'I forgot my daughter's birthday – it led to the worst news I could have imagined'
He made an appointment with his GP and was referred to a memory clinic where he was asked to draw a clock. But, try as he might, he couldn't remember where to put the number 12. A brain scan then followed after which he was told he had Alzheimer's disease. He was just 60.
Before then he thought it was just part of getting older but with the diagnosis came the warning he probably had between five and eight years to live. He is now 66 and five years on from his diagnosis.
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He had put forgetting names, or spellings, down to getting older. "I've never been the brightest star in the sky when it comes to putting pen to paper but I seem to have just lost the ability to spell anything. Basic words...it came as a bit of a shock," he said. For our free daily briefing on the biggest issues facing the nation, sign up to the Wales Matters newsletter here.
It dawned him it was more than getting older. "I was forgetting dates and I couldn't remember actually basic things like people's names – people I had known for a long time. I remember my kids' names still but even now when I go out I say: 'What's his name?'."
His overriding feeling when he struggled to spell a word or remember a name was one of frustration, he said. "After getting the diagnosis I thought: 'Well I can't argue with technology – I've had the scans and I won't beat this, because you won't beat it, but I've got to cope with it'."
In the years since his diagnosis his symptoms have got worse. He now relies on help of apps or Alexa for any spellings and his body shakes to such a degree he has had to change his life. It stops him doing day-to-day tasks and he is having to learn to adapt and ask for help.
"I won't eat out now in a restaurant because I don't want the food everywhere. I took my grandkids to McDonald's and dropped the tray with all the drinks on them and everything. I just wanted a big hole to swallow me me up but there are good people out there and when I dropped it there was a guy there who was fantastic. But what I should have done was have said to my grandson: 'Carry the tray for granddad'.
But he said: "It frustrated me more than anything and I suppose I was a little bit sad but I'm not one for dwelling or self-pity. So I gave myself a kick up the bum.
"I used to be embarrassed with myself but it's not fault – I didn't ask to get ill."
He is now awaiting brain surgery. His surgeon has warned him that the surgery could stop his tremors or it could bring on his condition quicker. But he wants to have good years in which he can start going back out for dinner without fearing not being able to control his hands so he is able to eat in public.
"What the surgeon said to me was: 'I don't know what your outlook is'. My outlook is is quality of life – not quantity. You're better to have two good years than five bad ones. That's what I believe in."
Andy, from Deeside, is involved in a number of charities, including Alzheimer's Society, and is involved with training North Wales Police and the Welsh Ambulance Service as well as giving talks at Bangor University. He wants to do anything he can to help people understand the condition.
His charity work has meant he has become a go-to for friends who approach him for advice, saying they are worried about a relative or even themselves. His advice is simple – go to the GP to get help.
Andy knew his GP and when he first approached him and told him he was worried they had an informal chat and then a formal one. He was then told to go to the memory clinic. Within weeks he had his first memory clinic appointment.
He had to carry out a number of predictive tests – things like drawing the clock or filling in the blanks. "It doesn't sound right on the clock because anybody can draw a clock. I drew a circle and I put the numbers in but the one at the top where the 12 should be. For that 10 minutes or half hour or so I didn't have a clue where the 12 went," he said.
He was fully aware something was missing and each time he tried he couldn't manage.
Then he was sent to hospital in Wrexham where his diagnosis was confirmed after a brain scan. He was told he had between five and eight years to live. Five years on from that "I'm going nowhere fast," said Andy.
The thing he struggled with most was his driving licence being taken from him. "The one thing that upset me was they took me driving licence off me literally the day after I was diagnosed. I thought: 'I could drive yesterday but I can't drive today? I've still got my faculties, I'm not making a silly decisions'. If I thought I was a threat on the roads to the road users I'd pack in myself but I've paid for a test and passed with flying colours," he said.
He has been paying for yearly assessments to keep his licence and just needs help from his son to fill the form in. "When the form comes around I say: 'Right, I'm not going to let this get me down'."
Andy has seen how much others struggle with the diagnosis. A friend who had an Alzheimer's diagnosis at the same time has since taken his own life "because he couldn't handle the fact he had a terminal illness and basically he was waiting around to die – but I don't look at it like that".
