Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended. Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US. Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total of 21511 participants were included in the analysis. Results: Prevalence of CRC screening in the participants was 19%. Adjusting for all factors, insomnia (OR = 1.18, 95%CI = 1.06 - 1.32), moderate alcohol drinking (OR = 1.16, 95%CI = 1.01 - 1.30), past smoking (OR = 1.17, 95%CI = 1.04 - 1.32), depression (OR = 1.37, 95%CI = 1.18 - 1.58), African American (AA) race, and cancer history were positively associated with CRC screening. Females and Single were inversely associated with CRC screening prevalence. In stratified analysis by races (White and AA), depression was associated with CRC screening in both races. Marital status, smoking, cancer history and insomnia were associated with CRC screening in Whites only; while alcohol use was associated with CRC screening in AAs only. Conclusions: We have found significant associations between lifestyle factors (alcohol consumption and smoking) and mental health problems (depression and insomnia) and CRC screening uptake. To improve overall CRC screening uptake in the US, it is important to consider racial differences in predictors and tailor appropriate interventions to each racial/ethnic group.

The purpose of this three-paper dissertation is to examine the influence of different social processes on insomnia symptoms among Latinx adults. Qualitative and quantitative methods were used in an effort to adequately capture the complex ways in which these processes impact insomnia symptoms in this population. Given that insomnia is more prevalent among women than men and that previous studies suggest different gender patterns in the influence of social processes on mental health exist, each paper includes an exploratory aim that investigates potential gender differences in the associations it examines. Paper 1 uses thematic content analysis to explore how Latinx adults with chronic insomnia describe the social processes through which social ties impact their lived experience of insomnia. Paper 2 tests the independent and synergistic effects of family and friend social support and social strain on insomnia symptoms. Lastly, Paper 3 builds upon previous studies demonstrating a positive association between acculturation stress and insomnia symptoms among Latinx adults by examining two emotion-focused coping strategies (i.e., brooding and alcohol use) as potential mechanisms driving this association. Taken together, the findings from these three papers suggest there may be a need for mental health providers to evaluate and address social processes when diagnosing and treating insomnia among Latinx adults.

CTE is a progressive neurodegenerative disease defined by p-tau lesions in characteristic locations of the brain, leading to cognitive impairment as well as mood and behavioral dysfunction. Exposure to repetitive head impacts is a major risk factor for developing CTE; however, additional risk factors and secondary modulating factors, which may expand available treatment and prevention options, are still being elucidated. Studies into the glymphatic system, a system of waste clearance in the brain thought to be activated during sleep, have implicated glymphatic dysfunction in the clearance of toxic proteins like amyloid-beta and hyperphosphorylated tau, as well as in cognitive decline in neurodegenerative disorders like Alzheimer’s Disease, bringing into question whether sleep, through impacting glymphatic clearance, may act as a modulating factor in the development of CTE. In the present study, we began to characterize the presence of sleep disorders and their co-morbid conditions in a cohort of former college football players to gain better insight into their prevalence and the health outcomes of those with sleep conditions. Our results found higher rates of sleep apnea in the study sample, as well as an association between diagnosis with sleep apnea and diagnosis with dementia, AD, MCI, CTE, and similar disorders. Sleep apnea was significantly associated with depression, anxiety, high cholesterol, and diabetes. Further research into whether sleep disorders exacerbate CTE pathology or clinical symptoms, and whether treatment of sleep symptoms leads to better outcomes for patients with CTE, is necessary to further elucidate a potential connection.

As people age they are more likely to develop chronic conditions and will tend to be on multiple medications for long periods of time to manage those conditions. Some of these medications have side effects that are anticholinergic in nature. These side effects can impact different parts of the body including the central nervous system. As people enter their later years the permeability of the blood brain barrier increases, increasing their risk of these kinds of side effects.

No description available.

Bakgrund: Restless legs syndrome (RLS) är en underbehandlad sjukdom som påverkar välbefinnande och hälsa. Sömnsituationen hos personer med RLS är komplex och påverkas av symtom och varierande omständigheter. Förmågan att ta sig an de utmaningar som kommer med symtom på kvällen och natten erfars stressande och tidigare forskning tyder på att fler erfar symtom än antal personer som får diagnos, vilket leder till onödigt lidande.  Syfte: Syftet var att utforska och beskriva hur personer med RLS erfar sin sömnsituation.  Metod: En kvalitativ intervjustudie med manifest innehållsanalys genomfördes av 25 personer med RLS bosatta i olika delar av Sverige. KASAM utgör den teoretiska ramen i studien. Resultat: Stress över att känna symtom på kvällen och natten samt svårigheter att sova erfors. Rutiner och distraktion var viktiga för att kunna sova. Oro över att inte hitta symtomlindrande behandling återberättades av informanterna, som ofta själva sökte efter fungerande medicinsk behandling. Ständig trötthet erfors och kunde leda till psykiska konsekvenser men även svårigheter med sociala kontakter och på arbetet. Slutsats: Det finns stora kunskapsluckor om RLS och dess påverkan på sömnen, därför behövs mer forskning inom området för att distriktssköterskan ska kunna hjälpa personer med RLS att få en bättre sömnkvalitet och ökat välbefinnande. / Background: RLS is an undertreated disease that affects well-being and health. For people with RLS, sleeping is a complex siuation and affected by symptoms in varying forms. Coping with symptoms that come at night is described as stressful, and previous research suggests that more people than diagnosed experience symptoms, which leads to unneccessary suffering.  Purpose: To explore and describe how people with RLS experience their sleeping situation. Method: A qualitative interview study with manifest content analysis was conducted by 25 people with RLS living in Sweden. KASAM forms the theoretical framework of the study. Result: Stress over feeling symptoms in the evening and at night as well as difficulty sleeping. Routines and distraction were important to being able to sleep. Concerns about not finding symptom-relieving treatment was recounted by the informants, who often searched for effective medical treatment themselves. Constant fatigue was experienced and could lead to psychological consequences but also difficulties with social contacts and at work. Conclusion: There are large gaps in knowledge about RLS and its impact on sleep, therefore more research is needed in the area so that the district nurse can help people with RLS get a better quality of sleep and increased well-being.

