Sleep Timing During Adolescence: A Latent Transition Analysis Approach.

Objective/Background: This paper utilized a person-centered approach to examine individual differences in sleep timing cross-sectionally and prospectively in adolescents. Participants: Data from Waves 5 and 6 of the Longitudinal Study of Australian Children were used. At Wave 5, the sample included 3,552 Australian adolescents aged 12-13 years (51% males, 49% females); 84% provided data at two-year follow-up (Wave 6). Methods: Through structured interviews, adolescents provided information on sleep timing (bedtimes, sleep-onset times, and wake times) on weekends and weekdays, and relevant covariates. Latent profile analysis identified sleep profiles at Waves 5 and 6 separately; latent transition analysis examined stability and change in profiles across time. Results: Six sleep timing profiles were identified at age 12-13 years: Early Larks (n = 228; 6.4%); Larks (n = 1257; 35.4%); Intermediate (n = 1311; 36.9%); Owls (n = 351; 9.9%); Variable Owls (n = 308; 8.7%); and, Late Owls (n = 97; 2.7%). Six similar profiles were identified at age 14-15 years. The latent transition analysis indicated that the Early Larks, Larks, and Intermediate profiles were more stable over time compared with the Owls, Variable Owls, and Late Owls profiles. Higher body mass index (BMI) and longer screen time predicted transitions from Larks and Early Larks to the Owls, Variable Owls, and Late Owls profiles. Conclusions: Many adolescents showed healthy sleep timing, which continued with age. However, the Variable Owls, Owls, and Late Owls profiles reflected less healthy and more variable sleep patterns that may require targeted interventions.

Trajectories of Psychological Distress in Australians Living in Urban Poverty: The Impact of Interpersonal Trauma.

Childhood maltreatment and interpersonal trauma experience is an important factor underpinning the apparent perpetuation of the cycle of social disadvantage experienced by homeless adults. This paper aimed to examine longitudinal patterns of psychological distress in a sample of 1,504 socially disadvantaged adult participants from the Journeys Home Study in Australia. The current paper utilized the "conservation of resources" theory and the concept of "risk factor caravans" to investigate the nature and implications of childhood trauma in the context of homelessness. Growth mixture modeling revealed four distinct trajectories of psychological distress as measured by the Kessler 6 across six time points (covering a period of 2.5 years): chronic, escalating, attenuating, and resistant. Our results also indicated that experiences of different types of trauma during childhood were associated with these psychological distress trajectories. In particular, adults experiencing chronic psychological distress were significantly more likely than those exhibiting distress resistance to have experienced multiple and varied childhood maltreatment, adjusted odds ratio (AOR) = 3.30, 95% CI [0.37, 6.05], p = .002. Furthermore, adult experiences of assault were found to be associated with psychological distress. These findings have important implications for mental health, as well as interventions aimed at breaking the cycle of urban poverty. Specific focus on interpersonal trauma vulnerabilities is important. Prioritizing socioecological stability, with mental health needs assessed on an individual level, may be most appropriate. This work also highlights the need to direct future attention to barriers to access and facilitation of social support services.

The Work-Family Interface and Sleep Quality.

OBJECTIVE: This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). PARTICIPANTS: The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. METHODS: Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. RESULTS: WFC was associated with poorer sleep quality (ß = .27, p < .001), and this relationship was stronger in males than females and in dual parent-single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (ß = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (ß = -.04 [-.07, -.02]). CONCLUSIONS: These results indicate that aspects of the work-family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

Social climate profiles in adolescent sports: Associations with enjoyment and intention to continue.

