Multisystem approach for management of OSA in Down syndrome: a case report.

Unlabelled: Obstructive sleep apnea (OSA) is common in children with Down syndrome, with reported prevalence rates as high as 69-76%. Multiple factors predispose children with Down syndrome for OSA, including craniofacial hypoplasia (maxillary and mandibular), airway abnormalities, macroglossia, generalized hypotonia, airway hypotonia, adenotonsillar hypertrophy, and obesity. Despite the fact that the pathophysiology for OSA in children with Down syndrome is multifactorial in nature, treatment methods have focused on soft tissue in the upper airway using adenotonsillectomy and/or continuous positive airway pressure therapy.

Nursing's Critical Role in Driving Toward Health Equity: One Organization's Experience.

In the last decade, there has been active discourse within nursing communities regarding healthcare disparities associated with racism. To address this critical problem, a multidisciplinary team at a pediatric healthcare setting identified 33 projects across 4 key drivers of health equity. The drivers of health equity include: 1) developing a diverse nursing workforce; 2) creating a nursing culture with a strong sense of belonging; 3) providing learning and growth opportunities; and 4) providing equitable nursing care.

Sleep disturbances in parental caregivers and patients with congenital central hypoventilation syndrome.

Study Objectives: Congenital central hypoventilation syndrome (CCHS) is a rare disease characterized by impaired control of breathing caused by paired-like homeobox 2B () gene variants, necessitating lifelong assisted ventilation (AV). This study aimed to assess sleep quality in patients with CCHS and their parents using sleep questionnaires.

Methods: Parents of patients with CCHS completed the Pittsburgh Sleep Quality Index (PSQI) regarding their sleep and the Sleep Disturbance Scale for Children (SDSC) regarding their child's sleep.

A meta-analysis of diagnostic test performance of peripheral arterial tonometry studies.

Study Objectives: The objective of this meta-analysis was to analyze agreement in apnea-hypopnea index (AHI) determination between peripheral arterial tonometry (PAT) and polysomnography (PSG) studies.

Methods: Mean AHI bias and standard deviation extracted from Bland-Altman plots reported in studies were pooled in a meta-analysis, which was then used to calculate percentage errors of limit agreement in AHI determination by PAT using PSG AHI as the reference. Individual participant data (where reported in studies) were used to compute Cohen's kappa to assess agreement between PSG and PAT on sleep apnea severity and for computing the sensitivity and specificity of PAT at different AHI thresholds using PSG AHI as the reference.

Temporal and spatial changes in social vulnerability to natural hazards.

During the past four decades (1960-2000), the United States experienced major transformations in population size, development patterns, economic conditions, and social characteristics. These social, economic, and built-environment changes altered the American hazardscape in profound ways, with more people living in high-hazard areas than ever before. To improve emergency management, it is important to recognize the variability in the vulnerable populations exposed to hazards and to develop place-based emergency plans accordingly.