Explaining sleep duration in adolescents: The impact of socio-demographic and lifestyle factors and working status

Previous studies found students who both work and attend school undergo a partial sleep deprivation that accumulates across the week. The aim of the present study was to obtain information using a questionnaire on a number of variables (e.g., socio-demographics, lifestyle, work timing, and sleep-wake habits) considered to impact on sleep duration of working (n = 51) and non-working (n = 41) high-school students aged 14-21 yrs old attending evening classes (19:00-22:30h) at a public school in the city of Sao Paulo, Brazil. Data were collected for working days and days off. Multiple linear regression analyses were performed to assess the factors associated with sleep duration on weekdays and weekends. Work, sex, age, smoking, consumption of alcohol and caffeine, and physical activity were considered control variables. Significant predictors of sleep duration were: work (p < 0.01), daily work duration (8-10h/day; p < 0.01), sex (p = 0.04), age 18-21 yrs (0.01), smoking (p = 0.02) and drinking habits (p = 0.03), irregular physical exercise (p < 0.01), ease of falling asleep (p = 0.04), and the sleep-wake cycle variables of napping (p < 0.01), nocturnal awakenings (p < 0.01), and mid-sleep regularity (p < 0.01). The results confirm the hypotheses that young students who work and attend school showed a reduction in night-time sleep duration. Sleep deprivation across the week, particularly in students working 8-10h/day, is manifested through a sleep rebound (i.e., extended sleep duration) on Saturdays. However, the different roles played by socio-demographic and lifestyle variables have proven to be factors that intervene with nocturnal sleep duration. The variables related to the sleep-wake cyclenaps and night awakeningsproved to be associated with a slight reduction in night-time sleep, while regularity in sleep and wake-up schedules was shown to be associated with more extended sleep duration, with a distinct expression along the week and the weekend. Having to attend school and work, coupled with other socio-demographic and lifestyle factors, creates an unfavorable scenario for satisfactory sleep duration.

Thermal simulation studies of a low energy university building in Australia

A key criterion by which any building will be judged when its environmental impact is assessed is its thermal performance. This paper describes the simulation of an office module in a three-storey university building in south eastern Australia. The module, located at the north-west corner of the top floor of the building, was chosen because it is likely to have the highest cooling load - a primary concern of energy conscious designers of commercial buildings for most parts of Australia.

In the paper, the initial key assumptions are stated, together with a description of a "reference" or base case, against which improvements in thermal performance were measured. The simulation process identified the major influences on thermal performance. This enabled changes in materials and construction, as well as basic design concepts to be evaluated. Features incorporated into the base case such as a metal roof and glazed walkway were found to have adverse influence on energy consumption, and were consequently rejected in preference for an improved design which included a hypocaust slab system on the roof of the office module. The final design was predicted to reduce the annual energy consumption for heating and cooling by 72% and 76% respectively.

La performance thermique est l'un des critegraveres cleacutes de l'eacutevaluation environnementale de tout bacirctiment. Cet article deacutecrit la simulation d'un module de bureau appartenant agrave un immeuble de trois eacutetages d'une universiteacute du sud-est de l'Australie. Ce module, situeacute agrave l'angle nord-ouest de l'eacutetage supeacuterieur du bacirctiment a eacuteteacute choisi car c'eacutetait lui qui, vraisemblablement, avait la charge de refroidissement la plus eacuteleveacutee, ce qui est une preacuteoccupation majeure des concepteurs conscients des problegravemes d'eacutenergie des bacirctiments commerciaux dans la plus grande partie du pays. Le processus de simulation a fait apparaicirctre trois influences principales sur la performance thermique par rapport agrave un cas de base. Cela a permis d'eacutevaluer les modifications apporteacutees aux mateacuteriaux et agrave la construction ainsi qu'aux avant-projets. Les caracteacuteristiques inteacutegreacutees dans le cas de base comme le toit meacutetallique et la passerelle vitreacutee avaient une influence neacutefaste sur la consommation d'eacutenergie et ont donc eacuteteacute rejeteacutees au beacuteneacutefice d'un concept ameacutelioreacute qui comprenait une dalle de type hypocauste sur le toit du module de bureau. Le concept final devrait reacuteduire la consommation annuelle d'eacutenergie pour le chauffage et le refroidissement de 72 % et 76 % respectivement, ce qui donne une ideacutee de la valeur ajouteacutee au processus de production agrave partir de proceacutedures avanceacutees de modeacutelisation et de simulation.