This study explored whether adolescent sports participants' perceptions of the social climate fall into distinct profiles, and whether these profiles are related to enjoyment and intention to continue. A Latent Profile Analysis using 313 Australian sports participants (Mage = 13.03 years) revealed four distinct profiles: positive social climate (45.1%), diminished social climate (19.8%), positive coach relationship quality (19.8%), and positive friendship quality (15.3%). Individuals within the positive social climate and the positive coach relationship quality profiles reported relatively higher levels of enjoyment and intention to continue than individuals in the diminished social climate and the positive friendship quality profiles. Indirect path analyses found the social climate profiles were linked with intention to continue through enjoyment. Results highlight the value of investigating multiple dimensions of the social climate and suggest that the coach may be of particular importance in this age group. Findings have implications for understanding youth sports participation and preventing dropout.

Exploration of Sedentary Behavior in Residential Substance Abuse Populations: Results From an Intervention Study.

BACKGROUND: There is a growing body of research linking sedentary behavior with increased risk of chronic disease and all-cause mortality. It is increasingly recommended that service providers address the multiple behavioral risk factors associated with these chronic diseases as part of routine substance abuse treatment. OBJECTIVES: The study objective was to investigate rates of physical activity and sedentary behavior in a residential substance abuse population. In addition, efficacy of a sedentary behavior intervention, "Sit Switch," was examined for feasibility in this context. METHODS: Participants (n = 54) were residents of The Salvation Army Recovery Service Centres located in Canberra and on the Gold Coast, Australia. Actigraph GT3X+ accelerometers were used to measure rates and patterns of sedentariness and physical activity. A nonrandomized controlled study of a single-session group intervention aimed at decreasing prolonged sitting ("Sit Switch") was conducted. Education, motivational-interviewing, and goal setting components underpinned the "Sit Switch" intervention. RESULTS: Individuals were highly sedentary, spending 73% of daily activity at sedentary intensity engaged in inadequate levels of moderate physical activity (6.6%/day). The single session educational program did not lead to any significant changes in sedentary behavior. Conclusion/Importance: High levels of sedentariness and low levels of physical activity engagement are evident in residents in substance abuse treatment programs. It is strongly recommended that sedentariness, a modifiable risk behavior with independent consequences for cardiovascular disease and cancer, be addressed within residential programs.

Trajectories and Predictors of Health-Related Quality of Life during Childhood.

OBJECTIVE: To identify distinct trajectories of health-related quality of life (HRQOL) during childhood, along with their predictors. STUDY DESIGN: A nationally representative sample of 2700 children aged 4-5 years at baseline was followed up every 24 months through to age 12-13 years. Parents reported the children's HRQOL and data on potential predictors at each wave (5 in total) as part of the Longitudinal Study of Australian Children. RESULTS: Growth mixture modeling identified 5 distinct trajectories of HRQOL during childhood. Eighty-five percent of children had consistently high levels of HRQOL from age 4-5 years to 12-13 years (healthy); 8% of children had a significant and continuous decrease in HRQOL over time (high risk); and a further 5.3% of children had decreases in HRQOL from age 4-5 years to 8-9 years, followed by increases through to 12-13 years (rebound). Finally, a small percentage (1.6%) of children had extremely low levels of HRQOL at age 4-5 years that increased over time (recovery). Maternal smoking, lower household income, living in a non-English speaking household, and nonparticipation in organized sports were predictive of poorer HRQOL trajectories when compared with children in the healthy trajectory. CONCLUSION: There are distinct trajectories of HRQOL during childhood. Most children (85%) have a healthy, stable pattern, but the remaining children have trajectories indicative of poor HRQOL. Participation in sports, maternal smoking, lower family income, and language spoken at home distinguish among these trajectories. Of these, participation in organized sports has received relatively little attention as a preventative health priority.

Sports participation and parent-reported health-related quality of life in children: longitudinal associations.

