The Epidemiology and Health Outcomes Associated with Sleep: A Comparison of the Literature and a Sleep Disorder Sample

The public health significance of sleep extends to both the impact of sleep on health outcomes and the demographic disparities of the experience of poor sleep. Sleep is often under-appreciated as a health factor. The purpose of this thesis is to provide a synthesis of the literature on the epidemiology of sleep and the health outcomes of poor sleep. METHODS: A literature review was conducted and compared to analysis of data from the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep assessment study. The PROMIS sample is comprised of 258 individuals who self-reported symptoms of a sleep disorder. RESULTS: Literature revealed that gender, race, marital status, and socioeconomic status are factors that are associated with sleep. The literature also stresses the impact of sleep on several cardiovascular conditions. Among the PROMIS study sample of individuals with sleep disorders, marital status, and socioeconomic status were associated with sleep quality. Correlations were found between sleep disturbance and income, education, and body mass index. Wake disturbance (daytime functioning problems) was associated with diabetes and was correlated with age, income, and education. A diagnosis of insomnia was associated with the Caucasian race, depression, and low income. Obstructive sleep apnea diagnosis was associated with high blood pressure, being overweight or obese, being married or living with a partner, and having an income from $50,000 -$99,999. Restless legs syndrome was associated with having high blood pressure. CONCLUSIONS: Though the literature and the PROMIS study analysis were generally in agreement, gaps and incongruities exist both within the literature and between PROMIS and the literature. Specifically, the PROMIS sample found no association between sleep and gender. It is important to note that the comparison is between a literature synthesis of sleep in the general population and a data analysis of sleep-disordered individuals. More research is needed to better understand the epidemiology of sleep and the health effects resulting from poor sleep. Suggestions for future research and interventions are provided

The experiences of women with polycystic ovary syndrome on a very low-calorie diet

The research was funded by an educational grant from LighterLife. Broom was the Medical Director for LighterLife at the time of the research. Johnson is the Head of Nutrition and Research at LighterLife. The authors report no other conflicts of interest in this work.Peer reviewedPublisher PD

Cognitive representations of disability behaviours in people with mobility limitations : consistency with theoretical constructs

Disability is conceptualised as behaviour by psychological theory and as a result of bodily impairment by medical models. However, how people with disabilities conceptualise those disabilities is unclear. The purpose of this study was to examine disability representations in people with mobility disabilities. Thirteen people with mobility disabilities completed personal repertory grids (using the method of triads) applied to activities used to measure disabilities. Ten judges with expertise in health psychology then examined the correspondence between the elicited disability constructs and psychological and medical models of disability. Participants with mobility disabilities generated 73 personal constructs ofdisability. These constructs were judged consistent with the content of two psychological models, namely the theory of planned behaviour and social cognitive theory and with the main medical model of disability, the International Classification of Functioning Disability and Health.Individuals with activity limitations conceptualise activities in a manner that is compatible with both psychological and medical models. This ensures adequate communication in contexts where the medical model is relevant, e.g. clinical contexts, as well as in everyday conversation about activities and behaviours. Finally, integrated models of disability may be of value for theory driven interdisciplinary approaches to disability and rehabilitation

Human filarial Wolbachia lipopeptide directly activates human neutrophils in vitro.

The host inflammatory response to the Onchocerca volvulus endosymbiont, Wolbachia, is a major contributing factor in the development of chronic pathology in humans (onchocerciasis/river blindness). Recently, the toll-like pattern recognition receptor motif of the major inflammatory ligands of filarial Wolbachia, membrane-associated diacylated lipoproteins, were functionally defined in murine models of pathology, including mediation of neutrophil recruitment to the cornea. However, the extent to which human neutrophils can be activated in response to this Wolbachia pattern recognition motif is not known. Therefore, the responses of purified peripheral blood human neutrophils to a synthetic N-terminal diacylated lipopeptide (WoLP) of filarial Wolbachia peptidoglycan-associated lipoprotein (PAL) were characterised. WoLP exposure led to a dose-dependent activation of healthy, human neutrophils that included gross morphological alterations and modulation of surface expressed integrins involved in tethering, rolling and extravasation. WoLP exposure induced chemotaxis but not chemokinesis of neutrophils, and secretion of the major neutrophil chemokine, interleukin 8. WoLP also induced and primed the respiratory burst, and enhanced neutrophil survival by delay of apoptosis. These results indicate that the major inflammatory motif of filarial Wolbachia lipoproteins directly activates human neutrophils in vitro and promotes a molecular pathway by which human neutrophils are recruited to sites of Onchocerca parasitism

