Patient partnership in medical research: An important consideration for systemic lupus erythematosus research in Australia: a patient perspective

Letter to the editor outlining the author's experience as a patient with auto-immune disease

Total sleep deprivation, chronic sleep restriction and sleep disruption

Sleep loss may result from total sleep deprivation (such as a shift worker might experience), chronic sleep restriction (due to work, medical conditions or lifestyle) or sleep disruption (which is common in sleep disorders such as sleep apnea or restless legs syndrome). Total sleep deprivation has been widely researched, and its effects have been well described. Chronic sleep restriction and sleep disruption (also known as sleep fragmentation) have received less experimental attention. Recently, there has been increasing interest in sleep restriction and disruption as it has been recognized that they have a similar impact on cognitive functioning as a period of total sleep deprivation. Sleep loss causes impairments in cognitive performance and simulated driving and induces sleepiness, fatigue and mood changes. This review examines recent research on the effects of sleep deprivation, restriction and disruption on cognition and neurophysiologic functioning in healthy adults, and contrasts the similarities and differences between these three modalities of sleep loss

Treatment of sleep disturbance in older adults

Sleep and circadian rhythm disturbances are prevalent in older populations. Numerous factors can affect sleep, including medications, living environment and physical, mental and psychosocial factors (e.g. loneliness and stress). Sleep architecture changes with aging, with less deep sleep (slow wave sleep) and an increased frequency of awakenings after sleep onset. Benzodiazepines, Z-drugs and low doses of the tricyclic antidepressant doxepin have modest positive benefits for sleep complaints, but side effects are a concern in older people because they include an increased risk of falls, fractures and cognitive impairment. Somnolence can be prolonged in older adults. Melatonin has very modest effects on sleep initiation in older adults, although appears safe. Overall, the effects of pharmacological treatments are modest and there are concerns about the efficacy and safety of their ongoing use. There is strong evidence for non-pharmacological interventions, including cognitive and behavioural strategies, to improve sleep. These have at least comparable efficacy to pharmacological interventions, fewer adverse effects and are more likely to have longer-term, sustained benefits. Sleep complaints in older adults need to be approached on a patient-by-patient basis, and medication should be reviewed frequently, with preference to limit pharmacological intervention as far as practicable. © 2019 The Society of Hospital Pharmacists of Australi

Disability and natural hazard emergency preparedness in an Australian sample

Each year natural hazards result in large numbers of deaths and injuries among residents of at-risk communities. Some individuals are especially vulnerable to the impacts of natural hazards. Residents with activity-limiting disabilities comprise one such vulnerable group. One of several reasons proposed for their vulnerability is lower levels of preparedness to survive a natural hazard emergency. However, findings from North American research present a mixed picture. Some studies have found no differences between residents with and without disability, yet others have found residents with a disability to be less prepared. Australian research addressing the issue is limited. The present study reports findings from a survey of 1253 Australian residents who completed measures of activity-limiting disability level, and both material and psychological preparedness for a natural hazard emergency. Those categorised as having a severe level of disability were found to be significantly less well prepared than those with no disabilities on average. The difference was small for both material preparedness and knowledge about disaster threat and safety, but appreciable for emotional preparedness for an emergency. This suggests a need for provision of greater social support for some residents with disabilities over the course of a natural hazard emergency

Sleep schedule regularity is associated with sleep duration in older Australian adults: Implications for improving the sleep health and wellbeing of our aging population

Objectives: The National Sleep Foundation (NSF) recommends 7 to 9 hours of sleep per night for adults ≥ 65 years of age. Sleep duration below 7h per night has been associated with negative health consequences, so enabling older adults to obtain at least 7 hours per night is important for health and wellbeing. However, little is known about behavioral factors that support sleep duration (≥ 7h/24h) in this group. Our aim was to determine factors associated with sleep duration in older adults, and evaluate the utility of sleep schedule regularity in particular, given the relationship between lifestyle regularity (of which sleep is an important component) and health in this population. Methods: A sample of 311 Australian adults (≥ 65 years old; 156 male, 155 female) completed a telephone survey assessing sleep history over the prior 24 hours, sleep schedule regularity, demographic and health factors as part of a larger study of the Australian population. Results: Sleep schedules with variability in bed and rise times of > 60 minutes were associated with increased odds of reporting sleep duration below 7 hours per night (< 7h/24h; OR = 2.38, CI = 1.26–4.48, p = .007). No other behaviors were associated with meeting sleep duration recommendations. Conclusions: Sleep schedule regularity may be associated with sleep duration (≥ 7h/24h) in older adults

Physical and psychological changes in shift working ambulance personnel entering the workforce: An exploratory, mixed-methods observational study

