Background: Insomnia is a prevalent health complaint that is often difficult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the ...clinical evaluation of insomnia complaints.
Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure in treatment research. The psychometric properties (internal consistency, concurrent validity, factor structure) of the ISI were evaluated in two samples of insomnia patients.
Methods: The first study examined the internal consistency and concurrent validity of the ISI in 145 patients evaluated for insomnia at a sleep disorders clinic. Data from the ISI were compared to those of a sleep diary measure. In the second study, the concurrent validity of the ISI was evaluated in a sample of 78 older patients who participated in a randomized-controlled trial of behavioral and pharmacological therapies for insomnia. Change scores on the ISI over time were compared with those obtained from sleep diaries and polysomnography. Comparisons were also made between ISI scores obtained from patients, significant others, and clinicians.
Results: The results of Study 1 showed that the ISI has adequate internal consistency and is a reliable self-report measure to evaluate perceived sleep difficulties. The results from Study 2 also indicated that the ISI is a valid and sensitive measure to detect changes in perceived sleep difficulties with treatment. In addition, there is a close convergence between scores obtained from the ISI patient's version and those from the clinician's and significant other's versions.
Conclusions: The present findings indicate that the ISI is a reliable and valid instrument to quantify perceived insomnia severity. The ISI is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.
Positive airway pressure treatment (CPAP) is the gold standard for obstructive sleep apnea syndrome (OSAS). CPAP is highly effective, but its issue lays in poor adherence rates mainly caused by its ...invasive nature and related stigma. In accordance with a biopsychosocial model of CPAP adherence, psychosocial interventions have been implemented to alleviate low rates of adherence with promising results. The increase in the number of psychosocial interventions has highlighted the need to systematically evaluate their effectiveness. This review aims to identify psychosocial interventions used to increase CPAP adherence, to compile available data on their effectiveness, and the reasons why they are effective. Moreover, the review evaluates the impact of the interventions on sleep quality. Experimental and quasi-experimental studies testing psychosocial interventions (excluding educational only interventions) that aimed to increase CPAP adherence in adults with obstructive sleep apnea vs. no intervention or control group were included. A literature search in PsycINFO, MEDLINE, COCHRANE, EMBASE, CINAHL, and Web of Science was performed for studies published in English and French between 1980 and January 2020. Risk of bias and methodological quality were assessed using the Joanna Briggs Institute Critical Appraisal Tools. Fourteen studies were included involving 1923 participants, six trials tested a motivational intervention, three trials tested a cognitive behavioral intervention and five others tested one of the following: relaxation, exposition therapy, phone coaching, audiotape or stage-matched intervention. Thirteen studies reported a positive effect of the intervention on CPAP adherence, while one reported no effect. Psychosocial interventions for CPAP adherence appear effective at increasing sleep quality, but more studies are needed to test this hypothesis. Reasons for the effectiveness of the interventions were pooled into five categories: time related, the intervention's adaptability, the patient's characteristics, the intervention's nature and characteristics and the intervention's specifics and target. The current review raises a significant gap between the biomedical and psychosocial domains. In fact, even in a psychosocial intervention study, the interpretation of the results revolves around biomedical models and very little consideration is given to biopsychosocial models. Our findings demonstrate the importance of examining the relationship between psychosocial variables and CPAP adherence to better tailor interventions to increase CPAP adherence.
•Psychosocial interventions effective at increasing CPAP adherence.•CPAP adherence is still mainly reduced to behavioral consideration.•Early implementation of intervention is beneficial on CPAP adherence.•Tailored interventions are preferrable over standardized to increase CPAP adherence.•Self-efficacy, motivation and acceptance, key targets to increase CPAP adherence.
Peroxygenases are very interesting catalysts for specific oxyfunctionalization chemistry. Instead of relying on complicated electron transport chains, they rely on simple hydrogen peroxide as the ...stoichiometric oxidant. Their poor robustness against H2O2 can be addressed via in situ generation of H2O2. Here we report that simple graphitic carbon nitride (g-C3N4) is a promising photocatalyst to drive peroxygenase-catalyzed hydroxylation reactions. The system has been characterized by outlining not only its scope but also its current limitations. In particular, spatial separation of the photocatalyst from the enzyme is shown as a solution to circumvent the undesired inactivation of the biocatalyst. Overall, very promising turnover numbers of the biocatalyst of more than 60.000 have been achieved.
