Increase In Number Of Hours Research Articles

Improving Sleep and Quality of Life after Use of a Haptic Vibrotactile Trigger Technology, Drug-Free, Topical Patch: Results from the HARMONI Study

Sleep issues are widely prevalent throughout the US and can greatly impact a person’s quality of life while imparting a significant personal and societal burden. Evidence supports the importance of sleep health to overall physical health, behavioral health, wellness, and safety. Several diseases have been identified as having a significant association with sleep disorders and sleep duration, including depression, diabetes, obesity, hypertension, and cardiovascular events. Conventional pharmacological treatments for sleep disorders have been associated with dangerous adverse effects. Identifying effective and safe alternative treatment strategies, including those that are non-invasive and non-pharmacologic and that have reduced and limited side effect profiles, will provide options that may be preferable in how clinicians traditionally treat sleep disorders. There has been research focusing on neuronal pathways and circuits that have been shown to respond to sensory (nociceptive) stimulation. Researchers have shown that these pathways and specific areas of the brain can change in response to external stimuli. Haptic vibrotactile trigger technology (VTT) is designed to target the nociceptive pathways and theorized to disrupt these brain centers. The technology has been incorporated into non-invasive, non-pharmacological topical patches and other routes of delivery. The purpose of this IRB-approved, minimal risk observational study was to evaluate patients’ experiences and/or perceptions and patient response for those who received a haptic vibrotactile trigger technology (VTT) embedded non-pharmacologic, non-invasive, over-the-counter sleep patch (REM Sleep Patch with VTT; Super Patch Company, Srysty Holding Co, Toronto, Canada). Methods: Baseline, 7- and 14-day data were recorded in one hundred thirteen (113) adult subjects (79 females and 34 males) with a mean age of 53 years who presented with sleep- or insomnia- related issues or associated symptoms. The study evaluated changes in overall sleep quality and insomnia severity scores via validated scales (PSQI (Pittsburgh Sleep Quality Index) and the ISI (Insomnia Severity Index)), changes in the use of prescription and OTC medications, patient satisfaction, and any side effects reported while using the patch. Future analysis will compare the outcomes reported here with control and crossover treatment groups. Results: The results showed statistically significant decreases in time to fall asleep, an increase in number of hours of sleep, improvement in the quality of sleep, and reduction in global PSQI Score after using the VTT embedded sleep patch. After 14 days, the vast majority of patients reported a reduction of usage of oral medications, that the patch was convenient and easy to use, and preferred the patch over oral and other medications for sleep. Results also showed positive outcomes in Quality of Life (QoL) components with improvements in daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, and mood. Conclusions: Study results indicate that this non-pharmacologic, non-invasive, haptic vibrotactile trigger technology (VTT) embedded topical patch improves sleep quality, duration, and quality-of-life components and may reduce the use of concurrent medications, including prescribed and other oral medication for adult patients with sleep or insomnia-related symptoms. Results reported suggest that the non-pharmacological topical sleep patch has incredible potential to be added to the current approaches and treatments of noninvasive and nonpharmacological sleep therapies.

Four Years of Reports of Alcohol-Related Harm to Pediatricians in the Netherlands

Over the four years of the study, the number of adolescents treated with alcohol-related harm increased significantly (from 297 in 2007 to 684 in 2010), up to a total of 1,616. The dominant reason for hospitalization was “alcohol intoxication” (in total 1,350; 88% of all cases). The gender ratio did not change over time (54% boys), but the average age increased over the years (14.9 years to 15.4 years). With respect to the 1,350 adolescents with an alcohol intoxication, the mean blood-alcohol concentration (BAC) in the population was 1.84 gram per liter (range 1.83 to 1.86), with a 1.76 average for girls and a 1.93 for boys, and this did not change over the four-year period. We did observe an increase in the average number of hours of reduced consciousness (2.2 hours to 3.2 hours), but the in-hospital stay of the adolescents decreased (1.07 days to 0.96 days).

A model of healing of Los Angeles grades C and D reflux oesophagitis: is there an optimal time of acid suppression for maximal healing?

In patients with Los Angeles (LA) grade C or D oesophagitis, a positive relationship has been established between the duration of intragastric acid suppression and healing. To determine whether there is an apparent optimal time of intragastric acid suppression for maximal healing of reflux oesophagitis. Post hoc analysis of data from a proof-of-concept, double-blind, randomized study of 134 adult patients treated with esomeprazole (10 or 40 mg od for 4 weeks) for LA grade C or D oesophagitis. A curve was fitted to pooled 24-h intragastric pH (day 5) and endoscopically assessed healing (4 weeks) data using piecewise quadratic logistic regression. Maximal reflux oesophagitis healing rates were achieved when intragastric pH >4 was achieved for approximately 50-70% (12-17 h) of the 24-h period. Acid suppression above this threshold did not yield further increases in healing rates. After 4 weeks' acid-suppressive therapy for LA grade C or D oesophagitis, successful healing appears to reach a threshold above which improvements are unlikely to be achieved despite an increase in number of hours with intragastric pH >4.

A Model of Healing of La Grade C and D Erosive Esophagitis

Purpose: To characterize the relationship between percent time with intragastric pH > 4 and patients achieving complete healing of erosive esophagitis (EE), and to determine if there is a threshold percent time pH > 4 for maximal healing. Methods: This is an exploratory analysis of data from a proof-of-concept study (ClinicalTrials.gov identifier: NCT00206180; AstraZeneca study code: D9612L00062) in adults with endoscopically verified Los Angeles (grade C or D) EE (Aliment Pharmacol Ther 2007;25:617–28). Patients were treated with 2 different doses of esomeprazole (10 or 40 mg once daily for 4 wks, chosen in random order) in an attempt to achieve a range of intragastric pH levels. All patients with evaluable EE healing and 24-h intragastric pH monitoring on day 5 were included in the final analysis. A curve was fitted to data using piecewise quadratic logistic regression. Point summaries using 10% increments of percent time pH > 4 were computed for purposes of graphic illustration. Results: Data were available from 134 patients. While overall the percent time pH > 4 correlated with greater EE healing, the curve displayed a non-linear function (Figure). Maximum healing rates, defined as the mean percentage of patients completely healed in each pH group, were achieved at approximately 60% time pH > 4. Acid suppression above this apparent threshold did not yield further increases in EE healing rates.Figure: Fitted curve (including 95% confidence region) of EE healing and observed mean EE healing rates in 10% intervals of time with intragastric pH > 4. Error bars indicate standard error of the mean.Conclusion: Healing of EE (LA grade C and D) at 4 wks appears to reach a threshold after which increased healing cannot be achieved despite an increase in number of hours of pH control. The apparent pH-healing threshold of pH > 4 for 60% of the day may or may not be due to randomness and small sample sizes, and warrants further clinical study with a larger patient group.

Computerized attendance surveillance to reduce absenteeism

Computerized data on absenteeism were used as a basis for employee counseling and disciplinary action, and the effect of this program on absenteeism was assessed. In the pharmacy department of an 1100-bed tertiary-care hospital, a microcomputer program provides weekly print-outs of number of occurrences of absence, reason for absence, and total hours absent for each employee. When an employee is within 10 absent hours or one occurrence of exceeding departmental absenteeism standards, these data are used in informal counseling. If absenteeism standards are exceeded, oral or written warning is given within one week after the violation. Absenteeism among pharmacists and technicians was compared for a 90-day period after implementation of this program and the same period during the year before implementation. The computerized attendance-surveillance program was associated with decreases in the mean number of absence occurrences for both pharmacists and technicians, fewer warnings issued to each group, and an increase in the mean number of hours worked.