Lipoprotein biosynthesis as a target for anti-Wolbachia treatment of filarial nematodes

<p>Abstract</p> <p>Background</p> <p>Lymphatic filariasis and onchocerciasis are debilitating diseases caused by filarial nematodes. Disease pathogenesis is induced by inflammatory responses following the death of the parasite. <it>Wolbachia </it>endosymbionts of filariae are potent inducers of innate and adaptive inflammation and bacterial lipoproteins have been identified as the ligands that bind toll-like receptors (TLR) 2 and TLR6. Lipoproteins are important structural and functional components of bacteria and therefore enzymes involved in <it>Wolbachia </it>lipoprotein biosynthesis are potential chemotherapeutic targets.</p> <p>Results</p> <p>Globomycin, a signal peptidase II (LspA) inhibitor, has activity against Gram-negative bacteria and a putative <it>lspA </it>gene has been identified from the <it>Wolbachia </it>genome of <it>Brugia malayi </it>(<it>w</it>Bm). The amino acids required for function are strictly conserved and functionality was verified by complementation tests in a temperature-sensitive <it>Escherichia coli lspA </it>mutant. Also, transformation of wild type <it>E. coli </it>with <it>Wolbachia lspA </it>conferred significant globomycin resistance. A cell-based screen has been developed utilizing a <it>Wolbachia</it>-containing <it>Aedes albopictus </it>cell line to assay novel compounds active against <it>Wolbachia</it>. Globomycin was screened using this assay, which resulted in a dose-dependent reduction in <it>Wolbachia </it>load. Furthermore, globomycin was also effective in reducing the motility and viability of adult <it>B. malayi in vitro</it>.</p> <p>Conclusions</p> <p>These studies validate lipoprotein biosynthesis as a target in an organism for which no genetic tools are available. Further studies to evaluate drugs targeting this pathway are underway as part of the A-WOL drug discovery and development program.</p

Absence of Wolbachia endobacteria in the non-filariid nematodes Angiostrongylus cantonensis and A. costaricensis

The majority of filarial nematodes harbour Wolbachia endobacteria, including the major pathogenic species in humans, Onchocerca volvulus, Brugia malayi and Wuchereria bancrofti. These obligate endosymbionts have never been demonstrated unequivocally in any non-filariid nematode. However, a recent report described the detection by PCR of Wolbachia in the metastrongylid nematode, Angiostrongylus cantonensis (rat lungworm), a leading cause of eosinophilic meningitis in humans. To address the intriguing possibility of Wolbachia infection in nematode species distinct from the Family Onchocercidae, we used both PCR and immunohistochemistry to screen samples of A. cantonensis and A. costaricensis for the presence of this endosymbiont. We were unable to detect Wolbachia in either species using these methodologies. In addition, bioinformatic and phylogenetic analyses of the Wolbachia gene sequences reported previously from A. cantonensis indicate that they most likely result from contamination with DNA from arthropods and filarial nematodes. This study demonstrates the need for caution in relying solely on PCR for identification of new endosymbiont strains from invertebrate DNA samples

Fitness, PA, Perceived Competence, Parental Support, and Literacy Outcomes in the REACH After-School Sports Program

The purpose of this study was to assess the effectiveness of the REACH program in increasing physical activity (PA) levels, cardiorespiratory fitness, perceived competence, self-efficacy, parental support, and literacy across a year-long after-school PA intervention. Participants (N = 78) were students who volunteered from after-school program at either one of the two intervention schools or the control schools. Data are presented from two time points: Baseline (Aug/Sep 2017), and Post (end of the school year in May 2018). Data consisted of PA levels measured by PAC-Q, PACER test, Harter’s Perceived Competence questionnaire, parental support, and literacy tests. School differences in post-intervention scores were found in three (parental support, literacy, PACER) of seven intervention-related measures. Most notably parental support was higher in intervention schools over the control and PACER scores were higher in one intervention school than the control. The results demonstrate that data collection methods may need to be reconsidered in diverse low-income schools. The dramatic amount of missing data and lack of student effort points to students perhaps being overwhelmed with standardized tests and performing tasks for researchers. This leads to a dilemma in data collection in after-school programs in low-income schools: researchers need data to understand what is happening but how are students being served by the data collection process? Researchers should consider new approaches to collect data in low-income urban after-school programs to limit loss of data and to make the data collection meaningful to student participants

