Participants believed that there will always be a place for the open-source community. It will continue to build on and advance commercial products, respond to user needs, offering a higher degree of control and customisation than afforded by commercial products and generating optimism for the future. Participants desired that future commercial diabetes technologies would be inspired by the open-source community and developed collaboratively with people with diabetes.
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Affiliation(s)
- Jasmine Schipp
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
- Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Edith Holloway
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Renza Scibilia
- Diabetes Australia, Canberra, Australian Capital Territory, Australia
| | - Henriette Langstrup
- Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jane Speight
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Christel Hendrieckx
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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24
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Skinner TC, Semmens L, Versace V, Bish M, Skinner IK. Does undertaking rural placements add to place of origin as a predictor of where health graduates work? Aust J Rural Health 2022; 30:529-535. [PMID: 35324046 PMCID: PMC9545767 DOI: 10.1111/ajr.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine the work location (metropolitan, regional, rural and remote) of graduates in nursing, allied health and oral health disciplines who complete their professional training, end-to-end training, in a regional or rural area noting the potential inclusion of a metropolitan-based placement for speciality practice not available in rural or regional Victoria. METHODS We tracked the place of employment from the Australian Health Practitioners Regulation Agency (AHPRA) of all graduates from a regional/rural tertiary education provider. The student home address at enrolment, locations where they undertook all placements and their current place of work were described using an objective geographical model of access, the Modified Monash Model. RESULTS Seventy-five per cent of 5506 graduates were located in the AHPRA database. About one third of graduates were working in metropolitan areas, 1/3 in regional cities and 1/3 in rural areas. Students' origin accounted for 1/3 of variance in current workplace location. The more placement days students completed in regional/ rural areas was also a significant predictor of working in a regional or rural area. CONCLUSION End-to-end training in regional/rural areas is an effective approach to retaining a regional/rural workforce. Student origin is a strong predictor of working rural or regionally, as is undertaking placements in rural areas. This suggests that priority for rural/ regional student placements should be given to students in end-to-end regional/ rural programs and students from a regional/ rural background.
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Affiliation(s)
- Timothy C Skinner
- La Trobe University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia.,Institute of Psychology, University of Copenhagen, Copenhagen, Denmark.,Centre for Rural and Remote Health, James Cooke University, Mount Isa, Queensland, Australia
| | - Libby Semmens
- La Trobe University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Melanie Bish
- La Trobe University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - Isabelle K Skinner
- Centre for Rural and Remote Health, James Cooke University, Mount Isa, Queensland, Australia
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25
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Holmes-Truscott E, Holloway EE, Husin HM, Furler J, Hagger V, Skinner TC, Speight J. 'Is insulin right for me?': Feasibility of a pilot randomised controlled trial and acceptability of a web-based intervention to reduce psychological barriers to insulin therapy among adults with type 2 diabetes. Diabet Med 2022; 39:e14759. [PMID: 34865232 DOI: 10.1111/dme.14759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
AIMS Acceptable and accessible interventions are needed to address 'psychological insulin resistance', which is a common barrier to insulin uptake among adults with type 2 diabetes (T2D). Our aim was to test the feasibility of a randomised controlled trial (RCT) study design and acceptability of a theoretically grounded, psycho-educational, web-based resource to reduce negative insulin appraisals among adults with T2D. METHODS A double-blinded, parallel group, two-arm pilot RCT (1:1), comparing intervention with active control (existing online information about insulin). Eligible participants were Australian adults with T2D, taking oral diabetes medications. EXCLUSION CRITERIA prior use of injectable medicines; being 'very willing' to commence insulin. Primary outcomes: study feasibility (recruitment ease, protocol fulfilment, attrition, data completeness); secondary outcomes: intervention acceptability (intervention engagement, user feedback) and likely efficacy (negative Insulin Treatment Appraisal Scale [ITAS] scores at follow-up). Online surveys completed at baseline and 2 weeks. RESULTS During 4-week recruitment, 76 people expressed interest: 51 eligible and 35 enrolled (intervention = 17, control = 18; median[interquartile range] age = 62[53, 69] years; 17 women). Protocol fulfilment achieved by 26 (74%) participants (n = 13 per arm), with low participant attrition (n = 6, 17%). Intervention acceptability was high (>80% endorsement, except format preference = 60%). ITAS negative scores differed between-groups at follow-up (M diff = -6.5, 95% confidence interval: -10.7 to -2.4), favouring the intervention. CONCLUSIONS This novel web-based resource ("Is insulin right for me?") is acceptable and associated with a likely reduction in negative insulin appraisals, relative to existing resources. This pilot shows the study design is feasible and supports conduct of a fully powered RCT.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Edith E Holloway
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Hanafi M Husin
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - John Furler
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Virginia Hagger
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
- La Trobe Rural Health School, La Trobe University, Flora Hill, Victoria, Australia
- Department of Psychology, University of Copenhagen, København, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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Holmes-Truscott E, Holloway EE, Husin HM, Furler J, Hagger V, Skinner TC, Speight J. Web-based intervention to reduce psychological barriers to insulin therapy among adults with non-insulin-treated type 2 diabetes: study protocol for a two-armed randomised controlled trial of ' Is insulin right for me?'. BMJ Open 2022; 12:e051524. [PMID: 35190420 PMCID: PMC8862461 DOI: 10.1136/bmjopen-2021-051524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Psychological barriers to insulin therapy are associated with the delay of clinically indicated treatment intensification for people with type 2 diabetes (T2D), yet few evidence-based interventions exist to address these barriers. We describe the protocol for a randomised controlled trial (RCT) examining the efficacy of a novel, theoretically grounded, psychoeducational, web-based resource designed to reduce psychological barriers to insulin among adults with non-insulin treated T2D: 'Is insulin right for me?'. METHODS AND ANALYSIS Double-blind, parallel group RCT. A target sample of N=392 participants (n=196/arm) will be randomised (1:1) to 'Is insulin right for me?' (intervention) or widely available online resources (control). Eligible participants include adults (18-75 years), residing in Australia, currently taking oral hypoglycaemic agents to manage T2D. They will be primarily recruited via invitations and reminders from the national diabetes registry (from a purposefully selected sample of N≥12 000). EXCLUSION CRITERIA experience of self-administered injectable; previously enrolled in pilot RCT; 'very willing' to start insulin as baseline. Outcomes will be assessed via online survey at 2 weeks and 6 months. Primary outcome between-group: difference in mean negative Insulin Treatment Appraisal Scores (ITAS negative) at 2-week and 6-month follow-up. SECONDARY OUTCOMES between-group differences in mean positive insulin appraisals (ITAS positive) and percentage difference in intention to commence insulin at follow-up time points. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION Deakin University Human Research Ethics Committee (2020-073). Dissemination via peer-reviewed journals, conferences and a plain-language summary. TRIAL REGISTRATION NUMBER ACTRN12621000191897; Australian and New Zealand Clinical Trials Registry.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Edith E Holloway
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Hanafi M Husin
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - John Furler
- Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