Asked how he keeps that attitude he said: "Obviously your life is going to be cut shorter than it normally would have been. But I think: 'What's the point in dwelling or self-pity and sadness? Keep doing what you were doing and if you can give help to other people.'
"There are ways to try and deal with it – the day will come when I can't deal with it but I won't be aware of it then. I'm one of these 'what will be will be' people – there's people worse off out there," he said.
Andy added: "I have what's called young-onset dementia. People expect somebody with dementia to be an old man or an old lady in a nursing home. with a walking stick or a blue rinse and it's something old people get. Since I've been doing what I've been doing I've spoken to guys at 40 and 50. It can happen to anybody."
Rachel Nelson from Alzheimer's Society Cymru said: 'Around 50,000 people are living with dementia in Wales and nearly half of them don't have a diagnosis. This means thousands of people are facing the devastating realities of dementia without access to the vital care, support, and treatment that a diagnosis can bring.
"Getting a diagnosis can be daunting but we believe it's better to know. Alzheimer's Society research showed 97% saw a benefit in getting a diagnosis. An early and accurate diagnosis is crucial to manage symptoms, live independently for longer, and avoid ending up in a crisis."

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Yahoo
8 minutes ago
- Yahoo
UK Food Safety Testing Market Size to Reach US$2.8 Billion by 2033
Shaped by strict Food Standards Agency (FSA) regulations and post-Brexit import complexities, the UK market emphasizes robust allergen management and supply chain traceability. High consumer awareness and advanced rapid testing methods are integral to maintaining confidence. Chicago, Aug. 20, 2025 (GLOBE NEWSWIRE) -- The UK food safety testing market was valued at US$ 1,306.23 million in 2024 and is expected to reach US$ 2,801.82 million by 2033, growing at a CAGR of 9.23% during the forecast period 2025–2033. A dramatic surge in foodborne pathogens is a primary catalyst for growth. The frequency and scale of recent outbreaks are alarming. Official data show 70,352 laboratory-confirmed cases of Campylobacter in England during 2024, marking a decade-long high. Similarly, Salmonella infections in England peaked at 10,388 reported cases in 2024. Specific outbreaks highlight the severity of the situation. A 2024 Salmonella Blockley event resulted in 54 cases across the UK. These cases were distributed with 36 in England, 11 in Scotland, and 7 in Wales. The outbreak led to the hospitalization of ten individuals. Download Sample Pages: Even more concerning was a major Shiga toxin-producing E. coli (STEC) O145 outbreak in summer 2024, which caused over 250 illnesses in the UK food safety testing market. By late June 2024, confirmed cases reached 275. The geographical breakdown shows 182 cases in England, 58 in Scotland, and 31 in Wales. The outbreak's severity is underscored by the 122 people hospitalized. Furthermore, seven confirmed cases of haemolytic uraemic syndrome (HUS) were directly linked to the STEC O145 event. The Food Standards Agency (FSA) is actively investigating an increased number of incidents. Investigations into Listeria-related outbreaks grew to 17 in the 2024/25 period. STEC-related outbreak investigations rose to 13, and Salmonella outbreak investigations increased to 11 in the same timeframe. Adding to the domestic pressure, 2,703 cases of travel-associated gastrointestinal infections were recorded in England in 2024, with 183 of these being travel-related STEC infections. Key Findings in UK Food Safety Testing Market Market Forecast (2033) US$ 2,801.82 million CAGR 9.23% By Test Method Microbiological Test (36.64%) By Product Type Processed Food (25.56%) By Containment Type Biological Contaminants (36.85%) By Technology Traditional Testing (54.63%) By Service Sourcing Inhouse (57.75%) By Application Pathogen Detection (44.03%) By End User Food & Beverage (66.6%) Top Drivers Stringent post-Brexit import controls require comprehensive testing regimes. High consumer demand for transparency and clean-label products. Growth of plant-based and free-from food categories necessitates testing. Top Trends Adoption of whole-genome sequencing for precise outbreak source tracking. Focus on developing rapid tests for emerging environmental contaminants. Increased use of data analytics for predictive risk modeling. Top Challenges Navigating regulatory divergence between the UK and the EU. Persistent labor shortages impacting food industry and laboratory staffing. Combatting sophisticated food fraud and economically motivated adulteration. Chemical Contaminant Risks Mandate Broader and More Sophisticated Testing Protocols The threat is not limited to pathogens; chemical contaminants demand equal attention in the UK food safety testing market. Growing concerns over pesticides, industrial chemicals, and mycotoxins are expanding the required scope of testing services. In 2024, the FSA issued 14 food alerts for metal contamination alone, with 4 of these occurring by April. Analysis