Osteocalcin is one of the most abundant noncollagenous proteins in bone. Phenotypes of osteocalcin knock-out mice (OC−/−) may vary on different backgrounds and with sex. Previous studies using adult ...female (OC−/−) mice on a mixed genetic background (129/B6) showed osteocalcin inhibited bone formation leading to weaker bone in wild-type (OC+/+). Yet on a pure (B6) genetic background male mice revealed osteocalcin improved fracture resistance and OC−/− bones were more prone to fracture. Osteocalcin is decreased with age and in some diseases (diabetes) where bone weakness is observed. The effect of osteocalcin in adult female bone from mice on a pure B6 background is unknown. We investigated differences in bone mineral properties and bone strength in female adult (6 months) (OC+/+) and (OC−/−) mice on a pure C57BL/6J background using Fourier Transform Infrared Imaging (FTIRI), micro-computed tomography (uCT), biomechanical measurements, histomorphometry and serum turnover markers (P1NP, CTX). Similar to female age matched mice on the (129/C57) background we found B6 OC−/− mice had a higher bone formation rate, no change in bone resorption, more immature mineral, decreased crystallinity and increased trabecular bone as compared to OC+/+. In contrast, the OC−/− mice on a pure B6 background had a lower bone mineral density, lower mineral to matrix ratio resulting in reduced stiffness and weaker bone strength. Our results demonstrate some properties of the OC−/− phenotype are dependent on genetic background. This may suggest that reduced osteocalcin may contribute to fracture and weaker bone in some groups of elderly and adults with diseases where osteocalcin is low.
•Female Osteocalcin knock-out mice (OC-/-) on pure B6 background had increased bone formation vs. OC+/+.•OC-/- bones had immature mineral phase, increased carbonate in mineral and decreased crystallinity as vs. OC+/+.•Contrary to OC-/- on 129/B6 background, a decreased mineral/matrix ratio in OC-/- cortical vs OC+/+ bones on B6 background.•Contrary to OC-/- on 129/B6 background, reduced stiffness and strength in OC-/- vs. OC+/+ bone on B6 background.•Some mineral properties are dependent on genetic background in OC-/- mice.
•Monolithic device with a vertical membrane for mechanical stimulation of tissues.•Actuation unit with 3 individual chambers to apply negative and/or positive pressure.•Real-time tissue imaging at ...the single cell level: monitoring cell deformation.•Application of healthy and hyper-physiological compressions to a cartilage model.•Possible generation of combinations of compression and bulk shear.
Movement is essential to our quality of life, and regulates cell behavior via mechanical stimulation. Here, we report a monolithic microfluidic platform, in which engineered tissues composed of cells in a hydrogel are exposed to gradients of mechanical compression. Mechanical stimulation is applied through the deflection of a thin polydimethylsiloxane (PDMS) vertical membrane. The device design and all actuation parameters were optimized in this work to produce physiologically relevant compression on a cartilage model (strain of 5–12 %), as well as gradients of compression ranging from healthy to hyper-physiological conditions in the same device, as evidenced by the measured gradients in cell deformation. While this work focuses on mechanical compression of engineered tissues, we also demonstrated that our platform allowed creating more sophisticated multi-modal stimulation patterns. As the membrane is actuated by three independently addressed yet connected pressurized chambers, a variety of programmable deflection patterns and various cell stimulation modalities can easily be created by tuning the pressure applied in the different chambers (positive vs. negative, and amplitude). Advantageously, the fabrication of this monolithic platform is straightforward, with a single-step process. Moreover, the vertical membrane configuration allows for real-time imaging of cells encapsulated in the hydrogel matrix. The herein reported platform is highly versatile and of great interest to model other types of tissues, which also experience complex mechanical actuation patterns in vivo.
In this paper we study a problem of passive nonlinear targeted energy transfer between a two degrees of freedom long span bridge model prone to coupled flutter and a single degree of freedom ...nonlinear energy sink (NES). This study is mainly analytical and use complexification methods, multiple scales expansions and exploits also the concept of limiting phase trajectories (LPTs). The system is studied under 1:1:1 nonlinear resonance involved in targeted energy transfer mechanisms. Several behaviors that suppress aeroelastic instability are identified. We show that analytical calculations permit to design a NES able to efficiently control the aeroelastic instability of the bridge. Numerical simulations are performed and good agreement with analytical predictions is observed. It results that the concept of limiting phase trajectories (LPT) allows formulating adequately the problem of intensive energy transfer from a bridge to a nonlinear energy sink.
