Identifying advanced and delayed sleep phase disorders in the general population: A national survey of New Zealand adults

The aim was to estimate the prevalence of, and identify independent risk factors for, Advanced (ASPD) and Delayed Sleep Phase Disorder (DSPD) among Māori (indigenous New Zealanders) and non-Māori adults using a self-report questionnaire. The Munich Chronotype Questionnaire was mailed to a stratified sample of 9100 adults (5100 Māori and 4000 non-Māori) aged 20–59 years randomly selected from the electoral rolls (54% response rate). Different definitions for ASPD and DSPD were developed using combinations of symptoms including self-reported bed and rising times, current chronotype, and a desire to change sleep schedule. Logistic regression models were used to model the likelihood of reporting ASPD or DSPD separately after adjusting for ethnicity (Māori versus non-Māori), sex (males versus females), age (in decades), socio-economic deprivation (NZDep2006 deciles) and employment status (unemployed, night work versus employed with no night work). The prevalence of ASPD ranged from 0.25% to 7.13% whereas the prevalence of DSPD was 1.51 to 8.90% depending on the definition used. The prevalence of ASPD was higher among men and increased with age. The prevalence of DSPD was higher among those living in more deprived areas and decreased with age. After controlling for ethnicity, gender, age, socio-economic deprivation and employment status, people with ASPD were more likely to report excessive daytime sleepiness, whereas those with DSPD were more likely to report poor or fair self-rated health. Reporting ASPD and DSPD were associated with self-reported night work. In this large sleep timing survey, we found no differences in the prevalence of self-identified ASPD and DSPD between Maori and non-Maori. This has implications for the development and provision of sleep health services and strategies for managing the significant impact of work patterns on sleep.     

Melatonin in circadian sleep disorders in the blind

Assessment of sleep patterns in blind people demonstrates a high prevalence of sleep disorders. Our studies have shown that subjects with no conscious light perception (NPL) have a higher occurrence and more severe sleep disorders than those with some degree of light perception (LP). A detailed study of 49 blind individuals showed that those with NPL are likely to have free-running (FR) circadian rhythms (aMT6s, cortisol) including sleep. Non-24-hour (or FR) sleep-wake disorder, characterised by periods of good and bad sleep is a condition that may benefit from melatonin treatment. Melatonin has been administered to NPL subjects with FR circadian rhythms and compared with placebo (or the no-treatment baseline) sleep parameters improved. The results suggest that prior knowledge of the subject's type of circadian rhythm, and timing of treatment in relation to the individual's circadian phase, may improve the efficacy of melatonin.     

Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study

Sleep and Biological Rhythms - Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide...     

Hepatitis B in a high prevalence New Zealand population: a mathematical model applied to infection control policy

Background

Chronic hepatitis B (CHB) is a vaccine preventable disease of global public health importance. The prevalence of CHB in New Zealand's Tongan population is over 10%, a level consistent with endemic infection, which contrasts to the low overall New Zealand prevalence (<0.5%). Despite the introduction of infant vaccination in 1988, coverage among Tongan children is estimated to be only 53%.

Aims

To estimate the population benefit of additional public health control measures besides ‘business as usual’ infant vaccination for hepatitis B in high prevalence populations.

Methods

A mathematical model of hepatitis B virus (HBV) transmission was used to predict future CHB prevalence in the New Zealand Tongan population under different infection control strategies.

Results

Prevalence of CHB is predicted to plateau at 2% in the New Zealand Tongan population if coverage remains at current levels, which are therefore insufficient to achieve long-term elimination of HBV. The critical proportion of immunisation coverage for elimination of the virus is estimated to be 73%. The effect of screening for HBV carriage and early disease management was unable to be quantified, but is likely to reduce the population burden of HBV infection and thus contribute to accelerating elimination.

Conclusions and recommendations

Mathematical models are a useful tool to forecast the future burden of CHB under a range of control strategy scenarios in high prevalence populations. Serosurveillance and targeted vaccination has similarly arrested HBV transmission in time-series prevalence studies from Taiwan and Alaska. Such a policy may demonstrate similar efficacy in New Zealand ethnic groups with endemic HBV infection.     

