Actigraphy assessment of mother's sleep at 6, 12 & 18 weeks postpartum

Introduction: Mothers’ sleep during the postpartum period is commonly characterised by bouts of sleep across the night, resulting in low sleep efficiency and daytime sleepiness. Understanding of the nature of mothers’ sleep disruption needs to incorporate indices of both sleep quantity and sleep quality, but objective assessment of sleep disturbance experienced during the first postpartum months has not been investigated in great detail. This longitudinal study aimed to objectively measure mothers’ sleep during the first 18 weeks postpartum, to ascertain the level of sleep disturbance experienced. Method: Eleven mothers (Mean age = 29.82, SD = 4.45) from Australia wore Actiwatch-2 devices for up to 7 days and nights at 6, 12 and 18 weeks postpartum. For each night of recording, a number of sleep bouts were identified. Total sleep time (TST) was calculated as the total number of minutes across the night within these bouts. Sleep efficiency was calculated as the percentage of minutes across the night classified as being part of a sleep bout, with higher scores indicating higher efficiency. Sleep quality captured the efficiency of sleep within sleep bouts, and was calculated as the percentage of epochs classified as sleep within sleep bouts, with higher scores indicating higher sleep quality. Results: At 6 weeks postpartum, mean total sleep time was 420.22 minutes (SD = 50.61). Total sleep time did not significantly differ across the assessment; however there was a trend towards an increase over time. Sleep efficiency increased across the time periods (F(2,10) = 10.30, p = .001), with a significant increase between week 12 and week 18. At 6 weeks postpartum, mean sleep quality was 93.15% (SD = 2.68) and scores did not significantly change across the assessment periods. While there was no relationship between sleep efficiency and sleep quality during weeks 6 and 12, a significant positive relationship was observed at week 18, r2 = .52, p = .013. Conclusions: Within this sample, a low level of disruption was consistently shown within the mothers’ night time sleep bouts. However, overall sleep efficiency suggested a significant proportion of time spent awake between sleep bouts. While TST remained stable over time, overall sleep efficiency improved, suggesting the mothers’ sleep was becoming more consolidated. A single sleep bout a night was not often experienced.

What can we learn from the crashes of learner riders?

In some parts of Australia, people wanting to learn to ride a motorcycle are required to complete an off-road training course before they are allowed to practice on the road. In the state of Queensland, they are only required to pass a short multiple-choice road rules knowledge test. This paper describes an analysis of police-reported crashes involving learner riders in Queensland that was undertaken as part of research investigating whether pre-learner training is needed and, if so, the issues that should be addressed in training.. The crashes of learner riders and other riders were compared to identify whether there are particular situations or locations in which learner motorcyclists are over-involved in crashes, which could then be targeted in the pre-learner package. The analyses were undertaken separately for riders aged under 25 (330 crashes) versus those aged 25 and over (237 crashes) to provide some insight into whether age or riding inexperience are the more important factors, and thus to indicate whether there are merits in having different licensing or training approaches for younger and older learner riders. Given that the average age of learner riders was 33 years, under 25 was chosen to provide a sufficiently large sample of younger riders. Learner riders appeared to be involved in more severe crashes and to be more often at fault than fully-licensed riders but this may reflect problems in reporting, rather than real differences. Compared to open licence holders, both younger and older learner riders had relatively more crashes in low speed zones and relatively fewer in high speed zones. Riders aged under 25 had elevated percentages of night-time crashes and fewer single unit (potentially involving rider error only) crashes regardless of the type of licence held. The contributing factors that were more prevalent in crashes of learner riders than holders of open licences were: inexperience (37.2% versus 0.5%), inattention (21.5% versus 15.6%), alcohol or drugs (12.0% versus 5.1%) and drink riding (9.9% versus 3.1%). The pattern of contributing factors was generally similar for younger and older learner riders, although younger learners were (not surprisingly) more likely to have inexperience coded as a contributing factor (49.7% versus 19.8%). Some of the differences in crashes between learner riders and fully-licensed riders appear to reflect relatively more riding in urban areas by learners, rather than increased risks relating to inexperience. The analysis of contributing factors in learner rider crashes suggests that hazard perception and risk management (in terms of speed and alcohol and drugs) should be included in a pre-learner program. Currently, most learner riders in Queensland complete pre-licence training and become licensed within one month of obtaining their learner permit. If the introduction of pre-learner training required that the learner permit was held for a minimum duration, then the immediate effect might be more learners riding (and crashing). Thus, it is important to consider how training and licensing initiatives work together in order to improve the safety of new riders (and how this can be evaluated).

