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Purpose: To examine racial and gender differences in treatment acceptance and relapse potential among rural residents admitted to a substance use disorder (SUD) treatment program. Methods: A cross‐sectional study using data collected from a sample of 1850 rural residents admitted to a South Carolina state‐run SUD treatment center between the years of 2018 and 2020. Chi‐square and t‐tests were used to compare treatment acceptance and relapse potential by race and gender. Multivariate logistic regression analyses was conducted to further examine the relationship of race and gender with treatment acceptance and relapse potential after adjusting for potential confounding variables. Findings: Approximately 50% of participants were classified as being accepting of their treatment and committed to changing their substance use, and there were no racial or gender differences in the bivariate and multivariate analyses. Approximately 25% of participants were classified as having low/no potential risk for relapsing, and there were no racial or gender differences in the bivariate analysis. However, the adjusted odds ratio of relapsing risk were lower among White compared to Black adults [AOR = 0.49 with 95% CI (0.31–0.77)]. Conclusion: This study suggests there are no gender or racial differences in treatment acceptance for SUD but that Black adults are at greater risk of relapsing relative to White adults. Additional research is needed to identify factors that increase Black adults' risk for relapse to inform interventions that can improve SUD treatment outcomes in this population. [ABSTRACT FROM AUTHOR]

Summary: Police officers experience exposures associated with increased inflammation, such as the stress associated with shiftwork and poor‐quality diet, both of which have been shown to affect sleep duration and quality. This study examined the longitudinal and cross‐sectional effects of the Energy‐density Dietary Inflammatory Index (E‐DII™) on objectively and subjectively measured sleep among police officers. Data were derived from the Buffalo Cardio‐Metabolic Occupational Police Stress Cohort (n = 464 at baseline), with longitudinal data collected from 2004 to 2019. A food frequency questionnaire obtained estimated dietary intake from which E‐DII scores were calculated. Dependent variables were objectively (Micro Motion Logger Sleep Watch™) and subjectively (Pittsburgh Sleep Quality Index) measured sleep quality and quantity. The analyses included a series of linear mixed‐effects models used to examine cross‐sectional and longitudinal associations between the E‐DII and sleep quantity and quality. Cross‐sectionally, more pro‐inflammatory diets were associated with higher wake‐after‐sleep‐onset but improved subjective sleep quality. In models accounting for both longitudinal and cross‐sectional effects, for every 1‐unit increase in the E‐DII scores over time (representing a pro‐inflammatory change), wake‐after‐sleep‐onset increased by nearly 1.4 min (p = 0.07). This result was driven by officers who primarily worked day shifts (β = 3.33, p = 0.01). Conversely, for every 1‐unit increase in E‐DII score, the Pittsburgh Sleep Quality Index global score improved. More pro‐inflammatory diets were associated with increased wake‐after‐sleep‐onset, an objective measure of sleep quality. Intervention studies to reduce dietary inflammatory potential may provide greater magnitude of effect for changes in sleep quality. [ABSTRACT FROM AUTHOR]

Aim: To clarify the meaning of the concept sleep quality. Background: Sleep loss and sleep quality are global health concerns. Poor sleep quality has significant adverse health outcomes. A clarification of the term is necessary to inform patients and healthcare providers, promote consistent theoretical and operational definitions in research, and develop prevention and treatment strategies. Design: Concept analysis. Data Sources: Scientific literature from electronic databases (CINAHL, PsycINFO, PubMED, Web of Science, and JSTOR) and definitions from online dictionaries. Review Methods: Rodgers' Evolutionary method was applied to guide the concept analysis to identify and determine the attributes, antecedents, and consequences. Results: Sleep quality is defined as an individual's self‐satisfaction with all aspects of the sleep experience. Sleep quality has four attributes: sleep efficiency, sleep latency, sleep duration, and wake after sleep onset. Antecedents include physiological (e.g., age, circadian rhythm, body mass index, NREM, REM), psychological (e.g., stress, anxiety, depression), and environmental factors (e.g., room temperature, television/device use), and family/social commitments. Good sleep quality has positive effects such as feeling rested, normal reflexes, and positive relationships. Poor sleep quality consequences include fatigue, irritability, daytime dysfunction, slowed responses, and increased caffeine/alcohol intake. Conclusions: Sleep quality is essential, and poor sleep quality contributes to disease and poor health outcomes. Given the extensive consequences of poor sleep quality, nurses and clinicians are vital in instructing the importance of good sleep. [ABSTRACT FROM AUTHOR]

