A Guiding Vision for Fluid Learning: The Future of Education and Training

Position paper by the Digital Media Collaboratory (DMC) of the IC² 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 (ρ=-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 Teachers’ Fidelity to a Drug Prevention Curriculum

Little is known about the trajectories over time of classroom teachers’ fidelity to drug prevention curricula. Using the “Concerns-Based Adoption Model” (C-BAM) as a theoretical framework, we hypothesized that teachers’ 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 teachers’ 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 “just in time” messages delivered electronically; but it is also possible that some prevention curricula may impose unrealistic expectations or burdens on teachers’ 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

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 Foundation—funded 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

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 students’ 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

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, mixed‐methods study examining changes in dreaming between individuals with and without insomnia symptoms and their relationship to mental health during the COVID‐19 pandemic. A global survey examining insomnia symptoms, dreams and mental health was launched in April 2020 and followed participants over 12 months. Of 2240 participants, 1009 (45%) reported dream changes at baseline. A higher proportion of participants with new‐onset insomnia reported dream changes (55%) than those with pre‐existing insomnia (45%) or good sleepers (36%). Overall, thematic analysis identified key dream change themes of increased dream activity, with participants dreaming vividly, in high‐definition, and with a strong negative charge. Themes around survival, adjusting to pandemic life, meaning‐making 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 new‐onset insomnia group used more anxious and death‐related words than those who slept well. Notably, all groups experienced a significant reduction in dream activity by 3‐month follow‐up. 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 new‐onset 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

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy