The Impact of Insult Ad Reads on Podcast Listeners

Audio podcasts have grown in popularity. Forty-six million Americans tune into an average of six podcasts each week (Nielson, 2020) and ad revenues are projected to top $4 billion by 2024 (IAB, 2022). To enhance the appeal of ads, many podcasters use humor in their ad reads. Although humor can be effective (Weinberger & Gulas, 1992) and reinforce the parasocial relationship between podcaster and audience, are there times when that humor has negative consequences? In this study, we are concerned primarily with the use of insult advertising in which the podcaster uses humor that targes the brand/product being endorsed. Participants were exposed to one of two versions of a podcast host-read ad and then responded to a survey about their impressions of the ad, the podcaster, and the endorsed brand. The data reveal that insult ads have deleterious effects on perceptions of both the endorsed brand and the podcaster. Results are discussed

Characterisation of sleep in intensive care using 24-hour polysomnography: An observational study

Introduction: Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environmental factors.Methods: This observational study was conducted in the adult ICU of a tertiary referral hospital in Australia, enrolling 57 patients. Polysomnography (PSG) was performed over a 24-hour period to assess the quantity (total sleep time: hh:mm) and quality (percentage per stage, duration of sleep episode) of patients' sleep while in ICU. Rechtschaffen and Kales criteria were used to categorise sleep. Interrater checks were performed. Sound pressure and illuminance levels and care events were simultaneously recorded. Patients reported on their sleep quality in ICU using the Richards Campbell Sleep Questionnaire and the Sleep in Intensive Care Questionnaire. Data were summarised using frequencies and proportions or measures of central tendency and dispersion as appropriate and Cohen's Kappa statistic was used for interrater reliability of the sleep data analysis.Results: Patients' median total sleep time was 05:00 (IQR: 02:52 to 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients' mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep.Conclusions: The quantity and quality of sleep in intensive care patients are poor and may be related to noise, critical illness itself and treatment events that disturb sleep. The study highlights the challenge of quantifying sleep in the critical care setting and the need for alternative methods of measuring sleep. The results suggest that a sound reduction program is required and other interventions to improve clinical practices to promote sleep in intensive care patients.Trial registration: Australian New Zealand clinical trial registry (http://www.anzctr.org.au/): ACTRN12610000688088. © 2013 Elliott et al.; licensee BioMed Central Ltd

Population-Based Study of Sleep Apnea in Pregnancy and Maternal and Infant Outcomes

Study Objectives: To examine the association between sleep apnea and pregnancy outcomes in a large population-based cohort. Methods: Population-based cohort study using linked birth and hospital records was conducted in New South Wales, Australia. Participants were all women who gave birth in hospital from 2002 to 2012 (N=636,227). Sleep apnea in the year before pregnancy or during pregnancy was identified from hospital records. Outcomes of interest were gestational diabetes, pregnancy hypertension, planned delivery, caesarean section, preterm birth, perinatal death, 5-minute Apgar score, admission to neonatal intensive care or special care nursery, and infant size for gestational age. Maternal outcomes were identified using a combination of hospital and birth records. Infant outcomes came from the birth record. Modified Poisson regression models were used to examine associations between sleep apnea and each outcome taking into account maternal age, country of birth, socioeconomic disadvantage, smoking, obesity, parity, pre-existing diabetes and hypertension. Results: Sleep apnea was significantly associated with pregnancy hypertension (adjusted RR 1.68; 95% CI 1.40 – 2.07), planned delivery (1.15; 1.07 – 1.23), preterm birth (1.50; 1.21 – 1.84), 5-minute Apgar <7 (1.60; 1.07 – 2.38), admission to neonatal intensive care/special care nursery (1.26; 1.11 – 1.44), large-for-gestational-age infants (1.27; 1.04 – 1.55) but not with gestational diabetes (1.09; 0.82 – 1.46), caesarean section (1.06; 0.96 – 1.17), perinatal death (1.73; 0.92 – 3.25), or small-for-gestational-age infants (0.81; 0.61 – 1.08). Conclusions: Sleep apnea is associated with higher rates of obstetric complications and intervention, as well as preterm delivery. Future research should examine if these are independent of obstetric history.NHMRC, AR