| | - Virginia Hagger
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
| | - Timothy C Skinner
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, University of Copenhagen, Kobenhavn, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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DeCosta P, Grabowski D, Jespersen LN, Skinner TC. Playful Communication and Care: Exploring Child-Centred Care of Young Children With Type 1 Diabetes Through the Framework of Zone of Proximal Development. Front Clin Diabetes Healthc 2022; 2:707553. [PMID: 36994334 PMCID: PMC10012162 DOI: 10.3389/fcdhc.2021.707553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/23/2021] [Indexed: 01/19/2023]
Abstract
IntroductionLittle is known about the psychosocial experiences and care needs of young children under the age of 7 years who have been diagnosed with type 1 diabetes. To address this knowledge gap, we examine children’s psychosocial care needs through the lens of child-centred care and the framework of Zone of Proximal Development.ObjectivesTo explore current care practices for young children with diabetes and identify aspects of child-centred care already successfully integrated into current practice.MethodIndividual face-to-face, semi-structured interviews were conducted with 20 Healthcare Professionals, representing 11 of 17 paediatric diabetes clinics in Denmark.ResultsOur data provided valuable insights into existing child-centred practices. Our analysis identified practices covering four main themes: 1. Accommodating immediate emotional needs, 2. Putting children before diabetes, 3. Encouraging meaningful participation, 4. Playful communication.DiscussionHealthcare Professionals provided child-centred care, largely through play-based approaches that make diabetes care meaningful and relevant. Such practices provide the scaffolding necessary to enable young children to gradually engage, comprehend and participate in their own care.
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Affiliation(s)
- Patricia DeCosta
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Patricia DeCosta,
| | - Dan Grabowski
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | | | - Timothy C. Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Rural Health, La Trobe University, Bendigo, VIC, Australia
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Speight J, Skinner TC, Huber JW, Lake AJ, Messina R, Mocan A, Nefs G, Newson L, Povey R, Vallis M, Willaing I. A PSAD Group response to the consensus report on the definition and interpretation of remission in type 2 diabetes: a psychosocial perspective is needed. Diabetologia 2022; 65:406-408. [PMID: 34778926 DOI: 10.1007/s00125-021-05615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jörg W Huber
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Amelia J Lake
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Rossella Messina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Andreia Mocan
- Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital Cluj, Cluj, Romania
| | - Giesje Nefs
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
- Center of Research on Psychological Disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- Diabeter, National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, the Netherlands
| | - Lisa Newson
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Rachel Povey
- Department of Psychology, Staffordshire University, Stoke-on-Trent, UK
| | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ingrid Willaing
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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Braune K, Lal RA, Petruželková L, Scheiner G, Winterdijk P, Schmidt S, Raimond L, Hood KK, Riddell MC, Skinner TC, Raile K, Hussain S. Open-source automated insulin delivery: international consensus statement and practical guidance for health-care professionals. Lancet Diabetes Endocrinol 2022; 10:58-74. [PMID: 34785000 PMCID: PMC8720075 DOI: 10.1016/s2213-8587(21)00267-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 01/15/2023]
Abstract
Open-source automated insulin delivery systems, commonly referred to as do-it-yourself automated insulin delivery systems, are examples of user-driven innovations that were co-created and supported by an online community who were directly affected by diabetes. Their uptake continues to increase globally, with current estimates suggesting several thousand active users worldwide. Real-world user-driven evidence is growing and provides insights into safety and effectiveness of these systems. The aim of this consensus statement is two-fold. Firstly, it provides a review of the current evidence, description of the technologies, and discusses the ethics and legal considerations for these systems from an international perspective. Secondly, it provides a much-needed international health-care consensus supporting the implementation of open-source systems in clinical settings, with detailed clinical guidance. This consensus also provides important recommendations for key stakeholders that are involved in diabetes technologies, including developers, regulators, and industry, and provides medico-legal and ethical support for patient-driven, open-source innovations.
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Affiliation(s)
- Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany
| | - Rayhan A Lal
- Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.
| | - Lenka Petruželková
- Department of Pediatrics, University Hospital Motol, Prague, Czech Republic
| | | | - Per Winterdijk
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, Netherlands
| | | | | | - Korey K Hood
- Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Timothy C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Klemens Raile
- Department of Paediatric Endocrinology and Diabetes, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sufyan Hussain
- Department of Diabetes and Endocrinology, Guy's and St Thomas' Hospital NHS Trust, London, UK; Department of Diabetes, King's College London, London, UK; Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
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O'Reilly SL, Burden C, Campoy C, McAuliffe FM, Teede H, Andresen J, Campbell KJ, Geraghty AA, Harrison CL, Laws R, Norman JE, Maindal HT, Vrangbæk K, Segurado R, Versace VL, Skinner TC. Bump2Baby and Me: protocol for a randomised trial of mHealth coaching for healthy gestational weight gain and improved postnatal outcomes in high-risk women and their children. Trials 2021; 22:963. [PMID: 34963483 PMCID: PMC8713543 DOI: 10.1186/s13063-021-05892-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes (GDM) impacts 8–18% of pregnancies and greatly increases both maternal and child risk of developing non-communicable diseases such as type 2 diabetes and obesity. Whilst lifestyle interventions in pregnancy and postpartum reduce this risk, a research translation gap remains around delivering implementable interventions with adequate population penetration and participation. Impact Diabetes Bump2Baby is an implementation project of an evidence-based system of care for the prevention of overweight and obesity. Bump2Baby and Me is the multicentre randomised controlled trial investigating the effectiveness of a mHealth coaching programme in pregnancy and postpartum for women at high risk of developing GDM. Methods Eight hundred women will be recruited in early pregnancy from 4 clinical sites within Ireland, the UK, Spain, and Australia. Women will be screened for eligibility using the validated Monash GDM screening tool. Participants will be enrolled from 12 to 24 weeks’ gestation and randomised on a 1:1 basis into the intervention or control arm. Alongside usual care, the intervention involves mHealth coaching via a smartphone application, which uses a combination of synchronous and asynchronous video and text messaging, and allows for personalised support and goal setting with a trained health coach. The control arm receives usual care. All women and their children will be followed from early pregnancy until 12 months postpartum. The primary outcome will be a difference in maternal body mass index (BMI) of 0.8 kg/m2 at 12 months postpartum. Secondary maternal and infant outcomes include the development of GDM, gestational weight gain, pregnancy outcomes, improvements in diet, physical activity, sleep, and neonatal weight and infant growth patterns. The 5-year project is funded by the EU Commission Horizon 2020 and the Australian National Health and Medical Research Council. Ethical approval has been received. Discussion Previous interventions have not moved beyond tightly controlled efficacy trials into routine service delivery. This project aims to provide evidence-based, sustainable support that could be incorporated into usual care for women during pregnancy and postpartum. This study will contribute evidence to inform the early prevention of non-communicable diseases like obesity and diabetes in mothers and the next generation. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620001240932. Registered on 19 November 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05892-4.
