Sleep disordered breathing in children is a common but largely underdiagnosed problem. It ranges in severity from primary snoring to obstructive sleep apnea syndrome (OSAS). Preliminary evidence suggests that children with severe OSAS show reduced neurocognitive performance, however, less is known about children who snore but do not have severe upper airway obstruction. Participants included 16 children referred to the Ear, Nose and Throat/Respiratory departments of a Children's Hospital for evaluation of snoring and 16 non-snoring controls aged 5-10 years. Overnight polysomnography (PSG) was carried out in 13 children who snored and 13 controls. The PSG confirmed the presence of primary snoring in seven and very mild OSAS (as evidenced by chest wall paradox) in eight children referred for snoring while controls showed a normal sleep pattern. To test for group differences in neurocognitive functioning and behavior, children underwent one day of testing during which measures of intelligence, memory, attention, social competency, and problematic behavior were collected. Compared to controls, children who snored showed significantly impaired attention and, although within the normal range, lower memory and intelligence scores. No significant group differences were observed for social competency and problematic behavior. These findings suggest that neurocognitive performance is reduced in children who snore but are otherwise healthy and who do not have severe OSAS. They further imply that the impact of mild sleep disordered breathing on daytime functioning may be more significant than previously realized with subsequent implications for successful academic and developmental progress.
These studies confirm the mediating role of intershift-shift recovery in the evolution of adaptive end-of-shift fatigue states to maladaptive persistent fatigue traits. The OFER scale is suggested as a potentially valuable new tool for use in work-related fatigue research.
Unpredictable internal shift rotations, including night duty, which are traditional and typical in nursing, are inimical to maintaining nurses' health. More creative approaches to rostering for nurses working multiple shifts are a necessary step towards reducing wastage from the profession due to chronic work-related fatigue. Younger nurses in particular, may need more support than is currently recognized if they are to be retained within the profession.
The OFER15 measure is a parsimonious scale with robust psychometric properties whose subscales distinguish well between acute fatigue states and chronic fatigue traits. The intershift recovery subscale is unique among published fatigue scales. The OFER15 is suggested as a valuable new instrument for the researchers in the work-related fatigue area, and also as screening instrument in Primary Care.
The present results indicate acceptable within-session test-retest reliability of TS and DNIC. The results support the possibility of future experimental studies examining factors affecting TS and DNIC.
Obstructive sleep apnea syndrome (OSAS) has been associated with reduced neurocognitive performance in children, but the underlying etiology is unclear. The aim of this study was to evaluate the relationship between hypoxemia, respiratory arousals, and neurocognitive performance in snoring children referred for adenotonsillectomy. Thirteen snoring children who were referred for evaluation regarding the need for adenotonsillectomy to a children's hospital otolaryngology/respiratory department underwent detailed neurocognitive and polysomnographic (PSG) evaluation. PSGs were evaluated for respiratory abnormalities and compared with 13 nonsnoring control children of similar age who were studied in the same manner. The snoring children had an obstructive respiratory disturbance index within normal range (mean obstructive apnea/hypopnea index, 0.6/hr). Despite this, several domains of neurocognitive function were reduced in the snoring group. These included mean verbal IQ scores (snorers 92.6 vs. nonsnorers 110.2, P < 0.001), mean global IQ scores (snorers 96.7 vs. nonsnorers 110.2, P < 0.005), mean selective attention scores (snorers 46.4 vs. nonsnorers 11.8, P < 0.001), mean sustained attention scores (snorers 8.0 vs. nonsnorers 2.2, P = 0.001), and mean memory index (snorers 95.2 vs. nonsnorers 112.1, P = 0.001). There was a direct relationship between number of mild oxygen desaturations of > or = 3%, obstructive hypopneas with > or = 3% oxygen desaturations, and respiratory arousals and severity of neurocognitive deficits, with the greatest effect being on memory scores. The disruption of sleep in snoring children produced by relatively mild changes in oxygen saturation or by increases in respiratory arousals may have a greater effect on neurocognitive function than hitherto appreciated. A possible explanation for these neurocognitive deficits may be the combination of the chronicity of sleep disruption secondary to snoring which is occurring at a time of rapid neurological development in the first decade of life. Future studies need to confirm the reversal of these relatively mild neurocognitive decrements post adenotonsillectomy.
This study examined the role of schools' psychosocial safety climate (PSC) in teachers' psychological outcomes. We proposed that PSC would moderate the effects of teachers' daily job demands on their fatigue and work engagement, and also the effects of teachers' daily recovery on fatigue and engagement. Sixty‐one Australian school teachers completed a diary that was repeated three times over the course of approximately 8 months. Each diary ran for five consecutive days, measuring daily self‐reports of job demands, recovery, fatigue, and engagement (N = 915 data points), while perceived PSC was measured once per diary. Multilevel analyses indicated that PSC moderated the relationships between job demands and fatigue, as well as job demands and engagement. This suggests that perceived PSC could act as a buffer against deleterious impacts of daily job demands. PSC also moderated the relationships between recovery and fatigue, and recovery and engagement. This indicates that higher levels of perceived PSC in schools could amplify the benefits of daily recovery for teachers. PSC also exerted a main effect on both fatigue and engagement. These results offer insight into the mechanisms by which PSC may act as a buffer to protect worker mental health, and highlight the importance for school management to promote PSC within their organization.
Practitioner points
Psychosocial safety climate in organizations may buffer workers from the negative psychological outcomes associated with job demands.
Psychosocial safety climate in organizations may boost the psychological benefits that workers gain from achieving good daily recovery outside of work.
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