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Welcome back can i buy ventolin over the counter in australia to the latest edition of the EMJ. It’s high Summer here in the Northern Hemisphere and our hopes that asthma treatment would be a distant memory by now are sadly broken. We are in wave n+1 at the moment (where n depends on where you are in the world), but there is hope in sight as treatment roll outs continue around can i buy ventolin over the counter in australia the world.This month our Editor’s choice is the PRIEST study.

This huge observational trial of asthma treatment 19 patients presenting to UK emergency departments gave us essential information on risk assessment in the asthma treatment ventolin. It’s a fantastic example of how a trial can be rapidly delivered in a ventolin and a lesson in how we can i buy ventolin over the counter in australia need to plan for the ventolin after asthma treatment. The study is particularly useful in that it focuses on information available to the emergency clinician in the form of well-known scores such as NEWS2 as opposed to data that may be available much later (such as some laboratory testing).

While therapeutic trials of repurposed drugs such as the RECOVERY and REMAP-CAP trials have received much of the publicity in the wake of asthma treatment we must remember that as emergency clinicians it is diagnosis, prognosis, risk assessment and disposition decisions can i buy ventolin over the counter in australia that are at the core of our specialty. The PRIEST study is a great example of how this can be done in a ventolin.Keeping with a asthma treatment theme Richards et al examined the evidence for prone positioning for non-intubated hypoxic asthma treatment patients. Despite the millions of cases worldwide and the enthusiasm for this technique the evidence base from 31 trials is actually very poor.

There are theoretical physiological advantages of course, and anecdotally short-term improvement can i buy ventolin over the counter in australia can be seen. However, it is still not clear whether this translates into important patient related outcomes. It’s clear can i buy ventolin over the counter in australia from this study that we need more data to support clinical practice and from well-designed clinical trials.Leading a cardiac arrest is a complex task that even experienced clinicians can find cognitively overwhelming.

There is the ‘in the moment’ task of sticking to an algorithm while at the same time trying to figure out a more strategic plan for the patient. Few individuals can do both effectively which can i buy ventolin over the counter in australia is why my colleagues have been teaching the concept of splitting roles to cognitively offload the strategic leader to strategically direct the arrest. I was therefore delighted to see this concept tested in the CANLEAD trial using a simulated model of cardiac arrest and nursing team leaders to run the ALS algorithm.

In 20 can i buy ventolin over the counter in australia simulations involving 120 participants they found improved overall team performance. Whether this would translate to better outcomes for patients in real world settings remains to be seen, but it has face validity and this study supports further work. It’s also a welcome reminder that nurses are perfectly capable of running cardiac arrests, and some of the best resuscitationists I know work with nurses in exactly this manner.Cardiac arrest is a condition (among others) where debriefing is important and so it’s good to see a study of the use of a structured debrief tool from Sugarman et al who report a quality improvement project looking at implementing the ‘TAKE STOCK’ tool, adapted from the Stop5 tool.

QIP reports can i buy ventolin over the counter in australia are relatively new to the journal, and we hope to highlight effective and interesting projects that can make a real difference to clinical care. The QIP shows a broad welcoming of a structured approach to debriefing from all staff members, and articulates a path for their introduction. If you are not already using a debriefing tool then this QIP may well help your department embed this important task.As I write this there is a lot of media attention in the UK regarding the number of paediatric attendances to UK emergency departments with colleagues such as Damian Roland from Leicester can i buy ventolin over the counter in australia working hard to educate the public on what fever really means in the paediatric population.

While most fevers are benign we all know that it can also be a marker of and so we have two paediatric studies looking at this in August. Chong et al looked at children under 3 months which are can i buy ventolin over the counter in australia a notoriously difficult group to differentiate serious from benign disease. In their cohort the incidence of severe disease was high (33%), but there are clues in the heart rate variability, temperature, and gender may help.

In a less risky group Mallet et al have looked at the prescription of antibiotics in paediatric sore throat finding a fair amount of variability between clinician choice and more formalised scoring mechanisms. It’s a good story to remind us that research findings (in this case scoring systems) rarely perform or penetrate can i buy ventolin over the counter in australia clinical practice in the way that we would hope or anticipate.Sticking with paediatrics I was interested to read a paper that made me stop and think about my own practice for Toddler’s fractures. My approach has been symptom led varying from the rare use of plaster of Paris through splints, and often very little indeed if the patient is not distressed or in pain.

This month we have a randomised controlled trial from Australia comparing above knee POP to a controlled ankle can i buy ventolin over the counter in australia motion boot. They found that a controlled motion boot is easier to live with and allows a faster return to activities of daily living and without any healing problems. However, I’m still left wondering if either of these levels of intervention are necessary for all patients.There’s lots more in this month’s edition but I’ll end with a reminder that our perceptions of emergency care may differ from those of our can i buy ventolin over the counter in australia patients.