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Affiliation(s)
- Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Christy Burden
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Cristina Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | | | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University Geelong, Geelong, Victoria, Australia
| | - Aisling A Geraghty
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University Geelong, Geelong, Victoria, Australia
| | - Jane E Norman
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Helle T Maindal
- Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| | - Karsten Vrangbæk
- Department of Public Health, Center for Health Economics and Policy, University of Copenhagen, Copenhagen, Denmark
| | - Ricardo Segurado
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin, Ireland
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Timothy C Skinner
- Institut for Psykologi, Center for Sundhed of Samfund, Københavns Universitet, Øster Farimagsgade, København K, Denmark.,University Department of Rural Health, La Trobe University, Bendigo, Australia
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Holloway EE, Hendrieckx C, Company G, Skinner TC, Speight J. Diabetes Distress During COVID-19: Three Brief ‘Snapshot’ Surveys of Adults With Diabetes Calling the Australian National Diabetes Services Scheme Helpline. Front Clin Diabetes Healthc 2021; 2:769528. [PMID: 36994350 PMCID: PMC10012053 DOI: 10.3389/fcdhc.2021.769528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/16/2021] [Indexed: 01/21/2023]
Abstract
The aim of this study was to take ‘snapshots’ of how people with diabetes are feeling emotionally during the coronavirus disease 2019 (COVID-19) pandemic. Three ‘snapshot’ surveys were conducted during May 2020, August 2020 and April 2021, each over a two-week period. Adults (≥18 years) with diabetes calling the Australian Government’s National Diabetes Services Scheme Helpline (NDSS) were invited to participate. Those who accepted were asked three questions sourced/adapted from the Problem Areas in Diabetes scale. Responses were recorded on a 5-point scale (0=’not a problem’, 4=’serious problem’). Of interest were scores ≥2, indicating this was at least a ‘moderate problem’. The survey was administered by NDSS Helpline staff via telephone. Basic demographic and clinical data were collected. In total, 1,278 surveys were completed over the three ‘snapshots’ (1st N=449; 2nd N=414; 3rd N=415). Participants were aged (median[IQR]) 62[47,72] years, 56% were women, and 57% had type 2 diabetes. At the 3rd ‘snapshot’, 21% had received a COVID-19 vaccine. Our findings show that feeling at least moderately ‘burned out’ by the constant effort needed to manage diabetes is salient, and consistently experienced by adults with diabetes calling the NDSS Helpline at three timepoints during the coronavirus pandemic. Those who participated in the 3rd ‘snapshot’ survey were less likely to report that feeling ‘alone with their diabetes’ or ‘worrying about their diabetes because of the COVID-19 pandemic’ were moderate or serious problems for them. Except for younger adults, findings indicate that the easing of restrictions may mitigate some of the effects of the pandemic on diabetes-specific emotional problems, including feeling ‘burned out’, ‘alone’ with diabetes, and/or worried about diabetes due to COVID-19. Prospective data are needed to improve our understanding of the emotional impact of COVID-19 on people with diabetes and to inform when and how to target support for those who need it most.
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Affiliation(s)
- Edith E. Holloway
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Edith E. Holloway,
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Timothy C. Skinner
- La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
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Versace VL, Skinner TC, Bourke L, Harvey P, Barnett T. National analysis of the Modified Monash Model, population distribution and a socio-economic index to inform rural health workforce planning. Aust J Rural Health 2021; 29:801-810. [PMID: 34672057 DOI: 10.1111/ajr.12805] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/29/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
AIMS To describe the population distribution and socio-economic position of residents across all states and territories of Australia, stratified using the 7 Modified Monash Model classifications. The numerical summary, and the methods described, can be applied by a variety of end users including workforce planners, researchers, policy-makers and funding bodies for guiding future investment under different scenarios, and aid in evaluating geographically focused programs. CONTEXT The Commonwealth Department of Health is transitioning to the Modified Monash Model to objectively describe geographical access. This change applies to the Rural Health Multidisciplinary Training Program, one of the Australian Government's key policies to address the maldistribution of the rural health workforce. Unlike the previously applied Australian Statistical Geography Standard-Remoteness Areas, a summary of the population in each Modified Monash Model classification is not available, nor is a socio-economic overview of the communities within these areas. APPROACH Spatial analysis of Australian Bureau of Statistics data (Modified Monash Model, population data and the Index of Relative Socio-economic Advantage and Disadvantage collected or derived from the 2016 census) at the Statistical Area 1-the smallest unit for the release of census data. CONCLUSION Linking the Modified Monash Model, a socio-economic index and granular population data at the national level highlights the disadvantage of many residents in small rural towns (Modified Monash 5). The Modified Monash Model does not exhibit a continuum of the largest population residing in the most accessible classification and the smallest population residing in the least accessible classification that is seen in the Australian Statistical Geography Standard-Remoteness Areas. Coupled with policy relevance, the advantage of using the Modified Monash Model as the basis for analysis is that it highlights areas that have both a critical mass of residents and differing levels of socio-economic advantage and disadvantage. This will help end users to target funding to those regions where there is potential to improve access to services for the greatest number of rural residents.
