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Urquhart DS, McLellan AE, Hill LE, Carruthers E, Hill EA, Chin RF, Shetty J. A case-control study to investigate the prevalence of obstructive sleep apnea and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in children and young people with epilepsy. J Clin Sleep Med 2024; 20:1039-1047. [PMID: 38318844 PMCID: PMC11217635 DOI: 10.5664/jcsm.11054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
STUDY OBJECTIVES Epilepsy and obstructive sleep apnea syndrome (OSAS) are each relatively common in children. OSAS may affect cognition, such that recognition of OSAS is important for children and young people with epilepsy (CYPWE). Published pilot data reported 55% of CYPWE had symptoms suggestive of OSAS, compared with 7% of typically developing controls. The primary aim of this study was to ascertain OSAS prevalence by polysomnography in CYPWE, with secondary aims being to evaluate the utility of sleep questionnaires in CYPWE. METHODS CYPWE and age- and sex-matched typically developing controls were studied. A single night of level I attended polysomnography was undertaken, along with questionnaires (Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire, Pittsburgh Sleep Quality Index, and the childhood and adolescent Epworth Sleepiness Scale). OSAS was defined as obstructive apnea-hypopnea index of ≥ 1 event/h. RESULTS Polysomnography was performed in 72 children including 48 CYPWE (60% male) and 24 controls (54% male). Mean age (11 years) was similar for CYPWE and controls (P = .42), with slightly higher body mass index z scores (0.7 vs 0.1, P = .03) noted in CYPWE. Mean obstructive apnea-hypopnea index was 0.61 in CYPWE vs 0.42 in controls (P = .62). Despite higher Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire scores in CYPWE (0.38 vs 0.12, P < .001), no difference in OSAS prevalence (10% vs 4%, P = .78) was found. CYPWE had higher childhood and adolescent Epworth Sleepiness Scale (6 vs 3.5, P = .01) and Pittsburgh Sleep Quality Index (5 vs 3.3, P = .02) scores, indicating greater levels of daytime sleepiness and poorer sleep quality. CONCLUSIONS The study found no evidence for increased OSAS prevalence in CYPWE, and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in predicting OSAS appears limited for CYPWE. CYPWE are, however, demonstrably sleepier and have poorer sleep quality. The cause for these findings remains unclear. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Investigation of Sleep Quality and Prevalence of Sleep-disordered Breathing in Children and Young People With Epilepsy; URL: https://www.clinicaltrials.gov/study/NCT03103841; Identifier: NCT03103841. CITATION Urquhart DS, McLellan AE, Hill LE, et al. A case-control study to investigate the prevalence of obstructive sleep apnea and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in children and young people with epilepsy. J Clin Sleep Med. 2024;20(7):1039-1047.
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Affiliation(s)
- Donald S. Urquhart
- Department of Paediatric Respiratory & Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ailsa E. McLellan
- Department of Paediatric Neurosciences, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Muir Maxwell Epilepsy Center, Center for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Laura E. Hill
- Department of Paediatric Respiratory & Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - Emma Carruthers
- Department of Paediatric Respiratory & Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - Elizabeth A. Hill
- Department of Paediatric Respiratory & Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Richard F. Chin
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, United Kingdom
- Department of Paediatric Neurosciences, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Muir Maxwell Epilepsy Center, Center for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Jay Shetty
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, United Kingdom
- Department of Paediatric Neurosciences, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
- Muir Maxwell Epilepsy Center, Center for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
