Faculty Bibliography

BACKGROUND:Sleep difficulties are common among older adults, and clinical management of sleep difficulties commonly includes sleep medication (pharmacological and non-pharmacological). Our research examines sleep medication use and incident dementia over 8 years using nationally representative data from older adults ages 65 years and older in the United States. METHODS:We used data collected from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of Medicare beneficiaries. Routine sleep medication use (pharmacological and non-pharmacological) was defined as use "most nights" or "every night." Participants were screened for dementia with validated instruments that assessed memory, orientation, and executive function. We conduct prospective analyses to examine the relationship between routine sleep medication use and incident dementia using Cox proportional hazards modeling and estimated survival curves. Analyses controlled for age, sex, marital status, education, and chronic conditions. RESULTS:Among respondents at baseline (n = 6373), most participants (21%) were age 70-74 years of age. Participants were 59% female and the sample comprised non-Hispanic White (71%). At baseline, 15% of our study sample reported using sleep medication routinely, which is representative of 4.6 million older adults in the US. Covariate adjusted proportional hazard models revealed that routinely using sleep medication was associated with incident dementia (HR = 1.30, 95%CI: 1.10 to 1.53, p < 0.01). CONCLUSIONS:Our study observed, in a nationally representative study of older adults in the US across 8 years of data that 15% of older adults report routinely using sleep medication, yet routine use of sleeping medication was associated with incident dementia across the follow-up interval. Future research may examine behavioral approaches to improving sleep among older adults.

(1) Background: Unhealthy sleep durations (short and long sleep) are associated with emotional distress (ED). Minority populations, specifically Blacks, are more burdened with unhealthy sleep durations and ED. The ameliorative effect of physical activity (PA) on ED and sleep duration may provide insight into how to reduce the burden among Blacks and other minorities. However, it is unclear whether PA attenuates the relationship between sleep and ED, and whether this relationship differs by race. (2) Methods: We analyzed data from the nationally representative 2005-2015 National Health Interview Survey (NHIS) dataset. ED, physical activity, and sleep duration were collected through self-reports. Regression analyses investigated the moderating effect of PA on the relationship between sleep and ED (adjusting for age, sex, BMI, and employment status) and stratified by race. (3) Results: We found that sleep duration was independently associated with ED. Physical activity moderated the relationship between sleep and ED, the full population, and Whites, but not Blacks. (4) Conclusion: PA moderated the relationship between short, average, or long sleep and ED, but in stratified analyses, this was only evident for Whites, suggesting Blacks received differing protective effects from physical activity. Further research should be performed to understand the connection of physical activity to sleep and mental health.

According to the Lancet Commission Report on Global Surgery, it was estimated that in 2010 about 16.9 million lives were lost due to the unavailability of surgical. It was further calculated that 77.2 million DALYs could simply have been averted by providing basic surgical inspection and triage. Aiding Universal Health Coverage (UHC) through Humanitarian Outreach Services in Resource-Poor Settings is both challenging and difficult to execute. However, to promote and ensure the right to health even by vulnerable groups, the role of global health diplomacy (GHD) and humanitarian diplomacy is pivotal. GHD advances the health of the poor, contribute peacekeeping and promote health security as it is also concerned with the design, and delivery of global health interventions and programs in accordance with diplomatic criteria. The synergistic Humanitarian diplomacy is more focused in persuading decision-makers and opinion leaders to act, at all times, in the interest of vulnerable people and with full respect for our fundamental principles. Since the inclusion of surgical care in the universal basic health care services play a critical role in addressing the rising epidemic of injuries, non-communicable diseases and improving quality of life, there is a great need to address the inequities in pediatric surgical services in resource-poor settings. Hence the successful practice of GHD and humanitarian diplomacy is indispensable for establishing global partnerships, securing funding and strengthening systems to promote cost-effective and essential surgical care to achieve UHC and economic development.