Bull et al.’s systematic review of patient experience in the emergency department is enlightening with two major themes, one of the interactions between patients and staff and the other with the environment of the emergency department. There is much to reflect on here and perhaps time to look at our departments from the patient perspective.Ethics statementsPatient consent for publicationNot required..

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Comments on the ICR can you buy ventolin over the counter in the us must be received on or before January 28, 2021. Submit your comments to http://www.reginfo.gov/​public/​do/​PRAMain or via facsimile to (202) 395-5806. Start Further Info can you buy ventolin over the counter in the us Sherrette Funn, Sherrette.Funn@hhs.gov or (202) 795-7714. When submitting comments or requesting information, please include the document identifier 0990-New and project title for reference.

End Further Info End Preamble Start Supplemental can you buy ventolin over the counter in the us Information In compliance with 44 U.S.C. 3507, OS/DHHS has submitted the following proposed collection of information to OMB for review and clearance. OMB No can you buy ventolin over the counter in the us. 0990-New—HHS Teletracking asthma treatment Portal.

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As of July 10, HHS reduced the number requests for data from hospitals to support allocations of Remdesivir. HHS has stopped sending out one-time can you buy ventolin over the counter in the us requests for data to aid in the distribution of Remdesivir or any other treatments or supplies. This consolidated daily reporting is the only mechanism used for the distribution calculations, and daily reports are needed to ensure accurate calculations. Type of Respondent can you buy ventolin over the counter in the us.

We acknowledge the burden placed on many hospitals, including resource constraints, and have allowed for some flexibilities, such as back-submissions or submitting every business days, with the understanding that respondents may not have sufficient staff working over the weekend. It is our belief that collection of this information daily is the most effective way to detect outbreaks and needs for Federal assistance over time, by hospital can you buy ventolin over the counter in the us and geographical area, and to alert the appropriate officials for action. It's requested that 5,500 hospitals, submit data daily on the number of patients tested for asthma treatment, as well as information on bed capacity and requirements for other supplies. The HHS can you buy ventolin over the counter in the us Teletracking asthma treatment Portal (U.S.

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National Library of Medicine has more on neurologic diseases.SOURCE can you buy ventolin over the counter in the us. American Academy of Neurology, news release, Dec. 23, 2020.

Start Preamble Office of can i buy ventolin over the counter in australia https://iciutah.com/generic-flagyl-online-for-sale/ the Secretary, HHS. Notice. Start Printed Page 85650 In compliance with the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health can i buy ventolin over the counter in australia and Human Services, is announcing it has submitted to the Office of Management and Budget (OMB) for review and clearance the following collection of information. The addresses section has been corrected to reflect the correct comments email address.

Comments on the ICR must be received on or before January 28, 2021 can i buy ventolin over the counter in australia. Submit your comments to http://www.reginfo.gov/​public/​do/​PRAMain or via facsimile to (202) 395-5806. Start Further Info Sherrette Funn, can i buy ventolin over the counter in australia Sherrette.Funn@hhs.gov or (202) 795-7714. When submitting comments or requesting information, please include the document identifier 0990-New and project title for reference.

End Further Info End Preamble Start Supplemental Information In compliance can i buy ventolin over the counter in australia with 44 U.S.C. 3507, OS/DHHS has submitted the following proposed collection of information to OMB for review and clearance. OMB No can i buy ventolin over the counter in australia. 0990-New—HHS Teletracking asthma treatment Portal.

OMB Control can i buy ventolin over the counter in australia Number Abstract. The data collected through this ICR informs the Federal Government's understanding of disease patterns and furthers the development of policies for prevention and control of disease spread and impact related to the 2019 Novel asthma (asthma treatment). One of the most important uses of the data collected through this ICR is to determine critical allocations of limited supplies (e.g., protective equipment and medication). For instance, this collection has been used to distribute Remdesivir, can i buy ventolin over the counter in australia a vital therapeutic that HHS distributes to the American healthcare system, via distinct data calls on regular intervals.

As of July 10, HHS reduced the number requests for data from hospitals to support allocations of Remdesivir. HHS has stopped sending out one-time requests for data to aid in can i buy ventolin over the counter in australia the distribution of Remdesivir or any other treatments or supplies. This consolidated daily reporting is the only mechanism used for the distribution calculations, and daily reports are needed to ensure accurate calculations. Type can i buy ventolin over the counter in australia of Respondent.

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End Signature End Supplemental Information [FR Doc. 2020-28787 Filed 12-28-20. 8:45 am]BILLING can i buy ventolin over the counter in australia CODE 4150-04-PTUESDAY, Dec. 29, 2020 (HealthDay News) -- A shortage of neurologists in rural parts of the United States means that people in those areas are less likely to receive specialized care for conditions such as stroke, dementia and back pain, a new study claims."Neurologists in the United States are not evenly spread out, which affects whether patients can see a neurologist for certain conditions like dementia and stroke," said study author Dr.

