To examine recent national trends in outpatient visits for sleep related difficulties in the United States and prescriptions for sleep medications.
Trend analysis.
Data from the National Ambulatory ...Medical Care Survey from 1999 to 2010.
Patients age 20 y or older.
The number of office visits with insomnia as the stated reason for visit increased from 4.9 million visits in 1999 to 5.5 million visits in 2010 (13% increase), whereas the number with any sleep disturbance ranged from 6,394,000 visits in 1999 to 8,237,000 visits in 2010 (29% increase). The number of office visits for which a diagnosis of sleep apnea was recorded increased from 1.1 million visits in 1999 to 5.8 million visits in 2010 (442% increase), whereas the number of office visits for which any sleep related diagnosis was recorded ranged from 3.3 million visits in 1999 to 12.1 million visits in 2010 (266% increase). The number of prescriptions for any sleep medication ranged from 5.3 in 1999 to 20.8 million in 2010 (293% increase). Strong increases in the percentage of office visits resulting in a prescription for nonbenzodiazepine sleep medications (∼350%), benzodiazepine receptor agonists (∼430%), and any sleep medication (∼200%) were noted.
Striking increases in the number and percentage of office visits for sleep related problems and in the number and percentage of office visits accompanied by a prescription for a sleep medication occurred from 1999-2010.
Ford ES, Wheaton AG, Cunningham TJ, Giles WH, Chapman DP, Croft JB. Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care Survey 1999-2010.
Although adverse childhood experiences (ACEs) have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among ...adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and frequent insufficient sleep among community-dwelling adults residing in 5 U.S. states in 2009.
To assess whether ACEs were associated with frequent insufficient sleep (respondent did not get sufficient rest or sleep ≥ 14 days in past 30 days) in adulthood, we analyzed ACE data collected in the 2009 Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey in Arkansas, Louisiana, New Mexico, Tennessee, and Washington. ACEs included physical abuse, sexual abuse, verbal abuse, household mental illness, incarcerated household members, household substance abuse, parental separation/divorce, and witnessing domestic violence before age 18. Smoking status and frequent mental distress (FMD) (≥ 14 days in past 30 days when self-perceived mental health was not good) were assessed as potential mediators in multivariate logistic regression analyses of frequent insufficient sleep by ACEs adjusted for race/ethnicity, gender, education, and body mass index.
Overall, 28.8% of 25,810 respondents reported frequent insufficient sleep, 18.8% were current smokers, 10.8% reported frequent mental distress, 59.5% percent reported ≥ 1 ACE, and 8.7% reported ≥ 5 ACEs. Each ACE was associated with frequent insufficient sleep in multivariate analyses. Odds of frequent insufficient sleep were 2.5 (95% CI, 2.1-3.1) times higher in persons with ≥ 5 ACEs compared to those with no ACEs. Most relationships were modestly attenuated by smoking and FMD, but remained significant.
Childhood exposures to eight indicators of child maltreatment and household dysfunction were significantly associated with frequent insufficient sleep during adulthood in this population. ACEs could be potential indicators promoting further investigation of sleep insufficiency, along with consideration of FMD and smoking.
Mountain plants are considered among the species most vulnerable to climate change, especially at high latitudes where there is little potential for poleward or uphill dispersal. Satellite monitoring ...can reveal spatiotemporal variation in vegetation activity, offering a largely unexploited potential for studying responses of montane ecosystems to temperature and predicting phenological shifts driven by climate change. Here, a novel remote‐sensing phenology approach is developed that advances existing techniques by considering variation in vegetation activity across the whole year, rather than just focusing on event dates (e.g. start and end of season). Time series of two vegetation indices (VI), normalized difference VI (NDVI) and enhanced VI (EVI) were obtained from the moderate resolution imaging spectroradiometer MODIS satellite for 2786 Scottish mountain summits (600–1344 m elevation) in the years 2000–2011. NDVI and EVI time series were temporally interpolated to derive values on the first day of each month, for comparison with gridded monthly temperatures from the preceding period. These were regressed against temperature in the previous months, elevation and their interaction, showing significant variation in temperature sensitivity between months. Warm years were associated with high NDVI and EVI in spring and summer, whereas there was little effect of temperature in autumn and a negative effect in winter. Elevation was shown to mediate phenological change via a magnification of temperature responses on the highest mountains. Together, these predict that climate change will drive substantial changes in mountain summit phenology, especially by advancing spring growth at high elevations. The phenological plasticity underlying these temperature responses may allow long‐lived alpine plants to acclimate to warmer temperatures. Conversely, longer growing seasons may facilitate colonization and competitive exclusion by species currently restricted to lower elevations. In either case, these results show previously unreported seasonal and elevational variation in the temperature sensitivity of mountain vegetation activity.
