Risk of incident dementia and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD): A large UK population-based study

Background: Although cognitive impairment and dementia are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), estimates of incidence following a diagnosis of COPD are inconclusive. Objective: To determine the incidence of cognitive impairment and dementia in people with and without a COPD diagnosis. Methods: A population-based study using UK General Practice (GP) health records from The Health Improvement Network database was conducted. Patients with confirmed COPD diagnosis, ≥40 years old, were matched to up to four subjects without a COPD diagnosis by age, sex and GP practice. Cox proportional hazards models were used to assess the incidence rates of cognitive impairment and dementia. Results: Of patients with COPD (n = 62,148), 9% developed cognitive impairment, compared with 7% of subjects without COPD (n = 230,076), p < 0.001. The incidence of cognitive impairment following COPD diagnosis was greater than in subjects without COPD following index date (adjusted Hazard Ratio (aHR), 1.21; 95% CI: 1.16 ─ 1.26, p < 0.001). The coded incidence of either cognitive impairment or dementia was also greater in patients with COPD following adjustment for confounders (aHR: 1.13, 95% CI: 1.09 ─ 1.18, p < 0.001). Coded incident dementia alone was not different between patients with COPD and subjects without COPD (aHR, 0.91, 95% CI: 0.83 ─ 1.01, p = 0.053). Conclusion: Despite the increased incidence of cognitive impairment in patients with COPD, incidence of dementia was not as frequently recorded in patients with COPD. This raises the concern of undiagnosed dementia and emphasises the need for a systematic assessment in this population

Measuring children’s involvement as an indicator of curriculum effectiveness : a curriculum evaluation of a selected child study centre in Singapore

This paper presents one aspect of a research project evaluating a curriculum model of a selected child study centre in Singapore. An issue of worldwide interest and concern is the &lsquo;quality of learning&rsquo; debate as it relates to early childhood centres. In Singapore, the government is focusing on expansion in child care settings and increases in the amount of funded training. One of the issues surrounding prior-to-school education raises the question of how one measures the quality of teaching and learning, to describe the value of using, funding and promoting early education. The research reported in this study used a quasi experimental research paradigm to assess one aspect of the quality of a curriculum programme in a child study centre in Singapore. Children aged between 18 months and 6 years (N = 81) participated in the research. Using the observation scale of Laevers&rsquo; Child Involvement Scale, the active involvement of children in learning experiences was measured. The findings are presented and discussed

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Research and trends in the field of technology-enhanced learning from 2006 to 2011: A content analysis of quick response code (QR-code) and its application in selected studies

This study provides a content analysis of selected articles in the field of QR code and its application in educational context that were published in journals and proceedings of international conferences and workshops from 2006 to 2011. These articles were cross analysed by published years, journal, and research topics. Further analysis was carried out according to research settings, participants, research design types, research methods and findings. It was found from analysis that QR code technology cover a wide range of applications such as augmented reality game, science education, student assignment submission, library catalogue system, communication tools in large classroom environment, system for learning language, collaborative mapping and knowledge management environment, multimedia access tools, assessment tools and so forth. Although the technology covers a wide range of applications, the reported effectiveness of QR technology was not conclusive as most of the data were self-reported such as from questionnaire survey. Most of the studies involved short term research which would not be sufficient to address the complexity of technology integration in educational settings. Hence, it is suggested that future studies should consider offering more reliable and richer findings through longitudinal study and providing inter-observer and intra-observer agreement reliability

Association of virulence genes with antibiotic resistance in Pakistani uropathogenic E. coli isolates

Background: Escherichia coli various strains can cause alarmingly serious infections. Countries like Pakistan harbour the class of bacteria with one of the highest rates of resistance, but very little has been done to explore their genetic pool. Objectives: This study was designed to find out the frequency of virulence genes of Uropathogenic E. coli and their association with antibiotic resistance along with the evolutionary adaptation of the selected gene through the phylogenetic tree. Methods: Isolates from 120 urinary tract infected patients were collected. Antibiotic sensitivity was detected by the disk diffusion method and DNA extraction was done by the boiling lysis method followed by PCR-based detection of virulence genes. The final results were analysed using the chi-square test. Results: The isolates were found to be least susceptible to nalidixic acid, followed by ampicillin, cotrimoxazole, cefotaxime, ciprofloxacin, aztreonam, amoxicillin, gentamycin, nitrofurantoin and imipenem. The iucC was the most common virulence gene among the resistant isolates. About 86% of the collected samples were found to be multi-drug resistant. Statistical analysis revealed a significant association between the iucC gene and resistance to ampicillin (P=0.03) and amoxicillin (P=0.04), and also between fimH and resistance to aztreonam (P=0.03). Conclusion: This study unravels the uncharted virulence genes of UPEC in our community for the very first time. We report a high frequency of the iucC and fimH virulence genes. This, along with their positive association with resistance to beta-lactam antibiotics in the studied community, indicates their important role in the development of complicated UTIs

The effect of cumulative night shift duties on insomnia, fatigue, and mental health in intensive care unit

BACKGROUND: Night shift duties are crucial in the ICU to ensure care continuity, where critically ill patients require round-the-clock care. However, cumulative night shift duties may disturb circadian rhythm, insomnia, fatigue, and depression, and require further elucidation. OBJECTIVES: This study aims to examine the negative consequences of various night shift patterns on insomnia, fatigue, and mental health of ICU Workers. METHODS: A cross-sectional study examined how cumulative night shift duty affects insomnia, fatigue, and mental health in critical care providers (CCPs). RESULTS: A total of 1006 participants completed this study between June 2022 and March 2023, including 54.5 % males. About 35 % were between 20 and 30 years of age, and Respiratory Therapists accounted for approximately 46.5 % of the entire sample. Most of our respondents (476; 47 %) reported working night shifts, with a monthly range of 8-15 nights. The prevalence rates for moderate to severe clinical insomnia, fatigue, and moderate to severe depression were 42 %, 48 %, and 32 %, respectively. CCPs working 8-15 nights had a 2-fold risk of clinical insomnia than those working fewer than eight nights with (AOR) and 95 % (CI) of 2.12 and 1.41-3.20, while those working ≥16 nights per month had a greater incidence of clinical insomnia compared to those working <8 nights per month, AOR (CI): 3.09 (1.90-5.03). Only those working ≥16-night shifts per month had a substantially higher fatigue risk compared to those working < 8-night shifts per month, with an AOR (CI) of 1.92 (1.19-3.08). Working 8-15-night shifts per month increases depression risks by 34 % compared to the <8-night shifts group, AOR (CI): 1.34 (0.87-2.08). Those working ≥16-night shifts per month showed a higher depression risk than those working <8-night shifts, AOR (CI): 2.53 (1.53-4.19). CONCLUSION: A cumulative night shift above eight nights per month is linked with an increased risk of insomnia, fatigue, and depression. The risk of these conditions was significantly directly proportional to the number of night shifts performed per month