Patterns and Consequences of Inadequate Sleep in College Students: Substance Use and Motor Vehicle Accidents

We examined college sleep patterns and consequences using a cross-sectional design. We found that students get insufficient sleep and frequently use medication and alcohol as sleep aids, use stimulants as alertness aids, and fall asleep at the wheel, or have motor vehicle accidents due to sleepiness. Future studies should focus on effective interventions for sleep in college students.     

Predictors of Smoking Cessation Among College Students in a Pragmatic Randomized Controlled Trial

Prevention Science - An effective strategy to quit smoking should consider demographic aspects, smoking-related characteristics and psychological factors. This study examined potential predictors...     

The Delivery of Behavioral Sleep Medicine to College Students

College students are vulnerable to a variety of sleep disorders, which can result in sleep deprivation and a variety of other consequences. The delivery of behavioral sleep medicine is particularly relevant for the college student population, as the early intervention on their sleep problems might prevent lifelong consequences. This article critically reviews the efficacy of relevant behavioral sleep medicine interventions and discusses special considerations for using them with college students who have unique sleep patterns and lifestyles. Recommendations are also given regarding ways to disseminate these empirically supported treatments into this environment. Finally, recommendations regarding future research directions are discussed in the present study.     

包头市大学生睡眠卫生知信行对睡眠质量的影响

目的了解大学生睡眠卫生知识、信念、行为与睡眠质量的关系。方法采用整群随机抽样选取773名在校大学生为测试对象,以中文版匹兹堡睡眠质量指数问卷(Pittsburgh Sleep Quality Index,PSQI)和大学生睡眠卫生知识、信念、行为问卷为工具,调查大学生的睡眠卫生知、信、行与睡眠质量的关系。结果大学生睡眠卫生知识、信念、行为得分依次为(16.30±2.79)、(40.61±7.46)、(49.65±8.61);不同性别在睡眠卫生信念得分上的差异有统计学意义(P<0.01);睡眠卫生信念及行为与PSQI总分呈负相关(P<0.01);睡眠卫生信念和行为与PSQI总分的标准回归系数分别为-0.164和-0.177(P<0.01)。结论睡眠卫生信念和行为对睡眠质量有预测作用。睡眠卫生信念与睡眠卫生行为是影响大学生睡眠质量的主要因素之一,开展大学生睡眠卫生健康教育是非常必要的。     

包头市大学生睡眠卫生知信行对睡眠质量的影响

目的了解大学生睡眠卫生知识、信念、行为与睡眠质量的关系。方法采用整群随机抽样选取773名在校大学生为测试对象,以中文版匹兹堡睡眠质量指数问卷(Pittsburgh Sleep Quality Index,PSQI)和大学生睡眠卫生知识、信念、行为问卷为工具,调查大学生的睡眠卫生知、信、行与睡眠质量的关系。结果大学生睡眠卫生知识、信念、行为得分依次为(16.30±2.79)、(40.61±7.46)、(49.65±8.61);不同性别在睡眠卫生信念得分上的差异有统计学意义(P0.01);睡眠卫生信念及行为与PSQI总分呈负相关(P0.01);睡眠卫生信念和行为与PSQI总分的标准回归系数分别为-0.164和-0.177(P0.01)。结论睡眠卫生信念和行为对睡眠质量有预测作用。睡眠卫生信念与睡眠卫生行为是影响大学生睡眠质量的主要因素之一,开展大学生睡眠卫生健康教育是非常必要的。     

民办高校大学生睡眠质量的影响因素调查

目的了解民办高校大学生睡眠质量的影响因素,从而采取有针对性的指导和管理。方法以某民办高校部分在校大学生为研究对象,随机抽取417人,采用人际关系评定量表、压力量表及匹兹堡睡眠质量指数量表进行问卷调查。采用SPSS13.0统计分析软件进行数据处理。结果民办高校大学生睡眠障碍,男女大学生总睡眠时间、上网时间、人际关系比较差异有统计学意义（P〈0.01）;多元回归分析显示,压力和入睡时间是影响大学生睡眠质量的主要危险因素（P〈0.01）。结论民办高校大学生睡眠质量与多因素有关,建议通过减压和作息管理提高大学生睡眠质量。     

广州大学生睡眠质量及其影响因素分析

目的了解大学生睡眠质量及其影响因素,为制定学校健康教育策略提供科学依据。方法采用整群抽样的方法,以匹兹堡睡眠质量指数(PittsburghSleepQualityIndex,PSQI)为测量工具评定大学生的睡眠情况。结果大学生PSQI得分为(6.23±2.62)分,女生得分(6.49±2.60)高于男生(5.94±2.62);28.6%的大学生有睡眠质量问题,女生睡眠质量问题现患率(32.3%)高于男生(24.8%);睡眠环境嘈杂、情绪不稳定、焦虑不安等是影响大学生睡眠质量的因素。结论大学生睡眠质量问题并不少见,常与社会、心理因素有关。应采取综合措施改善大学生的睡眠质量,保护他们的身心健康。     