No description available.

No description available.

Rationale: The severity of insomnia symptoms, including difficulty falling asleep and returning to sleep when awakened in the night, are major risk factors for more severe suicidality including suicidal ideation, suicide attempts, and death by suicide. As a modifiable risk factor, insomnia is a potential target for suicide prevention. There are several commonly observed gaps in the literature studying the association between insomnia and suicidality including little exploration of potential mediators, limited assessments of insomnia and suicidality, and a lack of sample diversity and representativeness. As such, the models that explain the association between insomnia and suicidality remain unclear and understudied. The purpose of this study is to investigate potential mediators that are associated with both insomnia severity and suicidality severity including emotion dysregulation, thwarted belongingness, and perceived burdensomeness with the use of validated measures in a nationally representative sample. Background: Evidence suggests that insomnia severity is related to suicidality severity, even when accounting for common risk factors of suicidality such as depression. Several models have been developed to explain the association between insomnia and suicidality severity. Neurocognitive models propose that insomnia prevents natural recuperative functions of sleep, thereby contributing to daytime impairment such as emotion dysregulation. Joiner’s suicide risk model may also outline potential psychosocial components that facilitate the association between insomnia and suicidality severity including thwarted belongingness and perceived burdensomeness. Emotion dysregulation, thwarted belongingness, and perceived burdensomeness have been individually associated with both insomnia and suicidality severity. Methods: We collected data on demographics, insomnia severity, depression, anxiety, suicidality severity, emotional regulation, thwarted belongingness, and perceived burdensomeness from 428 participants through an online survey. Our first aim was to replicate previous findings of the insomnia-suicidality severity association through regression analyses between self-reported insomnia and suicidality severity whilst controlling demographic variables, self-reported depression severity, and self-reported anxiety severity. Our second aim is to understand the role emotion dysregulation, thwarted belongingness, and perceived burdensomeness play in the insomnia and suicidal severity association, even when accounting for depression, through testing our proposed mediation models using structural equation modeling. Results: Insomnia severity was related to greater suicidality, but not when accounting for depression severity. Emotion dysregulation and perceived burdensomeness partially mediated the association between insomnia severity and suicidality severity. When accounting for depression severity, emotion dysregulation and perceived burdensomeness fully mediated the association between insomnia severity and suicidality severity. Conclusions: Depression, perceived burdensomeness, and emotion dysregulation may explain the association between insomnia and suicidality severity. These difficulties may serve as potent markers for suicide risk and potential targets for treatment and suicide prevention.

Under många år har det förekommit individer inom hälsovården som klagar på somatiska besvär. Ett koncept som förekommer för att kunna beskriva en underliggande mekanism är somatisering som innebär t ex trötthet och smärta i muskler. Dessa somatiska besvär kan orsakas av mentala hälsofaktorer som till exempel utbrändhet och ångest. I studien testades hypotesen att depression, ångest, utbrändhet och sömnproblem är relaterade till somatisering, och vidare undersöktes frågan i vilken utsträckning var och en av dessa fyra mentala hälsofaktorerna unikt förklarar grad av somatisering. För detta användes data från Västerbottens miljöhälsostudie som är en befolkningsstudie. Totalt deltog 3406 individer i studien, och av dessa var 1898 kvinnor och 1508 män mellan 18 och 79 år. Fyra separata multipla regressionsanalyser genomfördes för ångest, utbrändhet, depression och insomni samt en multipel regressionsanalys som inkluderade alla fyra mentala hälsofaktorer. Resultaten visade att alla fyra mentala hälsofaktorer var för sig var associerade med somatisering. Beträffande unik förklarad varians var den standardiserade beta-koefficienten störst för utbrändhet (0,546), lägre för ångest (0,468) och sömnstörning (0,382), och lägst för depression (0,379). Tillsammans förklarade de fyra faktorerna ca 38% av variansen i somatisering. Dessa resultat talar för att de undersökta typerna av mental ohälsa, och utbrändhet i synnerhet, bör undersökas och möjligen behandlas hos personer som är höga i somatisering. / For many years, there have been individuals in healthcare who complain of somatic symptoms. One concept that exists for describing an underlying mechanism is somatization, which involves, for example, fatigue and muscle pain. These somatic complaints can be caused by mental health factors such as burnout and anxiety. The study tested the hypothesis that depression, anxiety, burnout and sleep problems are related to somatization, and further investigated the extent to which each of these four mental health factors uniquely explains the degree of somatization. For this, data from the Västerbotten Environmental Health Study was used, which is a population study. A total of 3406 individuals participated in the study, of whom 1898 were women and 1508 men between the ages 18 and 79 years. Four separate multiple regression analyzes were performed for anxiety, burnout, depression and insomnia as well as a multiple regression analysis that included all four mental health factors. The results showed that all four mental health factors were individually associated with somatization. Regarding uniquely explained variance, the standardized beta coefficient was greatest for burnout (0.546), lower for anxiety (0.468) and sleep disturbance (0.382), and lowest for depression (0.379). Together, the four factors explained about 38% of the variance in somatization. These results suggest that the types of mental illness investigated, and burnout in particular, should be investigated in healthcare and possibly treated among people who are high in somatization.