0369 Sleep Disparities are Established by the First Month of College

Introduction

Short and poor quality sleep are particularly common in college students, likely impacting their ability to persist and succeed in difficult courses. In the current study, we investigated demographic-based sleep differences (sleep disparities) and demographic-based academic differences (achievement gaps) in first-semester college students, with the goal of informing whether sleep disparities contribute to achievement gaps.

Methods

From 2017 to 2018, first-semester undergraduate students at Baylor University completed the New2BU Survey [N=6,048, 61.9% female, 18.7% first-generation, 23.8% underrepresented racial/ethnic minority (URM)]. Data collection occurred within three to five weeks of classes beginning. The survey included self-reported weekday total sleep time (TST), which we classified as short sleep (≤6.9 hours), normal sleep (7-9 hours), or long sleep (>9 hours). Semester GPA data were obtained from university records for students’ first 4 semesters.

Results

There was evidence for both achievement gaps and sleep disparities. The risk for short sleep was increased in female students (p<.001; OR=1.20, 95%CI: 1.08-1.33), first-generation students (p=.02; OR=1.17, 95%CI: 1.03-1.33), and URM students (p<.001; OR=1.32, 95%CI: 1.16-1.50). The risk for long sleep increased substantially in first-generation students (p=.003, OR=1.92, 95%CI: 1.25-2.97) and URM students (p<.001; OR=2.41, 95%CI: 1.57-3.70), but not in female students (OR=0.88, 95%CI: 0.59-1.30). First-generation and URM students showed a 0.2-0.3 GPA reduction each semester relative to comparison groups (ps<.001), but short sleep and long sleep predicted GPA data up to four semesters later. Sleep-GPA correlations were modest in size (rs=.10-.14), but remained significant even after controlling for numerous demographic variables, high school GPA, and college entrance test scores.

Conclusion

Sleep disparities are noteworthy within the first month of college, and predictive of academic performance across four semesters. Addressing sleep health in all students—but particularly female, first-generation, and URM students—may increase academic success, bridge achievement gaps, and reduce health disparities.

Support

National Science Foundation (DRL 1920730)

Experiences of breast cancer in Arab countries. A thematic synthesis

BACKGROUND

Breast cancer is the most common cancer in women globally. Its negative effects on a woman's quality of life are related to the individual and socio-cultural factors. This review aimed to identify and synthesise the reported experiences and quality of life of women with breast cancer in Arab countries.

METHODS

PubMed, Embase, Web of Science, SCOPUS, PsychInfo, CINAHL, Allied and Complementary Medicine Database, and Index Medicus for the Eastern Mediterranean Region were searched for articles published from start to March 2019 using PRISMA guidelines. These searches were complimented by citation tracking and  hand searching of relevant journals. A thematic synthesis was carried out on the 'findings/results' sections from the identified papers.

RESULTS

Of 5228 records identified, 19 were included in the review which represented 401 women from 11 Arab countries. All used qualitative methods of data collection to produce rich descriptions of experiences. Thematic synthesis of the extracted data identified three major themes, Perceptions and reactions, Coping or enduring and Changing roles.

CONCLUSIONS

This review provides a rich description of the reported quality of life and experiences of women with breast cancer in Arab countries. These are influenced by the women's and society's views of cancer, the women's role in society and family, religious faith and the healthcare context and access to treatment choices and information.

Does pre-hospital telephone communication with a clinician result in more appropriate medication administration by parents during childhood asthma exacerbations?

BACKGROUND

The National Heart, Lung and Blood Institute asthma guidelines recommend that parents communicate with a clinician during childhood asthma exacerbations when symptoms worsen or do not improve with initial therapy. This study tested the hypothesis that communication by parents with a clinician before an Emergency Department visit was associated with more appropriate medication administration for children with asthma exacerbations.

METHODS

This was a retrospective cohort study using data gathered from parents of children presenting with an asthma exacerbation to the emergency department. The communicating cohort included parents who communicated by telephone with a clinician during the exacerbation and the non-communicating cohort included parents who did not. Multivariate logistic regression models were used to test three hypotheses; communication with a clinician is associated with (1) administration of short-acting beta-agonists (SABAs), (2) increased dosing frequency of SABAs, and (3) administration of an oral corticosteroid.

RESULTS

A total of 199 subjects were enrolled, with 104 (52.3%) in the communicating and 95 (47.7%) in the non-communicating cohort. There was an association between communication and provider practice type, with children who received routine care from a private practice provider more likely to communicate with the clinician than children in hospital-based clinics or community health centers (Adjusted OR 1.9, 95% CI 1.0-3.7). Impoverished children and children insured by Medicaid were less likely to communicate with a clinician (controlling for provider type). Parents who communicated with a clinician were more likely to administer a SABA (adjusted OR 3.6, 95% CI 1.3-9.4) and an oral corticosteroid (adjusted OR 3.3, 95% CI 1.3-8.4) but were not more likely to administer a SABA with increased dosing frequency (adjusted OR 0.9, 95% CI 0.5-1.6).

CONCLUSIONS

Parents of children with asthma exacerbations who communicated with clinicians were more likely to administer SABAs and an oral corticosteroid before bringing their child to an emergency department. Frequency of SABA dosing was not associated with communication. Clinicians providing telephone advice to parents need to provide explicit instructions about medication administration, emphasizing the frequency with which SABAs should be administered.

Epstein-Barr virus gp350/220 binding to the B lymphocyte C3d receptor mediates adsorption, capping, and endocytosis

The type 2 complement receptor, CR2, a B lymphocyte surface glycoprotein, is known to be a component of the EBV receptor. We now demonstrate that the major EBV outer membrane glycoprotein, gp350/220, is a highly specific ligand for CR2. EBV or beads coated with purified recombinant gp350/220 adsorb to normal B lymphocytes, cap with CR2, become endocytosed into vesicles, and are released into the cytoplasm. This is the first demonstration of herpesvirus glycoprotein-cell glycoprotein receptor interaction in viral adsorption and penetration. The capping of CR2 in response to virus, gp350/220-coated beads, or anti-CR2 monoclonal antibodies is associated with cocapping of surface immunoglobulin. Interaction between CR2 and surface immunoglobulin may be important in modulating the B cell activation that normally follows EBV infection or exposure to antigen.