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Lu R, Li R, Chen Y, Zhang Y, Kang W, Zhao A, Lin X, Hu Y, Liu S, Xu Z, Lu Z, Li S. A population-based study exploring association of parasomnia symptoms with sleep onset delay among school-aged children. Sleep Med 2024; 117:1-8. [PMID: 38460489 DOI: 10.1016/j.sleep.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE Parasomnia is potentially implicated in sleep pattern and sleep architecture, however, evidence is quite limited. This study aimed to investigate the association between parasomnia symptoms and sleep onset delay among children through a large epidemiological study. METHODS Two rounds of cross-sectional studies were conducted among 21,704 children aged 3-11; one taking place in Shanghai and the other in Sanya, Hainan province. Children's sleep characteristics were evaluated using the Children's Sleep Habits Questionnaire (CSHQ). Propensity score matching was adopted to balance the difference of covariates, and the logistic regression models were implemented to examine the associations between parasomnia symptoms and sleep onset delay. RESULTS A total of 38.2 % of children had sleep onset delay. Parasomnias, especially non rapid eye movement (NREM) and rapid eye movement (REM) parasomnia symptoms, were associated with an increased risk of sleep onset delay (Sleep Walking: OR = 1.55; Sleep Terror: OR = 1.34; Nightmare: OR = 1.37, all p˂0.001). The similar findings were observed in stratified analyses according to sleep duration, and the association was pronounced in sleep sufficiency group (Sleep Walking: OR = 1.62; Sleep Terror: OR = 1.35; Nightmare: OR = 1.35, all p˂0.001). Moreover, a dose-dependent pattern was observed, in which cumulative parasomnia symptoms were associated with increasing risk of sleep onset delay (2 symptoms: OR = 1.19; ≥3 symptoms: OR = 1.40; by comparison with ≤1 symptom). All these findings were also similarly observed in the propensity score matching sample. Moreover, the associations were generally established in both Shanghai and Sanya children. CONCLUSIONS Parasomnia symptoms were associated with a higher risk of sleep onset delay independently of sleep duration among children. More studies are needed to enrich the current evidence, thus further clarifying the association and interaction among different sleep parameters.
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Affiliation(s)
- Ruoyu Lu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Rong Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yiting Chen
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Ye Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Wenhui Kang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Anda Zhao
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Xiaoya Lin
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shijian Liu
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China; Department of Clinical Epidemiology and Biostatistics, Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia
| | - Zhaohui Lu
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China; National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China; Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Li W, Yang G, Tian W, Li Y, Zhang L, Wang Y, Hong Y. Bibliometric and visual analysis of nocturnal enuresis from 1982 to 2022. Front Pediatr 2022; 10:972751. [PMID: 36034562 PMCID: PMC9412014 DOI: 10.3389/fped.2022.972751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023] Open
Abstract
Nocturnal enuresis is a common disorder among children that seriously affects physical and mental health and has become a social problem. Bibliometric analysis is a valid way to examine existing research results, current research hotspots and research frontiers. Current studies on nocturnal enuresis are numerous and complex, but a bibliometric analysis of the existing research on nocturnal enuresis has yet to be published. To better identify the research trends and frontiers in nocturnal enuresis, it is necessary to conduct a comprehensive review and analysis. We used bibliometric and visualization methods to analyze the 1,111 papers published between 1982 and 2022 from the Web of Science core collection. Basic information about the country, institution, and authors was analyzed, which led to a basic understanding of nocturnal enuresis. The United States is the most prolific country, Ghent University is the most influential institution, and Rittig Soren is the most prominent scholar. The frequency of keywords, clustering, and the cited literature were analyzed to understand the hotspots and frontiers of research, and a brief review of the highly cited literature was conducted. The current research hotspots are the treatment modalities for nocturnal enuresis, epidemiological investigations, and the exploration of pathogenesis. Clinical research, adenoidectomy, aquaporin 2, and response inhibition are potential research hotspots. The standardization of terminology in nocturnal enuresis and the pathologies of polyuria and sleep disorder are at the forefront of research. In summary, the results of our bibliometric analysis reveal views on the current situation and the trend of nocturnal enuresis research for the first time. This study may provide guidance for promoting research on nocturnal enuresis.
