Factors associated with melatonin use in child sleep disturbance: A survey of Australian parents.

OBJECTIVE: Sleep disturbances are prevalent in Australian children and cause a significant amount of stress to both children and their parents. If sleep disturbances are left untreated, they can result in detrimental consequences to both child and parental wellbeing. While behavioural interventions are recognised as the gold standard treatment for paediatric insomnia, there is a growing use of melatonin from both prescription and non-prescription sources in paediatrics. However, empirical research on the efficacy and safety of melatonin for children is sparse, conflicting, and inconsistent. This first Australian study aimed to investigate correlates of melatonin use in a sample of children with sleep disturbance in Australia and assess whether melatonin is being administered to children contrary to Therapeutic Goods Administration Guidelines. METHODS: An exploratory online study was undertaken with 318 parents of Australian children with sleep disturbance (95.30% females). Logistic regression, mediation and descriptive analysis were conducted. RESULTS: As hypothesised, higher parental stress, older child age, and a diagnosis of ADHD were significantly associated with melatonin use in this sleep disturbed sample. Other potential correlates such as financial stress, number of household dependents, child sleep disturbance, and autism were not significantly associated with melatonin use in adjusted analyses. CONCLUSION: Findings show off-label melatonin use in children with sleep disturbance is prevalent. For the first time, this study showed an indirect path linking child sleep disturbances with melatonin use via parental stress. Overall, while the safety of melatonin use remains unknown, there is a clear need to mitigate parental stress to minimise potentially unmonitored and improper use of melatonin in children.

Sleep schedules and school performance in Indigenous Australian children.

BACKGROUND: Sleep duration and sleep schedule variability have been related to negative health and well-being outcomes in children, but little is known about Australian Indigenous children. METHODS: Data for children aged 7-9 years came from the Australian Longitudinal Study of Indigenous Children and the National Assessment Program-Literacy and Numeracy (NAPLAN). Latent class analysis determined sleep classes taking into account sleep duration, bedtimes, waketimes, and variability in bedtimes from weekdays to weekends. Regression models tested whether the sleep classes were cross-sectionally associated with grade 3 NAPLAN scores. Latent change score modeling then examined whether the sleep classes predicted changes in NAPLAN performance from grades 3 to 5. RESULTS: Five sleep schedule classes were identified: normative sleep, early risers, long sleep, variable sleep, and short sleep. Overall, long sleepers performed best, with those with reduced sleep (short sleepers and early risers) performing the worse on grammar, numeracy, and writing performance. Latent change score results also showed that long sleepers performed best in spelling and writing and short sleepers and typical sleepers performed the worst over time. CONCLUSIONS: In this sample of Australian Indigenous children, short sleep was associated with poorer school performance compared with long sleep, with this performance worsening over time for some performance indicators. Other sleep schedules (eg, early wake times and variable sleep) also had some relationships with school performance. As sleep scheduling is modifiable, this offers opportunity for improvement in sleep and thus performance outcomes for these and potentially all children.

A review of current practices to increase Chlamydia screening in the community--a consumer-centred social marketing perspective.

BACKGROUND: Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults. OBJECTIVE: To assess effectiveness of Chlamydia screening interventions targeting young adults in community-based settings, describe strategies utilized and assess them according to social marketing benchmark criteria. SEARCH STRATEGY: A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken. RESULTS: Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown. DISCUSSION: Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized.

Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

Personal and societal benefits of providing peer support: a survey of peer support specialists.

OBJECTIVE: Peer-delivered services have burgeoned, and evidence of the effectiveness of peer support is increasing. However, the potential benefits to peer support specialists (PSSs) themselves are not as well understood. The authors conducted a survey of PSSs to examine potential benefits. METHODS: A survey instrument was developed and refined and sent anonymously via the Internet to PSSs who had been employed for a minimum of two months by an agency that employs a large number of PSSs. RESULTS: A total of 253 respondents completed the survey (70% response rate). Respondents reported a variety of benefits in the intrapersonal, social, mental health, recovery, spiritual, and professional domains. Forty percent of respondents reported discontinuing at least one type of disability or social benefit. CONCLUSIONS: Results suggest that employment as a PSS is a potent vehicle for improving recovery and quality of life. Results accrue to society in reduction of public benefits.