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Nie Q, Shen Y, Luo M, Sheng Z, Zhou R, Li G, Huang W, Chen S. Analysis of sleep for the American population: Result from NHANES database. J Affect Disord 2024; 347:134-143. [PMID: 37995924 DOI: 10.1016/j.jad.2023.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES To assess the contemporary prevalence and decade-long trends of sleep duration, sleep disorders and trouble sleeping among adults in the United States, as well as their risk factors, from 2005 to 2018. MATERIALS AND METHODS We used National Health and Nutrition Examination Survey data to calculate the sleep duration and weighted prevalence of sleep disorders and trouble sleeping in adults aged 20 years or older. Sleep duration, sleep disorders and trouble sleeping were assessed by questionnaire. RESULTS A total of 27,399 people were included in the survey on sleep duration, with a weighted percentage of normal sleep (7-8 h/night) of 56.33 % (95 % CI, 53.06-59.60 %) and a weighted percentage of short sleep (5-6 h/night) of 31.73 %. In stratified descriptions, participants aged 40-49 years were more likely to sleep less than five hours, while women aged 80 years and older were more likely to sleep longer and blacks were more likely to sleep shorter. A total of 27,406 participants were included in the survey for sleep disorders. The weighted proportion of the population with sleep disorders was 8.44 % (95 % CI, 7.79-9.8 %). Independent risk factors for sleep disorders were being 40-69 years old, being white, having a high education level, smoking, having hypertension, diabetes, heart disease, and BMI ≥ 25. From 2005 to 2014, the prevalence of sleep disorders increased year by year, from 7.44 % in 2005-2006 to 10.40 % in 2013-2014 (P for Trend<0.001). A total of 38,165 participants were included in the survey on trouble sleeping. The weighted proportion of the population with troubled sleeping was 27.30 % (25.70-28.90 %). Independent risk factors for troubled sleeping were being 30-79 years old, being white, having a high education level, smoking, drinking, having hypertension, diabetes, heart disease and BMI ≥ 25. From 2005 to 2018, the prevalence of trouble sleeping increased annually, from 24.44 % in 2005-2006 to 30.58 % in 2017-2018 (P for trend<0.001). CONCLUSION Adults in the United States are likely to have abnormal sleep durations, and the prevalence of sleep disorders and troubled sleeping is on the rise.
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Affiliation(s)
- Qiurui Nie
- Department of Gerontology, Nanchang first hospital, Nanchang, China
| | - Yu Shen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Mengqin Luo
- Department of Health Management Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhiyong Sheng
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Rui Zhou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Guangmin Li
- Department of Gerontology, Nanchang first hospital, Nanchang, China
| | - Wei Huang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Shenjian Chen
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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Vestgarden LA, Dahlborg E, Strunck J, Aasen EM. Nurses' discursive construction of older adult immigrant patients in hospitals. BMC Health Serv Res 2023; 23:586. [PMID: 37286985 DOI: 10.1186/s12913-023-09590-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The immigrant population across Europe is ageing rapidly. Nurses will likely encounter an increasing number of patients who are older adult immigrants. Moreover, access to and equal provision of healthcare is a key issue for several European countries. The relationship between nurses and patients is asymmetrical with unequal power relations; however, the way nurses construct the patient through language and discourse can help maintain or change the balance of power. Unequal power relations can affect access and be a hindrance to equal healthcare delivery. Hence, the aim of this study is to explore how older adult immigrants are discursively constructed as patients by nurses. METHODS An exploratory qualitative design was used. Data were collected through in-depth interviews with a purposive sample of eight nurses from two hospitals. The nurses' narratives were analysed using critical discourse analysis (CDA) as described by Fairclough. RESULTS The analysis identified an overarching, stable, and dominant discursive practice; 'The discourse of the other', with three interdiscursive practices: (1) 'The discourse on the immigrant patient versus an ideal patient'; (2) 'The expert discourse'; and (3) 'The discourse of adaption'. Older immigrant adults were constructed as 'othered' patients, they were different, alienated, and 'they' were not like 'us'. CONCLUSION The way nurses construct older adult immigrants as patients can be an obstacle to equitable health care. The discursive practice indicates a social practice in which paternalism overrides the patient's autonomy and generalization is more prevalent than a person-centred approach. Furthermore, the discursive practice points to a social practice wherein the nurses' norms form the basis for normal; normality is presumed and desirable. Older adult immigrants do not conform to these norms; hence, they are constructed as 'othered', have limited agency, and may be considered rather powerless as patients. However, there are some examples of negotiated power relations where more power is transferred to the patient. The discourse of adaptation refers to a social practice in which nurses challenge their own existing norms to best adapt a caring relationship to the patient's wishes.