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Affiliation(s)
- Wenjie Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Yang
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenxiu Tian
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunqi Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zhang
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Youjie Wang
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanlong Hong
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Yilmaz EŞ, Büyük ET. Effect of education given to children with enuresis on quality of life. J Pediatr Urol 2021; 17:648.e1-648.e7. [PMID: 34518125 DOI: 10.1016/j.jpurol.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The quality of life of children diagnosed with enuresis is affected negatively compared with that of healthy children. OBJECTIVES This study aimed to evaluate the effect of the education program given within the framework of nursing activities on the quality of life of children diagnosed with enuresis. STUDY DESIGN The study was conducted on 60 children aged 7-12 years who applied to the urology clinic of a hospital in Turkey and were diagnosed with enuresis. Data were collected using the Pediatric Incontinence Questionnaire (PINQ). Children who met the study criteria were divided into two groups, control and experimental, using the random draw method. Participants in the experimental group were educated by the researcher with using the Enuresis Education Booklet. RESULTS Of the 60 children, 43.3% were aged 7-8 years and 63.3% were male. At baseline, the children in the control group revealed a total mean PINQ score of 45.00 ± 11.52, and the total mean PINQ score was 45.80 ± 12.05 at 1 month. At baseline, the children in the experimental group revealed a total mean PINQ score of 47.00 ± 11.88, and the total mean PINQ score of was 32.404 ± 8.62 at 1 month. A measurement carried out in the education and control groups 1 month later showed a statistically significant difference in the total mean PINQ scores (P < 0.001). CONCLUSION Explaining the disease thoroughly to a child created a positive effect on the child's quality of life.
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Affiliation(s)
| | - Esra Tural Büyük
- Department of Child Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey.
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Rangel RA, Seabra CR, Ferrarez CEPF, Soares JL, Choi M, Cotta RG, Figueiredo AA, de Bessa J, Murillo B J. Quality of life in enuretic children. Int Braz J Urol 2021; 47:535-541. [PMID: 33620999 PMCID: PMC7993947 DOI: 10.1590/s1677-5538.ibju.2020.0308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/02/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nocturnal enuresis is a highly incident chronic disorder that generates countless problems to the child and their parents. Bed-wetting has significant negative impacts on self-esteem and the performance of children. The aim of the current study is to assess the quality of life of enuretic children, as well as its association to sex and age. PATIENTS AND METHODS Thirty-nine enuretic children (23 boys) and 49 healthy children (27 boys) without any history of previous treatment for enuresis or voiding dysfunction were included. Age ranged between 6 and 11 years old. The "AUQEI" questionnaire was applied in a private environment to all children by the same researcher (psychologist) to evaluate quality of life. RESULTS Enuretic children displayed loss in quality of life when compared to non-enuretic (35.9% of enuretic x 16.3% of non-enuretic, p=0.035). They were mostly affected in their daily activities (p=0.02). No significant differences were found in the association of sex and gender with quality of life. These results suggest that, children with nocturnal enuresis have 2.87 times more chances of having loss in quality of life compared to non-enuretic. CONCLUSIONS Enuresis has a great impact in quality of life of children. This impact is not related to the age or sex of the child.
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Affiliation(s)
- Raquel A Rangel
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Carolina Ribeiro Seabra
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Carlos Eduardo P F Ferrarez
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Josana L Soares
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Mauro Choi
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Robert Gomes Cotta
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Andre Avarese Figueiredo
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - José de Bessa
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Jose Murillo B
- Departamento de Cirurgia, Seção de Urologia - Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
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Jamieson D, Beaudequin DA, McLoughlin LT, Parker MJ, Lagopoulos J, Hermens DF. Associations between sleep quality and psychological distress in early adolescence. J Child Adolesc Ment Health 2020; 32:77-86. [PMID: 33206591 DOI: 10.2989/17280583.2020.1811288] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Although numerous studies have reported an association between sleep quality and mental health, few have focused on this association exclusively in early adolescence. Targeting this age group is vital as many mental illnesses first emerge during adolescence and remain a significant burden throughout life. Method: In the current study n = 60 participants aged 12 years completed the Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10). Results: Consistent with previous findings, bivariate correlations revealed significant positive linear relationships between K10 total score and (i) PSQI total score; (ii) sleep quality; (iii) daytime dysfunction; and (iv) sleep disturbance. However, contrary to previous findings, there was no significant correlation between K10 scores and sleep duration. Conclusion: The association between sleep quality and psychological distress in early adolescents provides some important clues about the role that sleep may play in predicting the onset of anxiety and depressive disorders. Longitudinal studies should be undertaken to investigate age-related changes in sleep and psychological distress.