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Affiliation(s)
- Vincent L Versace
- Deakin Rural Health, Deakin University, Warrnambool, Vic., Australia
| | - Timothy C Skinner
- University Department of Rural Health, La Trobe University, Bendigo, Vic., Australia
| | - Lisa Bourke
- University Department of Rural Health, University of Melbourne, Shepparton, Vic., Australia
| | - Pam Harvey
- Monash Rural Health, Monash University, Bendigo, Vic., Australia
| | - Tony Barnett
- Centre for Rural Health, University of Tasmania, Launceston, TAS, Australia
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Holloway EE, Speight J, Furler J, Hagger V, O'Neal DN, Skinner TC, Holmes-Truscott E. 'Is Insulin Right for Me?' Development of a theory-informed, web-based resource for reducing psychological barriers to insulin therapy in type 2 diabetes. BMJ Open 2021; 11:e045853. [PMID: 34561252 PMCID: PMC8475140 DOI: 10.1136/bmjopen-2020-045853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To develop a theory and evidence-based web intervention to reduce psychological barriers towards insulin therapy among adults with non-insulin-treated type 2 diabetes (T2D). METHODS Salient psychological barriers towards insulin were identified from the literature and classified using the Theoretical Domains Framework (TDF). Relevant TDF domains were mapped to evidence-based behaviour change techniques (BCTs), which informed the content for each barrier. Acceptability was explored using cognitive debriefing interviews (n=6 adults with T2D). RESULTS 'Is Insulin Right for Me' addresses eight barriers, phrased as common questions: Does insulin mean my diabetes is more serious? Do insulin injections cause complications? Is it my fault I need to inject insulin? Will I gain weight? Will injecting hurt? What about hypos? Will injecting insulin be a burden? What will others think of me? BCTs, including persuasive communication and modelling/demonstration, were delivered using appropriate methods (eg, demonstration of the injection process). Participant suggestions for improvement included clear and direct messages, normalising insulin and avoiding confronting images. CONCLUSIONS 'Is Insulin Right for Me' is the first theory and evidence-based, web intervention designed to reduce psychological barriers towards insulin therapy for adults with T2D. Evaluation is needed to determine its impact on negative appraisals and receptiveness towards insulin.
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Affiliation(s)
- Edith E Holloway
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - John Furler
- Department of General Practice, The University of Melbourne, Carlton, Victoria, Australia
| | - Virginia Hagger
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - David N O'Neal
- Department of General Practice, The University of Melbourne, Carlton, Victoria, Australia
| | - Timothy C Skinner
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, University of Copenhagen, Kobenhavn, Denmark
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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McEvoy M, Parker C, Crombie A, Skinner TC, Begg S, Faulkner P, McEvoy A, Bamforth L, Caccaviello G. Loddon Mallee healthcare worker COVID-19 study-protocol for a prospective cohort study examining the health and well-being of rural Australian healthcare workers during the COVID-19 pandemic. BMJ Open 2021; 11:e050511. [PMID: 34380731 PMCID: PMC8359870 DOI: 10.1136/bmjopen-2021-050511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic is creating immense psychosocial disturbance. While global, broad-based research is being conducted, little is known about the effects of the COVID-19 pandemic on health and well-being or how protective and resilience factors influence the human response in Australian rural and regional communities. Rural and regional communities often have less resources to deal with such public health emergencies and face additional environmental adversity. Healthcare workers, including those in rural and regional areas, have felt the immediate impacts of COVID-19 in a multitude of ways and these impacts will continue for years to come. Therefore, this study aims to describe and understand the impacts of the COVID-19 pandemic on the rural and regional healthcare workforce within the Loddon Mallee region, Victoria, Australia. METHODS AND ANALYSIS This prospective cohort of rural and regional healthcare workers will be recruited and followed over 3 years to examine the effects of the COVID-19 pandemic on their health and well-being. Self-administered online questionnaires will be administered every 6 months for a 36-month period. Multiple outcomes will be assessed; however, the primary outcomes are emotional health and well-being and psychological resilience. Emotional health and well-being will be measured using validated instruments that will assess multiple domains of the emotional health and well-being continuum.Linear and logistic regression and latent growth curve modelling will be used to examine the association between baseline and follow-up participant emotional health, well-being and resilience while adjusting for potentially time-varying confounding variables. Participant characteristics measured at baseline will also be tested for association with incident health, morbidity, mortality and health service utilisation outcomes at follow-up. ETHICS AND DISSEMINATION Ethical approval has been obtained through the Bendigo Health Human Research Ethics Committee. The study findings will be disseminated through international conferences, international peer-reviewed journals and social media. TRIAL REGISTRATION NUMBER ACTRN12620001269921.
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Affiliation(s)
- Mark McEvoy
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Carol Parker
- Research and Innovation, Bendigo Health, Bendigo, Victoria, Australia
| | - Angela Crombie
- Research and Innovation, Bendigo Health, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Stephen Begg
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Peter Faulkner
- Research and Innovation, Bendigo Health, Bendigo, Victoria, Australia
| | - Anne McEvoy
- Executive Office, Kyabram District Health Service, Kyabram, Victoria, Australia
| | - Laura Bamforth
- Research and Innovation, Bendigo Health, Bendigo, Victoria, Australia
| | - Gabriel Caccaviello
- Staff Development, Swan Hill District Health, Swan Hill, Victoria, Australia
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Fatima Y, Bucks RS, Mamun AA, Skinner I, Rosenzweig I, Leschziner G, Skinner TC. Shift work is associated with increased risk of COVID-19: Findings from the UK Biobank cohort. J Sleep Res 2021; 30:e13326. [PMID: 33686714 PMCID: PMC8250353 DOI: 10.1111/jsr.13326] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 12/31/2022]
Abstract
Despite the strong evidence on circadian rhythm disruption in shift workers and consequent increased vulnerability for infection, longitudinal association between shift work and COVID-19 infection is unexplored. In this study, data from UK Biobank participants who were tested for COVID-19 infection (16 March to 7 September 2020) were used to explore the link between shift work and COVID-19 infection. Using the baseline occupational information, participants were categorised as non-shift workers, day shift workers, mixed shift workers and night shift workers. Multivariable regression models were used to assess the association between shift work and COVID-19 infection. Among the 18,221 participants (9.4% positive cases), 11.2% were health workers, and 16.4% were involved in shift-work-based jobs. Ethnic minorities (18%) and people in night-shift-based jobs (18.1%) had a significantly higher prevalence of COVID-19 infection than others. Adjusted logistics regression model suggest that, compared with their counterparts, people employed in a night-shift-based job were 1.85-fold (95% CI: 1.42-2.41) more likely to have COVID-19 infection. Sensitivity analysis focusing on people working in a non-healthcare setting suggests that people in shift-work-based jobs had 1.81-fold (95% CI: 1.04%-3.18%) higher odds of COVID-19 infection than their counterparts. Shift workers, particularly night shift workers, irrespective of their occupational group, seem to be at high risk of COVID-19 infection. If similar results are obtained from other studies, then it would mandate to revisit the criteria for defining high-risk groups for COVID-19 and implementing appropriate interventions to protect people in shift-based jobs.