Dying tumour cells can elicit a potent anticancer immune response by exposing the calreticulin (CRT)/ERp57 complex on the cell surface before the cells manifest any signs of apoptosis. Here, we ...enumerate elements of the pathway that mediates pre‐apoptotic CRT/ERp57 exposure in response to several immunogenic anticancer agents. Early activation of the endoplasmic reticulum (ER)‐sessile kinase PERK leads to phosphorylation of the translation initiation factor eIF2α, followed by partial activation of caspase‐8 (but not caspase‐3), caspase‐8‐mediated cleavage of the ER protein BAP31 and conformational activation of Bax and Bak. Finally, a pool of CRT that has transited the Golgi apparatus is secreted by SNARE‐dependent exocytosis. Knock‐in mutation of eIF2α (to make it non‐phosphorylatable) or BAP31 (to render it uncleavable), depletion of PERK, caspase‐8, BAP31, Bax, Bak or SNAREs abolished CRT/ERp57 exposure induced by anthracyclines, oxaliplatin and ultraviolet C light. Depletion of PERK, caspase‐8 or SNAREs had no effect on cell death induced by anthracyclines, yet abolished the immunogenicity of cell death, which could be restored by absorbing recombinant CRT to the cell surface.
Accurate models for species' distributions are needed to forecast the progress and impacts of alien invasive species and assess potential range‐shifting driven by global change. Although this has ...traditionally been achieved through data‐driven correlative modelling, robustly extrapolating these models into novel climatic conditions is challenging. Recently, a small number of process‐based or mechanistic distribution models have been developed to complement the correlative approaches. However, tests of these models are lacking, and there are very few process‐based models for invasive species. We develop a method for estimating the range of a globally invasive species, common ragweed (Ambrosia artemisiifolia L.), from a temperature‐ and photoperiod‐driven phenology model. The model predicts the region in which ragweed can reach reproductive maturity before frost kills the adult plants in autumn. This aligns well with the poleward and high‐elevation range limits in its native North America and in invaded Europe, clearly showing that phenological constraints determine the cold range margins of the species. Importantly, this is a ‘forward’ prediction made entirely independently of the distribution data. Therefore, it allows a confident and biologically informed forecasting of further invasion and range shifting driven by climate change. For ragweed, such forecasts are extremely important as the species is a serious crop weed and its airborne pollen is a major cause of allergy and asthma in humans. Our results show that phenology can be a key determinant of species' range margins, so integrating phenology into species distribution models offers great potential for the mechanistic modelling of range dynamics.
Species distribution models (SDMs) are used to infer niche responses and predict climate change-induced range shifts. However, their power to distinguish real and chance associations between ...spatially autocorrelated distribution and environmental data at continental scales has been questioned. Here this is investigated at a regional (10 km) scale by modelling the distributions of 100 plant species native to the UK. UK. SDMs fitted using real climate data were compared with those utilizing simulated climate gradients. The simulated gradients preserve the exact values and spatial structure of the real ones, but have no causal relationships with any species and so represent an appropriate null model. SDMs were fitted as generalized linear models (GLMs) or by the Random Forest machine-learning algorithm and were either non-spatial or included spatially explicit trend surfaces or autocovariates as predictors. Species distributions were significantly but erroneously related to the simulated gradients in 86% of cases (P < 0.05 in likelihood-ratio tests of GLMs), with the highest error for strongly autocorrelated species and gradients and when species occupied 50% of sites. Even more false effects were found when curvilinear responses were modelled, and this was not adequately mitigated in the spatially explicit models. Non-spatial SDMs based on simulated climate data suggested that 70-80% of the apparent explanatory power of the real data could be attributable to its spatial structure. Furthermore, the niche component of spatially explicit SDMs did not significantly contribute to model fit in most species. Spatial structure in the climate, rather than functional relationships with species distributions, may account for much of the apparent fit and predictive power of SDMs. Failure to account for this means that the evidence for climatic limitation of species distributions may have been overstated. As such, predicted regional- and national-scale impacts of climate change based on the analysis of static distribution snapshots will require re-evaluation.
•Insights for communication to improve coping with climate change are provided.•Communication principles are suggested for the climate change coping context.•Climate change will have diverse impacts ...on peoples’ stress and coping responses.•Individual resilience is linked to ecosystem and community resilience.
Climate change poses a major threat to human well-being and will be the root cause of a variety of stressors in coming decades. Psychologists have an important role to play in developing interventions and communication strategies to help people understand and cope with climate change impacts. Through a review of the literature, we identify three guiding insights for strategies to promote adaptive coping and resilience to climate change stress. First, it is unlikely that one single “correct” or “best” way of communicating about adaptive coping with climate change exists, but there are established best practices communicators can follow. Second, in implementing these best practices, practitioners must attend to the impact of variability in the nature of different kinds of stress caused by climate change, as well as individual differences in how people chronically respond to stressors. Third, because individuals, communities, and ecosystems are interconnected, work on adaptive coping to climate change must address individual coping in the context of community and ecosystem resilience. These insights from psychological science can be leveraged to promote human flourishing despite increasing stressors posed by climate change.
