Home ventilation in low resource settings: Learning to do more, with less.

Long-term ventilation (LTV) in children at home, especially invasive ventilation, is not widely available nor practised in low-resource settings (LRS). Barriers to providing LTV include underdeveloped pediatric critical care services, limited expertise in pediatric LTV, limited capacity to screen for sleep-disordered breathing (SDB) and high cost of LTV equipment and consumables. Additional challenges encountered in LRS may be unreliable electricity supply and difficult socioeconomic conditions.

Fighting to Breathe and Fighting for Health-Related Quality of Life: Measuring the Impact of Being Dependent on Technology for Breathing on the Child and Their Caregiver.

Background And Objective: Medical advancement has enabled children to survive congenital airway anomalies, rare diseases and critical illnesses with medical technology including tracheostomies and long-term ventilation to support breathing. This study aimed to assess (1) the validity of the EQ-TIPS and EQ-5D-Y-3L in children dependent on technology and (2) the impact of caring for these children on the EQ-5D-5L and CarerQoL.

Methods: Caregivers of children aged 1 month to 18 years completed the EQ-TIPS or EQ-5D-Y-3L, Pediatric Quality of Life Inventory (PedsQL) and Paediatric Tracheostomy Health Status Instrument (PTHSI) to reflect the child's health.

Self-reported sleep quality and exercise in polycystic ovary syndrome: A secondary analysis of a pilot randomized controlled trial.

Objective: To examine the proportion of participants with poor sleep quality, evaluate the associations between sleep quality and anthropometric and cardiometabolic health markers, and evaluate the effect of high intensity interval training (HIIT) and continuous aerobic exercise training (CAET) on sleep quality in polycystic ovary syndrome (PCOS).

Design: Secondary analysis of a pilot randomized controlled trial.

Patients: Women with PCOS aged 18-40 years.

Existing standardised questionnaires do not adequately capture quality-of-life outcomes of greatest importance for those living with type 1 diabetes in pregnancy.

Background: No standardised questionnaires have been specifically developed to assess the considerable demands of managing type 1 diabetes (T1D) during pregnancy.

Aims: This study aimed to explore what domains of measurement are important to quality of life during pregnancy with TID and to assess if standardised questionnaires, used by previous researchers, adequately capture patients' reported experience of TID in pregnancy.

Methods: A qualitative inquiry was conducted using semi-structured focus groups with Canadian women who have experienced T1D in pregnancy.

Sociodemographic Factors Associated With Objectively Measured Moderate- to Vigorous-intensity Physical Activity in Adults With Type 2 Diabetes: Cross-sectional Results From the Canadian Health Measures Survey (2007 to 2017).

Objectives: Individuals with type 2 diabetes should engage in ≥150 min of moderate- to vigorous-intensity physical activity (MVPA) weekly, but most do not meet this guideline. Understanding how social determinants correlate with physical activity in adults with type 2 diabetes may improve development and delivery of physical activity interventions. This study aimed to explore associations between objectively measured MVPA with sociodemographic characteristics in adults with type 2 diabetes.

Prevalence of and risk factors for excess weight gain in pregnancy: a cross-sectional study using survey data.

Background: Maternal weight gain during pregnancy is required for fetal development; however, excess gestational weight gain is associated with increased maternal and neonatal morbidity. We aimed to determine the proportion of Canadian women who gained excess weight during pregnancy and to identify risk factors for excess gestational weight gain.

Methods: Self-reported data on maternal weight gain were collected from the 2015/16 and 2017/18 cycles of the Canadian Community Health Survey (CCHS), a cross-sectional population-based survey.

Comparative Success of Recruitment Strategies for an Exercise Intervention Trial Among Women With Polycystic Ovary Syndrome: Observational Study.

Background: Effective and efficient participant recruitment is a key determinant of the success of a research program. Previously reported recruitment strategies have displayed variable success rates in studies on women with polycystic ovary syndrome (PCOS).