Brian Callaghan, from the University of Michigan.His team reviewed one year of Medicare data and identified 2.1 million patients who made at least one office visit for a neurologic condition during that time.They also identified more than 13,600 neurologists in the regions where those patients lived and found that the availability of neurologists ranged from a low of 10 for every 100,000 people to a high of 43 for every 100,000 people.Rates of neurologic conditions were similar across regions, with nearly one-third of all people in the regions included in the study reporting at least one office visit for a neurologic condition.Overall, 24% of patients with a neurologic condition were seen by a neurologist, but rates varied from 21% in more rural areas to 27% can i buy ventolin over the counter in australia in more urban areas with the most neurologists. Most of that difference involved patients with dementia, back pain and stroke.Among dementia patients, 38% of those in more rural areas saw a neurologist, compared to 47% in more urban areas. The rates for stroke patients were can i buy ventolin over the counter in australia 21% and 31%, respectively.The findings were published online Dec. 23 in the journal Neurology."It is important that all people have access to the best neurologic care," said Dr.

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NCHS Data Brief No ventolin for sale online http://herlifefranchise.com/levitra-tablet-buy-online. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with ventolin for sale online an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is “the permanent cessation of menstruation that occurs after the loss of ventolin for sale online ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, ventolin for sale online and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely ventolin for sale online than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 ventolin for sale online. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend ventolin for sale online by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year ventolin for sale online or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table ventolin for sale online for Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week ventolin for sale online (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 ventolin for sale online. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal ventolin for sale online status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle ventolin for sale online and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 2pdf ventolin for sale online icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women ventolin for sale online aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 ventolin for sale online. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image ventolin for sale online icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual ventolin for sale online cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for ventolin for sale online Figure 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 days or more ventolin for sale online in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 ventolin for sale online. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend ventolin for sale online by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago ventolin for sale online or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf ventolin for sale online icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status ventolin for sale online. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, ventolin for sale online postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes ventolin for sale online with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status ventolin for sale online. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when ventolin for sale online your periods or menstrual cycles started?.

€. 2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for ScienceTTHealthWatch is a weekly podcast from Texas Tech.

In it, Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center in El Paso, look at the top medical stories of the week. A transcript of the podcast is below the summary.This week's topics include two RNA SARS-CoV2 treatments, an inactivated treatment, a look at who's willing to be vaccinated, and guidelines for managing Down syndrome manifestations.Program notes:1:06 RNA treatments2:00 Similar immune responses young or old3:00 Inactivated ventolin3:10 treatment hesitancy4:10 treatment attributes multiple5:12 Suggests ways to address hesitancy6:13 Rigorously tested even for an EUA6:41 An inactivated viral treatment7:42 Inactivated treatments must be made properly8:44 Not a narrow treatment9:12 Guidelines for managing Down syndrome manifestations10:13 Literature survey11:12 Congenital heart disease common12:45 EndTranscript:Elizabeth Tracey. When a asthma treatment comes across the transom, will you take it?. Rick Lange.

Report on a promising inactivated whole-virion asthma treatment.Elizabeth. What's the best care for people with Down syndrome?. Rick. And the safety and immunogenicity of two RNA-based asthma treatments.Elizabeth.

That's what we're talking about this week on TT HealthWatch, your weekly look at the medical headlines from Texas Tech University Health Sciences Center in El Paso. I'm Elizabeth Tracey, a Baltimore-based medical journalist.Rick. And I'm Rick Lange, president of Texas Tech University Health Sciences Center in El Paso, where I'm also dean of the Paul L. Foster School of Medicine.Elizabeth.

And right now in the nation's hotspot, I would say, relative to battling asthma treatment. How's it going?. Rick. You know, it's really tough here.

I think we have the highest number of cases per capita across the U.S. And increasing. It's a really tough time in El Paso right now, so some of the stuff we're talking about is very relevant.Elizabeth. Yeah.

Let's turn, then, to... Why don't you talk about the first treatment candidate that you'd like to illustrate?. Rick. Okay.

This is a report from Pfizer and a company called BioNTech that is one of those treatments that's in phase III trials, so this is the initial report of their phase I and phase II trials. BioNTech and Pfizer launched a coordinated program to compare four RNA-based asthma treatment candidates. They did it in Germany initially and then brought it to the U.S.This is a report on two of those RNA-based treatments and how they decided for one over the other. I'm going to call them B1 and B2, because that's what they call them.

B1 is a RNA treatment directed towards the receptor-binding domain. They took three of these domains and actually bound them together, which could be more antigenic, and the B2 was they took the whole spike protein.They tested these in individuals 18 to 55 and those 65 to 85, and they did multiple different doses of these. What they discovered is that in both the younger and older individuals, they elicited similar immune reactions. The one directed towards the spike protein caused less side effects and that's the one they're testing in the U.S.