OBJECTIVE: To investigate the longitudinal association between sports participation and parent-reported health-related quality of life (HRQOL) in children. STUDY DESIGN: Cohort study that used data drawn from the Longitudinal Study of Australian Children in waves 3 (2008) and 4 (2010). Participants were a nationally representative sample of 4042 Australian children ages 8.25 (SD = 0.44) years at baseline and followed-up 24 months later. RESULTS: After we adjusted for multiple covariates, children who continued to participate in sports between the ages of 8 and 10 years had greater parent-reported HRQOL at age 10 (Eta2 = .02) compared with children who did not participate in sports (P ≤ .001), children who commenced participation after 8 years of age (P = .004), and children who dropped out of sports before reaching 10 years of age (P = .04). Children who participated in both team and individual sports (P = .02) or team sports alone (P = .04) had greater HRQOL compared with children who participated in individual sports alone (Eta2 = .01). The benefits of sports participation were strongest for girls (P < .05; Eta2 = .003). CONCLUSIONS: Children's participation in developmentally appropriate team sports helps to protect HRQOL and should be encouraged at an early age and maintained for as long as possible.

Personality change predicts self-reported mental and physical health.

OBJECTIVE: Personality dimensions are known to predict mortality and other health outcomes, but almost no research has assessed the effects of changes in personality traits on physical and mental health outcomes. In this article, we examined the effects of changes in the Big Five personality dimensions on health as assessed by the Short Form Health Survey (SF-36). METHOD: Respondents were 11,105 Australian adults aged 20-79 years (52.7% female). Latent difference score modeling was used to examine whether personality change over a 4-year period was associated with mental and physical health, and whether these effects were moderated by birth cohort. RESULTS: Increases in Conscientiousness and Extraversion were found to be associated with improved mental and physical health, whereas increased Neuroticism was linked with poorer health. The nature of these associations varied significantly by birth cohort. CONCLUSION: The findings have implications for understanding how changes in personality traits over time are related to health, and could be used to aid the development of effective health promotion strategies targeted to specific personality traits and birth cohorts.

Patterns of health behaviours predict obesity in Australian children.

AIMS: The study aims to examine whether patterns of health behaviours (based on sleep duration, physical activity, screen time and diet) were associated with obesity in Australian children. METHODS: This paper included 1833 children aged 6-7 years (51.6% male) recruited in 2006 as part of the Longitudinal Study of Australian Children. Latent class analysis was performed to identify the presence of distinct behavioural profiles on the basis of sleep duration, physical activity, screen time and eating habits. Logistic regression was performed to examine the association between the behavioural profiles and obesity assessed at baseline and 2-year follow-up. RESULTS: Three behavioural profiles, healthy (27.7%), sedentary (24.8%) and short sleepers/unhealthy eaters (47.5%), were identified. Compared with the healthy profile, the sedentary profile (odds ratio = 1.59, 95% confidence interval (1.06-2.38)) and short sleepers/unhealthy eaters (odds ratio = 1.47 (1.03-2.13)) had elevated odds of obesity at 2-year follow-up. CONCLUSIONS: The present study identified distinct profiles of health behaviours in this sample of Australian children. These findings add to existing findings that many health behaviours co-occur and that obesity interventions should target patterns of behaviours in children.

Short and long sleep duration are associated with prevalent cardiovascular disease in Australian adults.

A growing number of studies from a range of different countries have observed an association between sleep duration and cardiovascular disease. The objective of this paper was to examine the associations between sleep duration and prevalent cardiovascular disease in a large sample of Australian adults, and identify the sociodemographic and health-related factors moderating these associations. Participants included 218,155 Australian adults aged 45years and over. The results indicated that 6h versus 7h sleep was associated with increased odds of heart disease [odds ratio (OR)=1.11 (1.06-1.17)], diabetes [OR=1.15 (1.09-1.22)], stroke [OR=1.25 (1.14-1.38)] and high blood pressure [OR=1.08 (1.04-1.11)]. Long sleep (≥9h sleep) was also related to elevated odds of heart disease [OR=1.14 (1.09-1.19)], diabetes [OR=1.25 (1.19-1.31)], stroke [OR=1.50 (1.38-1.62)] and high blood pressure [OR=1.04 (1.01-1.08)] compared to 7h sleep. Some of these relationships varied by age, and were not evident in adults aged 75years and over. The magnitude of some associations varied significantly by body mass index, smoking and physical activity. These findings provide further insight into the nature of the relationship between sleep and cardiovascular health.

