Circadian Rhythm Disruptions and Health

The doctoral thesis defined connections between circadian rhythm disruptions and health problems. Sleep debt, jet-lag, shift work, as well as transitions into and out of the daylight saving time may lead to circadian rhythm disruptions. Disturbed circadian rhythm causes sleep deprivation and decrease of mood and these effects may lead to higher accident rates and trigger mental illnesses. Circadian clock genes are involved in the regulation of the cell cycle and metabolism and thus unstable circadian rhythmicity may also lead to cancer development. In publications I-III it was explored how transitions into and out of the daylight saving time impact the sleep efficiency and the rest-activity cycles of healthy individuals. Also it was explored whether the effect of transition is different in fall as compared to spring, and whether there are subgroup specific differences in the adjustment to transitions into and out of daylight saving time. The healthy participants of studies I-III used actigraphs before and after the transitions and filled in the morningness-eveningness and seasonal pattern assessment questionnaires. In publication IV the incidence of hospital-treated accidents and manic episodes was explored two weeks before and two weeks after the transitions into and out of the daylight saving time in years 1987-2003. In publication V the relationship between circadian rhythm disruption and the prevalence of Non-Hodgkin lymphoma was studied. The study V consisted of all working aged Finns who participated in the national population census in 1970. For our study, all the cancers diagnosed during the years 1971-1995 were extracted from the Finnish Cancer Register and linked with the 1970 census files. In studies I-III it was noticed that transitions into and out of the daylight saving time disturbs the sleep-wake cycle and the sleep efficiency of the healthy participants. We also noticed that short sleepers were more sensitive than long sleepers for sudden changes in the circadian rhythm. Our results also indicated that adaptation to changes in the circadian rhythm is potentially sex, age and chronotype-specific. In study IV no significant increase in the occurrence of hospital treated accidents or manic episodes was noticed. However, interesting observations about the seasonal fluctuation of the occurrence rates of accidents and manic episodes were made. Study V revealed that there might be close relationship between circadian rhythm disruption and cancer. The prevalence of Non-Hodgkin lymphoma was the highest among night workers. The five publications included in this thesis together point out that disturbed circadian rhythms may have adverse effect on health. Disturbed circadian rhythms decrease the quality of sleep and weaken the sleep-wake cycle. A continuous circadian rhythm disruption may also predispose individuals to cancer development. Since circadian rhythm disruptions are common in modern society they might have a remarkable impact on the public health. Thus it is important to continue circadian rhythm research so that better prevention and treatment methods can be developed. Keywords: Circadian rhythm, daylight saving time, manic episodes, accidents, Non-Hodgkin lymphoma 11

An eroding social justice agenda: The case of physical education and health edu-business in schools

In this paper we draw on current research to explore notions of a socially just Health and Physical Education (HPE), in light of claims that a neoliberal globalisation promotes markets over the states, and a new individualism that privileges self-interest over the collective good. We also invite readers to consider United Nations Educational, Scientific and Cultural Organization’s ambition for PE in light of preliminary findings from an Australian led research project exploring national and international patterns of outsourcing HPE curricula. Data were sourced from this international research project through a mixed method approach. Each external provider engaged in four phases of research activity: (a) Web-audits, (b) Interviews with external providers, (c) Network diagrams, and (d) School partner interviews and observations. Results We use these data to pose what we believe to be three emerging lines of inquiry and challenge for a socially just school HPE within neoliberal times. In particular our data indicates that the marketization of school HPE is strengthening an emphasis on individual responsibility for personal health, elevating expectations that schools and teachers will “fill the welfare gap” and finally, influencing the nature and purchase of educative HPE programs in schools. The apparent proliferation of external providers of health work, HPE resources and services reflects the rise and pervasiveness of neoliberalism in education. We conclude that this global HPE landscape warrants attention to investigate the extent to which external providers’ resources are compatible with schooling’s educative and inclusive mandates.