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Affiliation(s)
- Yaqoot Fatima
- Institute for Social Science Research, University of Queensland, Brisbane, Australia.,Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Abdullah A Mamun
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Isabelle Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - Ivana Rosenzweig
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - Guy Leschziner
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timothy C Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia.,Institut for Psykologi, Center for Sundhed of Samfund, Københavns Universitet, København K, Denmark
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36
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Skinner TC, Skinner IK. Willpower beliefs and diabetes distress: a preliminary cross‐sectional study. Pract Diab 2021. [DOI: 10.1002/pdi.2314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Timothy C Skinner
- La Trobe Rural Health School, La Trobe UniversityBendigo Australia
- Department of Psychology, University of CopenhagenCopenhagen Denmark
| | - Isabelle K Skinner
- La Trobe Rural Health School, La Trobe UniversityBendigo Australia
- Centre for Rural and Remote Health, James Cook UniversityMount Isa Australia
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Fatima Y, Bucks RS, Mamun AA, Skinner I, Rosenzweig I, Leschziner G, Skinner TC. Sleep trajectories and mediators of poor sleep: findings from the longitudinal analysis of 41,094 participants of the UK Biobank cohort. Sleep Med 2020; 76:120-127. [PMID: 33157426 DOI: 10.1016/j.sleep.2020.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023]
Abstract
STUDY OBJECTIVES To explore sleep trajectories and identify the risk factors and mediators of poor sleep in middle-aged adults. METHODS Group-based multi-trajectory modelling was applied to the three waves of sleep data the from UK Biobank cohort to identify latent trajectories of sleep and group characteristics. Self-reported sleep duration, sleep problems (based on insomnia symptoms, snoring and trouble waking up) and daytime sleepiness (based on daytime tiredness and sleepiness) were included in the trajectory analyses. Multinomial logistic regression and mediation analysis were used to identify the main factors associated with poor sleep. RESULTS Analysis of sleep data from 41,094 participants (51.9% females) with a median age of 57 years (interquartile range 50-62 years) identified three distinct trajectories of sleep: healthy sleepers (40.8%); borderline poor sleepers (31.6%); and poor sleepers (27.6%). Socio-economic disadvantage, ethnic minority background, shift work, unhealthy lifestyle, poor health, depressive symptoms and obesity were the main risk factors associated with poor sleep. Around a third of the total effect of socio-economic deprivation on poor sleep was mediated through depressive symptoms. CONCLUSIONS The distinct groups with differential risk for developing sleep issues and stable sleep trajectories highlight the non-transient nature of sleep issues. Early management of depressive symptoms can help in reducing the future burden of poor sleep. Due to the increased risk of poor sleep, people from socio-economically deprived groups, particularly females from ethnic minorities, should be the highest priority for interventions aiming to improve population sleep health.
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Affiliation(s)
- Yaqoot Fatima
- Institute for Social Science Research, University of Queensland, Brisbane, Australia; Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia.
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Abdullah A Mamun
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Isabelle Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - Ivana Rosenzweig
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Guy Leschziner
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Timothy C Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia; University Department of Rural Health, La Trobe University, Bendigo, Australia; Institut for Psykologi, Center for Sundhed of Samfund, Københavns Universitet, Øster Farimagsgade, København K, Denmark
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38
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DeCosta P, Grabowski D, Skinner TC. The psychosocial experience and needs of children newly diagnosed with type 1 diabetes from their own perspective: a systematic and narrative review. Diabet Med 2020; 37:1640-1652. [PMID: 32619028 DOI: 10.1111/dme.14354] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2020] [Indexed: 01/09/2023]
Abstract
AIM To understand the psychosocial experience of children and identify their primary support needs following a type 1 diabetes diagnosis. METHODS A systematic review and narrative synthesis of the literature in this area was conducted. RESULTS A total of 32 studies were included in the review. At diagnosis, the majority of children experienced high distress, including grief, anxiety, anger, irritation and injection anxiety. The intensity of this reaction decreased rapidly over the following weeks. At diagnosis, rates of depressive symptoms, anxiety, stress disorders and suicidal ideation were elevated. The initial reaction tended to peak shortly after diagnosis and declined over the following year. Thereafter, symptoms of depression and anxiety appeared to increase once again, corresponding with the children's experience of diabetes management and implications as being more difficult and upsetting. Injection anxiety, distress and depressive symptoms persisted for a smaller group of children. CONCLUSION The initial high prevalence of depressive symptoms following diagnosis is transitional and should be regarded as a normal adaptive response. To facilitate this adaptive process, specific child-centred support should be prioritized as an integrated part of early diabetes care. Our findings point to five inter-related support needs following a type 1 diabetes diagnosis: (1) children need time to adjust to the diagnosis; (2) children need supportive relationships; (3) children need an opportunity for meaningful participation and appropriate protection; (4) children need to engage and explore; and (5) children need to feel supported, but not different.
