Adverse effects of late sleep on physical health in a large cohort of community-dwelling adults.

Aims: Sleep timing, influenced by chronotype, behavior, and circadian rhythms, is critical for human health. While previous research has linked chronotype to various health outcomes, the impact of aligning sleep timing with chronotype on physical health remains underexplored. The objective of this study is to investigate the association between chronotype, actual sleep timing, and their alignment with a spectrum of physical health outcomes.

How many days are enough? Sleep-wake timing regularity and fragmentation scores change with the number of days included.

The duration of sleep data collection from actigraphy is often influenced by practical factors (e.g. workdays versus non-workdays), but the impact of the variation of duration on outcome measures of interest has not been well explored.

Perils of the nighttime: Impact of behavioral timing and preference on mental health in 73,888 community-dwelling adults.

Mental health is independently influenced by the inclination to sleep at specific times (chronotype) and the actual sleep timing (behavior). Chronotype and timing of actual sleep are, however, often misaligned. This study aims to determine how chronotype, sleep timing, and the alignment between the two impact mental health.

Fatigued but not sleepy? An empirical investigation of the differentiation between fatigue and sleepiness in sleep disorder patients in a cross-sectional study.

Objective: Sleepiness and fatigue are common complaints among individuals with sleep disorders. The two concepts are often used interchangeably, causing difficulty with differential diagnosis and treatment decisions. The current study investigated sleep disorder patients to determine which factors best differentiated sleepiness from fatigue.

Impaired 24-h activity patterns are associated with an increased risk of Alzheimer's disease, Parkinson's disease, and cognitive decline.

Background: Sleep-wake regulating circuits are affected during prodromal stages in the pathological progression of both Alzheimer's disease (AD) and Parkinson's disease (PD), and this disturbance can be measured passively using wearable devices. Our objective was to determine whether accelerometer-based measures of 24-h activity are associated with subsequent development of AD, PD, and cognitive decline.

Methods: This study obtained UK Biobank data from 82,829 individuals with wrist-worn accelerometer data aged 40 to 79 years with a mean (± SD) follow-up of 6.

Lessons learned from statewide contingency management rollouts addressing stimulant use in the Northwestern United States.

Increases in stimulant drug use (such as methamphetamine) and related deaths creates an imperative for community settings to adopt evidence-based practices to help people who use stimulants. Contingency management (CM) is a behavioral intervention with decades of research demonstrating efficacy for the treatment of stimulant use disorder, but real-world adoption has been slow, due to well-known implementation barriers, including difficulty funding reinforcers, and stigma. This paper describes the training and technical assistance (TTA) efforts and lessons learned for two state-wide stimulant-focused CM implementation projects in the Northwestern United States (Montana and Washington).

The Impact of Missing Data and Imputation Methods on the Analysis of 24-Hour Activity Patterns.

The purpose of this study is to characterize the impact of the timing and duration of missing actigraphy data on interdaily stability (IS) and intradaily variability (IV) calculation. The performance of three missing data imputation methods (linear interpolation, mean time of day (ToD), and median ToD imputation) for estimating IV and IS was also tested. Week-long actigraphy records with no non-wear or missing timeseries data were masked with zeros or 'Not a Number' (NaN) across a range of timings and durations for single and multiple missing data bouts.

Gait instability and estimated core temperature predict exertional heat stroke.

Objective: Exertional heat stroke (EHS), characterised by a high core body temperature (Tcr) and central nervous system (CNS) dysfunction, is a concern for athletes, workers and military personnel who must train and perform in hot environments. The objective of this study was to determine whether algorithms that estimate Tcr from heart rate and gait instability from a trunk-worn sensor system can forward predict EHS onset.

Methods: Heart rate and three-axis accelerometry data were collected from chest-worn sensors from 1806 US military personnel participating in timed 4/5-mile runs, and loaded marches of 7 and 12 miles; in total, 3422 high EHS-risk training datasets were available for analysis.

A Preliminary Investigation of the Effects of Obstacle Negotiation and Turning on Gait Variability in Adults with Multiple Sclerosis.

Many falls in persons with multiple sclerosis (PwMS) occur during daily activities such as negotiating obstacles or changing direction. While increased gait variability is a robust biomarker of fall risk in PwMS, gait variability in more ecologically related tasks is unclear. Here, the effects of turning and negotiating an obstacle on gait variability in PwMS were investigated.

Estimating Sedentary Breathing Rate from Chest-Worn Accelerometry From Free-Living Data.

