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Adverse events in patients with obstructive sleep apnea undergoing procedural sedation in ambulatory settings: An updated systematic review and meta-analysis
No full textObjective: Patients with obstructive sleep apnea (OSA) may be at increased risk for adverse events during pro?cedural sedation, however, there remains a gap in the literature quantifying these risks. This systematic review and meta-analysis aimed to evaluate the risk of peri-procedural adverse events in OSA patients undergoing procedural sedation in ambulatory settings, compared to those without OSA.Methods: Four databases were systematically searched for studies published from January 1, 2011 to January 4, 2024. The inclusion criteria were: adult patients with OSA undergoing procedural sedation in ambulatory set?tings, peri-procedural adverse events reported, and control group included. The primary outcome was the incidence of peri-procedural adverse events amongst patients with vs without OSA.Results: Nineteen studies (27,973 patients) were included. The odds of respiratory adverse events were signifi?cantly increased for patients with OSA (OR 1.65, 95 % CI 1.03–2.66, P = 0.04). Furthermore, the odds of requiring an airway maneuver/intervention were significantly greater for patients with OSA (OR 3.28, 95 % CI 1.43–7.51, P = 0.005). The odds of cardiovascular adverse events were not significantly increased for patients with OSA.Conclusion: Patients with OSA undergoing procedural sedation in ambulatory settings had 1.7-fold greater odds of respiratory adverse events and 3.3-fold greater odds of requiring airway maneuvers/interventions.</p
Cigarette smoking and perceived risk of cardiovascular disease in Iran
No full textIntroduction Studies have consistently demonstrated a strong link between cigarette smoking and an increased risk of cardiovascular diseases (CVD). On the other hand, studies have shown that most smokers do not have a real understanding of the cardiovascular health hazards of smoking. Therefore, the study aimed to determine the perceived risk of Myocardial Infarction (MI), Hypertension (HTN), and Stroke among current smokers in Iran. Methods This cross-sectional study was conducted between January and May 2023, and recruited 380 smokers by convenience sampling who smoked at least 100 cigarettes in their lifetime. The data were collected using three questionnaires (1) the questionnaire to assess the risk perception for MI, HTN, and Stroke, (2) the smoking stage of change questionnaire, and (3) the Fagerström Test for nicotine dependence (FTND). The CVD risk perception consisted of two parts, perceived susceptibility and perceived severity. Each part scores between 0 and 10 and finally gets a total score of 0–20. A score of zero indicated the lowest risk perception while a score of 20 indicated the highest risk perception. We examined the relationship between the demographic and smoking-related variables and the smokers’ perceived risk of MI, stroke, and HTN by using multiple linear regression. Findings The mean age of participants was 35.57±12.05 years, and 77.1% were male. The perceived risk score of MI was 10.68±4.69 out of 20. The scores related to stroke and HTN were 10.00±4.65 and 10.89±4.73, respectively. Identified variables collectively contributed significantly to predicting the perceived risk of MI (p<.0001, Adj R-squared=0.05%), stroke ( p<.0001, Adj R-squared=0.08%), and HTN (p<.0001, Adj R-squared=0.06%). We found that longer smoking duration [coefficient=-1.96 (95% CI= -3.91, −0.09)] for 20–29 years and −4.08 ( 95% CI= -6.70, -1.46 ) for 30+years), older smoking age onset [coefficient=-2.10 ( 95% CI= -3.24, −0.96 )] for 20+years), and dual tobacco users [coefficient= -1. 04 (95% CI= -2.08, −0.06)] were significantly associated with lower perceived risk for MI. We also found that longer smoking duration [coefficient=-2.23 (95% CI= -4.13, −0.32)] for 20–29 years and −5.01 (95% CI= -7.565734, -2.462361 ) for 30+years), older smoking age onset [coefficient=-1.86 (95% CI= -2.970021, −0.75 ] for 20+years), and being male [coefficient= -2. 00, (95% CI= -3.53, −0.47)] were significantly associated with lower perceived risk for stroke. We found that longer smoking duration (coefficient=-4.40 for 30+years), older smoking age onset [coefficient=-2.02 (95% CI= -3.14, −0.87,)] for 20+years), and being dual users [coefficient=-1.36, 95% CI= -2.40, −0.3241238)] were significantly associated with lower perceived risk for HTN. Conclusion The results of this study demonstrated a moderate perceived risk of participants to CVD. Also, the perceived risk decreases as the duration of smoking and the age for the smoking onset increases to 20 years and above. It seems necessary to carry out interventions to inform the public about the harms of smoking, especially for adolescents and young adults, and its risks in causing cardiovascular disease</p
Unveiling FOXO3's metabolic contribution to menopause and Alzheimer's disease