of imported food revealed residues of 48 pesticides not approved for use in the UK. A deeper look found residues from 46 cancer-linked pesticides in imported produce. In comparison, 19 cancer-linked pesticides were detected in food originating from the UK in 2024. The issue of "forever chemicals" has become prominent. A 2024 analysis discovered 10 different PFAS pesticides in fruit and vegetables sold in the UK food safety testing market. The nation currently approves 25 PFAS pesticides for use, with 6 of them classified as 'highly hazardous'. Government testing confirmed the presence of PFAS chemicals in over 3,300 food and drink samples in 2024. These findings came from a program that tested approximately 3,000 samples of food and produce. Meanwhile, the UK's annual testing for heavy metals covers a mere 400 to 450 samples of meat, milk, fish, and honey. A potential source of contamination is the UK's over 8,500 abandoned mines, which can leach toxic metals into the food chain. Specific food surveys also raise red flags. In a 2024 retail food survey, 13 out of 30 soy samples tested contained elevated levels of the mycotoxin ochratoxin A. A separate test of 90 samples for physical contaminants found one sample to be non-compliant. Escalating Product Recalls and Allergy Alerts Underscore Critical Testing Needs The sheer volume of product recalls provides a stark indicator of systemic weaknesses. These events in the UK food safety testing market are not only more frequent but also larger in scale, fuelling investment in preventive testing. In 2024, just three large-scale recall alerts implicated a staggering 424 different products. The average number of products recalled per event in 2024 was 2.5 times higher than in 2023. In the 2023/24 period, the FSA and Food Standards Scotland (FSS) issued a combined total of 136 food alerts. Within that total, 66 were specific Allergy Alerts. The focus on allergens intensified significantly, with 101 Allergy Alerts issued by the FSA and FSS in 2024. Beyond allergens, there were 67 product recalls in 2024 due to issues like foreign bodies and microbial contamination. The problem is widespread. In the first quarter of 2025, a total of 1,242 food and beverage recalls were recorded across the EU and UK. Non-bacterial contamination was responsible for 550 of these recalls. Aflatoxins were the culprit in 135 recall events. Bacterial contamination led to 237 recalls, with Salmonella being the cause of 174 of those incidents. Undeclared allergens prompted 94 recalls in Q1 2025, with milk being the most frequent issue, causing 19 separate recalls. Such figures make a compelling case for the expanding UK food safety testing market. Strict Regulatory Enforcement and Incident Management Spur Compliance-Driven Testing Demand Regulatory bodies are intensifying their oversight, making robust testing a non-negotiable aspect of compliance. The FSA's incidents response unit managed 1,837 food and feed incidents in the 2023/24 financial year. In the subsequent 2024/25 period, the FSA received notifications for 1,825 incidents across England, Wales, and Northern Ireland. Beyond direct notifications, the agency monitored 12,504 food safety signals in 2024/25. These signals prompted 810 intelligence assessments, which in turn launched 36 new investigations. Ultimately, these monitored signals resulted in 18 new incidents that required product withdrawal from the market. Local authorities are also increasing formal enforcement actions, which rose to 5,898 for food hygiene in 2023/24. Actions related to food standards in the food safety testing market grew to 658 in the same period. The financial consequences of non-compliance are severe. In a high-profile 2024 case, retailer ASDA was fined £640,000 for selling over 100 out-of-date food items. Asda was also ordered to pay an additional £15,115 in prosecution costs. The case was not an isolated one; it followed two other 2024 instances where Asda was fined £250,000 and £410,000 for similar food safety breaches. These penalties send a clear message to the industry. Specialized Food Crime and Fraud Investigations Are Now Major Market Drivers A growing area of focus is the criminal threat to the food supply chain. Specialized units are actively tackling food fraud, creating a niche for advanced authenticity and integrity testing. The UK's food crime units were running 29 live investigations during 2024. A significant portion of these, 20 investigations, involved meat and meat products. The scale of these operations is considerable. In a single food crime case in November 2024, officers seized 48 illegal sheep carcasses. As part of that National Food Crime Unit (NFCU) investigation into illegal meat, five men were arrested in London. The NFCU is also securing financial penalties against perpetrators. In a 2025 case, the unit obtained a confiscation order of over £30,000 from an individual selling illegal 'smokie' meat products. The action marked the third high-profile 'smokie' meat fraud case pursued by the NFCU within a single year. These enforcement successes highlight the critical need for sophisticated testing solutions that can verify