BackgroundGood General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research.MethodsMajor online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR “Allied Health”). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training.ResultsThe framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company VCoPs. Specific goals are important, but in specialised health fields sometimes less important than in business. Boundary spanning can involve the interactions of different professional groups, as well as using external experts seen in business VCoPs. There was less use of measurement in health VCoPs. Environments must be supportive as well as risk free. Additional findings were that ease of use of technology is paramount and it is desirable for VCoPs to blend online and face-to-face involvement.ConclusionsThe business themes of leadership, sponsorship, objectives and goals, boundary spanning, risk-free environment and measurements become, in the health literature, facilitation, champion and support, objectives and goals, a broad church, supportive environment, measurement benchmarking and feedback, and technology and community.General Practice training is under pressure from isolation and virtual communities of practice may be a way of overcoming isolation. The health literature supports, with some variation, the business CoP framework developed by Probst. Further re...

Objective Promoting adherence to healthy dietary patterns is a critical public health issue. Models of behaviour, such as the Theory of Planned Behaviour (TPB) allow programme designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. Methods A systematic literature search was conducted to identify relevant studies. Random-effects meta-analysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. Results In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r+ = 0.61) followed by perceived behavioural control (PBC, r+ = 0.46) and subjective norm (r+ = 0.35). The association between intention and behaviour was r+ = 0.47, and between PBC and behaviour r+ = 0.32. Moderator analyses revealed that younger participants had stronger PBC-behaviour associations than older participants had, and studies recording participants' perceptions of behaviour reported significantly higher intention-behaviour associations than did those using less subjective measures. Conclusions TPB variables were found to have medium to large associations with both intention and behaviour that were robust to the influence of key moderators. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behaviour. AbstractPromoting adherence to healthy dietary patterns is a critical public health issue. Models of behavior, such as the Theory of Planned Behavior (TPB) allow program designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. A systematic literature search was conducted to identify relevant studies. Random-effects metaanalysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r + = 0.61) followed by perceived behavioral control (PBC, r + = 0.46) and subjective norm (r + = 0.35). The association between intention and behavior was r + = 0.47, and between PBC and behavior r + = 0.32. These associations were robust to the influence of key moderators. However, analyses revealed that younger participants had stronger PBC-behavior associations than older participants, and studies recording participants' perceptions of behavior reported significantly higher intentionbehavior associations than those using less subjective measures. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behavior.3

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The Pittsburgh Sleep Quality Index (PSQI) is widely used to assess subjective sleep quality in clinical and non-clinical settings. Although the PSQI is routinely scored to provide a single sleep quality factor, two recent studies suggest that multiple factor scoring methods could be more appropriate. As a consequence, the present study investigated for the dimensionality and factor structure of the PSQI in 364 Australian adults aged 18 to 59 years. The results demonstrate that two factor and three factor scoring models were favored statistically over the single factor model. These results add to recent findings and suggest that scoring the PSQI in relation to multiple factors could facilitate the assessment of sleep problems, which are increasingly common in society.

The combination of economic and social costs associated with non-communicable diseases provide a compelling argument for developing strategies that can influence modifiable risk factors, such as discrete food choices. Models of behaviour, such as the Theory of Planned Behaviour (TPB) provide conceptual order that allows program designers and policy makers to identify the substantive elements that drive behaviour and design effective interventions. The primary aim of the current review was to examine the association between TPB variables and discrete food choice behaviours. A systematic literature search was conducted to identify relevant studies. Calculation of the pooled mean effect size (r+) was conducted using inverse-variance weighted, random effects meta-analysis. Heterogeneity across studies was assessed using the Q- and I2-statistics. Meta-regression was used to test the impact of moderator variables: type of food choice behaviour; participants’ age and gender. A total of 42 journal articles and four unpublished dissertations met the inclusion criteria. TPB variables were found to have medium to large associations with both intention and behaviour. Attitudes had the strongest association with intention (r+ = 0.54) followed by perceived behavioural control (PBC, r+ = 0.42) and subjective norm (SN, r+ = 0.37). The association between intention and behaviour was r+ = 0.45 and between PBC and behaviour was r+ = 0.27. Moderator analyses revealed the complex nature of dietary behaviour and the factors that underpin individual food choices. Significantly higher PBC-behaviour associations were found for choosing health compromising compared to health promoting foods. Significantly higher intention-behaviour and PBC-behaviour associations were found for choosing health promoting foods compared to avoiding health compromising foods. Participant characteristics were also found to moderate associations within the model. Higher intention-behaviour associations were found for older, compared to younger age groups. The variability in the association of the TPB with different food choice behaviours uncovered by the moderator analyses strongly suggest that researchers should carefully consider the nature of the behaviour being exhibited prior to selecting a theory.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0324-z) contains supplementary material, which is available to authorized users.

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.

Objective: Short (< 7 h) and long sleep durations (≥ 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. 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.

BackgroundGP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation.ObjectiveThe goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation.MethodsThe case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation.ResultsStep 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%).ConclusionsThe 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community...