A methodology for estimating exposure-controlled crash risk using traffic Police crash data

Exposure control or case-control methodologies are common techniques for estimating crash risks, however they require either observational data on control cases or exogenous exposure data, such as vehicle-kilometres travelled. This study proposes an alternative methodology for estimating crash risk of road user groups, whilst controlling for exposure under a variety of roadway, traffic and environmental factors by using readily available police-reported crash data. In particular, the proposed method employs a combination of a log-linear model and quasi-induced exposure technique to identify significant interactions among a range of roadway, environmental and traffic conditions to estimate associated crash risks. The proposed methodology is illustrated using a set of police-reported crash data from January 2004 to June 2009 on roadways in Queensland, Australia. Exposure-controlled crash risks of motorcyclists—involved in multi-vehicle crashes at intersections—were estimated under various combinations of variables like posted speed limit, intersection control type, intersection configuration, and lighting condition. Results show that the crash risk of motorcycles at three-legged intersections is high if the posted speed limits along the approaches are greater than 60 km/h. The crash risk at three-legged intersections is also high when they are unsignalized. Dark lighting conditions appear to increase the crash risk of motorcycles at signalized intersections, but the problem of night time conspicuity of motorcyclists at intersections is lessened on approaches with lower speed limits. This study demonstrates that this combined methodology is a promising tool for gaining new insights into the crash risks of road user groups, and is transferrable to other road users.

Towards condition-invariant, top-down visual place recognition

In this paper we present a novel place recognition algorithm inspired by recent discoveries in human visual neuroscience. The algorithm combines intolerant but fast low resolution whole image matching with highly tolerant, sub-image patch matching processes. The approach does not require prior training and works on single images (although we use a cohort normalization score to exploit temporal frame information), alleviating the need for either a velocity signal or image sequence, differentiating it from current state of the art methods. We demonstrate the algorithm on the challenging Alderley sunny day – rainy night dataset, which has only been previously solved by integrating over 320 frame long image sequences. The system is able to achieve 21.24% recall at 100% precision, matching drastically different day and night-time images of places while successfully rejecting match hypotheses between highly aliased images of different places. The results provide a new benchmark for single image, condition-invariant place recognition.

Analysis of traffic injury severity in Dhaka, Bangladesh

This research identifies roadway, traffic, and environmental factors that influence the injury severity of road traffic crashes in Dhaka. Dhaka provides a rather unusual driving risk environment to study, since virtually anyone can obtain a drivers’ license and very little traffic enforcement and fines are given when drivers violate traffic rules. To examine this city with presumed heightened crash severity risk, police reported crash data from 2007 to 2011 containing about 2714 road traffic crashes were collected. The injury severity of traffic crashes—recorded as either fatal, serious injury, or property damage only—were modeled using an ordered Probit model. Significant factors increasing the probability of fatal injuries include crashes along highways (65%), absence of a road divider (80%), crashes during night time (54%), and vehicle-pedestrian collisions (367%); whereas two-way traffic configuration (21%), and traffic police controlled schemes (41%) decrease the probability of fatalities. Both similarities and differences of the findings between crash risk in Dhaka and developed countries are discussed in policy relevant terms.

Sleep-related eye symptoms and their potential for identifying driver sleepiness

The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnoea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road. Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. ‘Eye strain’, ‘difficulty focusing’, ‘heavy eyelids’ and ‘difficulty keeping the eyes open’ were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have ‘heavy eyelids’ and ‘difficulty keeping the eyes open’. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice ‘stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open’.

Longitudinal change in sleep and daytime sleepiness in postpartum women

Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.