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Affiliation(s)
- P DeCosta
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Centre Copenhagen, Diabetes Management Research, Gentofte, Copenhagen, Denmark
| | - D Grabowski
- Steno Diabetes Centre Copenhagen, Diabetes Management Research, Gentofte, Copenhagen, Denmark
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Centre Copenhagen, Diabetes Management Research, Gentofte, Copenhagen, Denmark
- Department of Rural Health, La Trobe University, Bendigo, Vic., Australia
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Whitworth SR, Bruce DG, Starkstein SE, Davis TME, Skinner TC, Davis WA, Bucks RS. Risk factors and outcomes of anxiety symptom trajectories in type 2 diabetes: the Fremantle Diabetes Study Phase II. Diabet Med 2020; 37:1688-1695. [PMID: 32531090 DOI: 10.1111/dme.14344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
AIM To identify determinants and outcomes of 4-year trajectories of anxiety symptoms in a community-based cohort with type 2 diabetes. METHODS Some 1091 participants in the Fremantle Diabetes Study-Phase II with type 2 diabetes completed the Generalized Anxiety Disorder Scale at baseline and biennially for 4 years, in addition to psychological, biomedical and self-management measures. Latent growth mixture modelling identified trajectories of anxiety symptom severity, and regression models determined predictors of trajectory membership and associated outcomes. RESULTS Two distinct groups of participants were identified: those with continuously low-no anxiety symptoms (87%) and those with improving but consistently high anxiety symptoms (elevated anxiety; 13%). Higher HbA1c and BMI, macrovascular complications and a history of generalized anxiety and/or major depressive disorder increased the risk of elevated anxiety. Elevated anxiety did not predict change in health-related outcomes over time. Elevated anxiety and depression symptoms were highly comorbid and those with both displayed the most persistent anxiety symptoms. CONCLUSIONS A subgroup of individuals with type 2 diabetes are at risk of persistently elevated anxiety symptoms. Routine monitoring of the severity of psychological symptoms over time in this population should facilitate earlier and more intensive mood management.
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Affiliation(s)
- S R Whitworth
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - D G Bruce
- School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - S E Starkstein
- School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Western Australia, Australia
| | - T M E Davis
- School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - T C Skinner
- Institute for Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
| | - W A Davis
- School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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40
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Schmidt S, Andersen Nexø M, Norgaard O, Willaing I, Pedersen-Bjergaard U, Skinner TC, Nørgaard K. Psychosocial factors associated with HbA 1c in adults with insulin pump-treated type 1 diabetes: a systematic review. Diabet Med 2020; 37:1454-1462. [PMID: 32579748 DOI: 10.1111/dme.14347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/16/2020] [Accepted: 06/18/2020] [Indexed: 01/31/2023]
Abstract
AIMS To identify currently available studies on the association between psychosocial factors and HbA1c in adults with insulin pump-treated type 1 diabetes, by performing a systematic review of the literature. METHODS MEDLINE, Embase, CINAHL and PsycINFO were searched for original studies on the association between psychosocial factors and HbA1c in ≥ 50 adult, non-pregnant, insulin pump users with type 1 diabetes. RESULTS The search resulted in 1777 unique records, of which eight were eligible for inclusion. All identified studies were observational, with sample sizes ranging from 51 to 214. Seven different psychosocial factors were investigated in the eight studies. Study analysis suggested that HbA1c may be associated with diabetes numeracy and quality of life. There were no indications of associations between HbA1c and fear of hypoglycaemia or self-efficacy. Results regarding associations between HbA1c and coping style, diabetes distress and locus of control were inconsistent. CONCLUSIONS This systematic review summarizes the currently limited information on the association between psychosocial factors and HbA1c during insulin pump therapy. The evidence base of the included studies was weak, and this review highlights the need for more research in these areas, with improved methodological and theoretical frameworks, including exploration of a broader spectrum of psychosocial variables and their potential association with HbA1c and other metabolic outcomes. (PROSPERO International prospective register of systematic reviews registration no: CRD42020145705).
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Affiliation(s)
- S Schmidt
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | | | - O Norgaard
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - I Willaing
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - U Pedersen-Bjergaard
- Nordsjaellands Hospital, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - T C Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - K Nørgaard
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
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Speight J, Hendrieckx C, Pouwer F, Skinner TC, Snoek FJ. Back to the future: 25 years of 'Guidelines for encouraging psychological well-being' among people affected by diabetes. Diabet Med 2020; 37:1225-1229. [PMID: 31661183 DOI: 10.1111/dme.14165] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2019] [Indexed: 01/01/2023]
Affiliation(s)
- J Speight
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - C Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - F Pouwer
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- STENO Diabetes Centre, Odense, Denmark
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- STENO Diabetes Centre, Copenhagen, Denmark
| | - F J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands
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Speight J, Skinner TC, Rose KJ, Scibilia R, Boulton AJ. Oh sugar! How diabetes campaigns can be damaging to the cause they aim to serve. Lancet Diabetes Endocrinol 2020; 8:566-567. [PMID: 32559471 DOI: 10.1016/s2213-8587(20)30190-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Jane Speight
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Timothy C Skinner
- La Trobe Rural Health School, Bendigo, VIC, Australia; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Andrew J Boulton
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester and Manchester Royal Infirmary, Manchester, UK
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Lim SS, O'Reilly S, Versace V, Janus E, Skinner TC, Best JD, Dunbar J, Teede H. Recommendations for promoting healthier lifestyles in postpartum women after gestational diabetes. Diabet Med 2020; 37:706-708. [PMID: 31833086 DOI: 10.1111/dme.14208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- S S Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - S O'Reilly
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - V Versace
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Australia
| | - E Janus
- General Internal Medicine Unit, Western Health and Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - T C Skinner
- Institut for Psykologi, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - J D Best
- Lee Kong Chian School of Medicine, Nanyang Technology University, Singapore
| | - J Dunbar
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
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Abstract
The term 'diabetes distress' first entered the psychosocial research vernacular in 1995, and refers to 'the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes'. At first the proponents of the concept were hesitant in advocating that diabetes distress was a major barrier to individuals' self-care and management of diabetes. Since then, a burgeoning body of evidence, now including several systematic reviews of intervention studies, suggests that diabetes distress, in both type 1 and type 2 diabetes, across ages and in all countries and cultures where it has been studied, is common and can be a barrier to optimal emotional well-being, self-care and management of diabetes. As a consequence, monitoring diabetes distress as part of routine clinical care is part of many national guidelines. The present narrative review summarizes this research and related literature, to postulate the aetiology of diabetes distress, and thus how it may be prevented. The current evidence base for the management of diabetes distress is summarized, and the next steps in the prevention and management of diabetes distress identified.