The paper is composed of three main parts: The first part presents a two-degree-of-freedom coupled oscillators with rheology. One of the oscillators is intended to be the main structure, and the ...second one is a nonlinear energy sink. The rheology of the system is represented via a set of internal variables that are governed by either differential inclusions or differential equations or direct algebraic relations between system variables. A step-by-step methodology is explained to trace system behaviors around a 1:1 resonance at different timescales. Invariant of the system at fast timescale is detected, while possible periodic and strongly modulated regimes around its invariant are traced at slow time scales. The second part of the paper considers a set of several degree-of-freedom main oscillators which are coupled to several nonlinear energy sinks. The overall system can house several rheologies. Explained methodology of the first part is expanded to this general case for tracing system responses at different time scales around 1:1 resonances. The third part of the paper presents two practical examples: The proposed methodology is used to detect invariants of systems and their equilibrium and singular points. This methodology provides some tools for designing equilibrium and singular points, i.e., periodic and strongly modulated regimes which lead to the design of nonlinear energy sinks for passively controlling and/or energy harvesting of the main oscillators.
The latency and amplitude of the P3b component of event-related potentials (ERPs) have been related to behavioural performance on several attention and memory tasks in adult populations. However, the ...extent to which these results apply to children is unknown. This study examined the neurobehavioral correlates of the P3b component in a longitudinal sample of school-age children from Arctic Québec. Children (
N
=
110; mean age
=
11.3
years) were assessed on an ERP auditory oddball paradigm and a neurobehavioral evaluation targeting several aspects of cognition, including the Stewart Extended Continuous Performance Test (E-CPT), California Verbal Learning Test (CVLT), Stroop Color-Word Interference Test, and five subtests from the Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV). P3b latency was positively related to reaction time measures and negatively associated with performance on the WISC-IV Digit Span Forward subtest. Amplitude of the P3b was associated with shorter completion time on the Stroop test and better delayed recognition memory performance among children who did not use semantic strategies on the CVLT. Profile analyses revealed no difference in scalp distribution of the P3b according to performance on these tests. The results are consistent with previous studies with older participants and suggest that, despite age-related differences in waveform and scalp distribution, the P3b component relates to similar neurocognitive processes in children and adults.
Cognitive-Behavioral Therapy for Insomnia Bastien, Célyne H; Morin, Charles M; Ouellet, Marie-Christine ...
Journal of consulting and clinical psychology,
08/2004, Letnik:
72, Številka:
4
Journal Article
Recenzirano
Forty-five adults with primary insomnia received cognitive-behavioral therapy (CBT) implemented in a group therapy format, in individual face-to-face therapy or through brief individual telephone ...consultations. The results indicate that CBT was effective in improving sleep parameters with all 3 methods of treatment implementation, and there was no significant difference across methods of implementation. All 3 treatment modalities produced improvements in sleep that were maintained for 6 months after treatment completion. These results suggest that group therapy and telephone consultations represent cost-effective alternatives to individual therapy for the management of insomnia.
Objective: The objective of the present study was to evaluate the relationship between objective and subjective sleep quality and objective and subjective evaluation of cognitive performance in older ...adults suffering of chronic insomnia (using or not benzodiazepines, BZs) or self-reported good sleepers.
Methods: Three groups of participants 55 years and older were evaluated: 20 insomnia sufferers using BZs chronically, 20 drug-free insomnia sufferers and 20 good sleepers. Objective sleep (PSG) and subjective sleep (sleep diaries, SD) were measured. Objective measures of cognitive performance (attention/concentration, verbal/visual memory, executive function and psychomotor speed) and subjective perception of daily performance were evaluated.
Results: Correlational analysis revealed that objective and subjective measures of daytime performance are differentially related to sleep quality for the three groups. An objective good night of sleep is associated with better cognitive performance in good sleepers and drug-free individuals. On the other hand, the impression of having slept well is related to better cognitive performance in good sleepers and chronic insomnia sufferers using BZs.
Conclusion: Daytime performance and sleep quality are related, but differently so for a good sleeper, an insomnia sufferer without treatment, or one using BZs to alleviate sleep difficulties.
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