121 research outputs found
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A Guiding Vision for Fluid Learning: The Future of Education and Training
Position paper by the Digital Media Collaboratory (DMC) of the ICÂČ Institute at The University of Texas at Austin. The authors envision learning systems as a ubiquitous public utility and propose an architecture to accomplish it. The paper includes a description of DMC research activities in 2003.IC2 Institut
The contribution of fatigue and sleepiness to depression in patients attending the sleep laboratory for evaluation of obstructive sleep apnea
Purpose: A high prevalence of depressive symptomatology
has been reported amongst sufferers of obstructive sleep
apnea (OSA), but it remains unclear as to whether this is
due to their OSA or other factors associated with the
disorder. The current study aimed to assess the incidence
and aetiology of depression in a community sample of
individuals presenting to the sleep laboratory for diagnostic
assessment of OSA.
Methods: Forty-five consecutive individuals who presented to
the sleep laboratory were recruited; of those, 34 were
diagnosed with OSA, and 11 were primary snorers with no
clinical or laboratory features of OSA. Nineteen control
subjects were also recruited. Patients and controls completed
the Beck Depression Inventory, the Profile of Mood States
(POMS), and the Epworth Sleepiness Scale to assess their
mood and sleepiness, prior to their polysomnography.
Results: All patients reported significantly more depressive
symptoms compared with healthy controls, regardless of their degree of OSA. There were no significant differences
between OSA patients and primary snorers on any of the
mood and self-rated sleepiness measures. Depression scores
were not significantly associated with any of the nocturnal
variables. Regression analysis revealed that the POMS
fatigue subscale explained the majority of the variance in
subjects' depression scores.
Conclusions: Fatigue was the primary predictor of the level
of depressive symptoms in patients who attended the sleep
laboratory, regardless of the level of severity of sleep disordered breathing. When considering treatment options,
practitioners should be aware of the concomitant occurrence
of depressive symptoms and fatigue in patients presenting with sleep complaints, which may not be due
to a sleep disorder
Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study
Chronic Fatigue Syndrome (CFS) is a multisystem illness, which may be associated with imbalances in gut microbiota. This study builds on recent evidence that sleep may be influenced by gut microbiota, by assessing whether changes to microbiota in a clinical population known to have both poor sleep and high rates of colonization with gram-positive faecal Streptococcus, can improve sleep. Twenty-one CFS participants completed a 22- day open label trial. Faecal microbiota analysis was performed at baseline and at the end of the trial. Participants were administered erythromycin 400 mg b.d. for 6 days. Actigraphy and questionnaires were used to monitor sleep, symptoms and mood. Changes in patients who showed a clinically significant change in faecal Streptococcus after treatment (responders; defined as post-therapy distribution<6%) were compared to participants who did not respond to treatment. In the seven responders, there was a significant increase in actigraphic total sleep time (p=0.028) from baseline to follow up, compared with non-responders. Improved vigour scores were associated with a lower Streptococcus count (Ï=-0.90, p=0.037). For both the responders and the whole group, poorer mood was associated with higher Lactobacillus. Short term antibiotic treatment appears to be insufficient to effect sustainable changes in the gut ecosystem in most CFS participants. Some improvement in objective sleep parameters and mood were found in participants with reduced levels of gram-positive gut microbiota after antibiotic treatment, which is encouraging. Further study of possible links between gut microorganisms and sleep and mood disturbances is warranted
Three-Year Trajectory of Teachersâ Fidelity to a Drug Prevention Curriculum
Little is known about the trajectories over time of classroom teachersâ fidelity to drug prevention curricula. Using the âConcerns-Based Adoption Modelâ (C-BAM) as a theoretical framework, we hypothesized that teachersâ fidelity would improve with repetition. Participants comprised 23 middle school teachers who videotaped their administration of three entire iterations of the All Stars curriculum. Investigators coded two key curriculum lessons, specifically assessing the proportion of activities of each lesson teachers attempted and whether they omitted, added, or changed prescribed content, or delivered it using new methods. Study findings provided only partial support for the C-BAM model. Considerable variability in teachersâ performance over time was noted, suggesting that their progression over time may be nonlinear and dynamic, and quite possibly a function of their classroom and school contexts. There was also evidence that, by their third iteration of All Stars, teachers tended to regress toward the baseline mean. That is, the implementation quality of those that started out with high levels of fidelity tended to degrade, while those that started out with very low fidelity to the curriculum tended to improve. Study findings suggest the need for ongoing training and technical assistance, as well as âjust in timeâ messages delivered electronically; but it is also possible that some prevention curricula may impose unrealistic expectations or burdens on teachersâ abilities and classroom time
Tuberculosis Microepidemics among Dispersed Migrants, Birmingham, UK, 2004-2013
MIRU-VNTR typing was supported by the Public Health England
National TB Strain Typing Project. M.M. is funded by the
UK Clinical Research Collaboration Modernising Medical Microbiology
Consortium. C.B. is funded by the Heart of Birmingham
Primary Care Trust and Public Health England
Disseminating sleep education to graduate psychology programs online: a knowledge translation study to improve the management of insomnia
Study Objectives
Despite the negative impact of poor sleep on mental health, evidence-based insomnia management guidelines have not been translated into routine mental healthcare. Here, we evaluate a state-wide knowledge translation effort to disseminate sleep and insomnia education to graduate psychology programs online using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) evaluation framework.