the origin, composition, and legality of food products, a key growth area for the UK food safety testing market. Strained Local Authority Resources Create Significant Gaps in Public Food Safety While regulatory demands are increasing, the capacity of public enforcement bodies is strained. Under-resourced local authorities in the UK food safety testing market are struggling to maintain oversight, shifting a greater burden of responsibility onto businesses and their internal testing programs. As of 2024, there is a backlog of 95,000 overdue food business inspections across England, Wales, and Northern Ireland. Worryingly, this backlog includes 871 businesses classified as high-risk. In Scotland, 12,533 registered food businesses remained unrated as of December 2024. The number of unrated establishments awaiting a first inspection in England, Wales, and Northern Ireland had grown to around 41,000 by April 2024. This resource strain is directly impacting surveillance. The total number of food samples taken by local authorities across the UK dropped to 37,911 in the 2023/24 period. This figure is down from 40,144 samples in the prior period, showing a continuing decline in public testing capacity. Concurrently, consumer complaints are rising. There was an increase of 1,540 consumer complaints related to food hygiene in 2023/24, reaching a total of 60,919. Complaints regarding food standards and authenticity also rose by 200, to a total of 11,188 in the same period. Competitive Landscape Heats Up as Key Players Expand to Meet Demands Leading providers in the UK food safety testing market are responding to these challenges with strategic expansions and innovations. Key players are enhancing their capabilities to capture growing demand, particularly in identified hotspot sectors. In July 2025, Eurofins Food Testing UK demonstrated a clear growth strategy by finalizing its acquisition of the Bio Search food testing laboratory in Belfast. The move significantly expands its capabilities and footprint in Northern Ireland. In 2024, Eurofins also launched a new method for enumerating acetic acid bacteria, a service specifically targeting the needs of the UK beverage industry. These expansions are timely, as certain food categories are under intense scrutiny. A 2024 FSA survey found that 16 out of 40 samples of frozen raw chicken, a total of 40%, were non-compliant due to issues like undeclared water. The same survey revealed that 10 out of 24 frozen beef burger samples, or 42%, were non-compliant. Among the non-compliant burger samples, eight were found to have less meat content than what was declared on the label. These sector-specific failings create clear opportunities for specialized testing services. Advanced Whole Genome Sequencing Technology Revolutionizes Outbreak Response and Investigation The evolution of the UK food safety testing market is intrinsically linked to technological advancement. While widespread adoption rates are proprietary, official reports confirm the critical role of next-generation methods. Advanced testing technologies, particularly whole genome sequencing (WGS), are no longer on the horizon; they are central to modern surveillance and response. The UK Health Security Agency (UKHSA) extensively used WGS to successfully identify and manage the 2024 outbreaks of Salmonella Blockley and E. coli O145. The application of WGS in these high-profile incidents demonstrates the technology's power. It allows for a level of precision in linking cases and identifying the source of an outbreak that was previously impossible. This capability is transforming public health investigations. The clear success and growing reliance on WGS signal a market-wide shift. The move is away from traditional culturing methods and toward more rapid, accurate, and data-rich technologies. This technological pivot is a fundamental driver of investment and innovation across the entire food safety sector. Need a Customized Version? Request It Now: Post-Brexit Regulations and Future Trends Shaping the UK Food Safety Market The future of the UK food safety testing market will be shaped by an evolving regulatory framework and the continuation of current trends. Post-Brexit adjustments are creating new compliance hurdles and, consequently, new testing requirements. As of January 1, 2024, a significant new rule took effect. All pre-packaged food sold in Great Britain must now include a UK address for the Food Business Operator. The change introduces new labeling verification needs for the entire industry. Looking ahead, the market's growth trajectory appears strong and certain. The convergence of the key drivers—relentless pathogen pressure, expanding chemical threats, massive product recalls, tough enforcement, and public sector gaps—creates a compelling case for sustained investment. Businesses have no alternative but to integrate more frequent, more sophisticated, and more comprehensive testing into their operations. The demand is not just for testing, but for a true partnership in risk mitigation, making the UK food safety testing market a critical component of national food security and public health for years to come. UK