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Affiliation(s)
- Daniel Jamieson
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
| | - Denise A Beaudequin
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
| | - Larisa T McLoughlin
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
| | - Marcella J Parker
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
| | - Daniel F Hermens
- Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia
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Liu B, Gao F, Zhang J, Zhou H, Sun N, Li L, Liang L, Ning N, Wu Q, Zhao M. Sleep Quality of Students from Elementary School to University: A Cross-Sectional Study. Nat Sci Sleep 2020; 12:855-864. [PMID: 33154689 PMCID: PMC7605933 DOI: 10.2147/nss.s266493] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sleep affects a wide array of health outcomes and is associated with the quality of life. Among students, sleep quality is affected by school stage and grade; however, data regarding the different sleep-related problems students experience at different school stages are limited. In this study, we aimed to explore sleep quality among a student sample ranging from elementary school to university level. METHODS Overall, data were examined for 9392 subjects aged 9-22 years. Information on sociodemographic characteristics and other variables were collected through self-administered questionnaires. Sleep quality on school nights was evaluated using the standard Pittsburgh Sleep Quality Index; global score >5 was classified as poor sleep quality. For the high school sample, logistic regression analysis was used to estimate associations between sleep quality and certain factors. RESULTS Of the elementary school, middle school, vocational high school, senior high school, and university students, 7.5%, 19.2%, 28.6%, 41.9%, and 28.5%, respectively, showed poor sleep quality. The high school students reported the highest prevalence of shorter sleep duration (70.8%), day dysfunction (84.7%), and subjective poor sleep quality (17.2%). The elementary school students showed the highest prevalence of poor sleep efficiency (17.9%). The university students showed the highest prevalence of sleep medication use (6.4%). The vocational high school students reported the highest prevalence of sleep latency (6.3%) and sleep disturbance (7.4%). Logistic regression modeling indicated that sleep quality is positively associated with school stage, grade, family atmosphere, academic pressure, and number of friends. CONCLUSION Sleep quality and sleep features change greatly from elementary school to university. Interventions to improve sleep quality should consider targeting the specific issues students experience at each school stage. Alarmed by the high prevalence of poor sleep quality among high school students, it is recommended that high school students should be informed of their sleep matter and the consequences.
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Affiliation(s)
- Baohua Liu
- School of Health Services and Management, Ningbo College of Health Sciences, Ningbo315100, Zhejiang, People’s Republic of China
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin150081, Heilongjiang, People’s Republic of China
| | - Fei Gao
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin150030, Heilongjiang, People’s Republic of China
| | - Jianfeng Zhang
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin150030, Heilongjiang, People’s Republic of China
| | - Hongguo Zhou
- School of Health Services and Management, Ningbo College of Health Sciences, Ningbo315100, Zhejiang, People’s Republic of China
| | - Ning Sun
- School of Health Services and Management, Ningbo College of Health Sciences, Ningbo315100, Zhejiang, People’s Republic of China
| | - Laiyou Li
- School of Health Services and Management, Ningbo College of Health Sciences, Ningbo315100, Zhejiang, People’s Republic of China
| | - Libo Liang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin150081, Heilongjiang, People’s Republic of China
| | - Ning Ning
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin150081, Heilongjiang, People’s Republic of China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin150081, Heilongjiang, People’s Republic of China
| | - Miaomiao Zhao
- Department of Health Management, School of Public Health, Nantong University, Nantong226019, Jiangsu, People’s Republic of China