Effects of timed voiding for the management of uninary incontinence in adults: systematic review

Aim: The aim of this paper is to present a systematic review assessing the effectiveness of timed voiding for the management of urinary incontinence in adults. Background: Despite the widespread use of systematic voiding programmes, their effectiveness is unclear, and the evidence for timed voiding has not been subject to rigorous and systematic evaluation. The impact on psychosocial factors and cost is also untested. The physiological basis for timed voiding is also poorly established. Methods: The systematic review incorporated the methodology of the Cochrane Collaboration. All randomized or quasi-randomized controlled trials that addressed timed voiding for the management of urinary incontinence in adults were searched, appraised, analysed and summarized. The date of the latest search was 2002. Data were extracted independently and appraised according to the level of concealment of random allocation prior to formal entry; few and identifiable withdrawals and dropouts and an analysis based on an intention to treat. The relative risk for dichotomous data was calculated with 95% confidence intervals. Where data were insufficient to support quantitative analysis, a narrative overview was undertaken. Results: Two trials of timed voiding met the inclusion criteria. In both, timed voiding was combined with other strategies. Participants were predominantly cognitively and physically impaired older women who resided in nursing home settings. Within-group improvements for the intervention groups were reported for both trials. One trial additionally reported a statistically significant reduction in night-time incontinence for the intervention group. The quality of the trials was modest and interpretation was limited by the potential for bias associated with inadequate concealment, missing data and no analysis by intention to treat. Conclusion: Terms used to describe voiding programmes that involve a fixed interval of voiding are variable. No conclusions can be drawn at this point about the effectiveness of timed voiding for the management of urinary incontinence in adults.

Timed voiding for the management of urinary incontinence in adults (Review)

Background
Timed voiding is a fixed time interval toileting assistance program that has been promoted for the management of people with urinary incontinence who cannot participate in independent toileting. For this reason, it is commonly assumed to represent current practice in residential aged care settings.
Objectives
To assess the effects of timed voiding for the management of urinary incontinence in adults who cannot participate in independent toileting.
Search strategy
We searched the Cochrane Incontinence Group Specialised Register (28 February 2007), MEDLINE (January 1966 to November 2003), EMBASE (January 1980 to Week 18 2002), CINAHL (January 1982 to February 2001), PsycINFO (January 1972 to August 2002), Biological Abstracts (January 1980 to December 2000), Current Contents (January 1993 to December 2001) and the reference lists of relevant articles. We also contacted experts in the field, searched relevant websites and hand searched journals and conference proceedings.
Selection criteria
We selected all randomised and quasi-randomised trials that addressed timed voiding in an adult population and that had an alteration in continence status as a primary outcome. We included those trials that had assessed timed voiding delivered either alone or in combination with another intervention and compared it with either usual care, or no timed voiding, or another intervention.
Data collection and analysis
Data extraction and quality assessment were undertaken by at least two people working independently of each other. Any differences were resolved by discussion until agreement was reached. The relative risk for dichotomous data were calculated with 95% confidence intervals. Where data were insufficient to support a quantitative analysis, a narrative overview was undertaken.
Main results
Two trials with a total of 298 participants met the inclusion criteria. Both compared timed voiding plus additional intervention with usual care. In one of these timed voiding was combined with continence products, placement of a bedside commode for each participant, education to staff on transfer techniques, feedback and encouragement to staff, praise to participants for "successful responses" and administration of oxybutynin in small doses. The mean percentage who were incontinent when checked daily was 20% in the intervention group compared with 80% in the control group. No further between group analysis was possible from the data reported. The other trial combined timed voiding with a medical assessment and individualised medical management that was based on clinical data. Reduction in the number of participants with daytime and night-time incontinence was greater in the intervention group but this difference was statistically significant only for night-time wetting. There was no difference in the volume of urine lost as determined by pad weighing.
The methodological quality of these trials was not high based on the quality appraisal criteria of the Cochrane Incontinence Group. In particular, there was a lack of clarity regarding levels of blinding. It was not possible to combine data from trials. In both trials, the fixed schedule of toileting was combined with other interventions. The extent to which the results reflect the contribution of timed voiding is unknown because the trials' design did not allow assessment of the effects of the fixed schedule of toileting separately from other components of the interventions.
Authors' conclusions
The data were too few and of insufficient quality to provide empirical support for or against the intervention of timed voiding.

