Study Objectives
To document trends in self-reported sleep duration for the noninstitutionalized U.S. civilian population from 2004 to 2017 and examine how sleep trends vary by race/ethnicity.
Methods
We use data from the National Health Interview Survey (NHIS) for U.S. noninstitutionalized adults aged 18–84 from 2004 to 2017 (N = 398 382). NHIS respondents were asked how much they slept in a 24-hour period on average, which we categorized as ≤6 hr (short sleep), 7–8 hr (adequate sleep), and ≥9 hr (long sleep). We used multinomial logistic regression models to examine trends in self-reported sleep duration and assess race/ethnic differences in these trends. Our models statistically adjusted for demographic, socioeconomic, familial, behavioral, and health covariates.
Results
The prevalence of short sleep duration was relatively stable from 2004 to 2012. However, results from multinomial logistic regression models indicated that there was an increasing trend toward short sleep beginning in 2013 (b: 0.09, 95% CI: 0.05–0.14) that continued through 2017 (b: 0.18, 95% CI: 0.13–0.23). This trend was significantly more pronounced among Hispanics and non-Hispanic blacks, which resulted in widening racial/ethnic differences in reports of short sleep.
Conclusions
Recent increases in reports of short sleep are concerning as short sleep has been linked with a number of adverse health outcomes in the population. Moreover, growing race/ethnic disparities in short sleep may have consequences for racial and ethnic health disparities.
Objectives: This study investigates how factors related to collection, storage, transport time, and environmental conditions affect the quality and accuracy of analyses of dried blood spot (DBS) samples. Methods: Data come from the 2016 Health and Retirement Study (HRS) DBS laboratory reports and the HRS merged with the National Climatic Data Center (NCDC) Global Historical Climate Network Daily (NCDC GHCN-Daily) and the NCDC Local Climatological Data, by zip code. We ran regression models to examine the associations between assay values based on DBS for five analytes (total cholesterol, high-density lipoprotein (HDL) cholesterol, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and cystatin C) and the characteristics of DBS cards and drops, shipping time, and temperature, and humidity at the time of collection. Results: We found cholesterol measures to be sensitive to many factors including small spots, shipping time, high temperature and humidity. Small spots in DBS cards are related to lower values across all analytes. Longer DBS transit time before freezing is associated with lower values of total and HDL cholesterol and cystatin C. Results were similar whether or not venous blood sample values were included in equations. Conclusions: Small spots, long shipping time, and exposure to high temperature and humidity need to be avoided if possible. Quality of spots and cards and information on shipping time and conditions should be coded with the data to make adjustments in values when necessary. The different results across analytes indicate that results cannot be generalized to all DBS assays.
Nursing home (NH) residents account for over 2.2 million Emergency Department (ED) visits yearly; the majority are transported by Emergency Medical Services (EMS). The purpose of this study was to investigate how EMS providers respond to 911 calls when imminent death is from a chronic-non-acute condition. Surveys were conducted with 178 EMS providers and follow-up interviews with 43. Survey results indicated that 96% reported NH calls at least monthly -48% on every shift; 58% report receiving at least monthly requests to transport an actively dying resident to an ED. Nearly half (46%) endorsed the need for interdisciplinary interventions between EMS, hospice, and NHs to address challenges. Interview themes illustrated contributing factors as: Limited staff training, experience; Dying-related fear, panic, distress; Staff shortages; and Organizational protocols promoting 911 calls. The findings illuminated the lack of comprehensive advance care planning for NH residents who are frail and approaching life's end.
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