Neurodevelopmental Outcomes at Two Years of Age for Premature Infants Diagnosed With Neonatal Obstructive Sleep Apnea

STUDY OBJECTIVES: Neurocognitive deficits have been shown in school-aged children with sleep apnea. The effect of obstructive sleep apnea (OSA) on the neurodevelopmental outcome of preterm infants is unknown. METHODS: A retrospective chart review was performed for all preterm infants ( 1 event/h. Regression analyses were performed to find a relationship between PSG parameters and cognitive, language, and motor scores. RESULTS: Fifteen patients (males: n = 10) were eligible for the study. Median postmenstrual age at the time of the PSG was 41 weeks (37-46). Median AHI for the cohort was 17.4 events/h (2.2-41.3). Median cognitive, language, and motor scores were 90 (65-125), 89 (65-121), and 91 (61-112), respectively. Mean end-tidal CO2 (median 47 mm Hg [25-60]) negatively correlated with cognitive scores (P = .01) but did not significantly correlate with language or motor scores. AHI was not associated with cognitive, language, or motor scores. CONCLUSIONS: The median score for cognitive, language, and motor scores for preterm infants with neonatal OSA were within one standard deviation of the published norm. Mean end-tidal CO2, independent of AHI, may serve as a biomarker for predicting poor cognitive outcome in preterm infants with neonatal OSA

Development and Validation of the Counterfactual Thinking for Negative Events Scale

We examined the psychometric properties of the newly created Counterfactual Thinking for Negative Events Scale (CTNES) in two studies involving university undergraduates. In Study 1 (N = 634), factor analysis revealed four subscales that correspond with various types of counterfactual thinking: Nonreferent Downward, Other-Referent Upward, Self-Referent Upward, and Nonreferent Upward. The subscales were largely orthogonal and had adequate internal consistency and test–retest reliability. The CTNES subscales were positively correlated with a traditional method of assessing counterfactual thinking and were related as expected to contextual aspects of the negative event, negative affect, and cognitive style. In Study 2 (N = 208), we further examined the validity of the scale and demonstrated that the subscales were sensitive to an experimental manipulation concerning the type of negative event participants recalled. Moreover, the CTNES subscales correlated in the expected direction with measures of coping and cognitive style

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries

Highlights •Tuberculosis (TB)-related stigma is an important social determinant of health that can impact health-seeking practices and illness management. •Much research on TB-related stigma has been conducted in high incidence countries. •This study aimed to systematically map out the research in low incidence countries. •Few studies included stigma as a substantive topic; only one study aimed to reduce stigma. •Both TB control programmes and media reporting were implicated in the production of stigma. •Few studies theorized how stigma intersects with the social and structural determinants of health. •Future interventions to reduce stigma would benefit from a stronger theoretical underpinning in relation to stigma and the intersection with the social determinants. Summary Tuberculosis (TB)-related stigma is an important social determinant of health. Research generally highlights how stigma can have a considerable impact on individuals and communities, including delays in seeking health care and adherence to treatment. There is scant research into the assessment of TB-related stigma in low incidence countries. This study aimed to systematically map out the research into stigma. A particular emphasis was placed on the methods employed to measure stigma, the conceptual frameworks used to understand stigma, and whether structural factors were theorized. Twenty-two studies were identified; the majority adopted a qualitative approach and aimed to assess knowledge, attitudes, and beliefs about TB. Few studies included stigma as a substantive topic. Only one study aimed to reduce stigma. A number of studies suggested that TB control measures and representations of migrants in the media reporting of TB were implicated in the production of stigma. The paucity of conceptual models and theories about how the social and structural determinants intersect with stigma was apparent. Future interventions to reduce stigma, and measurements of effectiveness, would benefit from a stronger theoretical underpinning in relation to TB stigma and the intersection between the social and structural determinants of health

The Use of Computer Decision Support for Pediatric Obstructive Sleep Apnea Detection in Primary Care.

Study Objectives To (1) describe outcomes from a computer decision support system (CDSS) for pediatric obstructive sleep apnea (OSA) detection in primary care; and (2) identity the prevalence of children meeting criteria for an OSA referral. Methods A CDSS for OSA was implemented in two urban primary care clinics. Parents of children (age 2 to 11 years) presenting to the clinic were asked if their child snored regularly, with a positive response resulting in six additional OSA screening items. Primary care providers (PCPs) received a prompt for all snoring children, listing applicable OSA signs and symptoms and recommending further evaluation and referral for OSA. Results A total of 2,535 children were screened for snoring, identifying 475 snoring children (18.7%). Among snoring children, PCPs referred 40 (15.4%) for further evaluation. The prevalence of additional OSA signs and symptoms ranged from 3.5% for underweight to 43.7% for overweight. A total of 74.7% of snoring children had at least one additional sign or symptom and thus met American Academy of Pediatrics guidelines criteria for an OSA referral. Conclusions A CDSS can be used to support PCPs in identifying children at risk for OSA. Most snoring children met criteria for further evaluation. It will be important to further evaluate this referral threshold as well as the readiness of the sleep medicine field to meet this need

COVID-19 and tuberculosis in South Africa: A dangerous combination

There has been much speculation during the past week about the catastrophe that awaits once coronavirus disease 2019 (COVID-19) establishes itself in the poorest communities of South Africa (SA) and, importantly, in informal settlements. Evidence to date suggests that COVID-19 is efficiently passed from infected individuals via large droplets and hard-surface fomites