Shadows on the past : Does neonatal morphine use foreshadow neuropsychological functioning, stress response and pain sensitivity at primary school age?

Critically ill newborns often need to undergo invasive procedures that may bring discomfort and pain. This is very worrying because at newborn age the brain undergoes, in a relatively short time, an extreme growth and transformation, which makes the brain more susceptible to perturbation than at any other time of life. From a study performed in our Neonatal Intensive Care Unit (NICU) – at the Erasmus MC-Sophia Children’s hospital Rotterdam, the Netherlands – we learned that patients on average experienced an astonishingly high number of 14 painful procedures per day. Up to 65% of these patients did not receive appropriate analgesic therapy. At the time of that study, some ten years ago, pain treatment generally consisted of opioids as these had been proven effective for postoperative pain relief in preterm born infants. However, there was no evidence that they would be equally effective for other types of pain than postoperative pain. To learn more about the effects of morphine administration to critically ill newborns we set up a next study together with the Isala Clinics Zwolle. This randomized controlled trial (RCT), in which 150 neonates on ventilatory support received either continuous morphine or placebo, demonstrated no beneficial effect of continuous morphine on neurological outcome or pain and was therefore not recommended as ‘standard of care’ in this vulnerable population. This was later confirmed by a larger RCT, the so-called NEOPAIN trial3, and a meta-analysis

Addition of serum-containing medium to cerebrospinal fluid prevents cellular loss over time

Immediately after sampling, leukocyte counts in native cerebrospinal fluid (CSF) start to decrease rapidly. As the time lapse between CSF collection to analysis is not routinely registered, the clinical significance of decreasing cell counts in native CSF is not known. Earlier data suggest that addition of serum-containing medium to CSF directly after sampling prevents this rapid decrease in leukocyte counts and, thus, may improve the accuracy of CSF cell counting and cell characterization. Here, we prospectively examined the effect of storage time after lumbar puncture on counts of leukocytes and their major subsets in both native CSF and after immediate addition of serum-containing medium, measured by flow cytometry and microscopy. We collected CSF samples of 69 patients in tubes with and tubes without serum-containing medium and determined counts of leukocytes and subsets at 30 minutes, 1 hour, and 5 hours after sampling. Compared to cell counts at 30 minutes, no significant decrease in cell number was observed in CSF with serum-containing medium 1 and 5 hours after sampling, except for the granulocytes at 1 hour. In native CSF, approximately 50% of leukocytes and all their subsets were lost after 1 hour, both in flow cytometric and microscopic counting. In 6/7 (86%) samples with mild pleocytosis (5–15 × 106 leukocytes/l), native CSF at 1 hour was incorrectly diagnosed as normocellular. In conclusion, addition of serum-containing medium to CSF directly after sampling prevents cell loss and allows longer preservation of CSF cells prior to analysis, both for microscopic and flow cytometric enumeration. We suggest that this protocol results in more accurate CSF cell counts and may prevent incorrect conclusions based on underestimated CSF cell counts

Identification of Risk Factors for Dupilumab-associated OculaSurface Disease in Patients with Atopic Dermatitis

This study identified risk factors for the development of dupilumab-associated ocular surface disease in patients with moderate-to-severe atopic dermatitis in a large prospective daily practice cohort. Data from the Dutch BioDay Registry were used to assess the risk of developing dupilumab-associated ocular surface di-sease, by performing univariate and multivariate logistic regression analyses. A total of 469 patients were included, of which 152/469 (32.4%) developed dupi-lumab-associated ocular surface disease. Multivariate analysis showed a statistically significant association of the development of dupilumab-associated ocular surface disease with a history of any eye disease (his-tory of self-reported episodic acute allergic conjunctivitis excluded) combined with the use of ophthalmic medication at the start of dupilumab (odds ratio 5.16, 95% confidence interval 2.30–11.56, p < 0.001). In conclusion, a history of any eye disease (history of self-reported episodic acute allergic conjunctivitis ex-cluded) combined with the use of ophthalmic medication at baseline was associated with the development of dupilumab-associated ocular surface disease in patients with atopic dermatitis

Sex surveys in Europe: reflections on over four decades of sexual behavior and sexual health surveillance