Repurposing of approved drugs from the human pharmacopoeia to target Wolbachia endosymbionts of onchocerciasis and lymphatic filariasis

AbstractLymphatic filariasis and onchocerciasis are debilitating diseases caused by parasitic filarial nematodes infecting around 150 million people throughout the tropics with more than 1.5 billion at risk. As with other neglected tropical diseases, classical drug-discovery and development is lacking and a 50year programme of macrofilaricidal discovery failed to deliver a drug which can be used as a public health tool. Recently, antibiotic targeting of filarial Wolbachia, an essential bacterial symbiont, has provided a novel drug treatment for filariasis with macrofilaricidal activity, although the current gold-standard, doxycycline, is unsuitable for use in mass drug administration (MDA). The anti-Wolbachia (A·WOL) Consortium aims to identify novel anti-Wolbachia drugs, compounds or combinations that are suitable for use in MDA. Development of a Wolbachia cell-based assay has enabled the screening of the approved human drug-pharmacopoeia (∼2600 drugs) for a potential repurposing. This screening strategy has revealed that approved drugs from various classes show significant bacterial load reduction equal to or superior to the gold-standard doxycycline, with 69 orally available hits from different drug categories being identified. Based on our defined hit criteria, 15 compounds were then selectively screened in a Litomosoides sigmodontis mouse model, 4 of which were active. These came from the tetracycline, fluoroquinolone and rifamycin classes. This strategy of repurposing approved drugs is a promising development in the goal of finding a novel treatment against filariasis and could also be a strategy applicable for other neglected tropical diseases

Weight loss for women with and without polycystic ovary syndrome following a very low-calorie diet in a community-based setting with trained facilitators for 12 weeks.

Background: Polycystic ovary syndrome (PCOS) affects between 2% and 26% of reproductive-age women in the UK, and accounts for up to 75% of anovulatory infertility. The major symptoms include ovarian disruption, hyperandrogenism, insulin resistance, and polycystic ovaries. Interestingly, at least half of the women with PCOS are obese, with the excess weight playing a pathogenic role in the development and progress of the syndrome. The first-line treatment option for overweight/obese women with PCOS is diet and lifestyle interventions; however, optimal dietary guidelines are missing. Although many different dietary approaches have been investigated, data on the effectiveness of very low-calorie diets on PCOS are very limited. Materials and methods: The aim of this paper was to investigate how overweight/obese women with PCOS responded to LighterLife Total, a commercial very low-calorie diet, in conjunction with group behavioral change sessions when compared to women without PCOS (non-PCOS). Results: PCOS (n=508) and non-PCOS (n=508) participants were matched for age (age ±1 unit) and body mass index (body mass index ±1 unit). A 12-week completers analysis showed that the total weight loss did not differ significantly between PCOS (n=137) and non-PCOS participants (n=137) (-18.5±6.6 kg vs -19.4±5.7 kg, P=0.190). Similarly, the percentage of weight loss achieved by both groups was not significantly different (PCOS 17.1%±5.6% vs non-PCOS 18.2%±4.4%, P=0.08). Conclusion: Overall, LighterLife Total could be an effective weight-loss strategy in overweight/obese women with PCOS. However, further investigations are needed to achieve a thorough way of understanding the physiology of weight loss in PCOS

Language games and blurry terminology: Can clarity enhance athlete development?

This perspective focuses on the need for researchers and practitioners to carefully consider the clarity and consistency of their language in the context of athlete development. Evidence supporting a lack of congruency in the way certain terms and expressions are defined, understood, and operationalized continues to accumulate, highlighting the importance of this area for sport stakeholders and the potential looming crises. In systems that regularly rely on precision and accuracy, it will be critical that all involved in the co-creation of knowledge generation and application carefully consider terms that may further complicate athlete development practices. We highlight some potentially blurry terms and draw attention to potential avenues for future research