Methods
Using a non-randomized waitlist control design, graduate psychology students attended a validated 6-hour online sleep education workshop delivered live as part of their graduate psychology program in Victoria, Australia. Sleep knowledge, attitudes, and practice assessments were conducted pre- and post-program, with long-term feedback collected at 12 months.
Results
Seven out of ten graduate psychology programs adopted the workshop (adoption rate = 70%). The workshop reached 313 graduate students, with a research participation rate of 81%. The workshop was effective at improving studentsâ sleep knowledge and self-efficacy to manage sleep disturbances using cognitive behavioral therapy for insomnia (CBT-I), compared to the waitlist control with medium-to-large effect sizes (all p < .001). Implementation feedback was positive, with 96% of students rating the workshop as very good-to-excellent. Twelve-month maintenance data demonstrated that 83% of students had used the sleep knowledge/skills learned in the workshop in their clinical practice. However, more practical training is required to achieve CBT-I competency.
Conclusions
Online sleep education workshops can be scaled to deliver cost-effective foundational sleep training to graduate psychology students. This workshop will accelerate the translation of insomnia management guidelines into psychology practice to improve sleep and mental health outcomes nationwide
Past, present, and future roles of long-term experiments in the LTER Network
Author Posting. © American Institute of Biological Sciences, 2012. This article is posted here by permission of American Institute of Biological Sciences for personal use, not for redistribution. The definitive version was published in BioScience 62 (2012): 377-389, doi:10.1525/bio.2012.62.4.9.The US National Science Foundationâfunded Long Term Ecological Research (LTER) Network supports a large (around 240) and diverse portfolio of long-term ecological experiments. Collectively, these long-term experiments have (a) provided unique insights into ecological patterns and processes, although such insight often became apparent only after many years of study; (b) influenced management and policy decisions; and (c) evolved into research platforms supporting studies and involving investigators who were not part of the original design. Furthermore, this suite of long-term experiments addresses, at the site level, all of the US National Research Council's Grand Challenges in Environmental Sciences. Despite these contributions, we argue that the scale and scope of global environmental change requires a more-coordinated multisite approach to long-term experiments. Ideally, such an approach would include a network of spatially extensive multifactor experiments, designed in collaboration with ecological modelers that would build on and extend the unique context provided by the LTER Network.2012-10-0
Strange themes in pandemic dreams: Insomnia was associated with more negative, anxious and death-related dreams during the COVID-19 pandemic
Dreaming and insomnia are important markers of distress in times of crisis. Here, we present a longitudinal, mixedâmethods study examining changes in dreaming between individuals with and without insomnia symptoms and their relationship to mental health during the COVIDâ19 pandemic. A global survey examining insomnia symptoms, dreams and mental health was launched in April 2020 and followed participants over 12âmonths. Of 2240 participants, 1009 (45%) reported dream changes at baseline. A higher proportion of participants with newâonset insomnia reported dream changes (55%) than those with preâexisting insomnia (45%) or good sleepers (36%). Overall, thematic analysis identified key dream change themes of increased dream activity, with participants dreaming vividly, in highâdefinition, and with a strong negative charge. Themes around survival, adjusting to pandemic life, meaningâmaking and poor sleep quality were also noted. Linguistic Inquiry Word Count showed that individuals with insomnia used more negative words to describe their dream changes than good sleepers. Specifically, the newâonset insomnia group used more anxious and deathârelated words than those who slept well. Notably, all groups experienced a significant reduction in dream activity by 3âmonth followâup. Lastly, dream changes were associated with worse mental health symptoms over time, and this effect was more pronounced in individuals with insomnia. Our results highlight that insomnia symptoms, especially newâonset insomnia, are associated with more negative dream changes during collective stressful events, potentially compounding daytime distress and mental health symptoms over time. During times of crisis, dreaming and insomnia may reveal an important target for mental health interventions
The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician.
Erectile dysfunction (ED) and cardiovascular disease (CVD) share risk factors and frequently coexist, with endothelial dysfunction believed to be the pathophysiologic link. ED is common, affecting more than 70% of men with known CVD. In addition, clinical studies have demonstrated that ED in men with no known CVD often precedes a CVD event by 2-5 years. ED severity has been correlated with increasing plaque burden in patients with coronary artery disease. ED is an independent marker of increased CVD risk including all-cause and especially CVD mortality, particularly in men aged 30-60 years. Thus, ED identifies a window of opportunity for CVD risk mitigation. We recommend that a thorough history, physical exam (including visceral adiposity), assessment of ED severity and duration and evaluation including fasting plasma glucose, lipids, resting electrocardiogram, family history, lifestyle factors, serum creatinine (estimated glomerular filtration rate) and albumin:creatinine ratio, and determination of the presence or absence of the metabolic syndrome be performed to characterise cardiovascular risk in all men with ED. Assessment of testosterone levels should also be considered and biomarkers may help to further quantify risk, even though their roles in development of CVD have not been firmly established. Finally, we recommend that a question about ED be included in assessment of CVD risk in all men and be added to CVD risk assessment guidelines
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