The Johns Hopkins Community Health Partnerships (JCHiP) was developed in 2010 within the Johns Hopkins Health Systems. As part of JCHiP, the Patient Access Line call center was created. The average telephone reach rate at The Johns Hopkins Hospital in 2014 was only 53%. In a population of adult neurosurgical patients, this study aimed to: determine the impact of face-to-face meetings with neurosurgical patients before hospital discharge on telephone follow-up (TFU) reach rates, and determine the association between TFU reach rates and subsequent emergency department (ED) visits and hospital readmission rates. This quasi-experimental study used a posttest-only research design with a comparison group. Two adult inpatient neurosurgical units at the Johns Hopkins Hospital were selected as the intervention and comparison groups. A convenience sampling technique was used. Face-to-face meetings pre hospital discharge resulted in a TFU reach rate of 97.7% on the intervention unit while the comparison unit had only a 76.1% TFU reach rate (P < .001). Reached patients had fewer ED visits (7.8%) than not reached patients (17.4%); however, the difference was not statistically significant (P = .138). Reached patients also had fewer hospital readmissions (3.3%) than not reached patients (8.7%); this also was not statistically significant (P = .214). This study demonstrated that face-to-face meetings with neurosurgical patients prior to discharge increased TFU rates. Results were statistically significant. ED visits and hospital readmissions were also reduced in reached patients and the findings were clinically significant. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the context and the influence of night‐time care routine interactions (NCRIs) on night‐time sleep effectiveness (NSE) and daytime sleepiness (DSS) of patients in the cardiac surgery critical‐care and progressive‐care units of a hospital. Background: There exists a paucity of empirical data regarding the influence of NCRIs on sleep and associated outcomes in hospitalised adult cardiac surgery patients. Methods: An exploratory repeated‐measures research design was employed on the data provided by 38 elective cardiac surgery patients (mean age 60.0 ± 15.9 years). NCRI forms were completed by the bedside nurses and patients completed a 9‐item Visual Analogue Sleep Scale (100‐mm horizontal lines measuring NSE and DSS variables). All data were collected during postoperative nights/days (PON/POD) 1 through 5 and analysed with IBM SPSS software. Results: Patient assessment, medication administration and laboratory/diagnostic procedures were the top three NCRIs reported between midnight and 6:00 a.m. During PON/POD 1 through 5, the respective mean NSE and DSS scores ranged from 52.9 ± 17.2 to 57.8 ± 13.5 and from 27.0 ± 22.6 to 45.6 ± 16.5. Repeated‐measures ANOVA showed significant changes in DSS scores (p < .05). NSE and DSS were negatively correlated (r = −.44, p < .05), but changes in NSE scores were not significant (p > .05). Finally, of 8 NCRIs, only 1 (postoperative exercises) was significantly related to sleep variables (r > .40, p < .05). Conclusion and relevance to clinical practice: Frequent NCRIs are a common occurrence in cardiac surgery units of a hospital. Further research is needed to make a definitive conclusion about the impact of NCRIs on sleep/sleep disruptions and daytime sleepiness in adult cardiac surgery. Worldwide, acute and critical‐care nurses are well positioned to lead initiatives aimed at improving sleep and clinical outcomes in cardiac surgery. [ABSTRACT FROM AUTHOR]

Abstract African American (AA) men in the rural South may be at high risk for experiencing adverse health outcomes from substance use (SU). We conducted a scoping review to explore the research on SU among rural AA men in the rural South of the United States (US). Ten articles addressed the following thematic areas pertaining to SU: factors associated with SU (n = 6), associations between substance use and health outcomes (n = 2), and the influence of impulsivity on SU (n = 2). Additional research on SU among AA men in the rural South is needed, particularly pertaining to treatment-related considerations. [ABSTRACT FROM AUTHOR]