Exposure to alcohol advertising and alcohol consumption among Australian adolescents.

AIMS: Underage drinking is a major problem in Australia and may be influenced by exposure to alcohol advertising. The objective of the present study was to collect data on 12-17 year old Australian adolescents' exposure to different types of alcohol advertising and examine the association between exposure to advertising and alcohol consumption. METHODS: A cross-sectional survey of 1113 adolescents aged 12-17 years recruited with a variety of methods to gain a cross-section of participants across metropolitan, regional and rural New South Wales (including independent schools, mall intercepts and online). Participants answered a series of questions assessing adolescents' exposure to alcohol advertising across eight media (including television, Internet and point-of-sale). Alcohol consumption was assessed using three questions (initiation, recent consumption and frequency of consumption in the previous 12 months). RESULTS: The majority indicated that they had been exposed to alcohol advertisements on television, in newspapers and magazines, on the Internet, on billboards/posters and promotional materials and in bottleshops, bars and pubs; exposure to some of these types of alcohol advertisements was associated with increased alcohol consumption, with differences by age and gender. CONCLUSION: The results are consistent with studies from other countries and suggest that exposure to alcohol advertisements among Australian adolescents is strongly associated with drinking patterns. Given current high levels of drinking among Australian youth, these findings suggest the need to address the high levels of young people's exposure to alcohol advertising.

Short sleep mediates the association between long work hours and increased body mass index.

This study examined whether short sleep duration, physical activity and time spent sitting each day mediated the association between long work hours and body mass index (BMI). Participants included 16,951 middle aged Australian adults who were employed in full time work (i.e. ≥35 h a week). Data on BMI, sleep duration, work hours and other health and demographic variables were obtained through a self-report questionnaire. A multiple mediation model was tested whereby sleep duration, physical activity and amount of time spent sitting were entered as potential mediators between work hours and BMI. The results demonstrated that short sleep partially mediated the association between long work hours and increased BMI in males. In females, long work hours were indirectly related to higher BMI through short sleep. The results provide some support for the hypothesis that long work hours could contribute to obesity via a reduction in sleep duration; this warrants further investigation in prospective studies.

Is the Australian smoking population hardening?

BACKGROUND: The hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010 and 2016. METHODS: Data were drawn from three waves of the National Drug Strategy Household Survey (NDSHS) in 2010, 2013 and 2016. Two different definitions were used to assess hardcore smoking to arrive at an upper and lower rate. Logistic regression models assessed hardcore smoker characteristics for both definitions of hardcore smoking. RESULTS: The most inclusive definition of hardcore smoking (i.e., a smoker with no plan to quit) showed a significant decline in hardcore smoking between 2010 and 2016 (5.49%-4.85%) In contrast, the prevalence of hardcore smoking using the most stringent definition (i.e., a current daily smoker of at least 15 cigarettes per day, aged 26 years or over, with no intention to quit, a lifetime consumption of at least 100 cigarettes, and no quit attempt in the past 12 months) did not change significantly between 2010 and 2016. CONCLUSION: The observed trends in the prevalence of hardcore smokers (i.e., either stable or declining depending on the definition) suggest that the Australian smoking population is not hardening. These results do not support claims that remaining smokers are becoming hardcore.

Australian women's awareness of ovarian cancer symptoms, risk and protective factors, and estimates of own risk.

