Home' Southern Health News : Southern Health News February 2014 Contents 10 / FEBRUARY 2014 / SOUTHERN HEALTH NEWS
BY JACQUIE VAN SANTEN
People with epilepsy may
soon be able to sleep a little
easier, thanks to new research
carried out by a team of
researchers at Repatriation
General Hospital and Flinders
The research, prompted by the
Epilepsy Association of SA and
NT and funded by the Medical
Device Partnering Program, tested
the effectiveness of a prototype
anti-suffocation pillow designed to
reduce the risk of suffocation which
can sometimes occur as a result of
an epileptic seizure.
Sudden unexpected death in epilepsy is
rare, but suffocation post-seizure from
obstructed breathing against bedding
material, such as a pillow, is sometimes
concluded to have contributed to
death. Pillow safety is therefore a
concern in this patient group.
The research team compared two
low density foam 'lattice' pillows
to commercially available standard
cotton and latex pillows. Low density
foam is easier to breathe through
than traditional pillows and this could
help reduce the risk of suffocation.
However, expired gases accumulating
within the pillow from 'rebreathing'
could still contribute to suffocation risk.
Peter Catcheside, Associate Professor
in the Flinders University Clinical
Effectiveness Department, based in
the Adelaide Institute for Sleep Health
at Repatriation General Hospital, said
the study compared airflow resistance
and carbon dioxide rebreathing
characteristics between the pillows.
Working with Professor Karen
Reynolds and Dr Aaron Mohtar
from the Flinders Medical Device
Research Institute, the study used a
ventilation simulation machine and
a low flow rate of carbon dioxide to
simulate regular adult breathing and
normal carbon dioxide production
during 10-minute periods of expired
gas rebreathing from each pillow.
"We found that the low density
foam lattice and latex pillows had
considerably lower airflow resistance
compared to a cotton pillow. We
also found that the cotton and latex
pillows very quickly accumulated
high C02 levels, which are likely to
be life threatening if someone is lying
unconscious in the face-down position.
Lattice pillows accumulated CO2 much
more slowly. Although clearly much
safer, the CO2 levels reached could still
threaten health and survival, so further
work towards improved safety in this
area would be useful."
The Epilepsy Association of SA and
NT partnered with Flinders University
and Roche Foam to test the pillow.
The research was funded with a
grant from the Department for
Manufacturing, Innovation, Trade,
Resources and Energy.
BY SARAH GARVIS
The first social health
screening tool in Australia will
be developed by researchers
in the south to identify how
social factors can impact on a
patient's ability to act on their
doctors' advice and e ectively
self-manage their illness.
Preliminary work for the tool,
which will be a series of questions
developed by researchers from the
Southern Adelaide Local Health
Network (SALHN) and Flinders
University, has been funded by a
$16,000 grant from the Faculty of
Health Sciences at Flinders University.
Over the next year, a series of focus
groups with staff and consumers will
be set up to provide feedback on
the types of questions that might be
covered in the tool.
Flinders University Professor Fran
Baum, who is heading up this
research along with Director of the
Flinders Human Behaviour and Health
Research Unit Professor Malcolm
Battersby and Adelaide Institute for
Sleep Health Director Professor Doug
McEvoy, said the aim of the tool was
to better enable doctors to step into
their patients' shoes.
"The way I put it is there's a book
written by Professor Ron Patterson
called The Good Doctor - What
Patients Want and it says the ideal
healing relationship for a patient is
having the doctor stand in their shoes
for a moment," Professor Baum said.
"Clinicians are well aware that the
social and economic circumstances of
their patients' lives have a profound
impact on their health outcomes yet
there is no systematic way to measure
"The eventual development of
this tool should enable clinicians
to have a better understanding of
the constraints their patients face
in acting on their advice and the
reasons for non-compliance.
"The tool will also have the potential to
improve the extent to which patients
are able to self-manage their condition
by enabling self-management models
to be more effective in taking into
account the limitations people face in
their ability to self-manage given the
social determinants of health such
as unemployment, low income and
"It could also be used as a research
tool to examine in detail the ways in
which social determinants of health
affect peoples' access and effective use
of health services."
The first part of the research will
include two consumer focus groups,
which will examine consumers'
attitudes and feelings toward providing
information about their social history.
Interviews will also be held with a
broad range of clinicians including
doctors, nurses and psychologists
regarding their attitudes toward taking
the social histories of patients and what
social determinants would be of most
value to them.
A draft social health screening tool will
then be piloted with 25 of Professor
Battersby's patients (anxiety and
problem gambling clinics) and 25 of
Professor McEvoy's patients (physician,
nurse, psychology and psychiatric sleep
Professor McEvoy said the draft tool
was likely to be available for the patient
to complete prior to their appointment
with a clinician.
"Barriers and facilitators to the use of
the social health screening tool will
be noted and whether the tool aids
clinicians in approaching sensitive social
history questions," he said.
This feasibility study will inform a much
larger study to validate the tool, for
which National Health and Medical
Research Council project grant funding
will be sought. This would test the
tool with approximately 300 patients
to examine whether it's able to predict
which patients experience significant
social factors that affect their health
and ability to self-manage or attend
and benefit from health care.
Prototype pillow to help reduce su ocation fears
Social factors a determinant in good quality health care
What are social
determinants of health?
Social determinants of
health are the economic
and social conditions -- and
their distribution among the
population -- that influence
individual and group
differences in health status.
They are risk factors found
in one's living and working
conditions such as the
distribution of income, wealth,
influence, and power, rather
than individual factors such
as behavioural risk factors or
genetics that influence the risk
for a disease, or vulnerability to
disease or injury.
Some social determinants of
• Extent of financial and
• Extent and quality of social
• Employment status
• Perceived job stress
• Caring responsibilities
• Patient perception of social
and economic factors
impacting on their health.
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