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Affiliation(s)
- Lisbeth Alnes Vestgarden
- Department of Health Sciences in Aalesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Box 1517, Aalesund, 6025, Norway.
| | - Elisabeth Dahlborg
- Department of Health Sciences, University West, Trollhättan, 46132, Sweden
| | - Jeanne Strunck
- Department of Culture and Learning, Faculty of Social Sciences and Humanities, Aalborg University, Kroghstraede 3, Aalborg, 9220, Denmark
| | - Elin Margrethe Aasen
- Department of Health Sciences in Aalesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Box 1517, Aalesund, 6025, Norway
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Diaz E, Dimka J, Mamelund SE. Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study. BMC Public Health 2022; 22:1288. [PMID: 35788219 PMCID: PMC9252073 DOI: 10.1186/s12889-022-13687-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Vaccination is key to reducing the spread and impacts of COVID-19 and other infectious diseases. Migrants, compared to majority populations, tend to have lower vaccination rates, as well as higher infection disease burdens. Previous studies have tried to understand these disparities based on factors such as misinformation, vaccine hesitancy or medical mistrust. However, the necessary precondition of receiving, or recognizing receipt, of an offer to get a vaccine must also be considered. Methods We conducted a web-based survey in six parishes in Oslo that have a high proportion of migrant residents and were hard-hit during the COVID-19 pandemic. Logistic regression analyses were conducted to investigate differences in reporting being offered the COVID-19 vaccine based on migrant status. Different models controlling for vaccination prioritization variables (age, underlying health conditions, and health-related jobs), socioeconomic and demographic variables, and variables specific to migrant status (language spoken at home and years lived in Norway) were conducted. Results Responses from 5,442 participants (response rate of 9.1%) were included in analyses. The sample included 1,284 (23.6%) migrants. Fewer migrants than non-migrants reported receiving a vaccine offer (68.1% vs. 81.1%), and this difference was significant after controlling for prioritization variables (OR 0.65, 95% CI: 0.52–0.82). Subsequent models showed higher odds ratios for reporting having been offered the vaccine for females, and lower odds ratios for those with university education. There were few to no significant differences based on language spoken at home, or among birth countries compared to each other. Duration of residence emerged as an important explanatory variable, as migrants who had lived in Norway for fewer than 15 years were less likely to report offer of a vaccine. Conclusion Results were consistent with studies that show disparities between non-migrants and migrants in actual vaccine uptake. While differences in receiving an offer cannot fully explain disparities in vaccination rates, our analyses suggest that receiving, or recognizing and understanding, an offer does play a role. Issues related to duration of residence, such as inclusion in population and health registries and health and digital literacy, should be addressed by policymakers and health services organizers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13687-8.
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Affiliation(s)
- Esperanza Diaz
- Pandemic Center, Department for Global Public Health and Primary Care, University of Bergen, Bergen, Norway. .,Norwegian Institute Public Health, Oslo, Norway.
| | - Jessica Dimka
- Centre for Research On Pandemics & Society (PANSOC), Oslo Metropolitan University, Oslo, Norway
| | - Svenn-Erik Mamelund
- Centre for Research On Pandemics & Society (PANSOC), Oslo Metropolitan University, Oslo, Norway
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Terragni L, Rossi A, Miscali M, Calogiuri G. Self-Rated Health Among Italian Immigrants Living in Norway: A Cross-Sectional Study. Front Public Health 2022; 10:837728. [PMID: 35719667 PMCID: PMC9198252 DOI: 10.3389/fpubh.2022.837728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Most studies on immigrant health focus on immigrant groups coming from extra-European and/or low-income countries. Little attention is given to self-rated health (SRH) in the context EU/EEA migration. To know more about health among European immigrants can provide new insights related to social determinants of health in the migration context. Using the case of Italian immigrants in Norway, the aim of this study was to (i) examine the levels of SRH among Italian immigrants in Norway as compared with the Norwegian and the Italian population, (ii) examine the extent to which the Italian immigrant perceived that moving to Norway had a positive or negative impact on their SRH; and (iii) identify the most important factors predicting SRH among Italian immigrants in Norway. Methods A cross-sectional survey was conducted among adult Italian immigrants in Norway (n = 321). To enhance the sample's representativeness, the original dataset was oversampled to match the proportion of key sociodemographic characteristics of the reference population using the ADASYN method (oversampled n = 531). A one-sample Chi-squared was performed to compare the Italian immigrants' SRH with figures on the Norwegian and Italian populations according to Eurostat statistics. A machine-learning approach was used to identify the most important predictors of SRH among Italian immigrants. Results Most of the respondents (69%) rated their SRH as "good" or "very good". This figure was not significantly different with the Norwegian population, nor to the Italians living in Italy. A slight majority (55%) perceived that their health would have been the same if they continued living in Italy, while 23% perceived a negative impact. The machine-learning model selected 17 variables as relevant in predicting SRH. Among these, Age, Food habits, and Years of permanence in Norway were the variables with the highest level of importance, followed by Trust in people, Educational level, and Health literacy. Conclusions Italian immigrants in Norway can be considered as part of a "new mobility" of high educated people. SHR is shaped by several interconnected factors. Although this study relates specifically to Italian immigrants, the findings may be extended to other immigrant populations in similar contexts.