Breathing rate was estimated from chest-worn accelerometry collected from 1,522 servicemembers during training by a wearable physiological monitor. A total of 29,189 hours of training and sleep data were analyzed. The primary purpose of the monitor was to assess thermal-work strain and avoid heat injuries.

Safety of Same-Eye Subretinal Sequential Readministration of in Non-human Primates.

We have demonstrated safe and effective subretinal readministration of recombinant adeno-associated virus serotype (rAAV) to the contralateral eye in large animals and humans even in the setting of preexisting neutralizing antibodies (NAbs). Readministration of AAV to the same retina may be desirable in order to treat additional areas of the retina not targeted initially or to boost transgene expression levels at a later time point. To better understand the immune and structural consequences of subretinal rAAV readministration to the same eye, we administered bilateral subretinal injections of rAAV2- to three unaffected non-human primates (NHPs) and repeated the injections in those same eyes 2 months later.

Improving Provider Use of the Teach-Back Method.

The purpose of this pilot study was to improve patient health literacy by teaching acute care nurses the teach-back method. The study involved administration of an evaluation tool to assess knowledge, attitudes, and use of teach-back prior to and 30 days after an education session. Nursing professional development practitioners can use the findings from this study to develop an education program to improve patient health literacy.

Strategies for retinal cell generation from human pluripotent stem cells.

Induced pluripotent stem cells (iPSCs) are specialized self-renewing cells that are generated by exogenously expressing pluripotency-associated transcription factors in somatic cells such as fibroblasts, peripheral blood mononuclear cells, or lymphoblastoid cell lines (LCLs). iPSCs are functionally similar to naturally pluripotent embryonic stem cells (ESCs) in their capacity to propagate indefinitely and potential to differentiate into all human cell types, and are devoid of the associated ethical complications of origin. iPSCs are useful for studying embryonic development, disease modeling, and drug screening.

USING THE Internet TO INCREASE Physical Activity IN A FAITH COMMUNITY.

Physical inactivity is the biggest public health problem of the 21st Century. Additionally, minority populations have higher rates of obesity and obesity-related illnesses, supporting the need to develop culturally-appropriate physical activity interventions for these populations. For African Americans (AAs), churches promote spiritual, mental, and physical well-being.

Perinatal nurses' perceptions of competency assessments.

Competency assessment should be a changing and continuing process. In addition, it should be appropriate for the organization and the nursing staff. Nursing educators are challenged to provide a competency assessment process that is relevant and meaningful.

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done.

Diagnosing diagnostic failure.

Diagnostic failure results from misplaced dependence on the clinical judgments of expert physicians. The remedy for diagnostic failure involves defining standards of care for managing clinical information (medical knowledge and patient data), and implementing those standards with information tools designed for that purpose. These standards and tools are external to the minds of physicians, thus bypassing two inherent constraints on human cognition: limited capacities for information retrieval and processing, and innate heuristics and biases.

School-based interventions for overweight and obesity in minority school children.

The prevalence of childhood overweight and obesity in the United States has resulted in a number of school-based health interventions. This article provides a review of research that addressed childhood overweight and obesity in minority, U.S.

Gaining the most from an older adult research interview.

The relationship between research and practice is increasingly important. The research interview is part of the foundation of quality research and evidence-based practice decisions. Thorough preparation and planning is required for a successful research interview with an older adult.

Surgical anatomy of the axillary nerve within the quadrangular space.

Object: There is a paucity of literature regarding the surgical anatomy of the quadrangular space (QS), which is a potential site of entrapment for the axillary nerve. Muscle hypertrophy of this geometrical area and fascial bands within it have been implicated in compression of the axillary nerve.

Methods: Fifteen human cadavers (30 sides) were dissected for this study.

Surgical anatomy of the dorsal scapular nerve.

Object: There is a paucity of literature regarding the surgical anatomy of the dorsal scapular nerve (DSN). The aim of this study was to elucidate the relationship of this nerve to surrounding anatomical structures.

Methods: Ten formalin-fixed human cadavers (20 sides) were dissected, and measurements made between the DSN and related structures.

Shedding our illusions: a better way of medicine.

Caregivers are constantly trying to organize their collective efforts in a way that serves the needs of individual patients. And patients themselves seek active involvement and control in their own care. Disorder in medical practice frustrates achievement of all of these goals.

Clinical judgment revisited.

It is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician's unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible--a challenge in which we ourselves are among the working parts to be organized and brought under control.