Evaluating rammed earth aalls: a case study

The following research has been undertaken as a response to the recent controversy regarding the suitability of rammed earth wall construction as an effective building envelope. Empirical (in-situ) measurements of temperature and heat flux are taken on the walls of an existing rammed earth building in New South Wales, Australia. An analysis is performed which examines the influence of walls, floor, ceiling and windows on the recorded temperatures within the building. It appears that diffuse sky radiation transmitted by the windows is an important factor in the summer heat load, and that night time cooling coupled with thermal mass has a valuable conditioning effect.

Foraging behaviour of sympatric Antarctic and subantarctic fur seals: does their contrasting duration of lactation make a difference?

The duration of periods spent ashore versus foraging at sea, diving behaviour, and diet of lactating female Antarctic (Arctocephalus gazella, AFS) and subantarctic (A. tropicalis, SFS) fur seals were compared at Iles Crozet, where both species coexist. The large disparity in lactation duration (SFS: 10 months, AFS: 4 months), even under local sympatry, has led to the expectation that AFS should exhibit higher foraging effort or efficiency per unit time than SFS to allow them to wean their pups in a shorter period of time. Previous evidence, however, has not supported these expectations. In this study, the distribution of foraging trip durations revealed two types of trips: overnight (OFT, <1 day) and long (LFT, >1 day), in common with other results from Macquarie Island. However, diving behaviour differed significantly between foraging trip types, with greater diving effort in OFTs than in LFTs, and diving behaviour differed between fur seal species. OFTs were more frequent in SFS (48%) than in AFS (28%). SFS performed longer LFTs and maternal attendances than AFS, but spent a smaller proportion of their foraging cycle at sea (66.2 vs. 77.5%, respectively). SFS dove deeper and for longer periods than AFS, in both OFTs and LFTs, although indices of diving effort were similar between species. Diel variation in diving behaviour was lower among SFS, which foraged at greater depths during most of the night time available than AFS. The diving behaviour of AFS suggests they followed the nychthemeral migration of their prey more closely. Concomitant with the differences in diving behaviour, AFS and SFS fed on the same prey species, but in different proportions of three myctophid fish (Gymnoscopelus fraseri, G. piabilis, and G. nicholsi) that represented most of their diet. The estimated size of the most important fish consumed did not vary significantly between fur seal species, suggesting that the difference in dive depth was mostly a result of changes in the relative abundance of these myctophids. The energy content of these fish at Iles Crozet may thus influence the amount and quality of milk delivered to pups of each fur seal species. These results contrast with those found at other sites where both species coexist, and revealed a scale of variation in foraging behaviour which did not affect their effort while at sea, but that may be a major determinant of foraging efficiency and, consequently, maternal investment.