军校大学生人际关系与睡眠质量的相关性研究

目的研究军校大学生睡眠质量情况,探讨人际关系与睡眠质量的关系,为改善睡眠质量提供依据。方法先采用整群抽样法抽取西安市医学和非医学两所军校,再用随机抽样法抽取730名学生,运用匹兹堡睡眠质量指数调查表(Pittsburgh Sleep Quality Index,PSQI)和人际关系综合诊断量表对730名军校大学生进行问卷调查。结果 (1)不同专业、年级、生源学员在人际关系综合诊断量表总分方面差异均无统计学意义(P值均0.05);地方生源学员、战士生源学员在交际、待人接物方面差异具有统计学意义,主要表现为地方生源学员困扰率高于战士生源学员(P0.05);(2)32.2%军校大学生存在睡眠障碍,不同年级学员睡眠障碍发生率差异具有统计学意义(χ2=22.45,P0.05),其中,大一年级学员存在睡眠障碍百分比数明显高于其他4个年级;(3)人际关系综合诊断量表的交谈、社交活动与交友、待人接物、同异性朋友交往及人际关系综合诊断量表总分与睡眠质量成均呈显著正相关(r=0.28、0.28、0.20、0.24、0.30,P0.01)。结论军校大学生人际关系对睡眠质量具有较强影响,人际关系越好睡眠质量越高。     

Two Studies Examining Environmental Predictors of Heavy Drinking by College Students

Two sequential studies are presented that examine the validity of a set of environmental variables to predict heavy drinking at college students' most recent drinking occasions. Random telephone interviews (n = 1609, n = 400) of graduate and undergraduate students attending two large public universities in the southwestern United States were conducted during three separate surveys in 2000 and 2001. An original interview schedule was used and it included measures that examined environmental characteristics of students' most recent drinking events, motivations for drinking, demographics, and alcohol consumption. Using nonparametric exploratory and confirmatory discriminant analyses to distinguish between heavy episodic and nonheavy episodic drinking events, a discriminant function was identified that included the following environmental variables: (1) having many people intoxicated at an event, (2) having illicit drugs available at an event, (3) BYOB events and, (4) the playing of drinking games at the event. The validity of these environmental variables to predict heavy drinking among students was supported in a subsequent study examining a separate sample from the same student population. Environmental factors can be useful to predict heavy drinking events experienced by students. Prevention programs would benefit from targeting such factors in combination with more traditional individual-level approaches.     

剥夺睡眠对大学生不同部位诱发电位的影响

目的：研究睡眠不足对大学生中枢神经系统功能造成的影响。方法：对不同程度剥夺睡眠的大学生进行了上肢短潜伏期躯体感觉诱发电位，脑干听觉诱发电位和视觉诱发电位的测量。结果：剖剥夺睡眠上肢短潜伏期躯体感觉诱发电位无显变化，脑干听觉诱发电位和视觉诱发电位各波潜伏期较对照组有延长趋势。彻夜剥夺睡眠显延长（P＜0．05）。结论：睡眠不足降低了中枢神经系统对外在刺激的反应能力。     

Predictors of Intention to Practice Safer Sex Among Korean College Students

This study examined the efficacy of the Theory of Planned Behavior (TpB) among Korean college students on intentions of condom use. A cross-sectional, correlational design was conducted with an exploratory survey method. Young men and women aged 18-25 were recruited from a university in Seoul, Korea using a flyer and self-referral. Students completed a background and sexual behavior questionnaire, a parent-adolescent communication scale, and instruments derived from the TpB. Age, parent-adolescent communication, and perceived risk of sexual behavior were added to the model as potential determinants of intention of condom use. All the TpB components significantly predicted intention of condom use for young men, but only condom attitude and condom efficacy significantly predicted intention of condom use for young women. Age and quality of parent-adolescent communication indirectly affected the intention of condom use; however, perceived risk of sexual behavior did not predict intention of condom use, nor was it affected by age. Older students had a higher condom efficacy and a higher perceived peer norm of condom use. The quality of parent-adolescent communication significantly predicted a higher condom efficacy for young men, but not women.     

Patterns of Sickness Absence in a Railway Population

This investigation was carried out in order to obtain morbidity statistics in a large industrial population with special reference to the effects of ageing.

The population chosen, the “railway research population,” consisted of a sample of Scottish railwaymen, drawn from five of the eight areas in the Scottish Region of British Railways. Only certain occupational grades were studied.