OBJECTIVES/OBJECTIVE:The objective of the present study is to identify which underlying beliefs about the impact of sleep on health may motivate change in sleep behavior. DESIGN/METHODS:A cross-sectional study conducted between 2012 and 2014. SETTING/METHODS:Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study conducted in Philadelphia, PA, and its surrounding regions. PARTICIPANTS/METHODS:Participants consisted of N = 1007 community-dwelling adults age 22-60. MEASUREMENTS/METHODS:Respondents indicated behaviors they could improve on to facilitate sleep and their corresponding readiness to change. They were also asked items from the Sleep Practices and Attitudes Questionnaire (SPAQ) regarding the degree to which they agree with whether "not getting enough sleep" can impact a variety of health factors. RESULTS:In adjusted analyses, stage of change was associated with degree of agreement that insufficient sleep can cause sleepiness (odds ratio [OR] = 1.17, P = .035), weight gain (OR = 1.20, P < .0005), heart disease (OR = 1.21, P = .001), cholesterol (OR = 1.13, P = .047), hypertension (OR = 1.16, P = .014), moodiness (OR = 1.42, P < .0005), decreased energy (OR = 1.30, P = .002), absenteeism (OR = 1.13, P = .007), decreased performance (OR = 1.20, P = .003), concentration/memory problems (OR = 1.23, P = .004), diabetes (OR = 1.14, P = .042), and feeling tired (OR = 1.39, P < .0005). When sleep duration was added to the model, significant associations remained for all except cholesterol. When accounting for insomnia, significant associations were maintained for only weight, moodiness, performance, diabetes, and tiredness. CONCLUSIONS:Degree of belief that insufficient sleep can cause outcomes such as moodiness, occupational problems, and health problems may impact whether an individual is contemplating/attempting to change their sleep-related behaviors. Targeting these key messages about the associations between sleep health with moodiness and weight gain in informational material may enhance education/outreach efforts aimed at adults.

PURPOSE OF REVIEW/OBJECTIVE:The mental health toll on populations exposed to COVID-19 is alarming, and there is a need to address this with urgency. This current review provides insights on how individuals, communities, and specific populations, such as healthcare workers and patients are leveraging pre-COVID-19 and peri-COVID-19 factors to reinforce their psychological resilience during the global public health crisis. RECENT FINDINGS/RESULTS:Examination of the extant literature indicated that populations around the world rely often on support from their loved-ones, closed significant others, outdoor and physical activities, and spirituality to cope with the COVID-19-related distress. Increased sense of meaning/purpose since the COVID-19 pandemic was also reported. SUMMARY/CONCLUSIONS:A portion of publications provided intervention models to reinforce resilience among specific populations during the COVID-19 pandemic. Nevertheless, it is not convincing that some of these models can be applied universally. Additionally, it is important to note that in this category, translational data was scarce.

In spite of the many studies examining alcohol consumption, recent reviews have indicated that binge drinking has not been extensively studied. Furthermore, it is becoming increasingly clear that sleep is associated with many physiological functions and to drug addictions. The present study aimed to evaluate the relationship between alcohol binge drinking and insomnia in college students of health sciences. All first-year health sciences students (n=286) were evaluated in a cross-sectional study. Envelopes containing the Insomnia Severity Index (ISI), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and questions capturing sociodemographic data were distributed and collected in classes. It was found that most non-drinkers were female (70.6%), although there were no sex-related differences in the number of binge drinkers (more than 5 drinks on each occasion at least once a week), allowing statistical comparison. The Mann-Whitney U test indicated that the ISI scores were significantly greater in female than male binge drinkers (P=0.014). Moderate or severe insomnia was reported by 23% of the sample, with alcohol being the most frequently associated substance. A specialized intervention was suggested by ASSIST: brief for marijuana (19.2%) and tobacco (23.3%) use, and moderate (31.5%) or intensive (1.4%) for alcohol consumers. The data highlighted the need to pay attention to the habits of college students beyond obtaining scientific information. New data suggesting the influence of genetics on insomnia may be of importance when performing additional studies on the sex differences in alcohol binge drinking.

The disproportionately low number of under-represented minority (URM) faculty pursuing research careers is attributed partly to an inadequate pool of well-trained URM scientists. This is compounded by lower rates of successful competition for NIH funding by URM scientists. Evidence shows black scientists are 13% less likely to receive NIH funding relative to white scientists. Increasing the number of well-trained URM scientists is a highly significant goal, achievable through exposure to mentored learning opportunities in an autonomy-supportive academic network. In this article, the author describes his academic career trajectory leading to the establishment of the NHLBI-funded PRIDE Institute. The institute's overarching goal is to increase the number of URM scientists pursuing academic careers to address important cardiovascular health disparity issues. The PRIDE institute has been very successful in achieving 2020 Healthy People goals of a greater academic workforce diversity.