Continuity of sleep problems from adolescence to young adulthood: results from a longitudinal study

Background: Considering the lack of evidence on incidence and continuity of sleep problems from adolescence to young adulthood, this study explores sleep problems’ incidence and their continuation rates from 14 to 21 years. Methods: Sleep data from the 14-year (n = 4,924) and 21-year (n = 3660) follow-up of the Mater-University of Queensland Study of Pregnancy cohort were used. Sociodemographic, lifestyle, and psychological conditions were explored for their role in sleep problems. Modified Poisson regression with a robust error variance was used to identify predictors. Inverse probability weights were used to account for attrition. Results: Of all subjects, 26.0% of the subjects at 14 years and 28.3% of the subjects at 21 years reported “often” sleep problems, with 41.7% of adolescent sleep problems persisting at 21 years. Perinatal and early-life maternal factors, for example, drug abuse (incidence rate ratio (IRR), 1.32; 95% confidence interval [CI], 1.02-1.71), smoking, depression, and anxiety, were significant predictors of adolescent sleep problems. Female sex (IRR, 2.13; 95% CI, 1.55-2.94), advanced pubertal stages, and smoking were the important predictors of sleep problems at 21 years. Adolescent depression/anxiety supported the continuity of sleep problems (IRR, 1.21; 95% CI, 1.05-1.40), whereas exercise was seen to exert a protective effect. Conclusion: This study indicates high rates of sleep problems in young subjects, with around half of sleep problems originating in adolescence persisting in young adulthood. Therefore, early interventions are needed to manage sleep problems in young subjects and prevent further progression to other life stages. Future studies should explore if sleep problems in young adults also persist in later life stages and identify the factors supporting the continuity of sleep problems

The global distribution of comorbid depression and anxiety in people with diabetes mellitus: risk-adjusted estimates

Background: Previous reports suffer from the problem that they simply pooled data using aggregate means or standard meta-analytic method. The aim of the current study was to re-estimate the point prevalence of comorbid depression and anxiety in people with diabetes. Methods: The estimates were calculated using recently introduced directly standardized effect estimate method, which gives corrected risk-adjusted estimates for the population of interests. Reported are global and regional burden of prevalence, presented as risk-adjusted prevalence estimates with 95% confidence intervals. Results: Globally, the burden of comorbid depression was higher than the burden of anxiety (23.36% vs. 17.58%) symptoms and/or disorder in people with diabetes. There was a higher burden of comorbid depression in people living in developing regions (26.32%), in women (15.41%), and when assessed by self-report scales (SRS) (22.66%). The burden of anxiety was higher in developed regions in people with Type 2 diabetes mellitus (20.15%) and when assessed by SRS (20.75%). No statistically significant differences were observed due to gross heterogeneity across countries. Conclusions: There are wide-ranging differences in studies in developed and developing regions, regarding the burden of comorbid depression and of anxiety among people with diabetes and both conditions affect approximately a fifth of the diabetic population

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A novel prototype and simulation model for real time solid waste bin monitoring system

This research deals with an exclusive solution to monitor the solid waste bin condition on real time. The system architecture is designed using wireless sensor networks. A set of carefully chosen sensors are used to measure the status of the bins and ZigBee and GPRS are used as communication technologies. The physical architecture of the system contains three levels such as smart bins for the measurement and transmission of bin status, gateways for storing and forwarding bin data to server and control station for storing and analyzing the data. After the framework design, a simulation is performed using Castalia to ensure the feasibility and accuracy of the system. The simulation is performed for ten bins and taking ten samples from each bin where a fi ll level threshold of 15 is considered. The simulation result shows that, the proposed system would be able to automate the solid waste monitoring process that helps to optimize waste collection route

Continuity of sleep problems from adolescence to young adulthood: results from a longitudinal study

Background: Considering the lack of evidence on incidence and continuity of sleep problems from adolescence to young adulthood, this study explores sleep problems’ incidence and their continuation rates from 14 to 21 years. Methods: Sleep data from the 14-year (n = 4,924) and 21-year (n = 3660) follow-up of the Mater-University of Queensland Study of Pregnancy cohort were used. Sociodemographic, lifestyle, and psychological conditions were explored for their role in sleep problems. Modified Poisson regression with a robust error variance was used to identify predictors. Inverse probability weights were used to account for attrition. Results: Of all subjects, 26.0% of the subjects at 14 years and 28.3% of the subjects at 21 years reported “often” sleep problems, with 41.7% of adolescent sleep problems persisting at 21 years. Perinatal and early-life maternal factors, for example, drug abuse (incidence rate ratio (IRR), 1.32; 95% confidence interval [CI], 1.02-1.71), smoking, depression, and anxiety, were significant predictors of adolescent sleep problems. Female sex (IRR, 2.13; 95% CI, 1.55-2.94), advanced pubertal stages, and smoking were the important predictors of sleep problems at 21 years. Adolescent depression/anxiety supported the continuity of sleep problems (IRR, 1.21; 95% CI, 1.05-1.40), whereas exercise was seen to exert a protective effect. Conclusion: This study indicates high rates of sleep problems in young subjects, with around half of sleep problems originating in adolescence persisting in young adulthood. Therefore, early interventions are needed to manage sleep problems in young subjects and prevent further progression to other life stages. Future studies should explore if sleep problems in young adults also persist in later life stages and identify the factors supporting the continuity of sleep problems

Effects of compressive ratio and sintering temperature on mechanical properties of biocompatible collagen/hydroxyapatite composite scaffolds fabricated for bone tissue engineering

A sponge template method was used to synthesize scaffolds from hydroxyapatite (HAp) using varying sintering temperatures and compressive ratios. The HAp scaffolds were fabricated with collagen (COL) or collagen/HAp particles under room temperature coating conditions. The microstructure and mechanical properties of the fabricated biomaterials were analyzed by FE-SEM and EZ Test, respectively. The FE-SEM micrographs showed microporous structure of the fabricated composite scaffolds. Incorporation of COL or COL/HAp into pure HAp scaffolds under coating conditions significantly reduced the porosity and enhanced the mechanical properties. The results demonstrated that the porosity of fabricated scaffolds was reduced by lowering the compressive pressure and increasing the sintering temperature. The maximum estimated compressive moduli at 1000, 1100 and 1200 °C for HAp-COL and HAp-COL/HAp composite scaffolds were 4.36, 2.93, 5.09 MPa and 4.57, 8.19, 5.02 MPa, respectively, at a 50% compressive ratio. It was assumed that porosity was effectively reduced to the maximum level at a 50% compressive ratio. An in vitro stem cell study showed significant cell adhesion and proliferation over the fabricated HAp-COL and HAp-COL/HAp composite scaffolds. These results confirmed that fabrication of pure HAp with COL and COL/HAp materials had advanced effects on the mechanical properties of fabricated porous composite scaffolds