Integration of immigrants into a new culture is related to poor sleep quality

Background: This article reports on the relationship between cultural influences on life style, coping style, and sleep in a sample of female Portuguese immigrants living in Germany. Sleep quality is known to be poorer in women than in men, yet little is known about mediating psychological and sociological variables such as stress and coping with stressful life circumstances. Migration constitutes a particularly difficult life circumstance for women if it involves differing role conceptions in the country of origin and the emigrant country. Methods: The study investigated sleep quality, coping styles and level of integration in a sample of Portuguese (N = 48) and Moroccan (N = 64) immigrant women who took part in a structured personal interview. Results: Sleep quality was poor in 54% of Portuguese and 39% of Moroccan women, which strongly exceeds reports of sleep complaints in epidemiologic studies of sleep quality in German women. Reports of poor sleep were associated with the degree of adoption of a German life style. Women who had integrated more into German society slept worse than less integrated women in both samples, suggesting that non-integration serves a protective function. An unusually large proportion of women preferred an information-seeking (monitoring) coping style and adaptive coping. Poor sleep was related to high monitoring in the Portuguese but not the Moroccan sample. Conclusion: Sleep quality appears to be severely affected in women with a migration background. Our data suggest that non-integration may be less stressful than integration. This result points to possible benefits of non-integration. The high preference for an information-seeking coping style may be related to the process of migration, representing the attempt at regaining control over an uncontrollable and stressful life situation

Insight and Dissociation in Lucid Dreaming and Psychosis

Dreams and psychosis share several important features regarding symptoms and underlying neurobiology, which is helpful in constructing a testable model of, for example, schizophrenia and delirium. The purpose of the present communication is to discuss two major concepts in dreaming and psychosis that have received much attention in the recent literature: insight and dissociation. Both phenomena are considered functions of higher order consciousness because they involve metacognition in the form of reflective thought and attempted control of negative emotional impact. Insight in dreams is a core criterion for lucid dreams. Lucid dreams are usually accompanied by attempts to control the dream plot and dissociative elements akin to depersonalization and derealization. These concepts are also relevant in psychotic illness. Whereas insightfulness can be considered innocuous in lucid dreaming and even advantageous in psychosis, the concept of dissociation is still unresolved. The present review compares correlates and functions of insight and dissociation in lucid dreaming and psychosis. This is helpful in understanding the two concepts with regard to psychological function as well as neurophysiology

What are the barriers and facilitators to effective health promotion in urgent and emergency care? A systematic review

Background: There are potential health gains such as reducing early deaths, years spent in ill-health and costs to society and the health and care system by encouraging NHS staf to use encounters with patients to help individuals signifcantly reduce their risk of disease. Emergency department staf and paramedics are in a unique position to engage with a wide range of the population and to use these contacts as opportunities to help people improve their health. The aim of this research was to examine barriers and facilitators to efective health promotion by urgent and emergency care staf. Methods: A systematic search of the literature was performed to review and synthesise published evidence relating to barriers and facilitators to efective health promotion by urgent and emergency care staf. Medical and social science databases were searched for articles published between January 2000 and December 2021 and the reference lists of included articles were hand searched. Two reviewers independently screened the studies and assessed risk of bias. Data was extracted using a bespoke form created for the study. Results: A total of 19 papers were included in the study. Four themes capture the narratives of the included research papers: 1) should it be part of our job?; 2) staf comfort in broaching the topic; 3) format of health education; 4) competency and training needs. Whilst urgent and emergency care staf view health promotion as part of their job, time restraints and a lack of knowledge and experience are identifed as barriers to undertaking health promotion interventions. Staf and patients have diferent priorities in terms of the health topics they feel should be addressed. Patients reported receiving books and leafets as well as speaking with a knowledgeable person as their preferred health promotion approach. Staf often stated the need for more training. Conclusions: Few studies have investigated the barriers to health promotion interventions in urgent and emergency care settings and there is a lack of evidence about the acceptability of health promotion activity. Additional research is needed to determine whether extending the role of paramedics and emergency nurses to include health promotion interventions will be acceptable to staf and patients

Staff views on health promotion in emergency care settings – A qualitative scoping study

AimTo investigate the attitudes and barriers to health promotion practice behaviours amongst emergency nurses and ambulance service paramedics.MethodsWe used direct enquiry to recruit a convenience sample of emergency care staff (emergency department nurses and ambulance service paramedics). We conducted semi-structured interviews exploring the attitudes of staff. The interviews were analysed thematically.ResultsA total of six participants were interviewed: three emergency department nurses and three ambulance service paramedics. From the transcripts two main themes were identified: health promotion as part of the role of emergency care staff, and barriers to health promotion in the emergency care setting.ConclusionStaff interviewed were willing to undertake health promotion activities despite the barriers they discussed. There are opportunities for further development, and patients would benefit from a more structured approach to health promotion in these care settings