In phase III trials.One of the things they're going to be dealing with is there are four phase III trials here in the U.S., other phase III trials around the world, at least 39 different places the treatments are directed. There are over 200 candidates. As we test these things globally, we're going to have to decide which one's the safest and most effective.Elizabeth. That's the thing, I think, that I'm finding really interesting is all of these modifications and lots of speculation that's elsewhere in the literature about which of these is going to turn out to be both the most efficacious as well as having the least side effects, with some concerns that have arisen with two other front-runners right now, which are in this adenoventolin vector, that may end up actually potentiating responses against asthma.Rick.

We'll talk about that with the next type because these are not thought to, but in the inactivated ventolin it could be inactivated in a way that can actually potentially increase s. We'll talk about that when we talk about the next trial.Elizabeth. That was in the New England Journal of Medicine. Let's turn to JAMA Network Open.

When we talk about treatments, of course, the question is, "Is anyone going to take the treatment once it is available?. " Of course, here in the U.S., it's surrounded by so much controversy that's largely political in nature, although what is termed "treatment hesitancy" is certainly something that predated our current political turmoil.This study took a look at a population -- and it was supposed to be a representative population -- of people around the U.S. And asked them -- created these scenarios where they said, "Hey, talk to me about whether this would be a treatment that you would be interested in taking or not."They recruited 2,000 people. They ended up with 1,971 -- 51% were women, 73% were white, 14% Black, and 10% Latinx -- participants being asked to evaluate two hypothetical asthma treatments and whether they would choose A, B, or neither.treatment attributes included their efficacy, protection duration, major adverse effects, minor adverse effects, Food and Drug Administration -- whether it was an emergency use authorization or a full authorization -- where did this treatment come from, and who was endorsing it.Basically, what they found was that people said -- the majority, actually, of their respondents -- said, "Hmm.

If this was an emergency use authorization, I'm not going to take this treatment." More people also said, "I won't take it if it originated from China." And of course, Russia's working with some things too, so I would kind of throw their treatment into that mix and say if it was coming from there, probably more people would not take it also.Then with regard to who's endorsing it, if it was endorsed by President Trump, fewer people would take it than if it was endorsed by Anthony Fauci et al. It's an interesting snapshot of reluctance to take treatments and suggests, of course, ways that we can kind of hopefully package things ahead of time so that it's more acceptable to people to take it.Rick. This goes to the issue of building trust to achieve confidence in the asthma treatment, so this information is really important. We have people around the world, and certainly in the United States, that are just hesitant to take any treatment.

That has been based on inaccurate science and misinformation, so we need to be transparent if we talk about how it was approved, where it came from, who endorses it, and what the safety and efficacy is. We need to do that often to do it to build trust.Elizabeth. Exactly. I think that making this distinction between full approval and EUAs is also really important, and it's not appreciated by the public at large.

I don't blame anybody for not understanding it. It absolutely seems Byzantine to me, even, sometimes, let alone if it wasn't part of my world.So I think that it's really important for us to convey that that doesn't mean that we're just sort of knee-jerking it and letting it out there. I mean, it has been through an awful lot of rigor previous to that.Rick. It has been.

It's been tested in tens of thousands. We have at least 2-month follow-ups, but you're right. The only other time we've used an emergency use authorization (EUA) was in 2005 with the anthrax treatment because of the concerns about anthrax, so you're right. It's not the usual mechanism and so there will be some concern about it.That's why we need to be transparent and let people know, "Here's what we've done and here's what the FDA has done to assure to their best ability it's safe and efficacious." It's going to require some good communication.Elizabeth.

Continuing, then, with our exhaustive treatment survey, it seems like for this week, let's turn to the Lancet Infectious Diseases for another treatment that's out there being tested.Rick. We just talked about the RNA treatment. This is an inactivated asthma treatment. This is a double-blind, placebo-controlled phase I and phase II trial conducted in China, again, looking at two age groups, those under the age of 60 and those over the age of 60, using, again, an inactivated ventolin.It required two doses.

The older group had lower rates of adverse side effects than the younger group -- that was 47% versus 19% -- with most of those being fever and pain. The treatment was similarly immunogenic in both age groups, which is good.It tested positive against several drifted isolates, so that suggests that as there is genetic variations this particular treatment could be effective. It's usually given at 0 and 28 days. They did it at 0 and 28, 0 and 21, and 0 and 14 days, but the 0 and 14 days didn't give the same immunogenic response.As we talked about, these inactivated treatments have to be made properly.

