24-Hour sleep/wake patterns in healthy elderly persons

The purpose of this study was to examine the 24-hour sleep/wake patterns of healthy elderly persons. Data was obtained from 14 elderly subjects who wore a wrist actigraph for 48 hours and completed an activity diary during the monitoring period. Although subjects spent slightly more than 7.5 hours in bed at night, they were asleep for just over 6 hours. Subjects did not have trouble falling asleep, but once asleep, had trouble remaining asleep. All subjects took one or more naps during the recording period, but daytime naps composed only a small fraction of their total sleep time. Total duration of daytime sleep averaged 59.8 minutes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31596/1/0000525.pd

Sono, estresse e comportamentos compensatórios por enfermeiras e parteiras australianas

OBJECTIVE: To describe sleep, stress and compensatory behaviors in nurses and midwives. METHODS: The study included 41 midwives and 21 nurses working in Australian hospitals between 2005 and 2009. Participation was voluntary. All participants recorded on a daily basis their work and sleep hours, levels of stress and exhaustion, caffeine intake and use of sleep aids for a month (1,736 days, 1,002 work shifts). RESULTS: Participants reported moderate to high levels of stress and exhaustion on 20-40% of work days; experienced sleep disruption on more than 50% of work days; struggled to remain awake on 27% of work days; and suffered extreme drowsiness or experienced a near accident while travelling home on 9% of workdays. Age, perceived sleep duration and work hours were significant predictors of caffeine intake. About 60% of participants reported using sleep aids (about 20% reported taking prescription medications and 44% of nurses and 9% of midwives reported alcohol use as a sleep aid at least once during the study). Stress and workdays were significant predictors of sedative use. Overall, 22% reported being indifferent or mildly dissatisfied with their job. CONCLUSIONS: Sleep problems, high levels of stress and exhaustion and low job satisfaction are prevalent among nurses and midwives. The use of alcohol and sleeping pills as sleep aids, and the use of caffeine to help maintain alertness is also common. Nurses and midwives may use caffeine to compensate for reduced sleep, especially on workdays, and sleeping pills to cope with their daily work-related stress.OBJETIVO: Describir sueño, estrés y comportamientos compensatorios en enfermeras y parteras. MÉTODOS: El estudio incluyó 41 enfermeras 21 parteras en hospitales australianos de 2005 a 2009. La participación fue voluntaria. Los participantes registraron diariamente las horas de trabajo, sueño, estrés y niveles de agotamiento, cafeína y uso de ayuda para dormir durante un mes (1.736 días, 1.002 turnos). RESULTADOS: Los participantes relataron de moderados a elevados niveles de estrés y de agotamiento en 20%-40% de los días de trabajo; experimentaron disturbios del sueño en más de 50% de los días de trabajo; relataron esfuerzo para permanecer despierto en 27% de los días de trabajo; y sofrieron somnolencia extrema o accidente cerca de casa en 9% de los días de trabajo. Edad, duración del sueño percibido y jornadas fueron predictores significativos de la ingestión de cafeína. Aproximadamente 60% de los participantes relataron utilizar la ayuda para dormir: cerca de 20% usaron de medicación prescripta y 44% de las enfermeras y 9% de las parteras consumirán alcohol como auxilio para dormir al menos una vez durante el estudio. Estrés y días de trabajo fueron predictores significativos del uso de sedativos. En general, 22% relataron ser indiferente, o ligeramente insatisfecho con su trabajo. CONCLUSIONES: Problemas en el sueño, estrés y agotamiento elevados y disminución en la satisfacción en el trabajo son prevalecientes. Uso de alcohol y de medicamentos para dormir, y consumo de cafeína para mantenerse alerta también es común. Enfermeras y parteras pueden usar la cafeína para compensar la reducción del sueño, especialmente en días de trabajo, y usar somníferos para compensar el estrés diario.OBJETIVO: Descrever sono, estresse e comportamentos compensatórios em enfermeiras e parteiras. MÉTODOS: O estudo incluiu 41 enfermeiras 21 parteiras em hospitais australianos de 2005 a 2009. A participação foi voluntária. Os participantes registraram diariamente as horas de trabalho, sono, stress e níveis de exaustão, cafeína e uso de ajuda para dormir durante um mês (1.736 dias, 1.002 turnos). RESULTADOS: Os participantes relataram de moderados a elevados níveis de stress e de exaustão em 20%-40% dos dias de trabalho; experimentaram distúrbios do sono em mais de 50% dos dias de trabalho; relataram esforço para permanecer acordado em 27% dos dias de trabalho; e sofreram sonolência extrema ou acidente perto de casa em 9% dos dias de trabalho. Idade, duração do sono percebida e jornadas foram preditores significativos da ingestão de cafeína. Aproximadamente 60% dos participantes relataram utilizar a ajuda para dormir: cerca de 20% relataram uso de medicação prescrita e 44% das enfermeiras e 9% das parteiras consumiam álcool como auxílio para dormir pelo menos uma vez durante o estudo. Estresse e dias de trabalho foram preditores significativos do uso de sedativos. Em geral, 22% relataram ser indiferente, ou ligeiramente insatisfeito com seu trabalho. CONCLUSÕES: Problemas no sono, estresse e exaustão elevados e diminuição na satisfação no trabalho são prevalentes. São comuns o uso de álcool e de medicamentos para dormir, e consumo de cafeína para se manter alerta. Enfermeiras e parteiras parecem usar a cafeína para compensar a redução do sono, especialmente em dias de trabalho, e usar soníferos para compensar o estresse diário

Capacity of Ugandan public sector health facilities to prevent and control non-communicable diseases: an assessment based upon WHO-PEN standards

Abstract Background Non-communicable diseases (NCDs) are increasing in prevalence in low-income countries including Uganda. The Uganda Ministry of Health has prioritized NCD prevention, early diagnosis, and management. However, research on the capacity of public sector health facilities to address NCDs is limited. Methods We developed a survey guided by the literature and the standards of the World Health Organization Pacakage of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Resource Settings. We used this tool to conduct a needs assessment in 53 higher-level public sector facilities throughout Uganda, including all Regional Referral Hospitals (RRH) and a purposive sample of General Hospitals (GH) and Health Centre IVs (HCIV), to: (1) assess their capacity to detect and manage NCDs; (2) describe provider knowledge and practices regarding the management of NCDs; and (3) identify areas in need of focused improvement. We collected data on human resources, equipment, NCD screening and management, medicines, and laboratory tests. Descriptive statistics were used to summarize our findings. Results We identified significant resource gaps at all sampled facilities. All facilities reported deficiencies in NCD screening and management services. Less than half of all RRH and GH had an automated blood pressure machine. The only laboratory test uniformly available at all surveyed facilities was random blood glucose. Sub-specialty NCD clinics were available in some facilities with the most common type being a diabetes clinic present at eleven (85%) RRHs. These facilities offered enhanced services to patients with diabetes. Surveyed facilities had limited use of NCD patient registries and NCD management guidelines. Most facilities (46% RRH, 23% GH, 7% HCIV) did not track patients with NCDs by using registries and only 4 (31%) RRHs, 4 (15%) GHs, and 1 (7%) HCIVs had access to diabetes management guidelines. Conclusions Despite inter-facility variability, none of the facilities in our study met the WHO-PEN standards for essential tools and medicines to implement effective NCD interventions. In Uganda, improvements in the allocation of human resources and essential medicines and technologies, coupled with uptake in the use of quality assurance modalities are desperately needed in order to adequately address the rapidly growing NCD burden.https://deepblue.lib.umich.edu/bitstream/2027.42/145194/1/12913_2018_Article_3426.pd