Objective: This study aimed to evaluate the effectiveness and cost per participant of the recruitment strategies that we used in a prospective randomized controlled trial to examine the effects of exercise training among inactive women with PCOS, who are aged 18-40 years.

Systematic review and meta-analysis: SGLT2 inhibitors, blood pressure and cardiovascular outcomes.

Objective: Clinical trials suggest that SGLT2 inhibitors reduce the risk of cardiovascular mortality in patients with type 2 diabetes, however the mechanism is unclear. Our objective was to test the hypothesis that blood pressure reduction is one potential mechanism underlying the observed improvements in cardiovascular outcomes with SGLT2 inhibitors.

Methods: We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (inception-June 2019) for randomized controlled trials that reported the effect of SGLT2 inhibitors compared with placebo on cardiovascular outcomes in adults with type 2 diabetes.

Exercise training and reproductive outcomes in women with polycystic ovary syndrome: A pilot randomized controlled trial.

Objective: Exercise is recommended for polycystic ovary syndrome (PCOS), but the most effective exercise prescription is unclear. This trial compared effects of high-intensity interval training (HIIT), continuous aerobic exercise training (CAET) and no-exercise control on reproductive, anthropometric and cardiometabolic outcomes in PCOS.

Design: Pilot randomized controlled trial.

The assessment of quality of life in children with tracheostomies and their families in a low to middle income country (LMIC).

Introduction: The Breatheasy© Tracheostomy Program based at the Red Cross War Memorial Children's Hospital, Cape Town, manages children mostly from poor socio-economic backgrounds. In our resource-limited setting, it is unclear how these families cope with the demands of a tracheostomised child. We aim to assess the quality of life (QOL) of tracheostomised children and their families as the first study of its kind in a low-resource setting.

Long-Term Physical Activity Levels After the End of a Structured Exercise Intervention in Adults With Type 2 Diabetes and Prediabetes: A Systematic Review.

Objectives: Randomized, controlled trials have shown that exercise interventions reduce the incidence of type 2 diabetes in people with impaired glucose tolerance, and improve glycemic control, body composition and cardiorespiratory fitness in people with type 2 diabetes. We undertook the present systematic review to determine the extent to which participants in structured exercise trials continue to be physically active after the end of the interventions.

Methods: We systematically searched MEDLINE, EMBASE, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials for randomized, controlled trials that reported objective or self-reported physical activity levels in people with type 2 diabetes or prediabetes a minimum of 3 months after the end of a structured exercise intervention.

Significant Dose-Response between Exercise Adherence and Hemoglobin A1c Change.

Introduction: The Diabetes Aerobic and Resistance Exercise trial found that aerobic training and resistance training alone each reduced hemoglobin A1c (HbA1c) compared with nonexercising controls, and combined aerobic and resistance training caused greater HbA1c reduction than either training type alone. Our objective was to determine whether a dose-response relationship existed between frequency of exercise training and HbA1c change, and whether this varied by exercise modality or participant characteristics.

Methods: Post hoc analysis of data from 185 Diabetes Aerobic and Resistance Exercise trial participants with type 2 diabetes randomized to aerobic, resistance or combined training thrice weekly.

The First Case of Riboflavin Transporter Deficiency in sub-Saharan Africa.

This report describes the first case of a child with genetically confirmed Brown-Vialetto-van Laere syndrome in sub-Saharan Africa. This is an extremely rare clinical condition that presents with an auditory neuropathy, bulbar palsy, stridor, muscle weakness, and respiratory compromise that manifests with diaphragmatic and vocal cord paralysis. It is an autosomal recessive condition for which the genetic mutation has only recently been linked to a riboflavin transporter deficiency.

Acute flaccid paralysis in South African children: Causes, respiratory complications and neurological outcome.

Aim: To describe the causes, clinical presentation and neurological outcome of acute flaccid paralysis in children.

Methods: A retrospective study in a tertiary paediatric hospital in South Africa. Data on clinical presentation, respiratory complications and long-term neurological outcomes of children presenting with acute flaccid paralysis were collected.

Home Ventilation in South African Children: Do Socioeconomic Factors Matter?