Improper inactivation can actually alter the antigenic properties and it results in the induction of non-neutralizing antibodies that actually enhance the disease rather than protect against it.While this study came out, another study in a different journal suggested the same thing, that an inactivated whole virion treatment could be immunogenic and safe in phase I and phase II trials.Elizabeth. I would just say I'm hopeful that at the end of all of this we're a) going to have a much more nimble treatment production process that is really based on a lot of the characteristics of the particular ventolin that we're trying to vaccinate against and that b) we're going to find out what the best strategies are for all the different types of ventolines that are out there, both DNA and RNA ventolines, and single-stranded and double-stranded, and enveloped and non-enveloped, and all the rest of that stuff. I still have some concerns about natural subsequent to immunization.Rick. Yep.

Again, you don't want it have such a narrow vaccination that as there's genetic variation in the ventolin, that you're still not having an immune response. But I am heartened by the fact that when you think about it, the first occurred pretty much in January, and 9 months later, we have a number of different treatments that are on the drawing board and in phase III trial. The speed with which that's happened is just essentially unheard of before.Elizabeth. Good news.

We like those hopeful notes, so let's turn to another hopeful note in JAMA, a look at something that, to me at least, is astonishing, that it appears that nobody really has ever taken a comprehensive look at this particular issue before, and that's guidelines for care of adults with Down syndrome.Down syndrome, trisomy 21, is the most common chromosomal abnormality among people born, actually, worldwide, with 1 in 700 infants in the U.S. Being born with Down syndrome, so that's quite a lot.It used to be, lo these many years ago, that these people suffered truncated lifespans and a lot of other kinds of morbidities during their lifespan, and now they're having a median lifespan 57 years, with reported survival up to the age of 82, which, to me, sounds truly amazing. Clearly, people are doing a lot of good work, even though they're not getting together and talking about this.So this workgroup developed it's called the Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup. Wow, really a mouthful!.

What they did was survey the literature out there to find out, "Well, all right, what comprises best care?. "Out of an astonishing almost 12,000 literature citations, they were only able to identify 20 relevant studies. Out of that number, after they reviewed it, they came up with only one strong recommendation for the care of these folks, and that was for screening for Alzheimer-type dementia starting at age 40 years.They do have a lot of other recommendations that are less strong and those are relative to things like risk factors for cardiovascular disease and stroke prevention, screening for obesity, looking at secondary causes of osteoporosis, recommendations for diabetes screening, and shorter intervals, because folks with Down syndrome happen to have that more often and it's earlier onset.Rick. When I was in my training, their average lifespan was 25 years, and that's usually been accomplished because about half of them have congenital heart disease and now we can address that, many of them have respiratory illnesses, and many were institutionalized before.Again, this is the first time in either of our lifetimes these guidelines for care of adults with Down syndrome have been assimilated and published.

What do we do with that information?. It makes us aware of what conditions we need to screen for and recommends screening activity, so I applaud the authors, MDs, PhDs, and social workers who took on this daunting task of providing these recommendations.Elizabeth. Indeed. They also taught me something new -- which I had not been familiar with this term before -- atlantoaxial instability, that in fact there's a cervical spine, I guess, weakness, if you will, in people with Down syndrome and that they can actually suffer from that condition.

I thank them for teaching me a new term.Rick. Right. In the past, because the cervical spine abnormalities were there, there was some thought, "Well, maybe we need to do routine X-rays on these individuals to prevent them from having spinal cord injuries." What the studies suggest, as they have mentioned it, that doesn't need to be done.In fact, we have over 50,000 kids participating in Special Olympics and they've never had an issue with spinal cord injury as a result of that. Again, very thoughtful, knowledgeable, and evidence-based recommendations.Elizabeth.

We like that. On that note, that's a look at this week's medical headlines from Texas Tech. I'm Elizabeth Tracey.Rick. And I'm Rick Lange.

NCHS Data Brief No can i buy ventolin over the counter in australia. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such as cardiovascular disease (1) and can i buy ventolin over the counter in australia diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is “the permanent cessation of menstruation that occurs after can i buy ventolin over the counter in australia the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of can i buy ventolin over the counter in australia women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey can i buy ventolin over the counter in australia Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, can i buy ventolin over the counter in australia 2015image icon1Significant quadratic trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or can i buy ventolin over the counter in australia were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data can i buy ventolin over the counter in australia table for Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four can i buy ventolin over the counter in australia times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p can i buy ventolin over the counter in australia <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year can i buy ventolin over the counter in australia ago or less. Women were premenopausal if they still had a menstrual cycle. Access data can i buy ventolin over the counter in australia table for Figure 2pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women can i buy ventolin over the counter in australia aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend can i buy ventolin over the counter in australia by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a can i buy ventolin over the counter in australia menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure can i buy ventolin over the counter in australia 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who can i buy ventolin over the counter in australia did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, can i buy ventolin over the counter in australia 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were can i buy ventolin over the counter in australia perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table can i buy ventolin over the counter in australia for Figure 4pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women can i buy ventolin over the counter in australia aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely can i buy ventolin over the counter in australia to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age can i buy ventolin over the counter in australia (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status can i buy ventolin over the counter in australia. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles can i buy ventolin over the counter in australia started?.