Augmenting process elicitation with visual priming: An empirical exploration of user behaviour and modelling outcomes

Business process models have become an effective way of examining business practices to identify areas for improvement. While common information gathering approaches are generally efficacious, they can be quite time consuming and have the risk of developing inaccuracies when information is forgotten or incorrectly interpreted by analysts. In this study, the potential of a role-playing approach to process elicitation and specification has been examined. This method allows stakeholders to enter a virtual world and role-play actions similarly to how they would in reality. As actions are completed, a model is automatically developed, removing the need for stakeholders to learn and understand a modelling grammar. An empirical investigation comparing both the modelling outputs and participant behaviour of this virtual world role-play elicitor with an S-BPM process modelling tool found that while the modelling approaches of the two groups varied greatly, the virtual world elicitor may not only improve both the number of individual process task steps remembered and the correctness of task ordering, but also provide a reduction in the time required for stakeholders to model a process view.

Physical activity and health in mid age and older Australian women

The US Surgeon General's report was a landmark publication in the field of physical activity and health, but was constrained by a lack of evidence relating to women. This report examines the links between physical activity and health in mid-age and older women. It includes four parts (i)recent evidence relating physical activity to the national public health priorities and reproductive health (ii)consideration of the amount of physical activity required to obtain health benefits (iii)new data from the Australian Longitudinal Study on Women's Health on activity patterns, including relationships between changes in physical activity and life events, sociodemographic characteristics and health behaviours in mid-age and older Australian women (iv)new data from the Australian Longitudinal Study on Women's Health on the relationships between physical activity and menopausal symptoms, stiff or painful joints and arthritis, anxiety and depression, memory problems, falls and fractures, general physical and psychological well-being, and healthcare costs in mid-age and older Australian women

Truckies and health promotion: A “hard-to-reach” group without a “proper” workplace.

This literature review was undertaken to inform a settings based health promotion research project, conducted by a public health research team at the Queensland University of Technology (QUT). The aim of this project is to identify how transport workplaces can support their truck drivers to access healthy food options and increase physical activity. Truck drivers in Australia are at increased risk of numerous chronic diseases, in part due to the restrictions placed upon them by the environment in which they work. Barriers to good health through adequate nutrition and physical activity are the result of a complex interaction between government regulations, corporate policies, the built environment and individual factors. Few interventions target this population in a meaningful and sustainable way, though evidence exists for interventions which can be translated into truck drivers working environment.

Occupational Rhinitis : Diagnosis and Health-related Quality of Life

Occupational rhinitis is mainly caused by work environment and not by stimuli encountered outside the workplace. It differs from rhinitis that is worsened by, but not mainly caused by, workplace exposures. Occupational rhinitis can develop in response to allergens, inhaled irritants, or corrosive gases. The thesis evaluated the use of challenge tests in occupational rhinitis diagnostics, studied the long-term health-related quality of life among allergic occupational rhinitis patients, and the allergens of wheat grain among occupational respiratory allergy patients. The diagnosed occupational rhinitis was mainly allergic rhinitis, which was caused by occupational agents, most commonly flours and animal allergens. The non-IgE-mediated rhinitis reactions were less frequent and caused more often asthma than rhinitis. Both nasal challenges and inhalation challenges were found to be safe tests. The inhalation challenge tests had considerably resource-intensive methodology. However, the evaluation of nasal symptoms and signs together with bronchial reactions saved time and expense compared with the organization of multiple individual challenges. The scoring criteria used matched well with the weighted amount of discharge ≥ 0.2 g and in most cases gave comparable results. The challenge tests are valuable tools when there is uncertainty whether the patient's exposure should be reduced or discontinued. It was found that continuing exposure decreases health-related quality of life among patients with allergic occupational rhinitis despite of rhinitis medications, still approximately ten years after the diagnosis. Health-related quality of life among occupational rhinitis patients without any longer occupational exposure was mainly similar than that of the healthy controls. This highlights the importance of the reduction and cessation of occupational exposure. To achieve this, 17% of occupational rhinitis patients had been re-educated. Alpha-amylase inhibitors, lipid transfer protein 2G, thaumatin -like protein, and peroxidase I were found to be relevant allergens in Finnish patients with occupational respiratory wheat allergy. Of these allergens, thaumatin-like protein and lipid transfer protein 2G were found as new allergens associated with baker's rhinitis and asthma. The knowledge of the new clinically relevant proteins can be used in the future in the development of better standardized diagnostic preparations.