The sleep patterns of infants and young children with gastro-oesophageal reflux

Objective: Sleep disturbance in gastro-oesophageal reflux disease (GORD) in infants and young children has not been systematically studied nor has this manifestation been compared with population norms. Methods: Sleep patterns of 102 infants and children aged 1 to 36 months with and without GORD, defined by pH monitoring, were analysed using the same questionnaire as in recent studies of normal sleep behaviour in this age range. Main outcome measures included time taken to settle at night, the number of night time wakenings requiring parental intervention, day time sleep patterns and parents problems with their childs' sleep behaviour. Results: Compared with the population norms (n=3102), those with GORD (n=76) had greater prevalence of night time waking >3/night (50% vs 13% aged 3-12 months; 60% vs 10% aged 12-24 months, P<0.001), requirement of parental intervention (82% vs 55% aged 3-12 months, P < 0.05; 92% vs 55% aged 12-24 months, P < 0.001), significantly delayed onset of sleeping through the night, and greater prevalence of daytime sleep beyond 24 months. Similar but less striking differences were seen comparing those with (n = 76) and without GORD (n = 26). Conclusions: Sleep interruption occurs more frequently in infants and children with GORD than population norms. Objective evaluation of infants and children with sleep disturbance after the age of 3 months may avoid unnecessary over or under diagnosis of GORD. Systematic investigation of the contribution of GORD to sleep disturbance in infants and young children is warranted

Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009-2011

Objectives Studies from different parts of the world have indicated that the impact of road traffic incidents disproportionally affects young adults. Few known studies have been forthcoming from Arabian Gulf countries. Within Oman, a high proportion of the population is under the age of 20. Coupled with the drastic increase of motorization in recent years there is a need to understand the state of road safety among young people in Oman. The current research aimed to explore the prevalence and characteristics of road traffic injuries among young drivers aged 17-25 years. Methods Crash data from 2009-2011 was extracted from the Directorate General of Traffic, Royal Oman Police (ROP) database in Oman. The data was analyzed to explore the impact of road crashes on young people (17-25 years), the characteristics of young driver crashes and how these differ from older drivers and to identify key predictors of fatalities in young driver crashes. Results Overall, young people were over-represented in injuries and fatalities within the sample time period. While it is true that many young people in crashes were driving at the time, it was also evident that young people were often a victim in a crash caused by someone else. Thus, to reduce the impact of road crashes on young people, there is a need to generally address road safety within Oman. When young drivers were involved in crashes they were predominantly male. The types of crashes these drivers have can be broadly attributed to risk taking and inexperience. Speeding and night time driving were the key risk factors for fatalities. Conclusion The results highlight the need to address young driver safety in Oman. From these findings, the introduction of a graduated driver licensing system with night time driving restrictions could significantly improve young driver safety.

Crash risk perception of sleepy driving and its comparisons with drink driving and speeding: Which behavior is perceived as the riskiest?

- Objective Driver sleepiness is a major crash risk factor, but may be under-recognized as a risky driving behavior. Sleepy driving is usually rated as less of a road safety issue than more well-known risky driving behaviors, such as drink driving and speeding. The objective of this study was to compare perception of crash risk of sleepy driving, drink driving, and speeding. - Methods In total, 300 Australian drivers completed a questionnaire that assessed crash risk perceptions for sleepy driving, drink driving, and speeding. Additionally, the participants perception of crash risk was assessed for five different contextual scenarios that included different levels of sleepiness (low, high), driving duration (short, long), and time of day/circadian influences (afternoon, night-time) of driving. - Results The analysis confirmed that sleepy driving was considered a risky driving behavior, but not as risky as high levels of speeding (p < .05). Yet, the risk of crashing at 4 am was considered as equally risky as low levels of speeding (10 km over the limit). The comparisons of the contextual scenarios revealed driving scenarios that would arguably be perceived as quite risky due to time of day/circadian influences were not reported as high risk. - Conclusions The results suggest a lack of awareness or appreciation of circadian rhythm functioning, particularly the descending phase of circadian rhythm that promotes increased sleepiness in the afternoon and during the early hours of the morning. Yet, the results suggested an appreciation of the danger associated with long distance driving and driver sleepiness. Further efforts are required to improve the community’s awareness of the impairing effects from sleepiness and in particular, knowledge regarding the human circadian rhythm and the increased sleep propensity during the circadian nadir.

