One of the options for a low-pressure gas distribution system is the use of ductile PVC pipes and joints. The long-term performance of ductile PVC pipes has been reported in a number of previous studies. In this paper the long-term performance of the socket joints, in which elastomeric (NBR) sealing rings are used, is evaluated. The long-term quality of socket joints in ductile PVC pipeline systems has been determined by various tests on a number of excavated joints, which have been in operation for more than 20 years. Leak tightness determined according to the present specifications did fulfil all requirements. The quality of the rubberrings , established by e.g. tensile testing and hardness tests, was also still at the level of new rubberrings. The socket joints started only to leak at deflections of the pipes far exceeding the deflection levels met in field practice. The compression set of the excavated samples was also rather low and extrapolated to long times will not exceed a maximum required value of 70 % before 50 years. These results once again show that ductile PVC pipe systems for low-pressure gas distribution exhibit an excellent (long-term) performance.

The Durability of a Low-pressure Gas Distribution System of Ductile PVC

Objectives This study assessed the effects of obstructive sleep apnea (OSA) on mental health, health-related quality of life (HRQoL), and multimorbidity in Korean adults. Methods The study included 8030 participants from the Korea National Health and Nutrition Examination Survey Ⅷ (2019–2020). The risk of OSA was assessed using STOP-BANG questionnaire. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9), and stress was measured using a questionnaire. HRQoL was determined by EuroQol 5-dimension (EQ-5D) and Health-related Quality of Life Instrument with 8 Items (HINT-8) scores. Multimorbidity was defined as the presence of 2 or more chronic diseases. A complex sample multivariate logistic regression analysis was conducted. Results Participants with a high OSA risk were more likely to a have high PHQ-9 score (OR 4.31, 95% confidence interval [CI] 2.80–6.65), total depression (OR 4.07, 95% CI 2.67–6.19) stress (OR 2.33, 95% CI 1.85–2.95), lower EQ-5D (OR 2.88, 95% CI 2.00–4.15) and HINT-8 scores (OR 2.87, 95% CI 1.65–4.98), and multimorbidity (OR 2.62, 95% CI 2.01–3.41) than participants with low OSA risk. High OSA risk was significantly associated with all EQ-5D and HINT-8 items. Conclusions This study adds to the few population-based studies showing associations between mental health, HRQoL, and multimorbidity using nationwide data. OSA prevention might be helpful for good mental health, improving HRQoL, and comorbidity burdens. The results provide novel insights regarding the association between sleep apnea and multimorbidity.

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Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea

Approximately 30 million Americans suffer from sleep disorders. The incidence of and mortality rates associated with obstructive sleep apnea (OSA) have been increasing in recent years in the United States. OSA is associated with various health problems, including depression and hypertension, and it adversely affects occupational and academic performance. Hence, OSA is a major public health concern. Sleep specialists may be consulted for the evaluation and treatment of OSA. Continuous positive airway pressure (CPAP) is the mainstay of OSA treatment. The role of primary care physicians in such a scenario becomes vital, especially for choosing the most suitable approach for each patient, treating comorbidities and risk factors, and, if needed, referring them to sleep specialists for further management. In addition to medical management, primary care physicians serve as the main patient educator on this particular health condition.

The Management of Obstructive Sleep Apnea in Primary Care

Ductile PVC: a perfect pipe material

Family medicine practitioners can manage a wide range of health problems, either directly or through referral to other specialists, thereby optimizing the cost-effectiveness of the healthcare system. For most health problems, family medicine practitioners serve as an entry point for individualized healthcare. Providing comprehensive care for most specialties for all ages is the hallmark of family medicine. It is recognized as a distinct specialty in many developed countries, and training is provided through organized residency programs. Family medicine has been incorporated in the foundation course of Bachelor of Medicine, Bachelor of Surgery (MBBS) and is planned to be adopted in all medical institutes in India; however, the MBBS syllabus includes no mention of it. In medical schools in India, fully functioning family medicine departments should be established on an urgent scale. It is necessary to take the required measures to introduce the subject into the undergraduate MBBS program and to generalize it across India. It is recommended that the number of medical schools offering postgraduate residency training in family medicine be increased to meet current community health needs.

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L. Kop

Papers

The Management of Obstructive Sleep Apnea in Primary Care

Ductile PVC: a perfect pipe material

Need of the Hour: Family Medicine in India