Oxygen stabilized sleep disordered breathing and reduced sympathetic activity in patients with heart failure and Cheyne-Stokes respiration. We were unable to demonstrate an effect on either patient symptoms or cognitive function.
Objectives-To determine the effects of captopril and oxygen on sleep quality in patients with mild to moderate cardiac failure.Design-An open observational study. Patients-12 patients with New York Heart Association class II-III heart failure were studied at baseline. 9 of these patients were then examined at the end of 1 month of treatment with captopril; 9 of the patients were separately assessed during a single night of supplementary oxygen.Main outcome measures-Sleep patterns by polysomnography, overnight oximetry, and subjective sleep assessment using visual analogue scores. Results-Abnormal sleep was present in all baseline studies. Complete polysomnograms after treatment with captopril were obtained in 8 patients. Light sleep (stages 1 and 2) was reduced (mean (SEM) 61%(8)% to 48%(6)% actual sleep time, P < 0.05) but slow wave (stages 3 and 4) and REM (rapid eye movement) sleep increased (25%(6)% to 31%(5)%, 14%(2)% to 21%(5)% actual sleep time, P < 0.05). Apnoeic episodes (242(59) to 118(30), P < 0-05), desaturation events (171(60) to 73(37), P < 0.05), and arousals (33(5) to 18(3) P < 0.01) were reduced. Visual analogue scores of sleep quality increased 49(5) to 69(5), P < 0.01). Complete polysomnograms were obtained in 7 patients treated with oxygen. Light sleep duration was reduced (55% (7)% to 42%(5)% actual sleep time, P < 0 05) and slow wave sleep increased (30%(5)% to 38%(6)% actual sleep time, P < 0.05). REM sleep duration was not significantly different. Total arousals (33(6)% to 20(2) P < 0.05), desaturation events (140(33) to 38(10), P < 0.01), and apnoeic episodes (212(53) to 157(33), P < 0.05) were reduced. Visual analogue scores of sleep quality were unchanged. Conclusions-Captopril and oxygen may improve sleep quality and reduce nocturnal desaturation in patients with mild to moderate cardiac failure. Improved sleep quality could explain the reduction in daytime symptoms seen after treatment in patients with chronic heart failure. (Br Heart3' 1995;73:237-241)
The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in © 2008 by SOPHE Address correspondence to: David Buller, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401; dbuller@kleinbuendel.com. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAustralia (n = 2,077) and the United States (n = 1,234) in schools containing Grades 6 through 9. Australian children using Consider This reported reduced 30-day smoking prevalence. This reduction was mediated by decreased subjective norms. The amount of program exposure was low in many classes, but program use displayed a dose-response relationship with reduced smoking prevalence. American children only reported lower expectations for smoking in the future.Intervening to prevent smoking is a challenge, and this data suggest small benefits from an Internet-based program that are unlikely to be of practical significance unless increased by improved implementation. Implementation remains the major challenge to delivering interventions via the Internet, both for health educators and researchers. Keywordssmoking; prevention; adolescents; Internet Many adolescents will try smoking and eventually become adult smokers in the absence of effective intervention . One possible limitation of past interventions is that most focus on keeping children from trying their first cigarette. They do not talk with the large proportion that has tried smoking and convince them to stop (Buller et al., 2003;Hill, White, & Effendi, 2002; Office on Smoking and Health, CDC, 2002). This article reports on a trial to evaluate the effectiveness of a smoking prevention program, Consider This, that was delivered to schools via the Internet Hall et al., 2001). It was intended to reduce smoking by children in Grades 6 through 9 by convincing those who had not smoked not to start and persuading those who had already tried smoking to stop.A program aimed at both preventing the first cigarette and arresting experimentation needs to acknowledge children's experiences and expectancies and build off them. This presents two major challenges. First, one needs to know children's experiences with, and current plans and activities for, smoking. There may be at least four relevant groups-non-smokers (those who have never tried a cigarette), past users (those who have tried cigarettes but do not currently use them), experimental smokers (those who are smoking sporadically), and regular smokers (those who smoke every day) (Buller et al., 2003). Very few younger adolescents, the audience for Consider This, smoke regularly; thus, program content focused on the other three groups, which display variation in their beliefs and experiences that affects vulnerability to smoking (Buller et al., 2003). In the classroom, it can be difficult for tea...
The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in [2002][2003][2004]. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = − 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5+ servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.The Internet is a relatively new medium for health communication. It has several characteristics that might be used to improve health promotion: Its ability to span large distances at low cost with standardized information in multimedia formats that promote learning among populations with diverse ages, education, literacy levels, and social circumstances may help to address lower access to health care and transportation problems (Benton Foundation, 1998; U.S. Congress & Office of Technology Assessment, 1991;Walther, Pingree, Hawkins, & Buller, 2005). This article contains a report on diet changes produced by an Internet website among adults in a rural region in the southwestern United States. Rural communities present unique challenges to using this technology-lower Internet use, slower Internet connections, wide variations in computer and Internet skills, and limited training resources and technical support than in urban communities (Benton Foundation, 1998;Horrigan, 2005;Rainie & Horrigan, 2005 Efficacy of Internet-based Nutrition Education for Rural CommunitiesDiet, nutrition, vitamins, and nutritional supplements rank as the third most popular Internet health topic (Fox, 2005), but there is little evidence that it is effective to deliver nutrition education over the Internet in community settings. Internet-based health communication has produced positive changes in diet and related behaviors (Celio et al., 2000;Oenema, Brug, & Lechner, 2001;Oenema, Tan, & Brug, 2005;Papadaki & Scott, 2005;Rothert et al., 2006;Tate, Wing, & Winett, 2001;White et al., 2004;Williamson et al., 2005;Williamson et al., 2006;Winzelberg et al., 2000), although not in all studie...
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