€. 2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for ScienceTTHealthWatch is a weekly podcast from Texas Tech.

In it, Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center in El Paso, look at the top medical stories of the week. A transcript of the podcast is below the summary.This week's topics include two RNA SARS-CoV2 treatments, an inactivated treatment, a look at who's willing to be vaccinated, and guidelines for managing Down syndrome manifestations.Program notes:1:06 RNA treatments2:00 Similar immune responses young or old3:00 Inactivated ventolin3:10 treatment hesitancy4:10 treatment attributes multiple5:12 Suggests ways to address hesitancy6:13 Rigorously tested even for an EUA6:41 An inactivated viral treatment7:42 Inactivated treatments must be made properly8:44 Not a narrow treatment9:12 Guidelines for managing Down syndrome manifestations10:13 Literature survey11:12 Congenital heart disease common12:45 EndTranscript:Elizabeth Tracey. When a asthma treatment comes across the transom, will you take it?. Rick Lange.

Report on a promising inactivated whole-virion asthma treatment.Elizabeth. What's the best care for people with Down syndrome?. Rick. And the safety and immunogenicity of two RNA-based asthma treatments.Elizabeth.

That's what we're talking about this week on TT HealthWatch, your weekly look at the medical headlines from Texas Tech University Health Sciences Center in El Paso. I'm Elizabeth Tracey, a Baltimore-based medical journalist.Rick. And I'm Rick Lange, president of Texas Tech University Health Sciences Center in El Paso, where I'm also dean of the Paul L. Foster School of Medicine.Elizabeth.

And right now in the nation's hotspot, I would say, relative to battling asthma treatment. How's it going?. Rick. You know, it's really tough here.

I think we have the highest number of cases per capita across the U.S. And increasing. It's a really tough time in El Paso right now, so some of the stuff we're talking about is very relevant.Elizabeth. Yeah.

Let's turn, then, to... Why don't you talk about the first treatment candidate that you'd like to illustrate?. Rick. Okay.

This is a report from Pfizer and a company called BioNTech that is one of those treatments that's in phase III trials, so this is the initial report of their phase I and phase II trials. BioNTech and Pfizer launched a coordinated program to compare four RNA-based asthma treatment candidates. They did it in Germany initially and then brought it to the U.S.This is a report on two of those RNA-based treatments and how they decided for one over the other. I'm going to call them B1 and B2, because that's what they call them.

B1 is a RNA treatment directed towards the receptor-binding domain. They took three of these domains and actually bound them together, which could be more antigenic, and the B2 was they took the whole spike protein.They tested these in individuals 18 to 55 and those 65 to 85, and they did multiple different doses of these. What they discovered is that in both the younger and older individuals, they elicited similar immune reactions. The one directed towards the spike protein caused less side effects and that's the one they're testing in the U.S.

In phase III trials.One of the things they're going to be dealing with is there are four phase III trials here in the U.S., other phase III trials around the world, at least 39 different places the treatments are directed. There are over 200 candidates. As we test these things globally, we're going to have to decide which one's the safest and most effective.Elizabeth. That's the thing, I think, that I'm finding really interesting is all of these modifications and lots of speculation that's elsewhere in the literature about which of these is going to turn out to be both the most efficacious as well as having the least side effects, with some concerns that have arisen with two other front-runners right now, which are in this adenoventolin vector, that may end up actually potentiating responses against asthma.Rick.

We'll talk about that with the next type because these are not thought to, but in the inactivated ventolin it could be inactivated in a way that can actually potentially increase s. We'll talk about that when we talk about the next trial.Elizabeth. That was in the New England Journal of Medicine. Let's turn to JAMA Network Open.

When we talk about treatments, of course, the question is, "Is anyone going to take the treatment once it is available?. " Of course, here in the U.S., it's surrounded by so much controversy that's largely political in nature, although what is termed "treatment hesitancy" is certainly something that predated our current political turmoil.This study took a look at a population -- and it was supposed to be a representative population -- of people around the U.S. And asked them -- created these scenarios where they said, "Hey, talk to me about whether this would be a treatment that you would be interested in taking or not."They recruited 2,000 people. They ended up with 1,971 -- 51% were women, 73% were white, 14% Black, and 10% Latinx -- participants being asked to evaluate two hypothetical asthma treatments and whether they would choose A, B, or neither.treatment attributes included their efficacy, protection duration, major adverse effects, minor adverse effects, Food and Drug Administration -- whether it was an emergency use authorization or a full authorization -- where did this treatment come from, and who was endorsing it.Basically, what they found was that people said -- the majority, actually, of their respondents -- said, "Hmm.