Oral Appliance Treatment for Obstructive Sleep Apnea: An Update

Oral appliances (OA) have emerged as an alternative to continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) treatment. The most commonly used OA reduces upper airway collapse by advancing the mandible (OAm). There is a strong evidence base demonstrating OAm improve OSA in the majority of patients, including some with more severe disease. However OAm are not efficacious for all, with approximately one-third of patients experiencing no therapeutic benefit. OAm are generally well tolerated, although short-term adverse effects during acclimatization are common. Long-term dental changes do occur, but these are for the most part subclinical and do not preclude continued use. Patients often prefer OAm to gold-standard CPAP treatment. Head-to-head trials confirm CPAP is superior in reducing OSA parameters on polysomnography; however, this greater efficacy does not necessarily translate into better health outcomes in clinical practice. Comparable effectiveness of OAm and CPAP has been attributed to higher reported nightly use of OAm, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OAm technologies have been made. Remotely controlled mandibular positioners have the potential to identify treatment responders and the level of therapeutic advancement required in single night titration polysomnography. Objective monitoring of OAm adherence using small embedded temperature sensing data loggers is now available and will enhance clinical practice and research. These technologies will further enhance efficacy and effectiveness of OAm treatment for OSA

Assessing regional competitiveness: analysis of stock indicators and flows variables

The purpose of this paper is the identification and definition of approaches and tools for the assessment and measurement of territorial competitiveness. Territorial competitiveness can be defined as an area that is able to face up to market competition whilst at the same time ensuring environmental, social and cultural sustainability, based on the dual approach of networking and inter-territorial relationships. The rationale behind this work is that territorial competitiveness is a concept characterized by a high level of complexity: therefore in order to understand the dynamics and the factors responsible for the competitive development of an area it is necessary to use a combination of tools that can measure both the territorial stock (tangible and intangible assets) and the economic flows between the actors (households and institutions) of a region. The Territorial Competitiveness Index (TCI) – SAM approach proposed in this paper aims at integrating a Territorial Competitiveness Index, which measures territorial assets, with a Social Accounting Matrix (SAM), that measures the economic flows within a given area, in order to define a composite model that combines sectors’ potential resulting from the multipliers based on SAM with the Index. The integration of these “stock and flows” measurement tools will enhance the capacity to identify territorial potential (both expresses and latent) and to assess territorial development scenarios. The usefulness of this approach resides therefore first and foremost in its capacity to provide the policy makers at local and central level with a simple visualisation of information to better target strategies and policies and to better allocate resources. By recognizing the importance of interdependencies among actors, sectors and spaces, the tool is also suitable to capture the multi-dimensional nature of territorial competitiveness and to support policy makers in the identification of the most appropriate territorial development policy mix

ECONOMIC POLICIES FOR FEMALE LABOUR AND FOOD NUTRITION SECURITY: THE AL-GHAB REGION CASE

Dealing with the issue of poverty, food security and social disparities becomes an even more pressing prerogative for the policy maker during economic downturns. The debate among the economists focuses on what might be the major policy initiatives to be undertaken in order to produce complementarities between growth and income-redistribution. These would involve not only generating an inequality-reducing pattern of growth but also undertaking a growth-enhancing pattern of redistribution. Developing countries are the most sensitive to this issue and are committed to develop the policy measure able to both stimulate economic growth and reduce social disparities and food insecurity. The Al-Ghab region in Syria is considered the typical resource rich poor area in a developing country. The possibility to activate the economic growth in this area goes through the exigency of diversify the economic production to stimulate the value added generation and reduce the social and economic disparities between female and male labour employment. In this way the problem of food insecurity should be better address since it is strongly connected to the poverty level of households. To address this complex target an extended multi-sector model is considered the most suitable analysis instrument especially since it is developed by means of the Social Accounting Matrix (SAM) for the area of interest. In this paper, we develop a SAM for the Al-Ghab region and quantify the effects of selected policy scenarios in terms of economic diversification, female labour efficiency and food nutrition security for the Al-Ghab region, in order to identify the pillars able to sustain the economic growth of the area

Health outcomes of continuous positive airway pressure versus mandibular advancement device for the treatment of severe obstructive sleep apnea:an individual participant data meta-analysis

Study Objectives: The impact of therapy with continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) has not been directly compared in patients with severe obstructive sleep apnea (OSA). The purpose of this individual participant data meta-analysis was to compare the treatment effects of CPAP and titratable MAD on sleepiness, quality of life, sleep-disordered breathing severity, and sleep structure in patients with severe OSA. Methods: Randomized controlled trials (RCTs) that included severe OSA patients were identified in order to compare the impact of the two treatments. Individual data from severe OSA patients were extracted from the databases and pooled for analysis. Results: Of the seven studies identified, three crossover RCT and one parallel-group RCT corresponding to 151 patients and 249 observations (125 in the CPAP treatment arm and 124 in the MAD treatment arm) were included in the analysis. Titratable MAD had a similar impact to CPAP on major patient-centered outcomes (sleepiness and quality of life). CPAP was more effective in reducing AHI and ODI. However, the two treatments had a similar impact on sleep structure with an increase of N3 and REM sleep. Finally, treatment adherence and preference were largely in favor of MAD. Conclusion: This meta-analysis suggests that MAD represents an effective alternative treatment in severe OSA patients intolerant to CPAP or who prefer alternate therapy