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Affiliation(s)
- Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Alessio Rossi
- Department of Computer Science, University of Pisa, Pisa, Italy
| | - Monica Miscali
- Department of Historical and Classical Studies at the Norwegian University of Science and Technology, Trondheim, Norway
| | - Giovanna Calogiuri
- Department of Nursing and Health Sciences, Center for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
- Department of Public Health and Sport Sciences, Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Kjøllesdal MKR, Gerwing J, Indesth T. Health risks among long-term immigrants in Norway with poor Norwegian language proficiency. Scand J Public Health 2022:14034948221085399. [PMID: 35548943 DOI: 10.1177/14034948221085399] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Poor health among immigrants has been associated with longer duration of residence in the host country, poor host language proficiency and low education. However, the interplay among these factors is under-studied. OBJECTIVE To assess health among immigrants in Norway by combinations of duration of residence, Norwegian language proficiency and education. METHODS In 2015/2016 Statistics Norway carried out two cross-sectional Living Conditions Surveys in the general adult population (N=5703, response rate 59%) and among immigrants from 12 countries, with ⩾2 years of residence (N=3993, response rate 54%). Health outcomes (poor self-reported health, diabetes, cardiovascular disease, hypertension, obesity, mental health problems, back/neck pain) were assessed with logistic regressions according to combinations of duration of residence, Norwegian language proficiency and education. RESULTS Negative health conditions were more common among immigrants than in the general population, and varied by duration of residence, proficiency in the Norwegian language and education. In age- and sex-adjusted regressions, immigrants had higher odds of all negative health conditions, except hypertension, regardless of their duration of residence, proficiency of the Norwegian language and educational level. Immigrants with a long duration of residence and poor proficiency in the Norwegian language had the highest odds of negative health conditions. CONCLUSIONS Special attention is warranted towards health among immigrants who have lived in Norway the longest without acquiring good Norwegian language proficiency.
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Affiliation(s)
- Marte K R Kjøllesdal
- Norwegian Institute of Public Health, Health Services Research, Oslo, Norway.,Norwegian University of Lifesciences, Institute of Public Health Science, Ås, Norway
| | - Jennifer Gerwing
- Akershus University Hospital, Health Services Research Unit, Oslo, Norway
| | - Thor Indesth
- Norwegian Institute of Public Health, Health Services Research, Oslo, Norway
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Vinjerui KH, Elgersma IH, Fretheim A. Increased COVID-19 Testing Rates Following Combined Door-to-Door and Mobile Testing Facility Campaigns in Oslo, Norway, a Difference-in-Difference Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111078. [PMID: 34769597 PMCID: PMC8583631 DOI: 10.3390/ijerph182111078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022]
Abstract
High testing rates limit COVID-19 transmission. Attempting to increase testing rates, Stovner District in Oslo, Norway, combined door-to-door campaigns with easy access testing facilities. We studied the intervention’s impact on COVID-19 testing rates. The Stovner District administration executed three door-to-door campaigns promoting COVID-19 testing accompanied by drop-in mobile COVID-19 testing facilities in different areas at 2-week intervals. We calculated testing rates pre- and post-campaigns using data from the Norwegian emergency preparedness register for COVID-19 (Beredt C19). We applied a difference-in-difference approach using ordinary least square regression models and robust standard errors to estimate changes in COVID-19 testing rates. Door-to-door visits reached around one of three households. Intervention and comparison areas had identical testing rates before the intervention, and we observed an increase in intervention areas after the campaigns. We estimate a 43% increase in testing rates over the first three days following the door-to-door campaigns (p = 0.28), corresponding to an additional 79 (95% confidence interval, −54 to 175) people tested. Considering the shape of the time series curves and the large effect estimate, we find it highly likely that the campaigns had a substantial positive impact on COVID-19 testing rates, despite a p-value above the conventional levels for statistical significance. The results and the feasibility of the intervention suggest that it may be worth implementing in similar settings.
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Affiliation(s)
- Kristin Hestmann Vinjerui
- Division for Health Services, Norwegian Institute of Public Health, 0213 Oslo, Norway;
- Correspondence:
| | | | - Atle Fretheim
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, 0213 Oslo, Norway;
- Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
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