Sexual expression is fundamental to human existence and an important topic of enquiry in its own right. Understanding sexual behavior is also essential to establish effective sexual health prevention activities (e.g., education), services and policies, and to assess the progress of policies and action plans. Questions on sexual health are rarely included in general health surveys, and therefore dedicated population studies are required. Many countries lack both funding and sociopolitical support to conduct such surveys. A tradition of periodic population sexual health surveys exists in Europe but the methods used (e.g., in questionnaire construction, recruiting methods or interview format) vary from one survey to another. This is because the researchers within each country are confronted with conceptual, methodological, sociocultural and budgetary challenges, for which they find different solutions. These differences limit comparison across countries and pooling of estimates, but the variation in approaches provides a rich source of learning on population survey research. In this review, survey leads from 11 European countries discuss how their surveys evolved during the past four decades in response to sociohistorical and political context, and the challenges they encountered. The review discusses the solutions they identified and shows that it is possible to create well designed surveys which collect high quality data on a range of aspects of sexual health, despite the sensitivity of the topic. Herewith, we hope to support the research community in their perennial quest for political support and funding, and ongoing drive to advance methodology in future national sex surveys

Norovirus outbreak in a natural playground: A One Health approach

Norovirus constitutes the most frequently identified infectious cause of disease outbreaks associated with untreated recreational water. When investigating outbreaks related to surface water, a One Health approach is insightful. Historically, there has been a focus on potential contamination of recreational water by bird droppings and a recent publication demonstrating human noroviruses in bird faeces suggested this should be investigated in future water-related norovirus outbreaks. Here, we describe a One Health approach investigating a norovirus outbreak in a natural playground. On social media, a large amount of waterfowl were reported to defecate near these playground premises leading to speculations about their potential involvement. Surface water, as well as human and bird faecal specimens, was tested for human noroviruses. Norovirus was found to be the most likely cause of the outbreak but there was no evidence for transmission via waterfowl. Cases had become known on social media prior to notification to the public health service underscoring the potential of online media as an early warning system. In view of known risk factors, advice was given for future outbreak investigations and natural playgroun

Urban Stories: Producing news for urban youth

This paper will query whether a dedicated news platform can attune to young people’s civic needs? That is to ask: can this be a space that follows a social media logic of conversation and ‘give and take’ – with producers and consumers changing roles or even losing the distinction? How could and would such a news source be of interest to urban young, arguably the group that feels most removed from citizen status and social acceptance for who they happen to be? ‘Urban youth’ for us refers to a very specific group of young people. They are Marokko.nl’s community members. As the name suggests a fair number of them will consider themselves to be Moroccan-Dutch. From our perspective it is important to understand this group as identifying with ethnic minority groups in the Netherlands, although most of them will have been born in the Netherlands and hold Dutch citizenship. More than other young people they will recognize Islam as the religion they feel closest to. They also share a sense, as will become clear below, that they are caught ‘between two worlds’ (Elias and Lemish, 2008; Singla, 2004; Gezduci and D’Haenens, 2010). Mainstream Dutch media cast preciously few actors, anchors, audience members and experts from ethnic minority groups. Not surprisingly, this is often given as a reason to distrust hegemonic media and as underlining a sense of distance and alienation from Dutch society (see also Awad and Roth, 2011: 401)

Digital Storytelling in Sex Education. Avoiding the Pitfalls of a &apos;haram&apos; Website

Abstrac

The combined value of executive functions and self-regulated learning to predict differences in study success among higher education students

Introduction: Self-regulated learning (SRL) has traditionally been associated with study success in higher education. In contrast, study success is still rarely associated with executive functions (EF), while it is known from neuropsychological practice that EF can influence overall functioning and performance. However some studies have shown relationships between EF and study success, but this has mainly been investigated in school children and adolescents. EF refer to higher-order cognitive processes to regulate cognition, behavior, and emotion in service of adaptive and goal-directed behaviors. SRL is a dynamic process in which learners activate and maintain cognitions, affects, and behaviors to achieve personal learning goals. This study explores the added value of including EF and SRL to predict study success (i.e., the obtained credits). Methods: In this study, we collected data from 315 first-year psychology students of a University of Applied Sciences in the Netherlands who completed questionnaires related to both EF (BRIEF) and SRL (MSLQ) two months after the start of the academic year. Credit points were obtained at the end of that first academic year. We used Structural Equation Modeling to test whether EF and SRL together explain more variance in study success than either concept alone. Results: EF explains 19.8% of the variance, SRL 22.9%, and in line with our hypothesis, EF and SRL combined explain 39.8% of the variance in obtained credits. Discussion: These results indicate that focusing on EF and SRL could lead to a better understanding of how higher education students learn successfully. This might be the objective of further investigation.</p