Large-scale screening and subsequent effects of migraine treatment on the work floor in the Netherlands

In a large retail business group the ID Migraine Screening Test was sent to employees with three or more absences from work in the past year (n = 2893). Employees with positive results were invited for a neurological consultation and migraine patients were randomly assigned to: first attack 'treated as usual' and the second attack treated with 40 mg eletriptan, or reversed order. Of the 2893 employees, 799 responded (28%), 260 were positively screened for migraine (33%), 84 patients were diagnosed by a neurologist and 41 of the 75 included patients completed the protocol. Eletriptan induced pain-free response in 33.3% of the patients at 4 h compared with 0% after 'non-specific' treatment (P = 0.03). Eletriptan also significantly improved quality of life, but differences in absence from work and productivity loss could not be detected. In conclusion, in-company screening can be beneficial for undertreated employees, but implementation obstacles can reduce the effectiveness of screening

Cross-sectional associations between maternal parenting styles, physical activity and screen sedentary time in children

Abstract Background Children’s activity level, including physical activity (PA) and screen sedentary time (SST), is influenced by environmental factors in which parents play a critical role. Different types of parenting styles may influence children’s activity level. Inconsistent results were found on the association between parenting styles and PA, and few studies tested the association between parenting styles and SST. This study examined the association between parenting styles, PA and SST and the modifying effect of children’s gender and maternal educational level on these associations. Methods Cross-sectional data were collected from parents of children aged 8–11 years old who completed a web-based non-standardized questionnaire (N = 4047). Since 85% of the questionnaires were filled in by mothers, parenting styles are mainly reported by mothers. Multiple linear regression techniques were used to assess the associations between parenting styles (authoritative, permissive, authoritarian and neglectful), and PA and SST (mean min/day). The modifying effect of children’s gender and maternal educational level on these associations was explored. P values ≤.0125 were considered as statistically significant based on the Bonferroni correction for four primary analyses. Results The neglectful parenting style was most widely used (35.3%), while the authoritarian style was least common (14.8%). No significant association was found between parenting styles and PA level. As regards SST, an authoritative parenting style was significantly associated with lower SST in boys while a neglectful parenting style was significantly associated with higher SST in both boys and girls. When the mother had a medium educational level, an authoritative parenting style was significantly associated with lower SST while neglectful parenting was significantly associated with higher SST. Conclusions No association was found between parenting styles and PA. However, an authoritative parenting style was associated with a reduction in SST and a neglectful parenting style with an increase in SST, especially in boys and in children whose mother had a medium education level. Future studies of parenting practices are needed to gain more insight into the role of parents in children’s PA and SST levels, as a basis for the development of interventions tailored to support parents in stimulating PA and reducing SST in children

Attention Deficit Hyperactivity Disorder‐Symptoms, Social Media Use Intensity, and Social Media Use Problems in Adolescents: Investigating Directionality

Cross‐sectional research shows that adolescents’ social media use (SMU) and attention deficit hyperactivity disorder (ADHD)‐symptoms are related, but it is unclear whether this relation is explained by SMU intensity or by addiction‐like SMU problems. Also, due to the lack of longitudinal studies, the direction of this relation remains unknown. This study aims to disentangle which type of SMU is related to ADHD‐symptoms, and in which direction, using a three‐wave longitudinal study among Dutch adolescents aged 11–15 years (n = 543). Findings suggest a unidirectional relation: SMU problems increased ADHD‐symptoms over time, SMU intensity did not. This implies that problematic use, rather than the intensity of use harmfully affects adolescents’ ADHD‐symptoms

A experiência da doença na fibrose cística: caminhos para o cuidado integral

A Fibrose Cística é uma doença crônica que grande impacto exerce sobre a vida familiar. A experiência da doença é a maneira pela qual os indivíduos respondem à doença, atribuindo significados e buscando maneiras para lidar com ela no seu cotidiano. O estudo teve como objetivo compreender a experiência da Fibrose Cística a partir do contexto familiar. Estudo de caso etnográfico, realizado com famílias de crianças com a doença atendidas em um hospital escola do interior do estado de São Paulo. Os resultados foram divididos nos temas: passado, presente e futuro e permearam essas fases a busca pelo significado da doença e pelo suporte social, a importância da religião e espiritualidade e a centralidade da socialização da criança. Conhecer a experiência na doença e a rede social torna-se imprescindível para o planejamento de um cuidado integral. Essa abordagem mostrou-se inovadora para o cuidado à doença crônica

Accuracy of Pulse Oximetry Screening for Critical Congenital Heart Defects after Home Birth and Early Postnatal Discharge

Objective: To assess the accuracy of pulse oximetry screening for critical congenital heart defects (CCHDs) in a setting with home births and early discharge after hospital deliveries, by using an adapted protocol fitting the work patterns of community midwives. Study design: Pre- and postductal oxygen saturations (SpO2) were measured ≥1 hour after birth and on day 2 or 3. Screenings were positive if the SpO2 measurement was 3%. Positive screenings were referred for pediatric assessment. Primary outcomes were sensitivity, specificity, and false-positive rate of pulse oximetry screening for CCHD. Secondary outcome was detection of noncardiac illnesses. Results: The prenatal detection rate of CCHDs was 73%. After we excluded these cases and symptomatic CCHDs presenting immediately after birth, 23 959 newborns were screened. Pulse oximetry screening sensitivity in the remaining cohort was 50.0% (95% CI 23.7-76.3) and specificity was 99.1% (95% CI 99.0-99.2). Pulse oximetry screening was false positive for CCHDs in 221 infants, of whom 61% (134) had noncardiac illnesses, including infections (31) and respiratory pathology (88). Pulse oximetry screening did not detect left-heart obstructive CCHDs. Including cases with prenatally detected CCHDs increased the sensitivity to 70.2% (95% CI 56.0-81.4). Conclusion: Pulse oximetry screening adapted for perinatal care in home births and early postdelivery hospital discharge assisted the diagnosis of CCHDs before signs of cardiovascular collapse. High prenatal detection led to a moderate sensitivity of pulse oximetry screening. The screening also detected noncardiac illnesses in 0.6% of all infants, including infections and respiratory morbidity, which led to early recognition and referral for treatment