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Publication analysis on insomnia: how much has been done in the past two decades?

March 30, 2015 Comments off

Publication analysis on insomnia: how much has been done in the past two decades?
Source: Sleep Medicine

Insomnia has been a rising public concern in recent years. As one example of a multidisciplinary topic, the theme of insomnia research has gradually shifted over time; however, there is very little quantitative characterization of the research trends in insomnia. The current study aims to quantitatively analyze trends in insomnia publications for the past 20 years. We retrospectively analyzed insomnia-related publications retrieved from PubMed and Google Scholar between 1994 and 2013, and to analyze insomnia-related publications from different perspectives. We investigated the major areas of research focus for insomnia, journal characteristics, as well as trends in clinical management and treatment modalities. The resulting 5,841 publications presented an exponential growth trend over the past two decades, with mean annual growth rates at nearly 10% for each publication type. Analysis of major research focuses indicated that depression, hypnotics and sedatives, questionnaires, and polysomnography are the most common topics at present. Furthermore, we found that while studies on drug therapy and adverse effects decreased in the most recent 5 years, the greatest expansion of insomnia publications were in the areas of cognitive behavioral therapy for insomnia and alternative therapies. Collectively, insomnia publications present a continuous trend of increase. While sedative and hypnotic drugs dominated the treatment of insomnia, non-pharmacological therapies may have great potential for advancement in future years. Future research effort is warranted for novel tools and clinical trials, especially on insomnia treatments with inadequate evidence or not-yet-clear efficacy and side effects.

Comparison of Two Watch Schedules for Personnel at the White House Military Office President’s Emergency Operations Center

March 30, 2015 Comments off

Comparison of Two Watch Schedules for Personnel at the White House Military Office President’s Emergency Operations Center
Source: Human Factors

Objective
The aim of this study was to assess effectiveness of an alternative, 24-hr-on/72-hr-off watchstanding schedule on sleep and morale of personnel assigned to the President’s Emergency Operations Center (PEOC).

Background
As part of the White House Military Office, PEOC personnel historically worked a 12-hr “Panama” watch schedule. Personnel reported experiencing chronic insufficient and disrupted sleep patterns and sought advice for improving their watchstanding schedule.

Method
Participants (N = 14 active-duty military members, ages 29 to 42 years) completed the Profile of Mood State (POMS) three times: before, during, and after switching to the alternative schedule with 5-hr sleep periods built into their workday. Participants completed a poststudy questionnaire to assess individual schedule preferences. Sleep was measured actigraphically, supplemented by activity logs.

Results
As indicated by POMS scores, mood improved significantly on the new schedule. Although average total sleep amount did not change substantively, the timing of sleep was more consistent on the new schedule, resulting in better sleep hygiene. PEOC personnel overwhelmingly preferred the new schedule, reporting not only that they felt more rested but that the new schedule was more conducive to the demands of family life.

Conclusions
Demands of family life and time spent commuting were found to be critical factors for acceptance of the alternative schedule. This new schedule will be most effective if personnel adhere to the scheduled rest periods assigned during their 24-hr duty.

Application
A successful schedule should avoid conflicts between social life and operational demands. Results may lead to changes in the work schedules of other departments with similar 24/7 responsibilities.

Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons from the West African Ebola Epidemic

March 27, 2015 Comments off

Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons from the West African Ebola Epidemic
Source: PLoS Medicine

Summary Points

  • The international response to the West African Ebola virus disease epidemic has exemplified the great potential of the global public health community. However, the protracted early response also revealed critical gaps, which likely resulted in exacerbation of the epidemic.
  • It is incumbent on international health partners to learn from missteps that occurred in the early stages of the epidemic and strengthen our public health capacity to better respond to future public health emergencies.
  • Strategies to consider include development of a more precise system to risk stratify geographic settings susceptible to disease outbreaks, reconsideration of the 2005 International Health Regulations Criteria to allow for earlier responses to localized epidemics before they reach epidemic proportions, increasing the flexibility of the World Health Organization director general to characterize epidemics with more granularity, development of guidelines for best practices to promote partnership with local stakeholders and identify locally acceptable response strategies, and, most importantly, making good on international commitments to establish a fund for public health emergency preparedness and response.
  • The recent success of the global action to stem the Ebola virus disease epidemic is laudable but should not encourage complacency in our efforts to improve the global public health infrastructure.