Information was obtained over a period of one year by means of a detailed monthly return of (a) sickness absence data and (b) job changes. Indices of sickness absence were defined. The sickness absence experience of the railway research population was compared with that of other populations. It is a healthier group than the total insured population but differs in some respects from that of London Transport.

The nature of sickness absence within the railway research population was then studied. It was shown in all but one measure used that sickness tends to increase with age, the most important factor being the increase of long episodes. Examination of the frequency distribution of the duration of sickness episodes revealed that sickness absence tends to be taken in terms of weeks off rather than days off.

Analysis of the daily variation in sickness absence showed that the total absence rate increased from Monday to Friday. There was a well defined tendency for sickness to start on Mondays, and in longer episodes an additional tendency to start on Fridays. This was interpreted in terms of morale, both positive and negative.

Marked differences of the same order of magnitude as those due to age were noted in the sickness experience of the various grades, related to both conditions of work and responsibility.

The reasons for job changes were analysed and the grades to which men were transferred were identified. The choice of suitable grades for older workers was discussed.

It was concluded that working conditions might be important factors in the type of sickness absence experienced and that comparisons with other populations might be helpful in this context. More detailed work was also called for on the psychological as well as physical aspects of the work situation for both the individual and the grade.

     

睡眠不足对大学生中枢神经系统功能的影响

「目的」研究睡眠不足对大学生中枢神经系统功能造成的影响。「方法」对不同程度睡眠不足大学生进行了上肢短潜伏期躯体感觉诱发电位、脑干听觉诱发电位和视觉诱发电位的测试。「结果」与睡眠不足前比较,睡眠不足后上肢短潜伏期躯体感觉诱发电位无显著变化,脑干吸觉诱发电位和视觉诱发电位各波潜伏期较对照组有延长趋势,彻夜不眠者显著延长（Ｐ〈０．０５）。「结论」睡眠不足降低了中枢神经系统对外在刺激的应激能力。     

Sociodemographic,Behavioral, and Cognitive Predictors of Alcohol-Impaired Driving in a Sample of U.S. College Students

Alcohol-impaired driving continues to be a major public health concern, particularly among college students. The current study examined whether sociodemographic, behavioral, and cognitive variables predicted alcohol-impaired driving in a sample of college students. Data were collected via telephone interviews from a random sample of undergraduates, ages 18–25 years old, stratified by sex and class in school. Using hierarchical logistic regression analyses (n = 330), results revealed that higher levels of weekly alcohol use, being age 21 or older, and perceived difficulty in obtaining alternative transportation were associated with a greater likelihood of drinking and driving. In addition, perceived likelihood of drinking and driving-related consequences was associated with a lower likelihood of drinking and driving. Knowledge of the .08% per se and zero tolerance laws did not predict alcohol-impaired driving. Findings are discussed in terms of their implications for college media campaigns designed to reduce alcohol-impaired driving.     

Treatment Patterns,Survival, and Healthcare Costs of Patients with Malignant Gliomas in a Large US Commercially Insured Population

Background

Glioblastoma multiforme is the most common malignant primary brain tumor in adults and is associated with poor survival rates. Symptoms often include headaches; nausea and vomiting; and progressive memory, personality, or neurologic deficits. The treatment remains a challenge, and despite the approval of multiple new therapies in the past decade, survival has not improved.

Objective

To describe treatment patterns, survival, and healthcare costs of patients with incident glioblastoma in a large US population.

Methods

For this population-based study, adult patients (aged ≥18 years) with incident malignant brain neoplasm who had undergone brain surgery between January 1, 2006, and December 31, 2010, were identified in the Truven Health Analytics MarketScan Research Databases. The patients were stratified into 4 cohorts based on the use of temozolomide and/or external beam radiation therapy within 90 days after brain surgery (ie, the index event). Treatment patterns, survival, and healthcare costs were assessed until patient death, disenrollment, or the end-of-study period.

Results

A total of 2272 patients met the inclusion criteria; of these, 37% received temozolomide and radiation therapy, 13.8% received radiation alone, 3.9% received temozolomide alone, and 45.3% of patients received neither. The average patient age ranged from 55.3 years to 59.8 years across the study cohorts; between 29.8% and 44% of patients in each cohort were female. The duration of temozolomide use was similar between the temozolomide-only cohort and patients receiving temozolomide with external beam radiation; approximately 76% of patients received temozolomide at least 60 days, dropping to 48.1% and 23% at 180 days and 360 days of follow-up, respectively. The median survival was 456 days, ranging from 331 days in the temozolomide-only cohort to 529 days in the cohort that received neither temozolomide nor external beam radiation. The average total costs in the 6 months postindex were $106,896, from $79,099 for patients who received neither temozolomide nor radiation to $138,767 for those who received both therapies.