Poor socioeconomic circumstances and poverty are perceived to be barriers to successful home ventilation. Pediatric home ventilation has escalated rapidly in high-income countries but is underreported and underfunded in low-middle income countries. A retrospective chart review covering the past 20 years was carried out at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa, a low-middle income country.

Paediatric tracheostomy and ventilation home care with challenging socio-economic circumstances in South Africa.

Background: Children discharged home with a tracheostomy need a safe home environment and access to health care. We described the indications, clinical characteristics, socio-economic circumstances and outcomes of children enroled in a tracheostomy home care programme in South Africa.

Methods: We performed a retrospective chart review of children receiving a tracheostomy and enroled in the Breatheasy programme at the Red Cross War Memorial Children's Hospital, Cape Town.

Hypocalcemia post denosumab in patients with chronic kidney disease stage 4-5.

Background: Denosumab, a RANK-ligand inhibitor, is an effective treatment for osteoporosis in postmenopausal women and men. Unlike the bisphosphonates, it is not excreted by the kidney. Little is known, however, about its efficacy and safety in patients with severe chronic kidney disease (CKD).

PTSD and cognitive functioning: importance of including performance validity testing.

Many studies have observed an association between post-traumatic stress disorder (PTSD) and cognitive deficits across several domains including memory, attention, and executive functioning. The inclusion of response bias measures in these studies, however, remains largely unaddressed. The purpose of this study was to identify possible cognitive impairments correlated with PTSD in returning OEF/OIF/OND veterans after excluding individuals failing a well-validated performance validity test.

Mild traumatic brain injury and pain in Operation Iraqi Freedom/Operation Enduring Freedom veterans.

The purpose of this study was to describe the pain experience in Operation Iraqi Freedom/Operation Enduring Freedom veterans with and without a history of mild traumatic brain injury (mTBI) who present to polytrauma clinics for evaluation and management. We sought to evaluate the relationship between a veteran's history of mTBI and posttraumatic stress (PTS) on axial pain, head/headache pain, and pain interference. We performed retrospective chart reviews of 529 Iraq/Afghanistan veterans referred for evaluation at two Department of Veterans Affairs medical centers.

Performance on a neurocognitive measure of alerting differentiates ADHD combined and inattentive subtypes: a preliminary report.

The performance of 16 attention-deficit hyperactivity disorder (ADHD)/C, 26 ADHD/IA, and 24 control children was compared using a computer reaction time task designed to measure the effects of Posner's orienting, conflict and alerting attentional systems. No group differences in orienting or conflict were found. In contrast, children with ADHD/IA showed stronger alerting effects than those with ADHD/C, as indicated by relatively greater performance benefits following a warning cue.

Five-factor personality dimensions, mood states, and cognitive performance in older adults.

In this study we examined the impact of personality traits and negative mood state on performance in several cognitive domains in a sample of 398 elderly community-dwelling individuals. Multiple linear regression analyses were used to examine the variance in cognitive measures explained by state depression and anxiety after controlling for the effects of demographic characteristics and five-factor model personality traits. Personality traits were found to contribute significantly to cognitive function, explaining 2-7% of the variance in ability across domains.

Role of executive functioning in verbal and visual memory.

G. Tremont, S. Halpert, D.

Parent-, teacher-, and self-rated motivational styles in ADHD subtypes.

The motivational styles of 25 children with attention-deficit/hyperactivity disorder, combined type (ADHD/C), 13 children with ADHD, inattentive type (ADHD/IA), and 25 nondiagnosed controls (NC) were compared using parent, teacher, and self-ratings. Both ADHD subtypes demonstrated motivational impairment characterized by a preference for easy work, less enjoyment of learning, less persistence, and a greater reliance on external than on internal standards to judge their performance relative to NC. Some motivational style differences between ADHD subtypes were also revealed, with the ADHD/C group more motivated by competitiveness and a desire to be perceived as superior to others and the ADHD/IA group less uncooperative and possibly more passive in their learning styles.