Shift work, particularly night work, forces a mismatch between the body's natural inclination to sleep during the night, and to be awake/work during the day. Disruption to human sleep/wake behavior is associated with poor health outcomes in the medium- to long-term. While shift work is consistently associated with poor health outcomes (including obesity, type II diabetes, and cardiovascular disease) we still do not have a clear picture of how these diseases progress over time. This is due in part to a lack of research looking at the early changes in physiological and psychological wellbeing in new shift workers. The proposed study in new SAAS recruits will be the first of its kind worldwide to follow new recruits (n=40) from recruitment and over the first year of their employment as ambulance personnel to determine the impact of commencing shift work on physical and mental health. Recruits will be invited to participate in the study during their induction period when first recruited to SAAS. They will be monitored quarterly, and complete a series of questionnaires, a blood test, and ad libitum faecal samples, to explore the impact of early shift work and health changes in the first year. This information is needed to better understand the relationship between shift work and wellbeing, and to provide meaningful guidelines for managing wellbeing in this workforce

Causes and consequences of sleep loss and fatigue: The worker perspective in the coral reef tourism industry

This study provides an in-depth understanding of the causes and consequences of sleep loss and fatigue in the coral reef tourism industry. Utilizing a qualitative methodology, data were obtained from eight focus groups conducted in Far North Queensland with 42 reef tourism employees. Analysis involved identifying and inductively coding any emergent categories of the causes and consequences of sleep loss and fatigue. Findings are applied to Baum, Kralj, Robinson, and Solnet's (2016) taxonomy of tourism research to highlight where the causes of sleep loss and fatigue originate. This reflects individual, occupational and industry-level causes of sleep loss and fatigue which workers indicate have consequences for their wellbeing, and the safety and efficacy of their operations. Implications for the broader tourism industry are discussed

Psychological and demographic predictors of support for marriage equality: An Australian survey

In 2017, the Marriage Amendment Act was passed, which made same-sex marriage (SSM) legal in Australia. Research has identified factors that predict support for SSM. However, cultural and political differences between countries where the majority of research has originated makes generalising findings to Australia difficult. The purpose of this study was to investigate demographic, personality, and social psychological factors as predictors of both attitudes toward SSM and response to the Australian Marriage Law Postal Survey, which preceded the amendment. A sample of Australian citizens (n = 259) over 18 completed an anonymous online survey measuring demographics, religiosity, political conservatism, beliefs about marriage and sexuality, and personality characteristics (including empathy, openness to experience, rightwing authoritarianism, social dominance orientation). A series of separate linear (for SSM attitudes) and logistic (for Postal Survey response) regression models were used to investigate predictors of SSM attitudes and Postal Survey response, which were highly correlated. A range of demographic, personality, and social factors significantly predicted SSM attitudes and support for the legalisation of SSM in Australia. Results suggested that fostering characterises such as empathy, openness to experience, and contact with LGBTI people may increase positive attitudes towards LGBTI people and SSM following the legalisation of marriage equality

Crack a smile: The causes and consequences of emotional labour dysregulation in Australian reef tourism

There is a dearth of literature exploring the factors that cause emotional labour dysregulation and their resulting consequences within the reef tourism industry. To address this gap, this study examines the factors linked to emotional labour dysregulation and the social and affective consequences for reef tourism workers arising from emotional labour dysregulation. A total of eight focus groups utilizing a generative scenario technique were undertaken with reef tourism employees (n = 42) in Cairns, a destination in Far North Queensland offering easy access to the Great Barrier Reef using commercial tourism vessels. Analysis via Grounded Theory identified twelve causes and six social and affective consequences of emotional labour dysregulation, illustrating the role of multiple and interrelating factors in emotional labour dysregulation. Consideration is given to opportunities for better management of tourism employee emotional labour and future research directions. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Going the extra (s)mile: Countermeasures to emotional labour dysregulation in Australian reef tourism

Emotional labour is important to the performance of interactive service work in the tourism industry. However, emotional labour dysregulation, defined as a difficulty in managing emotions in daily routines, may lead to negative outcomes. This study aimed to fill an important gap by gaining a better understanding of perceived countermeasures for effectively managing emotional labour dysregulation in tourism workers. Using snowball sampling to recruit participants, eight focus groups were conducted with 42 reef workers in Cairns (Australia), using a novel scenario-based technique for knowledge elicitation. Findings outline countermeasures to emotional labour dysregulation according to two themes: (1) individual-level strategies, and (2) broader system factors. Both themes deal with the demands of emotional labour. Knowledge about countermeasures to emotional labour dysregulation has the potential to support employees and in turn influence positive tourism experiences which can help the industry to achieve business success and positive customer reviews.</p