Experimental study on shrinkage behaviour and prediction of shrinkage magnitudes of residual soils

The present study examines the shrinkage behaviour of residually derived black cotton (BC) soil and red soil compacted specimens that were subjected to air-drying from the swollen state. The soil specimens were compacted at varying dry density and moisture contents to simulate varied field conditions. The void ratio and moisture content of the swollen specimens were monitored during the drying process and relationship between them is analyzed. Shrinkage is represented as reduction in void ratio with decrease in water content of soil specimens. It is found to occur in three distinct stages. Total shrinkage magnitude depends on the type of clay mineral present. Variation in compaction conditions effect marginally total shrinkage magnitudes of BC soil specimens but have relatively more effect on red soil specimens. A linear relation is obtained between total shrinkage magnitude and volumetric water content of soil specimens in swollen state and can be used to predict the shrinkage magnitude of soils.

Evaluating the effectiveness of a self-management exercise intervention on wound healing, functional ability and health-related quality of life outcomes in adults with venous leg ulcers: a randomised controlled trial

Exercise that targets ankle joint mobility may lead to improvement in calf muscle pump function and subsequent healing. The objectives of this research were to assess the impact of an exercise intervention in addition to routine evidence-based care on the healing rates, functional ability and health-related quality of life for adults with venous leg ulcers (VLUs). This study included 63 patients with VLUs. Patients were randomised to receive either a 12-week exercise intervention with a telephone coaching component or usual care plus telephone calls at the same timepoints. The primary outcome evaluated the effectiveness of the intervention in relation to wound healing. The secondary outcomes evaluated physical activity, functional ability and health-related quality of life measures between groups at the end of the 12 weeks. A per protocol analysis complemented the effectiveness (intention-to-treat) analysis to highlight the importance of adherence to an exercise intervention. Intention-to-treat analyses for the primary outcome showed 77% of those in the intervention group healed by 12 weeks compared to 53% of those in the usual care group. Although this difference was not statistically significant due to a smaller than expected sample size, a 24% difference in healing rates could be considered clinically significant. The per protocol analysis for wound healing, however, showed that those in the intervention group who adhered to the exercise protocol 75% or more of the time were significantly more likely to heal and showed higher rates for wound healing than the control group (P = 0·01), that is, 95% of those who adhered in the intervention group healed in 12 weeks. The secondary outcomes of physical activity, functional ability and health-related quality of life were not significantly altered by the intervention. Among the secondary outcomes (physical activity, functional ability and health-related quality of life), intention-to-treat analyses did not support the effectiveness of the intervention. However, per protocol analyses revealed encouraging results with those participants who adhered more than 75% of the time (n = 19) showing significantly improved Range of Ankle Motion from the self-management exercise programme (P = 0·045). This study has shown that those participants who adhere to the exercise programme as an adjunctive treatment to standard care are more likely to heal and have better functional outcomes than those who do not adhere to the exercises in conjunction with usual care.

Relating food literacy to nutrition and health

This chapter describes the evolution of a model to propose the relationship between food literacy and nutrition. This model can also be used as a framework for program planning, implementation and evaluation. Practitioners and policy makers invest in food literacy with outcome expectations beyond diet quality. For this reason, a second model was developed to conceptualise the role of food literacy with respect to food security, body weight and chronic disease risk. This second model is useful in positioning food literacy within multi-strategic public health nutrition and chronic disease plans.