Food Safety Testing Market Major Players: ALS Laboratories (UK) Limited Bureau Veritas UK Limited Campden BRI Group Eurofins Food Testing UK Limited Fera Science Limited Food Forensics Limited Intertek Group Plc. Northern Hygiene Laboratories Limited SGS United Kingdom Limited TÜV SÜD UK Limited Other Prominent Players Key Market Segmentation: By Test Method Microbiological Test Total Plate Count (TPC) Coliform Testing Listeria Testing Salmonella Testing Campylobacter Testing Sensory Test Manual Smell Taste Appearance Others Instrumental Smell Taste Appearance Others Physical Test Chemical Test Allergen Test Others By Product Type Processed Food Fruits &Vegetables Beverages Grains & Cereal Confectionery Meat & Meat Products Milk & Milk Products Others By Technology Traditional Testing Rapid Testing By Service Sourcing Inhouse Outsource By End User Food & Beverage Academic and Research Institutions Testing Laboratories Need a Detailed Walkthrough of the Report? Request a Live Session: About Astute Analytica Astute Analytica is a global market research and advisory firm providing data-driven insights across industries such as technology, healthcare, chemicals, semiconductors, FMCG, and more. We publish multiple reports daily, equipping businesses with the intelligence they need to navigate market trends, emerging opportunities, competitive landscapes, and technological advancements. With a team of experienced business analysts, economists, and industry experts, we deliver accurate, in-depth, and actionable research tailored to meet the strategic needs of our clients. At Astute Analytica, our clients come first, and we are committed to delivering cost-effective, high-value research solutions that drive success in an evolving marketplace. Contact Us:Astute AnalyticaPhone: +1-888 429 6757 (US Toll Free); +91-0120- 4483891 (Rest of the World)For Sales Enquiries: sales@ Follow us on: LinkedIn | Twitter | YouTube CONTACT: Contact Us: Astute Analytica Phone: +1-888 429 6757 (US Toll Free); +91-0120- 4483891 (Rest of the World) For Sales Enquiries: sales@ Website:


Forbes
11 minutes ago
- Forbes
4 Reasons Why ‘Self-Blame' Is Your Default State, By A Psychologist
The habit of staying up at night and replaying all the embarrassing moments of your life while stewing in self-blame isn't just a personality quirk. For most people, this recurring phenomenon, often beyond their control, can start feeling like a mental trap where you keep turning thoughts like 'you should have known better' over and over again in your head. This can also disrupt your sleep cycle. A 2022 study published in the British Journal of Clinical Psychology found that people most often ruminate or worry about past mistakes, negative experiences and social interactions, with nighttime being a high-risk period for such overthinking. The reason you stay stuck in this cycle has to do with your mind's tendency to disguise rumination as 'problem-solving.' You might be under the impression that you're figuring out what went wrong or making sure you will not repeat the mistake. However, in reality, you're just reinforcing the guilt and trapping yourself even further in the same emotional cycle. Over time, this habit can end up chipping away at your confidence, relationships and most importantly, your sense of self. A 2025 study published in Self and Identity explored why forgiving yourself is so difficult for some people and why they can be stuck in self-condemnation. Out of 80 participants, researchers found that 41 of them said they couldn't forgive themselves after a perceived failure. For 39 of them, self-forgiveness came easier. Researchers also identified key patterns that keep people trapped in such self-blame. Here are four reasons you're stuck in a mindset of self-blame, based on the 2025 study: 1. Your 'Time Focus' Keeps You Stuck One of the patterns researchers uncovered through the study was a difference in time focus. People unable to forgive themselves tended to experience the past as if it were still the present. This showed up in many ways. They replayed mistakes in vivid detail and reimagined what they 'should have done.' Essentially, they emotionally relived the moment repeatedly, and painstakingly. The researchers described this as a 'past-as-present' mindset. 'It is a raw feeling. Just like it happened yesterday, but I moved my daughter 4 years ago,' one participant explains, remembering how she struggled to forgive herself when she found out her daughter was being bullied in school. In sharp contrast, the group that could more easily forgive themselves showed a 'future-focused' perspective. They acknowledged their mistake and redirected their attention toward growth, how they could change and what the next steps could be, rather than staying shackled to what had already happened. 'I needed to forgive myself so I could stop blaming myself and stop looking toward the past when I needed to be looking toward the future,' another participant explains, highlighting the power of a future-focus in finding self-forgiveness. These findings suggest that when your dominant focus is on the past, it becomes hard to even see the possibility of a different future. When you find yourself ruminating on the past, you may start to feel like this is an unchangeable part of who you are. But it helps to remember that you are not frozen in that moment. Being in the present moment gives you the power to decide what comes next and take actions that can bring about real change. 