If this was an emergency use authorization, I'm not going to take this treatment." More people also said, "I won't take it if it originated from China." And of course, Russia's working with some things too, so I would kind of throw their treatment into that mix and say if it was coming from there, probably more people would not take it also.Then with regard to who's endorsing it, if it was endorsed by President Trump, fewer people would take it than if it was endorsed by Anthony Fauci et al. It's an interesting snapshot of reluctance to take treatments and suggests, of course, ways that we can kind of hopefully package things ahead of time so that it's more acceptable to people to take it.Rick. This goes to the issue of building trust to achieve confidence in the asthma treatment, so this information is really important. We have people around the world, and certainly in the United States, that are just hesitant to take any treatment.

That has been based on inaccurate science and misinformation, so we need to be transparent if we talk about how it was approved, where it came from, who endorses it, and what the safety and efficacy is. We need to do that often to do it to build trust.Elizabeth. Exactly. I think that making this distinction between full approval and EUAs is also really important, and it's not appreciated by the public at large.

I don't blame anybody for not understanding it. It absolutely seems Byzantine to me, even, sometimes, let alone if it wasn't part of my world.So I think that it's really important for us to convey that that doesn't mean that we're just sort of knee-jerking it and letting it out there. I mean, it has been through an awful lot of rigor previous to that.Rick. It has been.

It's been tested in tens of thousands. We have at least 2-month follow-ups, but you're right. The only other time we've used an emergency use authorization (EUA) was in 2005 with the anthrax treatment because of the concerns about anthrax, so you're right. It's not the usual mechanism and so there will be some concern about it.That's why we need to be transparent and let people know, "Here's what we've done and here's what the FDA has done to assure to their best ability it's safe and efficacious." It's going to require some good communication.Elizabeth.

Continuing, then, with our exhaustive treatment survey, it seems like for this week, let's turn to the Lancet Infectious Diseases for another treatment that's out there being tested.Rick. We just talked about the RNA treatment. This is an inactivated asthma treatment. This is a double-blind, placebo-controlled phase I and phase II trial conducted in China, again, looking at two age groups, those under the age of 60 and those over the age of 60, using, again, an inactivated ventolin.It required two doses.

The older group had lower rates of adverse side effects than the younger group -- that was 47% versus 19% -- with most of those being fever and pain. The treatment was similarly immunogenic in both age groups, which is good.It tested positive against several drifted isolates, so that suggests that as there is genetic variations this particular treatment could be effective. It's usually given at 0 and 28 days. They did it at 0 and 28, 0 and 21, and 0 and 14 days, but the 0 and 14 days didn't give the same immunogenic response.As we talked about, these inactivated treatments have to be made properly.

Improper inactivation can actually alter the antigenic properties and it results in the induction of non-neutralizing antibodies that actually enhance the disease rather than protect against it.While this study came out, another study in a different journal suggested the same thing, that an inactivated whole virion treatment could be immunogenic and safe in phase I and phase II trials.Elizabeth. I would just say I'm hopeful that at the end of all of this we're a) going to have a much more nimble treatment production process that is really based on a lot of the characteristics of the particular ventolin that we're trying to vaccinate against and that b) we're going to find out what the best strategies are for all the different types of ventolines that are out there, both DNA and RNA ventolines, and single-stranded and double-stranded, and enveloped and non-enveloped, and all the rest of that stuff. I still have some concerns about natural subsequent to immunization.Rick. Yep.

Again, you don't want it have such a narrow vaccination that as there's genetic variation in the ventolin, that you're still not having an immune response. But I am heartened by the fact that when you think about it, the first occurred pretty much in January, and 9 months later, we have a number of different treatments that are on the drawing board and in phase III trial. The speed with which that's happened is just essentially unheard of before.Elizabeth. Good news.

We like those hopeful notes, so let's turn to another hopeful note in JAMA, a look at something that, to me at least, is astonishing, that it appears that nobody really has ever taken a comprehensive look at this particular issue before, and that's guidelines for care of adults with Down syndrome.Down syndrome, trisomy 21, is the most common chromosomal abnormality among people born, actually, worldwide, with 1 in 700 infants in the U.S. Being born with Down syndrome, so that's quite a lot.It used to be, lo these many years ago, that these people suffered truncated lifespans and a lot of other kinds of morbidities during their lifespan, and now they're having a median lifespan 57 years, with reported survival up to the age of 82, which, to me, sounds truly amazing. Clearly, people are doing a lot of good work, even though they're not getting together and talking about this.So this workgroup developed it's called the Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup. Wow, really a mouthful!.

What they did was survey the literature out there to find out, "Well, all right, what comprises best care?. "Out of an astonishing almost 12,000 literature citations, they were only able to identify 20 relevant studies. Out of that number, after they reviewed it, they came up with only one strong recommendation for the care of these folks, and that was for screening for Alzheimer-type dementia starting at age 40 years.They do have a lot of other recommendations that are less strong and those are relative to things like risk factors for cardiovascular disease and stroke prevention, screening for obesity, looking at secondary causes of osteoporosis, recommendations for diabetes screening, and shorter intervals, because folks with Down syndrome happen to have that more often and it's earlier onset.Rick. When I was in my training, their average lifespan was 25 years, and that's usually been accomplished because about half of them have congenital heart disease and now we can address that, many of them have respiratory illnesses, and many were institutionalized before.Again, this is the first time in either of our lifetimes these guidelines for care of adults with Down syndrome have been assimilated and published.

What do we do with that information?. It makes us aware of what conditions we need to screen for and recommends screening activity, so I applaud the authors, MDs, PhDs, and social workers who took on this daunting task of providing these recommendations.Elizabeth. Indeed. They also taught me something new -- which I had not been familiar with this term before -- atlantoaxial instability, that in fact there's a cervical spine, I guess, weakness, if you will, in people with Down syndrome and that they can actually suffer from that condition.

I thank them for teaching me a new term.Rick. Right. In the past, because the cervical spine abnormalities were there, there was some thought, "Well, maybe we need to do routine X-rays on these individuals to prevent them from having spinal cord injuries." What the studies suggest, as they have mentioned it, that doesn't need to be done.In fact, we have over 50,000 kids participating in Special Olympics and they've never had an issue with spinal cord injury as a result of that. Again, very thoughtful, knowledgeable, and evidence-based recommendations.Elizabeth.

We like that. On that note, that's a look at this week's medical headlines from Texas Tech. I'm Elizabeth Tracey.Rick. And I'm Rick Lange.

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NCHS Data Brief bronchodilator ventolin online ventolin prescription No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such as cardiovascular disease bronchodilator ventolin (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation of menstruation that bronchodilator ventolin occurs after the loss of ovarian activity” (3).

This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% bronchodilator ventolin of women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal. Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, bronchodilator ventolin on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1).

Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period. Figure 1 bronchodilator ventolin. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant bronchodilator ventolin quadratic trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle bronchodilator ventolin and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 1pdf icon.SOURCE bronchodilator ventolin.

NCHS, National Health Interview Survey, 2015. The percentage of bronchodilator ventolin women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week. Figure 2 bronchodilator ventolin.

Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear bronchodilator ventolin trend by menopausal status (p <. 0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and bronchodilator ventolin their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure bronchodilator ventolin 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had bronchodilator ventolin trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women.

Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week. Figure 3 bronchodilator ventolin. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend bronchodilator ventolin by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less bronchodilator ventolin. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 3pdf bronchodilator ventolin icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up bronchodilator ventolin feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week. Figure 4 bronchodilator ventolin. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status.

United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle.

Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion.

DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €. 2) “Do you still have periods or menstrual cycles?.

€. 3) “When did you have your last period or menstrual cycle?. €. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?. € Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis.

NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics.

The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report. ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF. Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon.

2016.Santoro N. Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al.

Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software]. 2012.

Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD. National Center for Health Statistics.

2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J. Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

NCHS Data can i buy ventolin over the counter in australia buy ventolin online usa Brief No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with can i buy ventolin over the counter in australia an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation of menstruation that occurs after the can i buy ventolin over the counter in australia loss of ovarian activity” (3).

This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% are can i buy ventolin over the counter in australia perimenopausal, and 22.1% are postmenopausal. Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 can i buy ventolin over the counter in australia hours, on average, in a 24-hour period (35.1%) (Figure 1).

Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period. Figure 1 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant can i buy ventolin over the counter in australia quadratic trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and can i buy ventolin over the counter in australia their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data can i buy ventolin over the counter in australia table for Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble falling asleep four times can i buy ventolin over the counter in australia or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week. Figure 2 can i buy ventolin over the counter in australia.

Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p < can i buy ventolin over the counter in australia. 0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle can i buy ventolin over the counter in australia and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table can i buy ventolin over the counter in australia for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble staying asleep four times can i buy ventolin over the counter in australia or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women.

Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week. Figure 3 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear can i buy ventolin over the counter in australia trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year can i buy ventolin over the counter in australia ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table can i buy ventolin over the counter in australia for Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age can i buy ventolin over the counter in australia group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week. Figure 4 can i buy ventolin over the counter in australia. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status.

United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle.

Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion.

DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. € https://excursionsireland.com/tour_location/garnish-island/. 2) “Do you still have periods or menstrual cycles?.

€. 3) “When did you have your last period or menstrual cycle?. €. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?. € Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis.

NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics.

The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report. ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF. Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon.

2016.Santoro N. Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al.

Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software]. 2012.

Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD. National Center for Health Statistics.

2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J. Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.