OBJECTIVE: To examine Australian women's perceived risk of ovarian cancer, reasons for perceived risk levels, and knowledge of ovarian cancer symptoms at two timepoints (2003 and 2007). METHODS: A computer-assisted telephone (CATI) survey of 2,954 Australian women with no history of ovarian cancer was conducted. RESULTS: Approximately 60% of women perceived their risk of ovarian cancer was similar to other women of their age; 10% indicated an increased risk, and 30% indicated a lower risk. These figures were similar in 2003 and 2007. Logistic regression found that lower income, increased age, being born overseas, and being retired were significantly associated with lower perceived risk (accounted for only 7.5% of the variance). Common reasons for higher perceived risk included family history of ovarian/other cancers, increasing age, and having had other types of cancer or health problems. Reasons for lower than average risk included absence of family history, having a hysterectomy, and having regular Pap smears (indicating confusion between ovarian and cervical cancer). There appeared to be substantial confusion in women's understanding of ovarian cancer symptoms; this was similar in 2003 and 2007. CONCLUSION: The observed misperceptions and confusion regarding ovarian cancer symptoms and risk factors suggest ongoing public education campaigns are needed to improve knowledge and awareness.

Complex Trauma and Ecological Vulnerability: Development of a Resources Perspective Framework to Inform Longitudinal Examination.

Translation and application of current complex trauma knowledge for high-risk groups such as the homeless is needed. Existing research in this area has been limited by lack of a cohesive theoretical framework that captures the dynamic and heterogeneous nature of complex trauma within the context of ecological vulnerability (e.g. homelessness). This paper aims to address these gaps by proposing an integrated resources perspective framework situating Layne and colleagues' (Layne et al. 2009, 2010) concept of 'risk factor caravans' as central focus. We demonstrate how the 'risk factor caravan' representation captures current theoretical and clinical insights into the pervasive and enduring consequences of complex trauma exposure. Personal resources are highlighted as key for understanding resource loss and gain in the current context. Longitudinal person-centered approaches as integral methodological considerations for future application of this proposed framework are examined. Implications for reducing barriers to access of available support services are discussed.

Tobacco harm reduction: are smokers becoming more hardcore?

We undertook a systematic review to identify and summarise studies on hardcore smoking and hardening to: determine the degree of variability in definitions of hardcore smoking and hardening; assess the evidence for claims that smokers are becoming increasingly hardened within the context of harm reduction as a policy initiative; and identify the determining characteristics of a hardcore smoker. We searched five electronic databases from 1970 to mid-April 2018 using the search term "smok* AND hard* AND (tobacco OR cigar* OR nicotin*)". We included studies if they included a definition of hardcore smokers and/or hardening, and provided a prevalence rate for hard core smokers or empirical evidence for hardening. Definitions of hardcore smoker varied substantially across studies. Hardening was not evident in the general smoking population and we found mounting evidence of softening occurring in smoking populations. These results indicate that hardening of smokers is not occurring and that calls for policy interventions on this basis should be challenged.

Factors associated with short and long sleep.

OBJECTIVE: Short (<7 h) and long sleep durations (> or = 9 h) have recently been linked with increased mortality in the US, Europe and Asia, but little is known about the sleep patterns of Australian adults. The present study examined the sleep habits of Australian adults and identified socio-demographic and health-related factors associated with short and long sleep. METHODS: This study analyzed cross-sectional and self-reported data from 49,405 Australian adults aged 45 to 65 years collected between 2006 and 2008. Socio-demographic and health-related factors were entered into multinomial logistic regression models predicting self-reported sleep duration. RESULTS: Short and long sleep were reported by 16.6% and 13.9% of participants respectively. Short sleep was associated with long working hours (odds ratio [OR]=1.17, 95% confidence interval (CI): 1.08, 1.28) and obesity (OR=1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR=1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR=1.58, 95% CI: 1.19, 2.09). CONCLUSIONS: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep.

EEG differences between eyes-closed and eyes-open resting conditions.

