Publications by authors named "Megan Sands"

Purpose: To explore mental health clinicians' attitudes, experiences, and perceived barriers regarding Advance Care Planning (ACP) with older people (aged 55+) with schizophrenia/other psychotic illnesses.

Methods: Qualitative analysis of focus group interviews with multidisciplinary mental health clinicians from public mental health services in Sydney, Australia. A senior external clinician facilitated online focus groups exploring clinicians' attitudes, experiences, and perceived barriers to ACP using a semi-structured interview guide.

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Article Synopsis
  • Opioid analgesics, often used for managing moderate to severe pain, pose safety and efficacy concerns for patients with kidney disease due to their compromised renal function.
  • A systematic review of 32 studies highlighted the use of various opioids, including morphine and fentanyl, despite the overall limited quality of evidence available on their effects in patients with reduced kidney function.
  • The review suggests morphine as the most studied opioid for safety and effectiveness in renal disease, emphasizing the need for further high-quality research to better understand the risks and benefits of different opioids in this patient population.
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Purpose: Delirium leads to poor outcomes for patients and careers and has negative impacts on staff and service provision. Cancer rates in elderly populations are increasing and frequently, cancer diagnoses are a co-morbidity in the context of frailty. Data relating to the epidemiology of delirium in hospitalised cancer patients are limited.

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Background: Delirium is a distressing neuropsychiatric disorder affecting patients in palliative care. Although many delirium screening tools exist, their utility, and validation within palliative care settings has not undergone systematic review.

Aim: To systematically review studies that validate delirium screening tools conducted in palliative care settings.

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Aim: A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the 'Single Question in Delirium' (SQiD), in comparison to psychiatrist clinical interview.

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Purpose: To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up.

Methods: This is a secondary analysis of data from the Women's Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study.

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Sleep disturbance has been found to be associated with numerous adverse health outcomes, including cancers. However, no epidemiologic study has examined the relation between sleep disturbance and thyroid cancer risk. A total of 142,933 postmenopausal women who were 50-79 years of age and enrolled in the Women's Health Initiative between September 1, 1993, and December 31, 1998, were followed up for a mean of 11 years.

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Habitual snoring may be associated with cardiovascular disease (CVD); however, limited evidence exists among women. We investigated whether frequent snoring is a predictor of coronary heart disease (CHD) and stroke among 42,244 postmenopausal women participating in the Women's Health Initiative Observational Study. Participants provided self-reported information regarding snoring habits at baseline (1993 to 1998) and were followed up for outcomes through August 2009.

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Long sleep duration has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. Inflammation and coagulation have been hypothesized as possible physiological pathways to explain this association, although specific biomarkers have not been studied. Using longitudinal data from 3942 postmenopausal women in the Women's Health Initiative observational study and clinical trials, we investigated whether fibrinogen, an acute-phase inflammatory protein involved in blood clotting, mediates the associations between sleep duration and coronary heart disease (CHD) and mortality among women.

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Background And Purpose: Carotid intima-media thickness (CIMT) is a subclinical marker of cardiovascular disease. Recent studies suggest that shorter sleep duration is a risk factor for cardiovascular disease, but there is limited evidence regarding this association using high-quality, objective assessments of sleep. The aim of this study is to determine whether sleep duration is associated with CIMT.

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