Context-No empirical longitudinal data on sleep and daytime sleepiness patterns in patients with an implantable left ventricular assist device (LVAD) exist. Objective-(1) To describe the sleep patterns (sleep onset latency, sleep efficiency, sleep fragmentation index, total sleep time, and wake after sleep onset), sleep quality, and daytime sleepiness variables and (2) to determine the change in the pattern of these variables before and up to 6 months after LVAD implantation. Design-A longitudinal descriptive repeated-measures design was used. Patients wore wrist actigraphs (AW64 Actiwatch), which objectively measured sleep, for 3 consecutive days and nights before LVAD implant and at the first and second week and first, third, and sixth month after implantation. During these periods, patients also completed questionnaires on sleep quality and daytime sleepiness. Patients-Twelve of 15 patients completed the 6-month data. Data were analyzed by using descriptive statistics and repeated-measures analysis of variance. Results-We found long sleep onset latencies and low sleep efficiency across time periods. High sleep fragmentation index was noted at baseline and 1 week after LVAD. Short total sleep times, long wake-after-sleep-onset durations, and poor sleep quality were evident at baseline and persisted up to 6 months after LVAD implantation. Low alertness level, a manifestation of sleepiness, was common during late morning to early evening hours. However, only sleep efficiency and wake after sleep onset showed significant changes in pattern (P< .05). Conclusion-Sleep disturbance and daytime sleepiness may be prevalent before and up to 6 months after LVAD implantation, warranting further investigation. [ABSTRACT FROM AUTHOR]

This study compared core temperature (Tc) measurements to active and passive body warming between rectal thermometry and a new ingestible capsule system. Eight healthy adult women participated in two 30-min warming trials consisting of moderate intensity leg cycle ergometry exercise (active body warming, ABW) and a controlled 40°C whole body bath (passive body warming, PBW). Changes in Tc were assessed concurrently using a telemetric, ingestible capsule sensor system (TCS) (Jonah™ capsule, Vitalsense®, Mini Mitter, Bend, OR) and standard rectal thermometry (RTS) (YSI 4600 with YSI 401 rectal probe, YSI, Yellow Springs, OH). A significant difference in Tc recordings between TCS and RTS in ABW and PBW was observed. Significant interactions of subjects' Tc and time indicated that the pattern of change was not the same among subjects. Examination of the plots of Tc vs. time revealed the existence of a proportional bias in all the cases. Regressing Tc on time and comparing the slopes revealed a significant difference in slope coefficients between TCS and RTS for ABW and PBW. However, using the statistical procedures by Bland and Altman (1-3), a good overall agreement between measurement methods was noted. It is concluded that the TCS offers a useful Tc index but is more responsive to active and passive body warming induced rises in Tc than the RTS. Also, cool fluid intake can sometimes produce transient reductions in TCS Tc readings long after initial ingestion. These findings have implications in the context of thermoregulatory status assessments of humans exposed to heat stress. [ABSTRACT FROM AUTHOR]

The interactions among psychosocial and environmental stressors and the hypothalamus-pituitary-adrenal-ovarianimmune axes may provide a framework for examining altered sleep-wake patterns in women. Based on this biobehavioral framework, homeless women represent a subgroup of the female population who have many lifestyle factors that might make them vulnerable to sleep disturbances. This article presents a study designed to investigate the self-reported sleep patterns and lifestyle factors associated with the sleep of 50 homeless women, 18-44 years of age, residing in the downtown area of Los Angeles. Results indicated that almost half of the women slept six or less hours a day and had a day/night sleep pattern. A majority of the women reported restless sleep. Drinking beer, using cocaine, anxiety, depression, loneliness, and concerns about safety and money were factors significantly related to altered sleep patterns. [ABSTRACT FROM AUTHOR]