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Affiliation(s)
- T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - L Joensen
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - T Parkin
- School of Health Professions, University of Plymouth, Plymouth, UK
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Moss SA, Skinner TC, Irons M, Alexi N. The inclination to shun healthy behaviours that generate only transient benefits: the role of future clarity. Health Promot Int 2020; 35:e32-e42. [PMID: 30590556 DOI: 10.1093/heapro/day113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Research has not definitively ascertained the circumstances that motivate people to live a healthier lifestyle. To redress this shortfall, we report two overlapping studies that examined whether people are more inclined to value health benefits that seem enduring and fundamental rather than transient or superficial-even after controlling effort and cost. In these studies, 242 participants indicated the degree to which they implement 17 health behaviours-as well as the extent to which they perceive the benefits of these behaviours as enduring and fundamental. Furthermore, participants completed a measure that gauges future clarity. Finally, they chose which of two drugs-drugs that differ only on the longevity of effects-they prefer. Participants were more inclined to implement health behaviours that seemed to generate enduring and fundamental benefits. This effect was more pronounced in people who perceive their future as vivid and certain. Furthermore, participants tended to choose the drug that was touted as generating more enduring benefits, even after controlling cost and effort. As these results imply, to encourage healthy behaviour, health practitioners should help people clarify their future goals and then advocate behaviours that generate lasting benefits.
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Affiliation(s)
- Simon A Moss
- School of Psychological and Clinical Sciences, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia
| | - Timothy C Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia
| | - Melanie Irons
- School of Psychological and Clinical Sciences, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia
| | - Nektarios Alexi
- School of Psychological and Clinical Sciences, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia
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Perrin BM, Allen P, Gardner MJ, Chappell A, Phillips B, Massey C, Skinner I, Skinner TC. The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study. J Foot Ankle Res 2019; 12:56. [PMID: 31827623 PMCID: PMC6896347 DOI: 10.1186/s13047-019-0366-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/21/2019] [Indexed: 12/22/2022] Open
Abstract
Background There is limited Australian epidemiological research that reports on the foot-health characteristics of people with diabetes, especially within rural and regional settings. The objective of this study was to explore the associations between demographic, socio-economic and diabetes-related variables with diabetes-related foot morbidity in people residing in regional and rural Australia. Methods Adults with diabetes were recruited from non-metropolitan Australian publicly-funded podiatry services. The primary variable of interest was the University of Texas diabetic foot risk classification designated to each participant at baseline. Independent risk factors for diabetes-related foot morbidity were identified using multivariable analysis. Results Eight-hundred and ninety-nine participants enrolled, 443 (49.3%) in Tasmania and 456 (50.7%) in Victoria. Mean age was 67 years (SD 12.7), 9.2% had type 1 diabetes, 506 (56.3%) were male, 498 (55.4%) had diabetes for longer than 10 years and 550 (61.2%) either did not know the ideal HbA1c target or reported that it was ≥7.0. A majority had peripheral neuropathy or worse foot morbidity (61.0%). Foot morbidity was associated with male sex (OR 2.42, 95% CI 1.82–3.22), duration of diabetes > 20 years (OR 3.25, 95% CI 2.22–4.75), and Tasmanian residence (OR 3.38, 95% CI 2.35–4.86). Conclusions A high proportion of the regional Australian clinical population with diabetes seen by the publicly-funded podiatric services in this study were at high risk of future limb threatening foot morbidity, and participants residing in Northern Tasmania are more likely to have worse diabetes-related foot morbidity than those from regional Victoria. Service models should be reviewed to ensure that diabetes-related foot services are appropriately developed and resourced to deliver interdisciplinary evidence-based care.
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Affiliation(s)
- Byron M Perrin
- 1La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, 3552 Australia
| | - Penny Allen
- 2Rural Clinical School, University of Tasmania, Burnie, Australia
| | - Marcus J Gardner
- 3Clinical Learning and Development, Bendigo Health, Bendigo, Australia
| | | | | | - Claire Massey
- Tasmanian Health Service- North, Launceston, Australia
| | - Isabelle Skinner
- 7Centre for Rural and Remote Health, James Cook University, Townsville, Australia
| | - Timothy C Skinner
- 1La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, 3552 Australia.,8Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Harding KA, Pushpanathan ME, Whitworth SR, Nanthakumar S, Bucks RS, Skinner TC. Depression prevalence in Type 2 diabetes is not related to diabetes-depression symptom overlap but is related to symptom dimensions within patient self-report measures: a meta-analysis. Diabet Med 2019; 36:1600-1611. [PMID: 31532013 DOI: 10.1111/dme.14139] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 01/24/2023]
Abstract
AIM Depression is common in Type 2 diabetes, yet rates vary. Overlap between symptoms of depression and diabetes may account for this variability in depression prevalence rates. We examined to what extent depression prevalence was a function of the proportion of depression-diabetes symptom overlap (items within symptom dimensions) and sample characteristics. METHODS Electronic and hand searching of published and unpublished works identified 147 eligible papers. Of 3656 screened, 147 studies (149 samples, N = 17-229 047, mean sample age 25.4-82.8 years, with 152 prevalence estimates), using 24 validated depression questionnaires were selected. Sample size, publication type, sample type, gender, age, BMI, HbA1c , depression questionnaire and prevalence rates were extracted. RESULTS Prevalence rates ranged from 1.8% to 88% (mean = 28.30%) and were higher in younger samples, samples with higher mean HbA1c and clinic samples. Diabetes-depression symptom overlap did not affect prevalence. A higher proportion of anhedonia, cognition, cognitive, negative affect and sleep disturbance symptoms, and a lower proportion of somatic symptoms were consistently associated with higher depression prevalence. CONCLUSIONS The lack of an overall effect of diabetes-depression symptom overlap might suggest that assessment of depression in Type 2 diabetes is generally not confounded by co-occuring symptoms. However, questionnaires with proportionally more or fewer items measuring other symptom categories were associated with higher estimates of depression prevalence. Depression measures that focus on the cardinal symptoms of depression (e.g. negative affect and cognition), limiting symptoms associated with increasing diabetes symptomatology (e.g. sleep disturbance, cognitive) may most accurately diagnose depression.