OBJECTIVE: Recent work has attempted to clarify the energetics of physiological responding and behaviour by refining and separating the operational definitions of "arousal" and "activation", which have different effects on physiological responding and behaviour. At the EEG level, we relate the former to widespread activity, and the latter to task-specific topographically-focussed activity reflecting regional processing. This study aimed to investigate this further in terms of differences in EEG activity between eyes-closed and eyes-open resting conditions. METHODS: EEG activity was recorded from 28 university students during both eyes-closed and eyes-open resting conditions, Fourier transformed to provide estimates for absolute power in the delta, theta, alpha and beta bands, and analysed in 9 regions across the scalp. Skin conductance level was also measured as an indicator of arousal level. RESULTS: Across the eyes-closed conditions, skin conductance levels were negatively correlated with mean alpha levels. Skin conductance levels increased significantly from eyes-closed to eyes-open conditions. Reductions were found in across-scalp mean absolute delta, theta, alpha and beta from the eyes-closed to eyes-open condition. Topographic changes were also evident in all bands except for alpha, with reduced lateral frontal delta and posterior theta, and decreased posterior/increased frontal beta in the eyes-open condition. In particular, the topographic beta effects indicate that the across-scalp reduction arose from focal reductions rather than global changes. CONCLUSIONS: The obtained results confirm the use of mean alpha level as a measure of resting-state arousal under eyes-closed and eyes-open conditions. The focal nature of EEG effects in the other bands suggests that these reflect cortical processing of visual input, producing differences in activation between eyes-closed and eyes-open resting conditions, rather than just the simple increase in arousal level shown in alpha. SIGNIFICANCE: This study demonstrates that the eyes-closed and eyes-open conditions provide EEG measures differing in topography as well as power levels. These differences should be recognised when evaluating EEG research, and considered when choosing eyes-open or eyes-closed baseline conditions for different paradigms.

Coherence in children with Attention-Deficit/Hyperactivity Disorder and excess beta activity in their EEG.

OBJECTIVE: This study investigated differences in coherence measures between two groups of children with Attention-Deficit/Hyperactivity Disorder (ADHD) - with the typical EEG profile (increased theta and decreased beta activity), and with excess beta activity - and a normal control group. METHODS: Thirty-four children with ADHD were included in each of the typical and excess beta groups, and were age and sex matched with 34 control subjects. EEG was recorded from 21 sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta bands. RESULTS: In comparison to the controls, the typical ADHD group primarily had increased intrahemispheric theta and beta coherence at short-medium inter-electrode distances, and increased interhemispheric coherence for theta in the frontal and central/parietal/occipital regions. Their laterality effect for interhemispheric short-medium inter-electrode distances was reduced in the theta band. Differences between the excess beta group and the control group were primarily found in laterality of the intrahemispheric theta coherence at short-medium electrode distances, and increased interhemispheric theta coherence in the frontal regions. Reduced delta coherence in the temporal regions was also found. CONCLUSIONS: These results suggest that ADHD children with excess beta power have an underlying brain dysfunction in the frontal lobes which is found in common with children with the typical EEG profile. However a number of qualitative differences exist which could be associated with other aspects of the ADHD diagnosis or another comorbid condition. SIGNIFICANCE: This is the first study to investigate EEG coherence in ADHD children who have increased beta power.

Sleep quality subtypes predict health-related quality of life in children.

OBJECTIVE: This paper aimed to investigate whether distinct sleep quality subtypes predicted health-related quality of life in a nonclinical sample of children. METHODS: This paper utilized data from two waves of the Longitudinal Study of Australian Children, a cohort study that follows a representative population of children in Australia. This paper examined data from Waves 4 and 5 of the LSAC (covering the period 2010-2012) and included 3974 children aged 10-11 years at Wave 4 (51.4% male). Multiple dimensions of sleep quality were assessed using a combination of child- and parent-reported measures. Health-related quality of life (HRQOL) was assessed through the Pediatric Quality of Life Inventory. RESULTS: Latent class analysis indicated six distinct sleep quality classes in children, namely good sleep, moderate sleep quality, mild sleep disturbances, short sleep, long sleep, and disordered sleep. In general, the disordered sleep and minor sleep disturbance classes had poorer HRQOL, which worsened over time. The long sleep and moderate sleep quality classes also showed some decreases in HRQOL over time. CONCLUSIONS: This study demonstrates that there are distinct sleep quality subtypes in children that could have implications for HRQOL. These findings may inform future strategies to promote improved sleep and HRQOL in children.