Study Objectives: Daylight saving time (DST) has been established with the intent to reduce energy expenditure, however unintentional effects on sleep and vigilance have not been consistently measured. The objective of this study was to test the hypothesis that DST adversely affects high school students' sleep and vigilance on the school days following its implementation. Methods: A natural experiment design was used to assess baseline and post-DST differences in objective and subjective measures of sleep and vigilance by actigraphy, sleep diary, sleepiness scale, and psychomotor vigilance testing (PVT). Students were tested during school days immediately preceding and following DST. Results: A total of 40 high school students were enrolled in this study; 35 completed the protocol. Sleep duration declined by an average of 32 minutes on the weeknights post-DST, refl ecting a cumulative sleep loss of 2 h 42 min as compared to the baseline week (p = 0.001). This fi nding was confi rmed by sleep diary analyses, refl ecting an average sleep loss of 27 min/night (p = 0.004) post-DST. Vigilance signifi cantly deteriorated, with a decline in PVT performance post-DST, resulting in longer reaction times (p < 0.001) and increased lapses (p < 0.001). Increased daytime sleepiness was also demonstrated (p < 0.001). Conclusions:The early March DST onset adversely affected sleep and vigilance in high school students resulting in increased daytime sleepiness. Larger scale evaluations of sleep impairments related to DST are needed to further quantify this problem in the population. If confi rmed, measures to attenuate sleep loss post-DST should be implemented.
Fibromyalgia is a syndrome characterized by chronic widespread pain, with a multifactorial etiopathogenesis and high incidence of neuropsychiatric comorbidity. It has been inaccurately considered a pathological condition affecting only middle-aged women. The study aimed to explore the association of sociodemographic and clinical factors in patients with fibromyalgia with depression and/or anxiety. The present study is an analysis of a cross-sectional study of a secondary source. The prevalence ratio (PR) between the demographic and clinical variables of patients with fibromyalgia and concomitant depression and/or anxiety was calculated. Overall, 1,106 medical records were obtained with a confirmed diagnosis of fibromyalgia between 2010 and 2016; of these, 318 (28.75%) patients had an associated diagnosis of depression and/or anxiety. Approximately 28% women (295 of 1,052) and 42.6% men (23 of 54) suffered from depression and/or anxiety. In the adjusted explanatory model of depression and/or anxiety in patients with fibromyalgia, the relationship between sex (female PR = 0.5 [0.28–0.86]) and low socioeconomic strata (PR = 0.53 [0.33–0.70]) remained constant. In the study population, patients with fibromyalgia belonging to lower social strata were less likely to present with depression and anxiety. The male sex may pose as a risk factor for depression and/or anxiety in patients with fibromyalgia. Fibromyalgia has a huge impact on men’s physical as well as mental health.
Background Cardiovascular diseases are a public health concern worldwide, with high rates of morbidity and mortality. Depression is a frequent comorbidity in coronary heart disease (CHD). It can be caused by the experience of suffering from heart disease, but it can also influence the prognosis of the CHD. The prevalence of depression in patients with cardiovascular disease is twice as high as that in the general population. Aim Assess the influence of depression in the prognosis at 5 years in patients with CHD. Methods 145 patients diagnosed with CHD were recruited between September 2013 and June 2015. Depression was assessed based on the PHQ-9 results at the time of hospitalization and 3 months after discharged. Sociodemographic and clinical variables were collected. A 5-year follow-up was carried out to verify death, reinfarction or any adverse outcome. Results 20% of the study population had depression at hospital admission compared with 11% at 3 months. Depression at 3 months after discharged was a differentiating factor to present complications (42.6 months, CI 95% 27.3–57.9) compared with patients without depression (55 months, CI 95%, 50.9–59.1) (Log-Rank p = 0.034). In the unadjusted model, the risk of heart complications increased with patients that have comorbidities, such as diabetes (HR 2.78, 95% CI 1.21–6.3) or hypothyroidism (HR 2.5 95% CI 1.09–5.7). Also, patients with post-hospitalization depression at 3 months were 3 times (95% CI 1.023–8.8) more likely to have complications during the follow-up period than nondepressed patients. After risk factor adjustment, the HR for depression was 2.01 (95% CI 0.57–6.9). Findings Patients with depression at 3 months following the coronary event, presented complications sooner than those without depression.
ResumenEl objetivo de esta investigación fue profundizar en las necesidades de las familias y la escuela en la educación de niños y niñas con discapacidad intelectual, teniendo en cuenta la percepción de padres, profesores, estudiantes con discapacidad y sus compañeros de clase. Para esto se realizó una entrevista semiestructurada a profundidad, que permite conocer detalles significativos de las experiencias.Aunque la educación inclusiva promueve el desarrollo de niños con discapacidad, es importante que padres y profesores cuenten con capacitación para lograr este propósito. De igual forma, es necesario que familia y escuela aúnen estrategias educativas con el fin de contribuir a la formación de los niños con discapacidad en estos dos contextos y así elevar su calidad de vida.
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