Low genetic and morphological differentiation between an introduced population of dunnocks in New Zealand and an ancestral population in England

Species invasions and exotic species introductions can be considered as ??unplanned experiments??, which help us to understand the evolution of organisms. In this study, we investigated whether an exotic bird species, the dunnock (Prunella modularis), has diverged genetically and morphologically from its native source population (Cambridge, England) after introduction into a new environment (Dunedin, South Island of New Zealand; exotic population). We used a set of microsatellite markers and three morphological traits to quantify the divergence between these two populations. We quantified neutral genotypic differentiation between the populations, and also used an individual-based Bayesian clustering method to assess genetic structure. We compared morphological divergence using univariate and principal components analyses. We found that individuals from the Dunedin population are genetically distinct from the Cambridge population, but levels of differentiation are very low. Overall within-population levels of genetic diversity are low compared to other bird species, and effective population sizes are small; indicating that the native population probably has a historically low level of genetic diversity, and that the introduced population retained most of that diversity after its introduction into New Zealand. We found little evidence of morphological divergence, and the evolutionary rate of change in these traits is below the average for other taxa. Our study adds support to the growing literature showing that invasive species maintain most of their initial genetic diversity after multiple founder events, even when population size is severely reduced. Moreover, our morphological data indicate slow evolutionary rates in species introduced to similar habitats.     

Pulmonary function and fuel use: A population survey

Background

In the backdrop of conflicting reports (some studies reported adverse outcomes of biomass fuel use whereas few studies reported absence of any association between adverse health effect and fuel use, may be due to presence of large number of confounding variables) on the respiratory health effects of biomass fuel use, this cross sectional survey was undertaken to understand the role of fuel use on pulmonary function.

Method

This study was conducted in a village of western India involving 369 randomly selected adult subjects (165 male and 204 female). All the subjects were interviewed and were subjected to pulmonary function test. Analysis of covariance was performed to compare the levels of different pulmonary function test parameters in relation to different fuel use taking care of the role of possible confounding factors.

Results

This study showed that biomass fuel use (especially wood) is an important factor for deterioration of pulmonary function (particularly in female). FEV₁ (p < .05), FEV₁ % (p < .01), PEFR (p < .05) and FEF_25–75 (p < .01) values were significantly lower in biomass fuel using females than nonusers. Comparison of only biomass fuel use vs. only LPG (Liquefied Petroleum Gas) use and only wood vs. only LPG use has showed that LPG is a safer fuel so far as deterioration of pulmonary function is concerned. This study observes some deterioration of pulmonary function in the male subjects also, who came from biomass fuel using families.

Conclusion

This study concluded that traditional biomass fuels like wood have adverse effects on pulmonary function.     

The economic costs of insomnia comorbid with depression and anxiety disorders: an observational study at a sleep clinic in Mexico

Sleep and Biological Rhythms - Significant advances documenting the costs associated with insomnia have been achieved. However, those related to insomnia associated with mood disorders remain...     

Placebo medication use in patient care: a survey of medical interns

The use of placebo medication, long recognized by clinicians, often has serious practical implications, such as patient deception. Past evidence has suggested that resident physicians tend to misuse placebo medication. Interns from two consecutive years of a residency program were surveyed anonymously to assess their knowledge and use of placebos. Of the 74 interns surveyed, 44 (59%) were familiar with placebo use in patient care. Fifty percent of these interns familiar with placebo use had learned about placebos from another physician. All interns who had learned about placebos during their internships had learned from another physician, whereas interns who had gained their knowledge of placebos as medical students were as likely to have learned from the medical literature as they were to have learned from a physician (P = 0.027). Interns aware of placebo use were more likely to consider placebo administration for suspected, factitious pain (P = 0.022). The present study uncovered no relationship between interns' estimations of placebo efficacy and the utility they attributed to placebos in assessing a complaint of pain. This suggests that conceptual inconsistencies underlie their use of placebos. Interns often learn of placebos as medical students and are influenced by physician-mentors. Placebo use in patient care is an area of attention for medical educators.     

Bullying,sleep/wake patterns and subjective sleep disorders: Findings from a cross-sectional survey