2. You Doubt Your Own Agency Moving on from your mistakes isn't just about where your attention is. An important factor we often ignore is our belief in our own ability to make things different. The 2025 study found that people who struggled to forgive themselves frequently questioned whether they even had the ability to change the situation or prevent it from happening again. This 'low-agency' mindset left them feeling powerless. Participants who found themselves stuck in self-condemnation harped on their lack of control over their behavior or circumstances. This led to a deepening of their guilt. On the other hand, those who forgave themselves believed they still had agency. They believed in their capacity to make choices and influence life outcomes. This belief allowed them to move forward. If you lack a sense of agency, it's quite possible your mind lingers on your mistakes, negative events and the past as a prediction of your future. Rebuilding self-trust, therefore, is the first order of business. And you're allowed to start small, such as keeping a promise to yourself, showing up on time to a commitment you've made or making one healthier choice than the day before. 3. You See Your Mistakes As A Reflection Of Your Entire Character Often, the heaviest part of self-blame isn't the action itself. It's what you believe that action says about you that can determine how you see yourself. The researchers of the 2025 study found that people trapped in self-condemnation often saw their mistakes as a reflection of their social-moral identity, or their sense of being a 'good' or 'bad' person in their own eyes and the eyes of others. So, instead of viewing their wrongdoing as a single or isolated event, they saw it as proof that they were fundamentally flawed or unworthy. 'I have a particularly bad habit that has developed over many years. I have tried many times to break the habit without success. This is something I should be able to choose not to do, yet I keep doing it. I cannot forgive myself for developing the habit, and I cannot forgive myself for failing to break the habit. It's demoralizing, frustrating, and has ruined my self-esteem,' one participant shares. However, people who managed to forgive themselves were more likely to separate what they did from who they are. They acknowledged the harm but didn't let it define their whole identity. Moving forward can feel like a moral battle when your self-image feels tied to every misstep. 4. You Cope By Avoiding Instead Of Processing When you're drowning in deep guilt or regret, a natural instinct to quiet the discomfort might kick-in. This can happen in different ways for everyone, say binge-watching something, scrolling endlessly, overworking or distracting yourself in other ways. Indulging in these distractions can numb the emotions for a while, but that might not always be a solution for the long term. Researchers found correlations between self-condemnation and this 'emotion-reduction' style of coping. The defining characteristic of this style was pushing away uncomfortable feelings and a steadfast avoidance of processing and working through them. While this silences short-term pain, it leaves the root cause untouched, with guilt floating just beneath the surface. On the other hand, making sense of a certain event or feeling helps give it a proper ending in your mind. You reflect on what you've learned, have a compassionate conversation with yourself or reframe the event as part of your growth. For instance, one participant mentioned, 'In order to be the best parent I could be, I had to forgive myself and focus on my daughter. I just had to make myself understand that there were many factors that contributed to my daughter's depression, and I was not solely to blame.' Keep in mind that while you cannot change the past, you certainly can change the role it plays in your story and determine how it impacts you and your life. Mistakes Are Proof That You Tried To truly break free from self-blame, you need to make a shift in the relationship you have with that moment frozen in time. Your mistakes do not vanish, no matter how much you try. The good news is, they don't have to. When you learn to approach them from a growth perspective, you can see them as separate from yourself and they become catalysts for insight and resilience. An easy way to shift your perspective is using a narrative reframing technique for your past. Instead of just trying to push guilt away or analyze your mistake, you can go back to the memory and forage for moments of growth and perseverance. Done enough times, you'll likely notice that the emotions you associate with the mistake have taken a 180 degree turn for the positive. Do you keep replaying your mistakes in your mind? Take the science-backed Mistake Rumination Scale to learn more about this habit.


