Sleep disturbance in patients with an implantable cardioverter defibrillator:Prevalence, predictors and impact on health status

Background:  Sleep disturbances are highly prevalent in patients with cardiac diseases and associated with poor health outcomes. However, little is known about sleep disturbance in patients with an implantable cardioverter defibrillator. Aims:  We examined the prevalence and predictors of sleep disturbance and the impact on perceived health status in a Dutch cohort of implantable cardioverter defibrillator patients. Methods:  Patients ( n=195) enrolled in the Web-based distress program for implantable cardioverter defibrillator patients (WEBCARE) trial completed questionnaires at the time of implantable cardioverter defibrillator implantation, three, six and 12 months afterwards. Sleep disturbance was assessed with the corresponding item #3 of the Patient Health Questionnaire 9. Results:  At baseline, 67% ( n=130) reported sleep disturbance (cut off ≥1). One year later, the prevalence was 57% ( n=112). Younger age (odds ratio=0.96, 95% confidence interval 0.92-0.99; p=0.012) and high negative affectivity/low social inhibition (odds ratio=4.47, 95% confidence interval 1.52-13.17; p=0.007) were associated with sleep disturbance at 12 months in adjusted analyses. Sleep disturbance was not associated with health status at 12 months. Charlson Comorbidity Index, anxiety, Type D personality and high negative affectivity/low social inhibition were associated with impaired health status at follow-up. Conclusions:  Sleep disturbance was highly prevalent in patients with an implantable cardioverter defibrillator. Younger age and high negative affectivity predicted sleep disturbance 12 months post-implantation independent of other demographic, clinical, intervention and psychological covariates. Sleep disturbance was not associated with impaired health status at the 12-month follow-up

Entrepreneurial change in government-led development:Ethiopian universities

Purpose The purpose of this paper is answer the research question to what extent Ethiopian universities can be considered to be entrepreneurial and explains possible differences among these universities. Design/methodology/approach The paper is inspired by a mixed methods study at nine universities in Ethiopia applying the entrepreneurial university framework of the European Commission/OECD: a content analysis of university policy and educational documents, a structured survey with 203 respondents, in particular staff and students, and in-depth interviews and focus group discussions with 223 people comprising university top-management, faculty, students and external stakeholders. Findings Findings indicate that entrepreneurial activities in Ethiopian universities are at their infant stage with limited differences among the universities. The universities are operating in a top-down, central governmental-led development that is not enabling entrepreneurial behaviour at the level of the individual institutions. The paper argues that within this context, leadership is the lever for an entrepreneurial turn at the universities. Social implications - Entrepreneurship development is a priority in many African countries as an instrument for employability of the predominant young populations towards which universities are expected to contribute considerably. The study highlights the tension between a strong say of the government in university operations and creating an autonomous, integrated entrepreneurial culture. Originality/value The results of this study have relevance for the higher education community in terms of understanding the complexity of transforming institutions into more entrepreneurial organisations in Africa. To the best of the authors' knowledge, there is no previous study that examines entrepreneurial characteristics of several universities in Ethiopia

The effect of Brexit on the UK Economy (so far)

The political turmoil in the UK following the referendum on future membership of the European Union in 2016 provides a natural experiment for studying the effects of political uncertainty (in the Knightian sense) on the economy. We find that the subsequent confusion and infighting in British politics has not affected the real economy much – employment is at a historical high and output growth is positive – but there are some signs of slowing investment and house price increases. The stock market has also not been much affected although it did fall after the referendum of 2016. The main effect of the Brexit vote and the subsequent political developments is found in the currency market where news that make a hard Brexit more likely cause the currency to depreciate. We conclude that leaving the European Union without an agreement is likely to make the currency depreciate and the stock market fall while output declines. In contrast, leaving with an agreement that gives continued access to the Single Market would likely make the currency appreciate, the stock market rise and employment and output increase further

Ethnopolitics Across Central and Eastern Europe in a State of Flux: Time for Updating and Upgrading?

This chapter illustrates why and how the existing theoretical models in the study of ethnopolitics need to be updated in light of the latest developments and the increasing impact of new catalysts. These are, namely, anti-immigration and the rise of the populist and radical right across Central and Eastern Europe. This chapter hints that the more systematic cooperation between academic experts in nationalism and academic experts in the populist and radical right will enable: (a) the former to assess more accurately the degree to which new variables such as Euroscepticism and anti-immigrant trends can reshape ethnopolitics, both as a living reality and a field of study, across Central and Eastern Europe; (b) the latter to formulate new interpretative models about how (right-wing) populist and Eurosceptic actors embed their agendas inside the pre-existing political cultures of nationalism and particularistic identity and memory politics. This chapter introduces and outlines the ethnosymbolic approach as well as the triadic and quadratic configurations of ethnopolitics. Then, it proceeds into a more empirical assessment of the applicability of these theoretical approaches in a series of case studies during the 1990s, as well as the more recent emergence of new catalysts and the ensuing necessity to update and upgrade the existing theoretical models