The aim of this study was to explore: (a) sleep patterns and disorders possibly associated with adolescent bullying profiles (pure bully, pure victim, bully/victim and neutral) and (b) the effect of sleep on psychosocial problems (externalized and internalized) related to bullying. The sample consisted of 1422 students aged 10–18 (mean?=?14.3, SD?=?2.7; 57% male) from five socioeconomically diverse schools in France. Bullying profiles were obtained using the revised Bully–Victim Questionnaire. Subjective sleep disorders were assessed using the Athens Insomnia Scale. School-week and weekend sleep/wake patterns were recorded. Internalizing problems were investigated using a Perceived Social Disintegration Scale and a Psychological Distress Scale. Externalizing behaviors were assessed using a General Aggressiveness Scale and an Antisocial Behavior Scale. These questionnaires were administered during individual interviews at school. After controlling for effects of gender and age, victims of bullying showed significantly more subjective sleep disturbances than the pure-bully or neutral groups (p?<?0.001). Bullies’ sleep schedules were more irregular (p?<?0.001 for bedtime irregularity and p<0.01 for wake-up time irregularity) and their sleep duration was shorter than their schoolmates (p?<?0.001 for the school week and p?<?0.05 for the weekend). There was an effect of sleep on psychosocial problems related to bullying, and our results indicate that sleep has a moderating effect on aggression in bullies (p?<?0.001). This would suggest a higher vulnerability of bullies to sleep deprivation. These results show differences in sleep problems and patterns in school-bullying profiles. Findings of this study open up new perspectives for understanding and preventing bullying in schools, with implications for research and clinical applications.     

Nightmares and sleep paralysis among the general Japanese population: a nationwide representative survey

Sleep and Biological Rhythms - The objective of this study was to determine the prevalence of nightmares and sleep paralysis and their associated factors in the general population in Japan. This...     

Risk factors in the prevalence of anencephalus and spina bifida in New Zealand

This paper presents results from an epidemiological study on the 51 anencephalus and 53 spina bifida cases in the 1978 New Zealand birth cohort. Multiple sources were used in the ascertainment, and the prevalence rates were 0.98 and 1.02 per 1,000 total births, respectively. No association was found with the traditional indicators of the effect of environmental factors: maternal age, social class, nuptiality, month of birth, or estimated month of conception. Males comprised 41% of anencephalus and 36% of spina bifida cases; the prevalence was higher in the non-Maori than in the Maori population. New Zealand-born mothers appear to have a much lower risk of spina bifida, but not anencephaly, than those born in England/Scotland. The rate for the latter population was within the range of a number of UK-based studies. As the bloodstock of New Zealand whites has been predominantly derived from the UK population, and as New Zealand is a low prevalence area, this suggests that the higher risk for these women is likely to be attributable to factors present in their birthplace but absent in New Zealand. These findings provide further evidence that the epidemiologic patterns of anencephalus and spina bifida in low-prevalence areas are at variance with those in high-prevalence areas, such as the United Kingdom. They also support the hypothesis that the contrast in rates between high- and low-prevalence areas is a reflection of the impact of environmental factors in high-prevalence areas on the "background" or baseline frequency of anencephalus and spina bifida found in low-prevalence areas.     

Decreased immunocompetence in a severely bottlenecked population of an endemic New Zealand bird

Inbreeding resulting from severe population bottlenecks may impair an individual's immune system and render it more susceptible to disease. Although a reduced immune response could threaten the survival of highly endangered species, few studies have assessed the effect of population bottlenecks on immunocompetence. We compared the counts of leucocytes and external, blood and gastrointestinal parasite loads in two populations of the endemic New Zealand robin Petroica australis to assess the immunocompetence of birds in a severely bottlenecked population relative to its more genetically diverse source population. Despite similar parasite loads in both populations, robins in the severely bottlenecked population showed lower counts of both total leucocyte and total lymphocyte numbers. When the immune system was experimentally challenged using the phytohaemagglutinin skin test, robins in the severely bottlenecked population exhibited a significantly lower immune response than the source population, suggesting that birds passing through a severe bottleneck have a compromised immunocompetence. Our results confirm that severe bottlenecks reduce the immune response of birds and highlight the need to avoid severe bottlenecks in the recovery programmes of endangered species.     

Modelling population persistence on islands: mammal introductions in the New Zealand archipelago

Islands are likely to differ in their susceptibility to colonization or invasion due to variation in factors that affect population persistence, including island area, climatic severity and habitat modification. We tested the importance of these factors in explaining the persistence of 164 introductions of six mammal species to 85 islands in the New Zealand archipelago using survival analysis and model selection techniques. As predicted by the theory of stochastic population growth, extinction risk was the greatest in the period immediately following introduction, declining rapidly to low probability by ca 25 years. This suggests that initially small populations were at greatest risk of extinction and that populations which survived for 25 years were likely to persist subsequently for much longer. Islands in the New Zealand archipelago become colder and windier with increasing latitude, and the probability of mammal populations persisting on islands declined steeply with increasing latitude. Hence, our results suggest that climatic suitability was an important determinant of the outcome of these invasions. The form of the relationship between latitude and persistence probability differed among species, emphasizing that the outcome of colonization attempts is species-environment specific.     