Medscape
40 minutes ago
- Medscape
Oximetry Weak for Predicting OSA in Kids With Down Syndrome
TOPLINE: Nocturnal pulse oximetry (NPO) indices, such as the 3% and 4% Oxygen Desaturation Indices (ODI3 and ODI4, respectively), demonstrated moderate sensitivity and specificity for detecting moderate and severe obstructive sleep apnoea (OSA) in children with Down syndrome but showed low sensitivity for detecting mild OSA. METHODOLOGY: Researchers conducted a retrospective study to evaluate the ability of two NPO indices (ODI3 and ODI4) for predicting OSA in children with Down syndrome. They compared cardiorespiratory polygraphy (CRP) and NPO recordings in 387 children aged 2-16 years with Down syndrome (median age, 6.1 years; 46.7% girls) who were referred for the evaluation of OSA at two tertiary sleep centres in the UK between May 2016 and May 2024. OSA was defined as having an Obstructive Apnoea-Hypopnoea Index (OAHI) of one or more events per hour and classified according to severity as mild (one or more to less than five events per hour), moderate (five or more to less than 10 events per hour), or severe (10 or more events per hour). Two-by-two tables were used to determine the sensitivity and specificity of various cutoff values of NPO parameters for predicting OSA: oxygen saturation (SpO2), ODI3, ODI4, minimum SpO2, the Delta 12-second index, and the percentage of analysis time with SpO2 < 94%, < 92%, and < 90%. TAKEAWAY: Of 387 children, 265 (68.5%) had OSA, with 164 (42.4%) having mild OSA, 51 (13.2%) having moderate OSA, and 50 (12.9%) having severe OSA. An ODI3 threshold of 19 or more events per hour provided the highest combined sensitivity and specificity for predicting OSA (59.2% and 74.6%, respectively); increasing the threshold to 23 or more events per hour provided the highest combined sensitivity and specificity for an OAHI of five or more events per hour (70.3% and 79.7%, respectively) and 10 or more events per hour (82.0% and 73.9%, respectively). An ODI4 threshold of 10 or more events per hour yielded moderate sensitivity (76.2%) and specificity (75.2%) for predicting OSA; a threshold of 13 or more events per hour provided moderate sensitivity (72.0%) and high specificity (80.7%) for an OAHI of 10 or more events per hour. For predicting an OAHI of one or more events per hour, an ODI3 threshold of 19 or more events per hour yielded a positive predictive value of 83.5% and a negative predictive value of 45.7%, and an ODI4 of eight or more events per hour yielded a positive predictive value of 82.8% and a negative predictive value of 47.5%. IN PRACTICE: "Oximetry alone does not provide a reliable diagnostic tool for evaluating OSA in children with DS [Down syndrome]; therefore, we recommend CRP/PSG [polysomnography] should be performed," the authors wrote. SOURCE: This study was led by Hannah Vennard, Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children, Glasgow in Glasgow, Scotland. It was published online on August 11, 2025, in Archives of Disease in Childhood. LIMITATIONS: Using CRP instead of polysomnography meant that total sleep time was estimated, which could have potentially led to the underestimation of the OAHI due to underscoring of hypopnoeas not associated with desaturation when arousals from sleep could not be detected. The total recording time of stand-alone oximetry does not match the total sleep time measured using CRP, which may have affected the accuracy of oximetry indices in predicting the OAHI. The high prevalence of central apnoeic events may have affected the accuracy of ODI thresholds for predicting OSA. DISCLOSURES: This study did not receive any funding from any source. The authors declared no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication