The prevalence of sleep complaints in Northern Ireland is unknown. Sleep disruption can result in excessive daytime sleepiness (EDS), with significant socioeconomic consequences. The aim of this study was to assess the prevalence of sleep complaints and to determine risk factors for EDS in a Northern Irish community. From an urban and rural community of 499 111 people, a random sample of 3391 adult men were sent a questionnaire by mail. Questions were asked regarding sleep, EDS and medical history. There were 2364 completed questionnaires returned (response rate 70%). The mean age of respondents was 46.0 years (range 18–91 years). 26.7% of men were not satisfied with their usual night’s sleep and 68% of men woke up at least once during the night. Based on pre‐defined criteria, 24.6% of the population had insomnia and 19.8% had EDS. The strongest risk factor identified for EDS was a history of snoring loudly (odds ratio 2.62; 95% CI 1.82–3.77). Other risk factors included ankle swelling, feeling sad or depressed stopping sleep, experiencing vivid dreams while falling asleep, waking up feeling unrefreshed and age > 35 years. The prevalence rates of sleep complaints and EDS in this community‐based study is high, although this does depend directly on the criteria used to define insomnia and EDS. Recognition of risk factors for EDS may help to identify and treat those affected.

Radical-induced carbon-carbon and carbon-oxygen bond cleavage reactions in a highly substituted epoxide, and in epoxides fused to other rings are reported. Substitution at the site of the developing radical assists C-C bond cleavage. In ring-fused epoxides, C-C bond cleavage was not seen where stereoelectronic factors oppose it.

This paper describes the identification of carbon-arbon bond cleavage within a defined range of epoxides as being a reaction type which is specifically diagnostic of free radicals adjacent to the epoxide. The speed of the epoxide cleavage is greater than that of hex-5-enyl radical cyclisation, and hence the reaction is kinetically competent to act as a new and discriminating type of probe for free radicals in solution.

Background Third‐wave therapies appear to produce positive outcomes for people without intellectual disabilities. This systematic review aimed to establish which third‐wave therapies have been adapted for adults with intellectual disabilities and whether they produced positive outcomes. Method Four databases were searched systematically (PsycINFO, Web of Science, MEDLINE and PubMed), yielding 1,395 results. Twenty studies (N = 109) met the present review's inclusion/exclusion criteria. Results Included studies used mindfulness‐based approaches, dialectical behaviour therapy, compassion focused therapy and acceptance and commitment therapy. Due to considerable heterogeneity in the designs and outcome measures used, a meta‐analysis was not possible. Conclusions Evidence indicated that third‐wave therapies improved mental health symptoms for some and improved challenging/offending behaviour, smoking and mindfulness/acceptance skills for most. These findings must be interpreted with caution due to the low methodological quality of included studies. Future research should build on the current evidence base, using scientifically rigorous designs and standardized measures.

BackgroundResearch indicates that 40% of hospital-acquired delirium cases may be preventable. However, despite its clinical significance, delirium often goes unrecognized or is misdiagnosed. The purpose of this study was to assess the need for delirium education in acute care hospitals in Hamilton, Ontario.MethodsApproximately 100 health professionals were trained as delirium screeners. On ‘Delirium Day’, all patients ≥ 65 years of age in non-critical care areas in all acute care sites in Hamilton were identified. Those willing to take part in the prevalence study were assessed for delirium using the Standardized Mini-Mental State Examination and the Confusion Assessment Method. The Research Ethics Boards at Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton approved this quality assurance project.ResultsOf the 562 patients eligible for screening, eight were excluded and six did not have sufficient data collected to assess for delirium. Of the 548 individuals screened for delirium, 10.6% screened positive. Prevalence estimates ranged by site from 0% to 21% and type of unit from 3.8% to 16%. Recognition of delirium by nursing staff was fair; but, documentation was usually absent.ConclusionWhile the prevalence rates were somewhat lower than in other studies, the results support the need for education among health-care providers in the prevention, identification, and management of delirium.