Prevalence of HLA-B27 in the New Zealand population: effect of age and ethnicity

Introduction

HLA-B27 genotyping is commonly used to support a diagnosis of ankylosing spondylitis (AS). A recent study has suggested that HLA-B27 may adversely affect longevity. The objectives of this study were to determine, for the first time, the prevalence of HLA-B27 in the New Zealand population, and to test whether HLA-B27 prevalence declines with age.

Methods

117 Caucasian controls, 111 New Zealand Māori controls, and 176 AS patients were directly genotyped for HLA-B27 using PCR-SSP. These participants and a further 1103 Caucasian controls were genotyped for the HLA-B27 tagging single nucleotide polymorphisms (SNPs) rs4349859 and rs116488202. All AS patients testing positive for HLA-B27 of New Zealand Māori ancestry underwent high resolution typing to determine sub-allele status.

Results

HLA-B27 prevalence was 9.2% in New Zealand Caucasian controls and 6.5% in Māori controls. No decline in HLA-B27 prevalence with age was detected in Caucasian controls (p = 0.92). Concordance between HLA-B27 and SNP genotypes was 98.7-99.3% in Caucasians and 76.9-86% in Māori. Of the 14 AS patients of Māori ancestry, 1 was negative for HLA-B27, 10 were positive for HLAB*2705, and 3 positive for HLAB*2704. All cases of genotype discordance were explained by the presence of HLAB*2704.

Conclusions

HLA-B27 prevalence in New Zealand Caucasians is consistent with that of Northern European populations and did not decline with increasing age. In Māori with AS who were HLA-B27 positive, 76.9% were positive for HLA-B*2705, suggesting that genetic susceptibility to AS in Māori is primarily due to admixture with Caucasians.     

The use of maize by the New Zealand Maoris

The only European vegetable introductions which have been absorbed by the Maoris as standard items are potatoes, squash and maize. The one use of maize developed by the Maoris which has been considered unique is the process of “rotting” or fermenting in water prior to eating. This process is similar to one employed in the Sierra of Ancash in Peru.     

Genetic diversity and historical population structure in the New Zealand mayfly Acanthophlebia cruentata

1. Nucleotide sequences of a 280 base pair region of the cytochrome b gene were used to assess genetic diversity and to infer population histories in the New Zealand mayfly Acanthophlebia cruentata. 2. A hierarchial examination of populations from 19 streams at different spatial scales in the central and northern North Island of New Zealand found 34 haplotypes. A common haplotype was found in all central region streams and unique haplotypes in northern streams. Several central streams had region specific haplotypes with genetically differentiated populations at the 70–100 km scale. 3. Haplotype diversity was high (0.53–0.8) at most sites, but low (0–0.22) in some central sites. amova analyses found significant genetic diversity among regions (69%) and among catchments (58%). Most population pairwise F_ST tests were significant, with non‐significant pairwise tests among sites in the central region and pairs of sites between neighbouring streams. 4. The levels of sequence divergence are interpreted as the result of Pleistocene divergence in multiple refugia, leading to the evolution of regionally unique haplotypes. The low diversity in some central region populations may result from recent colonisation following local extinctions, associated with volcanic events.     

Seasonal variation in diel activity and microhabitat use of an endemic New Zealand stream-dwelling galaxiid fish

1. Seasonal variation in microhabitat use and activity of 14 giant kokopu Galaxias argenteus, a drift‐feeding galaxiid fish, was compared using radiotelemetry. 2. During winter giant kokopu predominantly used low velocities and intermediate depths by night and day. Activity recorded during 24 and 72 h periods indicated that fish were consistently active at night and inactive during the day. Activity data corresponded with point‐in‐time habitat use data, both of which indicated that fish were concealed amongst cover during the day and used open water habitats at night. 3. During summer, giant kokopu used higher water velocities, shallower depths and coarser substrata, particularly at night but also occasionally during the day relative to winter. Giant kokopu were active by both day and night in summer, although periods of activity were less defined and less predictable than during winter. 4. Adults used predictable home reaches at base‐flow, with most individuals repeatedly using of one or two cover locations within their ‘home’ reach. Reaches used by fish were relatively short (rarely exceeding 26 m) irrespective of season and always included a single pool‐riffle sequence. 5. Diel and seasonal behaviour of giant kokopu was generally comparable with that exhibited by other drift feeding fish species in small temperate streams. However, the nocturnal activity of giant kokopu contrasts with activity patterns in various salmonids, indicating that the impact of predation by different drift feeding fish may vary considerably.