1. This account presents information on all aspects of the biology of Ambrosia artemisiifolia L. (Common ragweed) that are relevant to understanding its ecology. The main topics are presented within ...the standard framework of the Biological Flora of the British Isles: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, and history, conservation, impacts and management. 2. Ambrosia artemisiifolia is a monoecious, wind-pollinated, annual herb native to North America whose height varies from 10 cm to 2.5 m, according to environmental conditions. It has erect, branched stems and pinnately lobed leaves. Spike-like racemes of male capitula composed of staminate (male) florets terminate the stems, while cyme-like clusters of pistillate (female) florets are arranged in groups in the axils of main and lateral stem leaves. 3. Seeds require prolonged chilling to break dormancy. Following seedling emergence in spring, the rate of vegetative growth depends on temperature, but development occurs over a wide thermal range. In temperate European climates, male and female flowers are produced from summer to early autumn (July to October). 4. Ambrosia artemisiifolia is sensitive to freezing. Late spring frosts kill seedlings and the first autumn frosts terminate the growing season. It has a preference for dry soils of intermediate to rich nutrient level. 5. Ambrosia artemisiifolia was introduced into Europe with seed imports from North America in the 19th century. Since World War II, it has become widespread in temperate regions of Europe and is now abundant in open, disturbed habitats as a ruderal and agricultural weed. 6. Recently, the North American ragweed leaf beetle (Ophraella communa) has been detected in southern Switzerland and northern Italy. This species appears to have the capacity to substantially reduce growth and seed production of A. artemisiifolia. 7. In heavily infested regions of Europe, A. artemisiifolia causes substantial crop-yield losses and its copious, highly allergenic pollen creates considerable public health problems. There is a consensus among models that climate change will allow its northward and uphill spread in Europe.
Wildfire smoke contributes substantially to the global disease burden and is a major cause of air pollution in the US states of Oregon and Washington. Climate change is expected to bring more ...wildfires to this region. Social media is a popular platform for health promotion and a need exists for effective communication about smoke risks and mitigation measures to educate citizens and safeguard public health.
Using a sample of 1,287 Tweets from 2022, we aimed to analyze temporal Tweeting patterns in relation to potential smoke exposure and evaluate and compare institutions' use of social media communication best practices which include (i) encouraging adoption of smoke-protective actions; (ii) leveraging numeric, verbal, and Air Quality Index risk information; and (iii) promoting community-building. Tweets were characterized using keyword searches and the Linguistic Inquiry and Word Count (LIWC) software. Descriptive and inferential statistics were carried out.
44% of Tweets in our sample were authored between January-August 2022, prior to peak wildfire smoke levels, whereas 54% of Tweets were authored during the two-month peak in smoke (September-October). Institutional accounts used Twitter (or X) to encourage the adoption of smoke-related protective actions (82% of Tweets), more than they used it to disseminate wildfire smoke risk information (25%) or promote community-building (47%). Only 10% of Tweets discussed populations vulnerable to wildfire smoke health effects, and 14% mentioned smoke mitigation measures. Tweets from Washington-based accounts used significantly more verbal and numeric risk information to discuss wildfire smoke than Oregon-based accounts (p = 0.042 and p = 0.003, respectively); however, Tweets from Oregon-based accounts on average contained a higher percentage of words associated with community-building language (p < 0.001).
This research provides practical recommendations for public health practitioners and researchers communicating wildfire smoke risks on social media. As exposures to wildfire smoke rise due to climate change, reducing the environmental disease burden requires health officials to leverage popular communication platforms, distribute necessary health-related messaging rapidly, and get the message right. Timely, evidence-based, and theory-driven messaging is critical for educating and empowering individuals to make informed decisions about protecting themselves from harmful exposures. Thus, proactive and sustained communications about wildfire smoke should be prioritized even during wildfire "off-seasons."
Traumatic brain injury (TBI) and repetitive head impacts can result in a wide range of neurological symptoms. Despite being the most common neurological disorder in the world, repeat head impacts and ...TBI do not have any FDA-approved treatments. Single neuron modeling allows researchers to extrapolate cellular changes in individual neurons based on experimental data. We recently characterized a model of high frequency head impact (HFHI) with a phenotype of cognitive deficits associated with decreases in neuronal excitability of CA1 neurons and synaptic changes. While the synaptic changes have been interrogated
in vivo
, the cause and potential therapeutic targets of hypoexcitability following repetitive head impacts are unknown. Here, we generated
in silico
models of CA1 pyramidal neurons from current clamp data of control mice and mice that sustained HFHI. We use a directed evolution algorithm with a crowding penalty to generate a large and unbiased population of plausible models for each group that approximated the experimental features. The HFHI neuron model population showed decreased voltage gated sodium conductance and a general increase in potassium channel conductance. We used partial least squares regression analysis to identify combinations of channels that may account for CA1 hypoexcitability after HFHI. The hypoexcitability phenotype in models was linked to A- and M-type potassium channels in combination, but not by any single channel correlations. We provide an open access set of CA1 pyramidal neuron models for both control and HFHI conditions that can be used to predict the effects of pharmacological interventions in TBI models.
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