No full textThe increasing prevalence of Alzheimer's disease (AD) calls for a comprehensive exploration of its complex etiology, with a focus on sex-specific vulnerability, particularly the heightened susceptibility observed in post menopausal women. Neurometabolic alterations during the endocrine transition emerge as early indicators of AD pathology, including reduced glucose metabolism and increased amyloid-beta (Aβ) deposition. The fluctuating endocrine environment, marked by declining estradiol levels and reduced estrogen receptor beta (ERβ) activity, further exacerbates this process. In this context, here we explore the potential of forkhead box O3 (FOXO3) as a critical mediator linking metabolic disturbances to hormonal decline. We propose that FOXO3 plays a key role in the intersection of menopause and AD, given its dysregulation in both AD patients and postmenopausal women, modulating cellular metabolism through interactions with the AMPK/AKT/PI3K pathways. This relationship highlights the intersection between hormonal changes and increased AD susceptibility. This review aims to open a discussion on FOXO3's contribution to the metabolic dysregulation seen in menopause and its impact on the progression of AD. Understanding the functional role of FOXO3 in menopause-associated metabolic changes could lead to targeted therapeutic strategies, offering novel insights for managing for this condition.</p
Machine learning models for anxiety detection and prediction using perceived control data
No full textAnxiety, as defined by the World Health Organization (WHO), is the intense and excessive feeling of fear and worry. It is considered one of the precursors of depression and other mental health conditions. Perceived control refers to the belief or perception that one has the ability to achieve positive outcomes through their own actions, and it is closely associated with mental health. Individuals with high levels of perceived control are strongly linked to good mental well-being and psychological health. We utilized an Android app that allowed users to estimate their level of control over a ‘boing’ sound after multiple interactions with the app. This data and other user behaviour data are extracted and used to generate Machine Learning models to predict symptoms of anxiety. We analyzed 401 samples, with 115 showing symptoms of anxiety and 286 not showing any symptoms. The models achieved up to 88% Mean ROC/AUC and a mean of 79.5% for Area Under the Precision-Recall curve with a 6-fold cross validation technique using the Random Forest algorithm. The results suggest a link between perception of control and anxiety, offering insights for further exploration.</p
Exploring stakeholder perspectives on antipsychotic use for challenging behaviours in intellectual disabilities using a World Café approach
No full textAims: Adults with intellectual disability frequently experience challenging behaviours and are prescribed antipsychotics (AP). Management of challenging behaviours remains controversial and AP use is often based on low-quality evidence. Our study explores the development of educational resources with healthcare workers and paid carers regarding the use of AP.Method: A mixed-methods approach utilised a “World Café Event”. Thematic analysis and descriptive analysis were conducted.Results: Participants reported the importance of training that explores the balancing of the risks and benefits of AP use and the setting of a pluralistic approach towards treatment. We identified the need for further education of caregivers to improve confidence in AP prescribing to facilitate correct protocols and dose tapering where possible.Clinical implications: Engaging mixed disciplines to discuss medication safety is feasible using a World Café approach and useful to create shared values, identify knowledge gaps and promote change via a social movement</p
Evolution of COVID-19 in the state of São Paulo: analysis of incidence, mortality and lethality from 2020 to 2023
No full textIntroduction: COVID-19 is a respiratory disease caused by the SARS-CoV-2 virus, which belongs to the coronavirus family. SARS-CoV-2 is related to other viruses that cause severe acute respiratory syndrome. The emergence of cases of pneumonia of unknown origin triggered the largest viral pandemic in modern times, presenting major challenges to global public health. Objective: To analyze the evolution of the COVID-19 pandemic in the state of São Paulo from 2020 to 2023, focusing on trends in incidence, mortality, and lethality. Methods: Ecological study of time series of incidence, mortality and lethality by COVID-19 in the state of São Paulo using Prais-Winsten regression considering the Weekly Percentage Change (WPC) and probability values (p), considering a significance level of 95% (95% CI). To ensure the reliability of the entered data, double-blind typing was performed by different researchers in the same database extracted from the 2024 Ministry of Health Coronavirus dashboard. Results: From February 2020 and the end of December 2023, 6,763,310 accumulated cases and 182,254 deaths were recorded. Stationary trends were observed for the year 2022, with a reduction in incidence and mortality in the year 2023. However, the epidemiological variable lethality showed a stationary trend. Conclusion: The analysis of the trends in incidence, mortality, and lethality revealed variable dynamics over time, with emphasis on the significant reduction of these indicators in 2023.</p
‘Their mind is made up to attack you’; anti-Muslim racism and the systemic function of microaggressions
No full textResearch on anti-Muslim racism in Ireland has developed steadily over the past decade ([Brooks, M. C., M. D. Ezzani, Y. Sai, and F. Sanjakdar. 2023. “Racialization of Muslim students in Australia, Ireland, and the United States: cross-cultural perspectives.” Race Ethnicity and Education 26 (2): 164–183. https://doi.org/10.1080/ 13613324.2021.1997977]; [Carr, J. 2016b. Experiences of Islamophobia: Living with racism in the neoliberal era. London: Routledge]). Despite this, gaps remain in our understanding of how anti-Muslim racism manifests in Ireland, including in the form of microaggressions. This paper commences with a discussion of the construction of Muslims as racialised Other, before unpacking the concept of microaggressions and moving to elaborate on their function in racialised social systems. We argue that anti-Muslim microaggressive acts are instantiations of power dynamics in the context of systemic racism, demarcating who belongs, and reminding the Other, in this case Muslims in Ireland, of their outsider place. Following a discussion of racism as a systemic phenomenon, this paper draws from data derived from original fieldwork with almost two hundred Muslim participants from across four Irish cities. Our findings provide new insights on microaggressions set to anti-Muslim racism and their ‘everyday’ function in Ireland as a racialised social system.</p