Repeatable Condition-Invariant Visual Odometry for Sequence-Based Place Recognition

This paper describes a vision-only system for place recognition in environments that are tra- versed at different times of day, when chang- ing conditions drastically affect visual appear- ance, and at different speeds, where places aren’t visited at a consistent linear rate. The ma- jor contribution is the removal of wheel-based odometry from the previously presented algo- rithm (SMART), allowing the technique to op- erate on any camera-based device; in our case a mobile phone. While we show that the di- rect application of visual odometry to our night- time datasets does not achieve a level of perfor- mance typically needed, the VO requirements of SMART are orthogonal to typical usage: firstly only the magnitude of the velocity is required, and secondly the calculated velocity signal only needs to be repeatable in any one part of the environment over day and night cycles, but not necessarily globally consistent. Our results show that the smoothing effect of motion constraints is highly beneficial for achieving a locally consis- tent, lighting-independent velocity estimate. We also show that the advantage of our patch-based technique used previously for frame recogni- tion, surprisingly, does not transfer to VO, where SIFT demonstrates equally good performance. Nevertheless, we present the SMART system us- ing only vision, which performs sequence-base place recognition in extreme low-light condi- tions where standard 6-DOF VO fails and that improves place recognition performance over odometry-less benchmarks, approaching that of wheel odometry.

Climate Change - Risks and Opportunities for the Custard Apple Industry

Climate affects the custard apple industry in a range of ways through impacts on growth, disease risk, fruit set and industry location. Climates in Australia are influenced by surrounding oceans, and are very variable from year to year. However, amidst this variability there are significant trends, with Australian annual mean temperatures increasing since 1910, and particularly since 1950, with night-time temperatures increasing faster (0.11oC/decade) than daytime temperatures (0.06oC/decade). These temperature increases and other climate changes are expected to continue as a result of greenhouse gas emissions, with ongoing impacts on the custard apple industry. Five sites were chosen to assess possible future climate changes : Mareeba, Yeppoon, Bundaberg, Nambour and Lismore, these sites representing the extent of the majority of custard apple production in eastern Australia. A fifth site (Coffs Harbour) was selected as it is south of the current production regions. A mean warming of 0.8 to 1.2oC is anticipated over most of these sites by the year 2030, relative to 1990. This paper assesses the potential effects of climate change on custard apple production, and suggests strategies for adaptation.

Improving the prediction of odour impacts from meat chicken farms with detailed ventilation and odour data

Odour from meat chicken (broiler) farms is an environmental issue affecting the sustainable development of the chicken meat industry but is a normal part of broiler production. Odour plumes exhausted from broiler sheds interact with the environment, where dispersion and dilution of the odours varies constantly, especially diurnally. The potential for odour impacts is greatest when odour emission rates are high and/or when atmospheric dispersion and dilution of odour plumes is limited (i.e. during stable conditions). We continuously monitored ventilation rate, on-site weather conditions, atmospheric stability, and estimated odour concentration with an artificial olfaction system. Detailed inspection of odour emission rates at critical times, i.e. dawn, dusk and night time, revealed that maximum daily and batch odour emission rates are not necessarily the cause of odour impacts. Periods of lower odour emission rates on each day are more likely to correspond with odour impacts. Odour emission rates need to be measured at the times when odour impacts are most likely to occur, which is likely to be at night. Additionally, high resolution ventilation rate data should be sought after to improve odour emission models, especially at critical times of the day. Consultants, regulators and researchers need to give more thought to odour emission rates from meat chicken farms to improved prediction and management of odour impacts.

