Poor Sleep and Impaired Self-Care: Towards a Comprehensive Model Linking Sleep, Cognition, and Heart Failure Outcomes

Background: Persons with heart failure (HF) have significantly lower sleep quantity and quality than persons without HF. The purpose of this article is to propose a conceptual model describing how poor sleep may contribute to inadequate self-care and untoward outcomes in persons with HF. Aims: Our overarching hypothesis is that sleep affects self-care and outcomes through its effects on cognition. Building on the work of others, we outline a conceptual model that illustrates that even transient sleep disruption prevents sleep-related restorative processes and contributes to cognitive dysfunction—especially in the 25–50% of HF patients with existing cognitive impairment. Poor sleep may be sufficient to impair cognition to a level that interferes with higher order functions involved in effective HF self-care practices. Through these mechanisms, inadequate sleep may contribute to poor outcomes such as low health-related quality of life and greater risk of unplanned hospitalization. Conclusion: The proposed model (1) bridges physical, neuropsychological and behavioral phenomena, (2) suggests a mechanism by which poor sleep affects daytime behavior, and (3) is empirically testable. Exploring factors that interfere with sleep may improve self-care and outcomes in persons with HF

Home range utilisation and long-range movement of estuarine crocodiles during the breeding and nesting season

The estuarine crocodile (Crocodylus porosus) is the apex-predator in waterways and coastlines throughout south-east Asia and Australasia. C. porosus pose a potential risk to humans, and management strategies are implemented to control their movement and distribution. Here we used GPS-based telemetry to accurately record geographical location of adult C. porosus during the breeding and nesting season. The purpose of the study was to assess how C. porosus movement and distribution may be influenced by localised social conditions. During breeding, the females (2.92 +/- 0.013 metres total length (TL), mean +/- S.E., n = 4) occupied an area < 1 km length of river, but to nest they travelled up to 54 km away from the breeding area. All tagged male C. porosus sustained high rates of movement (6.49 +/- 0.9 km d(-1); n = 8) during the breeding and nesting period. The orientation of the daily movements differed between individuals revealing two discontinuous behavioural strategies. Five tagged male C. porosus (4.17 +/- 0.14 m TL) exhibited a 'site-fidelic' strategy and moved within well-defined zones around the female home range areas. In contrast, three males (3.81 +/- 0.08 m TL) exhibited 'nomadic' behaviour where they travelled continually throughout hundreds of kilometres of waterway. We argue that the 'site-fidelic' males patrolled territories around the female home ranges to maximise reproductive success, whilst the 'nomadic' males were subordinate animals that were forced to range over a far greater area in search of unguarded females. We conclude that C. porosus are highly mobile animals existing within a complex social system, and mate/con-specific interactions are likely to have a profound effect upon population density and distribution, and an individual's travel potential. We recommend that impacts on socio-spatial behaviour are considered prior to the implementation of management interventions