Editorial: Raising awareness around trends in noncommunicable diseases and their risk factors to promote global prevention and control
No full textNon-communicable diseases (NCDs), encompassing cardiovascular diseases, cancer, diabetes, and chronic respiratory illnesses, have emerged as a significant global health challenge, exerting immense pressure on healthcare systems and economies worldwide. As per the World Health Organization (WHO), Non-communicable diseases (NCDs) globally account for 41 million deaths annually, resulting in 74% of global mortality (1). The NCD's contributions to the Disability-adjusted life years (DALY) are the highest globally and is the only disease group for which DALYs increased from 1.47 billion in 2010 to 1.73 billion years in 2021 (2). The multifaceted etiology of NCDs underscores the imperative for comprehensive approaches addressing underlying risk factors and quantifying their impact of exposure to key risk factors is necessary to inform public health policy and practice and help prioritize the use of scarce resources to reduce the existing disparities (3). According to WHO, NCDs arise from a combination of behavioral, metabolic, and environmental risk factors. Modifiable behaviors such as tobacco use, physical inactivity, unhealthy diets, and harmful alcohol consumption significantly elevate NCD risks (1). Metabolic risk factors, including high blood pressure, obesity, elevated blood glucose, and high blood lipids, drive NCD development. Environmental factors like air pollution further exacerbate NCD risks, causing 6.7 million deaths globally, with 5.7 million linked to conditions such as stroke, heart disease, chronic obstructive pulmonary disease, and lung cancer (1). While most of the risk factors are considered modifiable, efforts to minimize them are abysmally low worldwide. One crucial bottleneck to this sluggish response is a lack of awareness or insufficient knowledge about NCDs and their risk factors among people and policymakers.</p
Silenced and stressed: impact of reporting workplace bullying and harassment for academic staff in Irish higher education
No full textPurpose – Workplace well-being is an increasingly critical issue influenced by systemic factors, particularly in academic settings. This study investigated workplace bullying (WPB) and harassment in higher education institutions in Ireland, drawing upon the Ottawa Charter and conservation of resources theory to contextualise the impacts on employee well-being. Design/methodology/approach – Twenty-five participants responded to a survey that first measured occurrences and impact of WPB. The survey was followed by open-ended questioning eliciting narratives around the experience of reporting WPB to reveal organisational responses and subsequent impacts of reporting WPB. Findings – The prevalence of barriers to reporting showed that out of 25 participants, 18 experienced barriers to reporting WPB. Seventeen participants documented the negative impacts of barriers to reporting WPB. Lack of human resource management (HRM) implementation incurred organisational consequences, such as increased staff turnover and a negative impact on institutional culture. Research limitations/implications – The online survey was conducted during the summer annual leave period, which impeded distribution. The mixed-method approach did not capture complete narratives from some participants in response to the open-ended question. Furthermore, all disclosures were self-reported, making it challenging to confirm that the reported impacts were directly linked to workplace experiences. Practical implications – The findings of this research highlight the need for more effective HRM practices, leadership training and accountability to manage WPB reporting processes to reduce impact and inform prevention. Social implications – The challenges of reporting WPB have broader social ramifications, affecting the overall well-being of academic staff and institutional cultures. Originality/value – This approach moved away from WPB as the measured impact, focusing on the subsequent impacts of voicing concern.</p
Mapping Melmoth: Maturin in/and the World Republic of Letters
No full textThis article offers a transnational mapping of Melmoth the Wanderer (1820) that links fictional narrative both to the contexts of its production and dissemination in a global literary marketplace and to its network of influence, and more particularly, its reputation and afterlife within what Pascale Casanova has influentially called ‘the world republic of letters’. It first considers Melmoth’s internal geography and the novel’s use of space in relation to Maturin’s quest for ‘literary capital’.1 It then expands upon, in Casanova’s terms, Melmoth’s ‘littérisation’, namely, the process by which, in spite of its often-unfavourable contemporary reception, Melmoth was transformed from a state of ‘literary inexistence to existence’ via translation and adaptation. Finally, it explores Northern Irish Big Telly Theatre Company’s 2012 dramatic adaptation as evidence of Melmoth’s littérisation. 2</p