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Affiliation(s)
- K A Harding
- VA Puget Sound Healthcare System, Seattle, WA, USA
| | - M E Pushpanathan
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - S R Whitworth
- Australian Government Department of Health, Canberra, Australia
| | - S Nanthakumar
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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48
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Bucks RS, Nanthakumar S, Starkstein SS, Hillman DR, James A, McArdle N, Hatch K, Skinner TC. Discerning depressive symptoms in patients with obstructive sleep apnea: the effect of continuous positive airway pressure therapy on Hamilton Depression Rating Scale symptoms. Sleep 2019; 41:5092935. [PMID: 30203079 DOI: 10.1093/sleep/zsy178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Indexed: 11/12/2022] Open
Abstract
The assessment of depression in obstructive sleep apnea (OSA) is confounded by the overlap in symptoms between the disorders. However, previous analysis by our group has suggested that while some depressive symptoms tend to overlap with OSA (such as insomnia, lethargy, impaired concentration, psychomotor retardation) other, nonoverlapping symptoms appear more specific to depression (such as negative affect, anhedonia, and depressive cognitions). We sought to determine the value of such categorization of depressive symptoms in identifying clinical depression within OSA patient populations by examining the response of these two categories of depression symptoms to treatment of OSA by continuous positive airway pressure (CPAP). Three hundred fifty-seven unselected, CPAP-naïve OSA patients were treated with CPAP and followed over 12 weeks. Depressive symptoms were elicited before, during and at the end of this period using the Hamilton Rating Scale for Depression (HAM-D). Data were analyzed using latent growth curve modeling. At baseline, individuals reported proportionally more severe overlapping than nonoverlapping depressive symptoms. Both overlapping and nonoverlapping symptoms significantly decreased over time, but with a greater reduction in the severity of overlapping than nonoverlapping depressive symptoms. Moreover, greater CPAP use was associated with a faster rate of improvement in overlapping symptoms, but not in nonoverlapping symptoms. These findings suggest that nonoverlapping depressive symptoms may be useful discriminators of clinical depression amongst patients with untreated, symptomatic OSA.
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Affiliation(s)
- Romola S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Shenooka Nanthakumar
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Sergio S Starkstein
- School of Psychiatry and Neuroscience, University of Western Australia, Crawley, Australia
| | - David R Hillman
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Australia.,Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Alan James
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Australia.,School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia
| | - Nigel McArdle
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.,Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, The University of Western Australia, Crawley, Australia
| | - Katherine Hatch
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Timothy C Skinner
- Institut for Psykologi, Center for Sundhed og Samfund, Københavns Universitet, København, Denmark
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49
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Oguoma VM, Nwose EU, Skinner TC, Richards RS, Bwititi PT. Diet and lifestyle habits: Association with cardiovascular disease indices in a Nigerian sub-population. Diabetes Metab Syndr 2018; 12:653-659. [PMID: 29673925 DOI: 10.1016/j.dsx.2018.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/09/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is inadequate evidence regarding the pattern of unhealthy lifestyle behaviours in Nigeria hence the aim of this study was to assess the pattern of lifestyle-related habits that predispose to risk of cardiovascular disease (CVD) indices in a Nigerian population. METHODS A population-based cross-sectional study was carried out on 422 apparently healthy males and females ≥18 years old. The World Health Organisation (WHO) STEPwise questionnaire was used to collect information on tobacco use or smoking habits, alcohol consumption and dietary habits. Logistic regression analysis was employed. RESULTS 22.8% and 30.2% of participants indicated that someone smoked in their home and/or in closed areas at workplace, respectively, in the past 30 days. 225/422 admitted to taking alcohol including 72% within the past 12 months. 52.8% of the participants consumed <5 servings of fruits and/or vegetables each day. Results further showed that participants with <5 servings of fruits and/or vegetables (OR: 1.06, CI: 1.01-1.13, p = 0.028) and high level of alcohol consumption (OR: 1.85, CI: 1.18-2.88, p = 0.007) were more likely to have hypertension. CONCLUSIONS The relatively high prevalence of alcohol consumption and apparent unhealthy diet are of huge concern given the increasing prevalence of CVD indices in the population.
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Affiliation(s)
- Victor M Oguoma
- Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia.
| | - Ezekiel U Nwose
- School of Community Health, Charles Sturt University, New South Wales, Australia
| | - Timothy C Skinner
- Department of Psychology, University of Copenhagen, København, Denmark
| | - Ross S Richards
- School of Community Health, Charles Sturt University, New South Wales, Australia
| | - Phillip T Bwititi
- School of Biomedical Sciences, Charles Sturt University, New South Wales, Australia
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50
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Hansen UM, Olesen K, Browne JL, Skinner TC, Willaing I. A call for inclusion of work-related diabetes distress in the spectrum of diabetes management: Results from a cross-sectional survey among working people with type 1 diabetes. Diabetes Res Clin Pract 2018; 140:139-147. [PMID: 29604390 DOI: 10.1016/j.diabres.2018.03.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/27/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
AIM Diabetes distress captures a range of emotional responses and reactions to life with diabetes and is considered a part of the experience of managing diabetes and its treatment. Given the importance of the social context of work life for people of working age we set out to explore whether work-related diabetes distress is a distinct and important dimension of diabetes-related emotional distress in working people with type 1 diabetes. METHODS A questionnaire with self-reported measures of psychosocial health and well-being at work was completed by 1126 working people with type 1 diabetes from a specialist diabetes clinic in Denmark. Work-related diabetes distress was assessed with two questions about worry and exhaustion related to reconciling work life and diabetes. Diabetes-related emotional distress was assessed with the Problem Areas in Diabetes scale (PAID-5), a short form version of the full PAID scale. We performed inter-item correlation analyses, exploratory factor analysis, and hierarchical multiple regression analyses. RESULTS Inter-item correlations and exploratory factor analysis indicated that work-related diabetes distress was distinct from diabetes-related emotional distress. Further, work-related diabetes distress was found to be a unique contributor to work ability, quality of life, intentional hyperglycaemia at work, and absenteeism, after adjusting for covariates and diabetes-related emotional distress. CONCLUSIONS The findings suggest that work-related diabetes distress captures an aspect of distress so far unaccounted for in workers with type 1 diabetes. Further studies are needed to strengthen the conceptual basis of work-related diabetes distress, explore its clinical usefulness and clarify its risk factors.
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Affiliation(s)
- Ulla M Hansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark.
| | | | - Jessica L Browne
- Deakin University, Geelong, School of Psychology, Victoria, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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