Selective attention in a synchronising bushcricket: physiology, behaviour and ecology

Synchronising bushcricket males achieve synchrony by delaying their chirps in response to calling neighbours. In multi-male choruses, males that delay chirps in response to all their neighbours would remain silent most of the time and be unable to attract mates. This problem could be overcome if the afferent auditory system exhibited selective attention, and thus a male interacted only with a subset of neighbours. We investigated whether individuals of the bushcricket genus Mecopoda restricted their attention to louder chirps neurophysiologically, behaviourally and through spacing. We found that louder leading chirps were preferentially represented in the omega neuron but the representation of softer following chirps was not completely abolished. Following chirps that were 20 dB louder than leading chirps were better represented than leading chirps. During acoustic interactions, males synchronised with leading chirps even when the following chirps were 20 dB louder. Males did not restrict their attention to louder chirps during interactions but were affected by all chirps above a particular threshold. In the field, we found that males on average had only one or two neighbours whose calls were above this threshold. Selective attention is thus achieved in this bushcricket through spacing rather than neurophysiological filtering of softer signals.

Selective attention in a synchronising bushcricket: physiology, behaviour and ecology

Synchronising bushcricket males achieve synchrony by delaying their chirps in response to calling neighbours. In multi-male choruses, males that delay chirps in response to all their neighbours would remain silent most of the time and be unable to attract mates. This problem could be overcome if the afferent auditory system exhibited selective attention, and thus a male interacted only with a subset of neighbours. We investigated whether individuals of the bushcricket genus Mecopoda restricted their attention to louder chirps neurophysiologically, behaviourally and through spacing. We found that louder leading chirps were preferentially represented in the omega neuron but the representation of softer following chirps was not completely abolished. Following chirps that were 20 dB louder than leading chirps were better represented than leading chirps. During acoustic interactions, males synchronised with leading chirps even when the following chirps were 20 dB louder. Males did not restrict their attention to louder chirps during interactions but were affected by all chirps above a particular threshold. In the field, we found that males on average had only one or two neighbours whose calls were above this threshold. Selective attention is thus achieved in this bushcricket through spacing rather than neurophysiological filtering of softer signals.

Strategies for improving safety and health of ethnic minority construction workers

The construction industries of developed countries are faced with an aging workforce and a shortage of recruits. It is common for migrant workers/ethnic minorities (EMs) who are already part of the society to join the construction industry. With increasing involvement of EMs in the construction industry, effective strategies for improving their safety and health are urgently needed. The existing body of knowledge is mainly derived from research conducted in English-speaking countries with Western cultures. Research on safety of migrant/EM construction workers in multidialect Asian countries with Eastern cultures has been lacking. This study aimed to identify various strategies for improving the safety and health of EM construction workers from the Asian perspective. Twenty-two face-to-face semistructured interviews were performed with safety professionals in Hong Kong followed by two rounds of Delphi survey with 18 safety experts to verify the interview findings and rank the relative importance of the strategies. The study unveiled 14 strategies for improving the safety performance of EM workers. The three most important ones identified were: (1) to provide safety training in EM native languages; (2) that government and industry associations should play an active role in promoting health and safety awareness of EM workers, and; (3) to encourage EM workers to learn the local language. This study contributes to filling the research gap by evaluating the strategies for improving safety of migrant/EM construction workers in Asian countries with Eastern cultures in which English is not the first language. Research findings would assist occupational health and safety experts and relevant stakeholders in designing strategies for improving the safety and health of EM workers, which will ultimately improve overall safety performance of the construction industry.

Asymptotic behaviour and boundedness of linear systems with time varying coefficients

Motivated by developments in spacecraft dynamics, the asymptotic behaviour and boundedness of solution of a special class of time varying systems in which each term appears as the sum of a constant and a time varying part, are analysed in this paper. It is not possible to apply standard textbook results to such systems, which are originally in second order. Some of the existing results are reformulated. Four theorems which explore the relations between the asymptotic behaviour/boundedness of the constant coefficient system, obtained by equating the time varying terms to zero, to the corresponding behaviour of the time varying system, are developed. The results show the behaviour of the two systems to be intimately related, provided the solutions of the constant coefficient system approach zero are bounded for large values of time, and the time varying terms are suitably restrained. Two problems are tackled using these theorems.