Effect of load pattern on solar-boosted heat pump water heater performance

The performance of a solar-boosted heat pump water heater (HPWH) operating under full load and part load conditions was determined in an outdoor experimental study. The system utilised flat unglazed aluminium solar evaporator panels to absorb solar and ambient energy. Absorbed energy was transferred to the water tank by means of the heat pump and a wrap around condenser coil on the outside of the tank. The system COP was found to be in the range of 5–7 under clear daytime conditions and 3–5 under clear night-time conditions. Using part load testing of the HPWH system it was found that concentrating the coils in the lower portion of the tank could increase the efficiency of the condenser coil. It was also shown that there exists a generalised linear relationship that can be used to describe the system COP in terms of the temperature difference between the water in the storage tank and the ambient air.

Baltic winter (amped folk instruments-ethereal and haunting with female vocals)

Baltic Winter - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, female vocals, percussion, and a couple of synths.

Baltic winter (beautiful ethereal sweeping music with haunting female vocals)

Baltic Winter - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, female vocals, percussion, and a couple of synths.

Baltic winter (under 1 minute haunting female vocals and ethereal)

Baltic Winter Shorts 02 - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, female vocals, percussion, and a couple of synths.

Baltic winter (under 1 minute haunting female vocals and ethereal)

Baltic Winter Short 01 - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, female vocals, percussion, and a couple of synths.

Baltic winter 42 seconds ethereal sweeping and haunting with female vocals

Baltic Winter Shorts 03 - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, female vocals, percussion, and a couple of synths.

Baltic winter ethereal cinematic and haunting

Baltic Winter (No Vocals - a Slavic mermaid rests upon a rock on the edge of the Baltic Sea. It is night time during the depths of winter. She risks not being able to return to the sea as it could freeze in the time that she drapes the snow crested pine trees with her ethereal calls. Her voice travels through the Medieval forest in search of her nymph . . . will he hear her? Or will her calls only serve to sing her loneliness?

OK . . . now for the technical . . . I wrote this with a documentary in mind. I have used a sampled Finnish/Estonian Kantele, a touch of an acoustic guitar, percussion, and a couple of synths.

Parent initiated prednisolone for acute asthma in children of school age : randomised controlled crossover trial

Objective To evaluate the efficacy of a short course of parent initiated oral prednisolone for acute asthma in children of school age.

Design Double blind, randomised, placebo controlled, crossover trial in which episodes of asthma, rather than participants, were randomised to treatment.

Setting The Barwon region of Victoria, Australia.

Participants Children aged 5-12 years with a history of recurrent episodes of acute asthma.

Intervention A short course of parent initiated treatment with prednisolone (1 mg/kg a day) or placebo.

Main outcome measures The primary outcome measure was the mean daytime symptom score over seven days. Secondary outcome measures were mean night time symptom score over seven days, use of health resources, and school absenteeism.

Results 230 children were enrolled in the study. Over a three year period, 131 (57%) of the participants contributed a total of 308 episodes of asthma that required parent initiated treatment: 155 episodes were treated with parent initiated prednisolone and 153 with placebo. The mean daytime symptom score was 15% lower in episodes treated with prednisolone than in those treated with placebo (geometric mean ratio 0.85, 95% CI 0.74 to 0.98; P=0.023). Treatment with prednisolone was also associated with a 16% reduction in the night time symptom score (geometric mean ratio 0.84, 95% CI 0.70 to 1.00; P=0.050), a reduced risk of health resource use (odds ratio 0.54, 95% CI 0.34 to 0.86; P=0.010), and reduced school absenteeism (mean difference −0.4 days, 95% CI −0.8 to 0.0 days; P=0.045).

Conclusion A short course of oral prednisolone initiated by parents when their child experiences an episode of acute asthma may reduce asthma symptoms, health resource use, and school absenteeism. However, the modest benefits of this strategy must be balanced against potential side effects of repeated short courses of an oral corticosteroid.

Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

Background

There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children’s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child’s weight.
Methods

A cross-sectional analysis was conducted on a sample of school-aged children (6–11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1–6) in rural America. After measuring children’s height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.
Results

Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.
Conclusions

Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children’s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.