Understanding Sleep And Sleep Disturbances In Nursing-Home Eligible Community Dwelling Older Adults: A Mixed Methods Study

ABSTRACT UNDERSTANDING SLEEP AND SLEEP DISTURBANCES IN NURSING-HOME ELGIBLE COMMUNITY DWELLING OLDER ADULTS: A MIXED METHODS STUDY Miranda S. Varrasse Barbara J. Riegel It is estimated that one-half to two-thirds of older adults have at least one sleep related complaint and older adults with chronic conditions and functional limitations are even more likely to suffer from sleep disturbances. Sleep disturbances can lead to poor overall health, a decrease in physical and cognitive function, and an increase in health care service utilization and cost. Yet, sleep complaints are often underreported and underdiagnosed. Nursing-home eligible older adults who remain living in the community are at an increased risk of nursing home placement, due to their high level of care needs, comorbidities and functional status. Sleep disturbances may increase the risk of decline but relatively little is known about sleep disturbances in this high risk group. The overall purpose of this concurrent nested mixed methods study [QUAL+quan] was to describe sleep characteristics in 40 nursing-home eligible, community dwelling older adults. Qualitative data were weighted more heavily and obtained via semi-structured interviews. Quantitative data consisted of three self-report sleep surveys and one week of actigraphy and sleep diary. Data were collected concurrently and analyzed sequentially. Our final sample of 40 older adults was comprised of Black (100%), primarily female (85%) older adults with a mean age of 72.37 � 9.54. The two major findings were: 1) the majority of the sample had objectively poor sleep quality and napped frequently during the day, regardless of self-perceptions of sleep quality, and 2) these older adults had adjusted their health expectations and adapted to their sleep disturbances. We also identified modifiable targets for intervention development and testing. To our knowledge this is the first mixed methods study of sleep in nursing-home eligible, community dwelling, at-risk older adults. These results begin to equip us to intervene on modifiable factors that have the potential to improve health outcomes in this vulnerable population

Poor Sleep Quality and Its Consequences on Mental Health During the COVID-19 Lockdown in Italy

Background: Coronavirus disease 2019 (COVID-19) seriously affected the whole of Italy. The extreme virulence and the speed of propagation resulted in restrictions and home confinement. This change was immediately perceived by people who found themselves exposed to feelings of uncertainty, fear, anger, stress, and a drastic change in the diurnal but above all nocturnal lifestyle. For these reasons, we aimed to study the quality of sleep and its connection to distress levels and to evaluate how lifestyle changed in the Italian population during the lockdown. Methods: By means of an Internet survey we recruited 6,519 adults during the whole of the COVID-19 lockdown (from March 10–1st phase to May 4–2nd phase). We investigated the sociodemographic and COVID-19-related information and assessed sleep quality using the Medical Outcomes Study–sleep scale (MOS-SS) and mental health with the short form of Depression, Anxiety, and Stress Scales–21 Items (DASS- 21). Multiple logistic regression model was used to evaluate the multivariate association between the dependent variable (good sleeper vs. poor sleeper) and all the variables that were significant in the univariate analysis. Results: A total of 3,562 (55.32%) participants reported poor sleep quality according to the MOS-Sleep Index II score. The multiple binary logistic regression results of poor sleepers revealed several risk factors during the outbreak restrictions: female gender, living in Central Italy, having someone close who died because of COVID-19, markedly changed sleep–wake rhythms characterized by earlier or postponed habitual bedtime, earlier habitual awakening time and reduced number of afternoon naps, and extremely severe levels of stress, anxiety, and depression. Conclusion: This is the first study designed to understand sleep quality and sleep habits during the whole of the lockdown period in the Italian population that provides more than 6,000 participants in a survey developed specifically for the health emergency related to COVID-19. Our study found that more than half of the Italian population had impaired sleep quality and sleep habits due to elevated psychological distress during the COVID- 19 lockdown containment measures. A multidisciplinary action should be undertaken in order to plan appropriate responses to the current crisis caused by the lockdown for the COVID-19 outbreak

Airline Pilot Non-Flight Related Activities During Cruise Flight and Perceptions on Their Safety Effects

Automation complacency, boredom, and fatigue pose significant risk to aviation. There have been many incidents and accidents as a result of these challenges to human performance. In previous studies pilots have admitted to performing non- flight related activities in order to deal with these challenges. However, no research has been done on the frequency and perceived safety effects of non-flight related activities. If pilots are engaging in activities intended to counter these challenges, it is important to know the frequency and how pilots feel these non-flight activities affect safety. This study used a survey tool to gather information regarding non-flight related activities from airline pilots in the United States. Participants provided data on frequency of non-flight related activities, perceptions of their safety effects, opinions on the activities related to automation complacency, boredom, and fatigue, and general information on the positive and negative outcomes of these activities. Results suggest that pilots routinely engage in non-flight related activities during cruise flight and perceive most of the activities to be safe. In addition, pilots believe that these activities help to prevent boredom, which then helps to prevent automation complacency and fatigue. Pilots seem to understand that these activities can have negative safety implications, but overall have more positive outcomes

THE INTERSECTION OF PHYSICAL ACTIVITY, SELF-REGULATION AND ACADEMIC ACHIEVEMENT: IMPLICATIONS FOR EDUCATIONAL SUCCESS

In recent years young children have concurrently experienced startling rises in their rates of obesity and stark reductions in their opportunities for physical activity. These trends have potentially serious implications for young children’s school performance. However, much of the current physical activity research is concerned with health-related outcomes and the prediction of physical activity. Less work has examined the influence of activity on other domains of child development, such as academic and social skills. The current dissertation is comprised of two studies examining opportunities for and levels of physical activity in two distinct developmental periods (preschool and elementary school) and elucidating associations of physical activity with children’s self-regulation and achievement. Examining two independent samples facilitated comparisons of physical activity characteristics and associations across age groups, school settings and demographic contexts. The first study consisted of a within-group analysis of a primarily low-income minority subsample of 4 and 5 year-old preschoolers (N = 104) drawn from the Pitt School Readiness Study, a study of preschoolers from the metropolitan Pittsburgh area. Results from this examination suggest that, although children’s moderate to vigorous activity was not related to self-regulation or achievement, opportunities for physical activity seemed important. Specifically, more time in free play predicted worse attention, and more time in recess predicted more externalizing behavior, less self-control, and worse math achievement. In contrast, more physical education time predicted better reading and math skills. The second study consisted of analyses on a large, economically and ethnically diverse sample of third and fifth graders (N = 993) and a low income subsample (n = 297). Across these samples, more physical education emerged as a positive predictor of self-control but more recess time was negatively associated with math achievement. Accelerometry measured physical activity was not predictive across outcomes. Finally, post-hoc examinations revealed that attention, self-control, and externalizing behaviors acted as possible agents of indirect associations between opportunities for physical activity and achievement. Overall, findings across both studies suggest that children benefit most from physical activity that is structured and regularly scheduled within school settings. Furthermore, large quantities of unstructured activity seemed detrimental for self-regulation and achievement

Periodical Index

Subject Index of Articles, Comments, Notes, and Recent Developments Appearing in Leading Law Review

Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 314)

This bibliography lists 139 reports, articles, and other documents introduced into the NASA scientific and technical information system in August, 1988