Conclusion

The survival patterns of patients with glioblastoma seen in this real-world study of current treatments in a clinical setting is similar to the survival rate reported in clinical trials. However, further cost-effectiveness and quality-of-life analyses will be critical to better understand the role of temozolomide therapy in this patient population, considering its considerable cost burden and potential negative impact on survival seen in this study.Glioblastoma multiforme is the most common malignant primary brain tumor in adults, with an estimated incidence of 4.43 per 100,000 person-years in the United States and a median age at presentation of 64 years.1 Glioblastoma multiforme is characterized by seizures; nausea; vomiting; headaches; and progressive memory, personality, or neurologic deficits, as well as treatment resistance.2 The treatment of glioblastoma multiforme is a challenge, and despite the approval of multiple new therapies in the past decade, survival remains poor.Based on a national report on the status of cancer published in 2011 in the Journal of the National Cancer Institute, the 5-year relative survival rates for glioblastoma multiforme among adults between 2000 and 2006 was only 21.3% for patients aged 20 to 39 years, 5.3% for those aged 40 to 64 years, and only 1.1% for patients aged ≥65 years in the United States.1 These national 5-year relative survival rates were slightly better when considering all tumors of the neuroepithelial tissue (65.1%, 26.6%, and 4.6% for the same 3 age-groups, respectively).1The current standard of care for newly diagnosed glioblastoma is derived from a randomized clinical trial published in 2005 and consists of maximal feasible surgical resection followed by radiotherapy with concurrent and adjuvant temozolomide.3 This treatment regimen, known as the Stupp regimen, has resulted in a median survival of 14.6 months in patients receiving temozolomide therapy alone compared with 12.1 months in patients receiving external beam radiation alone.3 The adoption of the Stupp regimen has been credited for improvement in the survival of patients with glioblastoma multiforme from 2005 to 2008 compared with the survival from 2000 to 2003, particularly among younger patients.4,5The US Food and Drug Administration (FDA) approved the use of temozolomide for the treatment of glioblastoma multiforme in March 2005. The FDA also approved carmustine wafers (initially in 1997) and bevacizumab (in 2009, for glioblastoma multiforme that has progressed after initial treatment) for the treatment of glioblastoma multiforme, but neither of these treatments has demonstrated a significant role in the upfront treatment of this disease.6The financial costs associated with the addition of temozolomide are significant and have been well documented, particularly in European and Canadian health systems.7 In the United States, several analyses have underscored the overall costs and burden of out-of-pocket (OOP) costs incurred by patients with glioblastoma multiforme for hospital visits, ancillary care, and drug costs.8,9 The total expenditures in this patient population have also been described in 2007 by Kutikova and colleagues for 653 patients with primary malignant brain tumors and were estimated at $6364 per month compared with $277 for controls.9 These costs were mostly associated with inpatient care and likely reflect patient care before the widespread use of temozolomide.9To our knowledge, no study has comprehensively described the total healthcare costs associated with the treatment of glioblastoma and malignant gliomas in the temozolomide era in the United States. We sought to understand the treatment patterns, survival, and economic burden incurred by patients with glioblastoma in clinical practice in the United States. In this study, we used a large commercial claims database and specifically sought to identify a cohort of patients based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) 191.xx codes that most likely represent newly diagnosed glioblastoma to describe patient survival, comorbidities, treatment duration, and healthcare expenditures in the time period after the FDA''s approval of temozolomide.

KEY POINTS

• ▸ Glioblastoma multiforme is the most common malignant primary brain tumor in adults, and its survival rates remain poor.
• ▸ The current standard of care consists of surgical resection followed by radiotherapy, with concurrent and adjuvant temozolomide therapy.
• ▸ This is the first study to analyze real-world data related to treatment patterns, costs, and survival trends associated with temozolomide therapy in patients with glioblastoma.
• ▸ Total healthcare costs 6 months postindex were highest ($138,767) per patient receiving temozolomide plus radiation and lowest ($79,099) for those receiving neither.
• ▸ The median survival time was highest (529 days) in patients who received neither temozolomide nor radiation and lowest (331 days) with temozolomide therapy alone.
• ▸ As can be expected, the addition of temozolomide significantly increases the cost of care, and evidence regarding its exact efficacy is limited in this patient population.
• ▸ Future cost-effectiveness and quality-of-life analyses are critical to better understand the role of temozolomide in this patient population.

     

Beverage Consumption Patterns of a Low-Income Population

High-energy-dense foods provide an inexpensive source of calories. Healthy Aging in Neighborhoods of Diversity across the Life Span study participants (n = 1987), low- to low-middle-income, urban African American and white adults, consumed between 17% and 20% of their daily energy intake from beverages. Of all beverages consumed, calorically sweetened beverages ranked second among African Americans and third among whites. Calorically-sweetened beverage consumption was not influenced by weight status. Increasing awareness of risks for adverse health outcomes associated with selected beverages may improve dietary choices.