New Hepatitis C Treatments: Considerations and Potential Strategies for States

March 24, 2015 Comments off

New Hepatitis C Treatments: Considerations and Potential Strategies for States
Source: National Governors Association

The National Governors Association Center for Best Practices (NGA Center) convened an expert roundtable to discuss the opportunities and challenges presented by new hepatitis C virus (HCV) treatments and other pharmaceutical therapies known as high-impact drugs. Such drug treatments share the common characteristics of being more effective than prevailing drug therapies, often resulting in a change in clinical practice that includes treating many more people and being much more expensive. Experts participating in the roundtable included state health care leaders, scientists, national health care experts, subject-matter experts from insurance and pharmaceutical companies, Medicaid and corrections legal experts, and senior staff from the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Veterans Affairs (VA). This paper summarizes the expert roundtable discussion supplemented by NGA Center research to flesh out the background information and strategies discussed.

The Food Assistance Landscape: FY 2014 Annual Report

March 24, 2015 Comments off

The Food Assistance Landscape: FY 2014 Annual Report
Source: USDA Economic Research Service

In this report, the Economic Research Service (ERS) uses preliminary data from USDA’s Food and Nutrition Service (FNS) to examine trends in U.S. food and nutrition assistance programs through fiscal 2014 (October 1, 2013 to September 30, 2014) and ERS data to examine trends in the prevalence and severity of household food insecurity in the United States through 2013.

Tuberculosis Trends — United States, 2014

March 23, 2015 Comments off

Tuberculosis Trends — United States, 2014
Source: Morbidity and Mortality Weekly Report (CDC)

In 2014, a total of 9,412 new tuberculosis (TB) cases were reported in the United States, with an incidence rate of 3.0* cases per 100,000 persons, a decrease of 2.2% from 2013 (1). Although overall numbers of TB cases and rates continue to decline, the percentage decrease in rate is the smallest decrease in over a decade (1). This report summarizes provisional TB surveillance data reported to CDC’s National Tuberculosis Surveillance System for 2014. TB cases and rates decreased among U.S.-born persons, and although the case rate also decreased among foreign-born persons,† there was an increase in total number of cases among foreign-born persons. The rate among foreign-born persons in the United States in 2014 was 13.4 times higher than among U.S.-born persons. Racial/ethnic minorities continue to be disproportionately affected by TB within the United States. Asians continue to be the racial/ethnic group with the largest number of TB cases. Compared with non-Hispanic whites, the TB rate among Asians was 28.5 times higher, whereas rates among non-Hispanic blacks and Hispanics were each eight times higher. Four states (California, Texas, New York, and Florida), representing approximately one third of the U.S. population, accounted for half of all TB cases reported in 2014. Continued progress toward TB elimination in the United States will require focused TB control efforts among populations and in geographic areas with disproportionate burdens of TB.

County-Level Variation in Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, 2012

March 23, 2015 Comments off

County-Level Variation in Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, 2012
Source: Preventing Chronic Disease (CDC)

In 2012, 15% of aged Medicare beneficiaries had 6 or more chronic conditions. Prevalence varied geographically by county; counties in the lowest quintile had prevalence estimates of 10.3% or lower, and those in the highest quintile had prevalence estimates of 17.3% or higher. Counties in the highest quintile had prevalence estimates that were 1.2 times higher than the national average of 15%. Eighty-seven counties had estimates at least 1.5 times higher than the national average; 3 counties had prevalence estimates at least twice the national average. Counties in the Northeast and Southeast generally had a higher prevalence of aged beneficiaries with 6 or more chronic conditions than the national average, whereas counties with prevalence estimates below the national average were predominantly in the western states of Oregon, Montana, and Wyoming.

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