Postmenopausal hot flushes, vascular health and hormone therapy

Vasomotor hot flushes are complained of by approximately 75% of postmenopausal women, but their frequency and severity show great individual variation. Hot flushes have been present in women attending observational studies showing cardiovascular benefit associated with hormone therapy use, whereas they have been absent or very mild in randomized hormone therapy trials showing cardiovascular harm. Therefore, if hot flushes are a factor connected with vascular health, they could perhaps be one explanation for the divergence of cardiovascular data in observational versus randomized studies. For the present study 150 healthy, recently postmenopausal women showing a large variation in hot flushes were studied in regard to cardiovascular health by way of pulse wave analysis, ambulatory blood pressure and several biochemical vascular markers. In addition, the possible impact of hot flushes on outcomes of hormone therapy was studied. This study shows that women with severe hot flushes exhibit a greater vasodilatory reactivity as assessed by pulse wave analysis than do women without vasomotor symptoms. This can be seen as a hot flush-related vascular benefit. Although severe night-time hot flushes seem to be accompanied by transient increases in blood pressure and heart rate, the diurnal blood pressure and heart rate profiles show no significant differences between women without and with mild, moderate or severe hot flushes. The levels of vascular markers, such as lipids, lipoproteins, C-reactive protein and sex hormone-binding globulin show no association with hot flush status. In the 6-month hormone therapy trial the women were classified as having either tolerable or intolerable hot flushes. These groups were treated in a randomized order with transdermal estradiol gel, oral estradiol alone or in combination with medroxyprogesterone acetate, or with placebo. In women with only tolerable hot flushes, oral estradiol leads to a reduced vasodilatory response and increases in 24-hour and daytime blood pressures as compared to women with intolerable hot flushes receiving the same therapy. No such effects were observed with the other treatment regimes or in women with intolerable hot flushes. The responses of vascular biomarkers to hormone therapy are unaffected by hot flush status. In conclusion, hot flush status contributes to cardiovascular health before and during hormone therapy. Severe hot flushes are associated with an increased vasodilatory, and thus, a beneficial vascular status. Oral estradiol leads to vasoconstrictive changes and increases in blood pressure, and thus to possible vascular harm, but only in women whose hot flushes are so mild that they would probably not lead to the initiation of hormone therapy in clinical practice. Healthy, recently postmenopausal women with moderate to severe hot flushes should be given the opportunity to use hormone therapy alleviate hot flushes, and if estrogen is prescribed for indications other than for the control of hot flushes, transdermal route of administration should be favored.

Helsingin lämpösaareke ajallisena ja paikallisena ilmiönä

The urban heat island phenomenon is the most well-known all-year-round urban climate phenomenon. It occurs in summer during the daytime due to the short-wave radiation from the sun and in wintertime, through anthropogenic heat production. In summertime, the properties of the fabric of city buildings determine how much energy is stored, conducted and transmitted through the material. During night-time, when there is no incoming short-wave radiation, all fabrics of the city release the energy in form of heat back to the urban atmosphere. In wintertime anthropogenic heating of buildings and traffic deliver energy into the urban atmosphere. The initial focus of Helsinki urban heat island was on the description of the intensity of the urban heat island (Fogelberg 1973, Alestalo 1975). In this project our goal was to carry out as many measurements as possible over a large area of Helsinki to give a long term estimate of the Helsinki urban heat island. Helsinki is a city with 550 000 inhabitants and located on the north shore of Finnish Bay of the Baltic Sea. Initially, comparison studies against long-term weather station records showed that our regular, but weekly, sampling of observations adequately describe the Helsinki urban heat island. The project covered an entire seasonal cycle over the 12 months from July 2009 to June 2010. The measurements were conducted using a moving platform following microclimatological traditions. Tuesday was selected as the measuring day because it was the only weekday during the one year time span without any public holidays. Once a week, two set of measurements, in total 104, were conducted in the heterogeneous temperature conditions of Helsinki city centre. In the more homogeneous suburban areas, one set of measurements was taken every second week, to give a total of 52.The first set of measurements took place before noon, and the second 12 hours, just prior to midnight. Helsinki Kaisaniemi weather station was chosen as the reference station. This weather station is located in a large park in the city centre of Helsinki. Along the measurement route, 336 fixed points were established, and the monthly air temperature differences to Kaisaniemi were calculated to produce monthly and annual maps. The monthly air temperature differences were interpolated 21.1 km by 18.1 km horizontal grid with 100 metre resolution residual kriging method. The following independent variables for the kriging interpolation method were used: topographical height, portion of sea area, portion of trees, fraction of built-up and not built-up area, volumes of buildings, and population density. The annual mean air temperature difference gives the best representation of the Helsinki urban heat island effect- Due to natural variability of weather conditions during the measurement campaign care must be taken when interpretation the results for the monthly values. The main results of this urban heat island research project are: a) The city centre of Helsinki is warmer than its surroundings, both on a monthly main basis, and for the annual mean, however, there are only a few grid points, 46 out of 38 191, which display a temperature difference of more than 1K. b) If the monthly spatial variation is air temperature differences is small, then usually the temperature difference between the city and the surroundings is also small. c) Isolated large buildings and suburban centres create their own individual heat island. d) The topographical influence on air temperature can generally be neglected for the monthly mean, but can be strong under certain weather conditions.