Neurocognitive Outcomes at 10 Years of Age in Extremely Preterm Newborns with Late-Onset Bacteremia.

OBJECTIVE: To evaluate the difference in 10-year neurocognitive outcomes between extremely low gestational age newborns without bacteremia and those with suspected or confirmed late-onset bacteremia. STUDY DESIGN: Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture-positive) late-onset bacteremia during postnatal weeks 2-4 was identified in 223 children, and 129 children had suspected bacteremia. RESULTS: Infants with the lowest gestational age and birth weight z-score had the highest prevalence of definite and suspected late-onset bacteremia. Compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even after adjustment for potential confounders. Adjustment for low IQ attenuated the associations between bacteremia and all dysfunctions at age 10 years. Children with suspected bacteremia did not differ appreciably from those with no evidence of bacteremia. The motor domain was unaffected. CONCLUSIONS: Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2-4 are at heightened risk of neurocognitive limitations at age 10 years.

Impact of a Discussion Series on Race on Medical Student Perceptions of Bias in Health Care.

BACKGROUND AND OBJECTIVES: Racial bias in health care is increasingly recognized as a factor in health inequities, yet there is limited research regarding medical school education around race and racism and its impact on medical students. The purpose of this study was to understand attitudes of medical students on race and racism in health care and to study the impact of participation in a voluntary structured program on race and racism. METHODS: First-year medical students had the opportunity to participate in a series of discussions (10 hours total) on race and racism. A 10-question survey addressing comfort, knowledge, and the adequacy of education on race and racism was sent to all first-year medical students (n=61/180, response rate 34%), and was administered to series participants (n=23/25, response rate 92%) in a pre/post format. RESULTS: Participant and nonparticipant attitudes were similar at baseline, with the exception that participants were less likely to feel that the medical school curriculum provided adequate education on race and racism, and reported higher levels of knowledge around these issues. Following the discussion series, participants showed significant changes regarding knowledge and awareness, as well as comfort level discussing race and racism. CONCLUSIONS: Participants were more likely than nonparticipants to think that the curriculum should include more discussion on race and racism. Postparticipation analysis demonstrated significant increases in comfort level, knowledge, and awareness in discussion of race and racism.