Factors associated with undiagnosed obstructive sleep apnoea in hypertensive primary care patients

Objective. In hypertensive primary care patients below 65 years of age, ( i ) to describe the occurrence of undiagnosed obstructive sleep apnoea ( OSA ), and ( ii ) to identify the determinants of moderate/severe OSA. Design. Cross-sectional. Setting. Four primary care health centres in Sweden. Patients. 411 consecutive patients ( 52% women ), mean age 57.9 years ( SD 5.9 years ), with diagnosed and treated hypertension ( BP >140/90 ). Main outcome measures. Occurrence of OSA as measured by the apnoea hypopnoea index ( AHI ). Results. Mild ( AHI 5–14.9/h ) and moderate/severe ( AHI > 15/h ) OSA were seen among 29% and 30% of the patients, respectively. Comparing those without OSA with those with mild or moderate/severe OSA, no differences were found in blood pressure, pharmacological treatment ( anti-hypertensive, anti-depressive, and hypnotics ), sleep, insomnia symptoms, daytime sleepiness, or depressive symptoms. Obesity ( BMI > 30 kg/m2 ) was seen in 30% and 68% of the patients with mild and moderate/severe OSA, respectively. Male gender, BMI > 30 kg/m2, snoring, witnessed apnoeas, and sleep duration >8 hours were determinants of obstructive sleep apnoea. Conclusion. Previously undiagnosed OSA is common among patients with hypertension in primary care. Obesity, snoring, witnessed apnoeas, long sleep duration, and male gender were the best predictors of OSA, even in the absence of daytime sleepiness and depressive symptoms

Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior

Poor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)—which centres on an individual’s attitude toward performing the behaviour, subjective norms and perceived behavioural control—has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a selfreported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents’ sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self-reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker–Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health-care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents’ sleep hygiene behaviours, rather than rely solely upon increasing adolescents’ sleep hygiene knowledge

Development of Advanced Thin Films by PECVD for Photovoltaic Applications

Compared to wafer based solar cells, thin film solar cells greatly reduce material cost and thermal budget due to low temperature process. Monolithically manufacturing allows large area fabrication and continuous processing. In this work, several photovoltaic thin films have been developed by rf-PECVD including a-Si:H and μc-Si, both intrinsic and doped on Corning 4 inch glass substrate at low temperature. The conductivity of n type and p type μc-Si at 180ºC was 17S/cm and 7.1E-2S/cm, respectively. B dopants either in a-Si:H or μc-Si films require higher plasma power to get active doping. The B2H6-to-SiH4 flow ratio for p type μc-Si lies from 0.01 to 0.025. Chamber conditions have critical effect on film quality. Repeatable and superior results require a well-established cleaning passivation procedure. Moreover, μc-Si films have been deposited from pure silane on glass substrate by modified rf-ICP-CVD. The deposition rate has been dramatically increased to 5Å/s due to little H2 dilution with crystalline fraction was around 69%, and 6.2Å/s with crystalline fraction 45%. Microstructure started to form at 150ºC with a thin incubation layer on the glass substrate, and became fully dense conical conglomerates around 300nm where conductivity and crystallinity saturated. Additionally, a-SiGe:H films have been developed by modified rf-ICP-CVD. The optical band gaps have been varied from 1.25 to 1.63eV by changing SiH4-to-GeH4 ratio. Also high temperature resulted in low bandgap. Cross-section TEM showed some microcrystllites appeared near interface region. Heterojunction solar cells on p type c-Si wafer have been fabricated using films developed in this thesis. Interference fringes in EQE disappeared on either textured substrate or cells with lift-off contacts. Maximum EQE was 87% around 700nm. I-V curves have also been studied where the interesting kink suggests a counter-diode has formed between emitter region and contacts

Investing in Localized Relationships with Universities: What are the Benefits for R&D Subsidiaries of Multinational Enterprises?

In spite of a long-standing interest in the distribution of knowledge spillovers from university research, there is only limited theoretical understanding of if and when opportunities to interact with a research university constitute a significant force of attraction for globally mobile investment in R&D. Based on an empirical investigation of the benefits of interaction with universities, this paper proposes an analytical framework and four ideal types of strategy for localised collaboration between R&D subsidiaries and universities. This taxonomy, which largely transcends industry sectors, and the illustrative cases presented in this paper provide insights into the potential scope for localised university-industry interaction from the perspective of multinational enterprises. By connecting the empirical results to the question whether these benefits are significant enough to enhance a region's attractiveness as a location for R&D, we are able to develop a better understanding of the alternative strategies for policymakers and university leaders interested in stimulating such linkages.Knowledge spillovers, multinational enterprises, university-industry interaction, localisation of R&D,

Sustainability-oriented textile/fashion partnerships: mechanisms and levels of change

Firms engage in partnerships to address various sustainability issues such as greenhouse gas emissions, cleaner production, labour rights or working conditions in their operations and throughout their supply chains. These partnerships utilise various mechanisms that can be seen as enablers of change, including product development, process enhancements, policy-related initiatives and awareness-raising campaigns. Through these mechanisms, partnerships can seek to achieve change at the firm, industry, supply chain and societal levels. This paper studies the relationship between these mechanisms and firms’ targeted level of change in textiles/fashion. We analyse 444 sustainability partnerships using a mixed-method approach. We find that partnerships targeting these broader levels focus more on social sustainability issues in this industry. Those targeting society-level partnerships involve cross-sector partners. Our study adds to the conversations about sustainability-oriented partnerships by demonstrating how mechanism-change dynamics can be contextual and industry-specific

Workforce Composition and Innovation: How Diversity in Employees’ Ethnic and Educational Backgrounds Facilitates Firm-Level Innovativeness

This article studies how workforce composition is related to a firm's success in introducing radical innovations. Previous studies have argued that teams composed of individuals with diverse backgrounds are able to perform more information processing and make deeper use of the information, which is important to accomplish complex tasks. We suggest that this argument can be extended to the level of the aggregate workforce of high-technology firms. In particular, we argue that ethnic and higher education diversity within the workforce is associated with superior performance in radical innovation. Using a sample of 3,888 Swedish firms, this article demonstrates that having greater workforce diversity in terms of both ethnic background and educational disciplinary background is positively correlated to the share of a firm's turnover generated by radical innovation. Having more external collaborations does, however, seem to reduce the importance of educational background diversity. The impact of ethnic diversity is not affected by external collaboration. These findings hold after using alternative measures of dependent and independent variables, alternative sample sizes, and alternative estimation techniques. The research findings presented in this article would seem to have immediate and important practical implications. They would suggest that companies may pursue recruitment policies inspired by greater ethnic and disciplinary diversity as a way to boost the innovativeness of the organization. From a managerial perspective, it may be concluded that workforce disciplinary diversity could be potentially replaced by more external links, while ethnic diversity could not

Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior

Poor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)—which centres on an individual’s attitude toward performing the behaviour, subjective norms and perceived behavioural control—has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a selfreported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents’ sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self-reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker–Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health-care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents’ sleep hygiene behaviours, rather than rely solely upon increasing adolescents’ sleep hygiene knowledge

The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease

Aims: This study explores if nightly hypoxia (i.e. percentage of sleep time with oxygen saturation lower than 90% (SaO2 < 90%)) contributed to the association between sleep-disordered breathing (SDB) and insomnia in community-dwelling elderly with and without cardiovascular disease (CVD). A second aim was to explore a potential cut-off score for hypoxia to predict insomnia and the association of the cut-off with clinical characteristics and cardiovascular mortality. Method: A total of 331 community-dwelling elderly aged 71–87 years underwent one-night polygraphic recordings. The presence of insomnia was recorded by a self-report questionnaire. The presence of CVD was objectively established and mortality data were collected after three and six years. Results: In both patients with CVD (n=119) or without CVD (n=212) SDB was associated with hypoxia (p < 0.005). Only in the patients with CVD was hypoxia associated with insomnia (p < 0.001) which mediated an indirect effect (p < 0.05) between SDB and insomnia. Hypoxia of more than 1.5% of sleep time with SaO2 < 90% was found to be a critical level for causing insomnia. According to this criterion 32% (n=39) and 26% (n=55) of those with and without CVD had hypoxia, respectively. These groups did not differ with respect to age, gender, body mass index, diabetes, hypertension, respiratory disease or levels of SDB. However, in the CVD group, hypoxia was associated with cardiovascular mortality at the three-year follow-up (p=0.008) and higher levels of insomnia (p=0.002). Conclusion: In the elderly with CVD, SDB mediated by hypoxia can be associated with more insomnia and a worse prognosis

Can a Multifaceted Intervention Including Motivational Interviewing Improve Medication Adherence, Quality of Life, and Mortality Rates in Older Patients Undergoing Coronary Artery Bypass Surgery A Multicenter, Randomized Controlled Trial with 18-Month Follow-Up

Background Patients undergoing coronary artery bypass graft (CABG) surgery are required to take a complex regimen of medications for extended periods, and they may have negative outcomes because they struggle to adhere to this regimen. Designing effective interventions to promote medication adherence in this patient group is therefore important. Objective The present study aimed to evaluate the longterm effects of a multifaceted intervention (psycho-education, motivational interviewing, and short message services) on medication adherence, quality of life (QoL), and mortality rates in older patients undergoing CABG surgery. Methods Patients aged over 65 years from 12 centers were assigned to the intervention (EXP; n = 144) or treatmentas- usual (TAU; n = 144) groups using cluster randomization at center level. Medication adherence was evaluated using the Medication Adherence Rating Scale (MARS), pharmacy refill rate, and lipid profile; QoL was evaluated using Short Form-36. Data were collected at baseline; 3, 6, and 18 months after intervention. Survival status was followed up at 18 months. Multi-level regressions and survival analyses for hazard ratio (HR) were used for analyses. Results Compared with patients who received TAU, the MARS, pharmacy refill rate, and lipid profile of patients in the EXP group improved 6 months after surgery (p\0.01) and remained so 18 months after surgery (p\0.01). QoL also increased among patients in the EXP group as compared with those who received TAU at 18 months postsurgery (physical component summary score p = 0.02; mental component summary score p = 0.04). HR in the EXP group compared with the TAU group was 0.38 (p = 0.04). Conclusion The findings suggest that a multifaceted intervention can improve medication adherence in older patients undergoing CABG surgery, with these improvements being maintained after 18 months. QoL and survival rates increased as a function of better medication adherence