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Caswell N, Kuru K, Ansell D, Jones MJ, Watkinson BJ, Leather P, Lancaster A, Sugden P, Briggs E, Davies C, Oh C, Bennett K, DeGoede C. Patient Engagement in Medical Device Design: Refining the Essential Attributes of a Wearable, Pre-Void, Ultrasound Alarm for Nocturnal Enuresis. Pharmaceut Med 2020; 34:39-48. [PMID: 31970684 DOI: 10.1007/s40290-019-00324-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To date, no pre-void wearable alarm exists to treat nocturnal enuresis (NE)-night-time bedwetting, and children with NE and their families are disappointed in relation to the post-void moisture alarms and medicine currently available. Development of a safe, comfortable and non-invasive wearable pre-void alarm and associated technology, using advanced mechatronics, is underway (the MyPAD device). Each stage of development includes patient and public involvement (PPI), particularly with respect to human factors, in collaboration with physicians, radiologists, psychologists, nurses, engineers and designers. OBJECTIVES The aim of this study was to help us understand the families' experience of the condition of enuresis, and to provide opinion relating to existing NE alarms, designed to detect moisture, and most importantly, the initial design of the MyPAD wearable technology. METHODS A PPI workshop in the form of a focus group, made up of children with enuresis and their parents, was conducted during the early stage of the MyPAD product development. The key research questions (RQs) were: (RQ1) What were the families' experiences of using existing post-void enuresis alarms? (RQ2) What do families like about the MyPAD prototype? and (RQ3) What do families not like about the MyPAD prototype? A nurse specialised in terms of NE treatment, including post-void alarms, from the Lancashire Teaching Hospitals NHS Foundation Trust, and two MyPAD design engineers were also present, to explain the MyPAD design concept. Braun and Clarke's six-phase approach to thematic analysis was implemented, which included familiarisation with the data, initial descriptive coding, identifying themes, reviewing themes, defining and labelling themes and producing a report. RESULTS Four common themes were identified from the focus group discussions: the importance of sleep; children do not want to feel different; parents feel frustrated and concerned; resilience and perseverance. These themes applied across the research questions; for example, sleep disruption was highlighted as an issue with existing post-void alarms and as an important requirement for the design of MyPAD. The evaluation of the early version of the MyPAD device has prompted the consideration of changes to some existing facets of the device, including providing multiple alarm types, more options for the design of the garment that houses the device, and the need for clear, age-appropriate and informative instructions relating to how the device should be used, in order to maximise its performance/efficiency and acceptance. CONCLUSIONS The qualitative data derived from the focus group discussion was incredibly valuable as it enabled the research and design team to experience the perspectives of the families in terms of the challenges and conflicts of managing the condition and the limited utility of existing post-void alarms. This has improved our understanding of the social and environmental challenges that will need to be considered during the design process.
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Affiliation(s)
- Noreen Caswell
- School of Psychology, University of Central Lancashire, 118 Darwin Building, Preston, Lancashire, PR1 2HE, UK.
| | - Kaya Kuru
- School of Engineering, University of Central Lancashire, Preston, UK
| | - Darren Ansell
- School of Engineering, University of Central Lancashire, Preston, UK
| | - Martin J Jones
- School of Engineering, University of Central Lancashire, Preston, UK
| | | | - Peter Leather
- Department of IP and Commercialization Innovation and Enterprise, University of Central Lancashire, Preston, UK
| | - Andrew Lancaster
- Department of Paediatric, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Paula Sugden
- Department of Paediatric, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Eleanor Briggs
- School of Psychology, University of Central Lancashire, 118 Darwin Building, Preston, Lancashire, PR1 2HE, UK
| | - Carl Davies
- School of Engineering, University of Central Lancashire, Preston, UK
| | - Chooi Oh
- Department of Radiology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Kina Bennett
- Centre for Health Research and Innovation, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Christian DeGoede
- Department of Paediatric, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Hu Z, Qin L, Kaminga AC, Xu H. Relationship between multiple lifestyle behaviors and health-related quality of life among elderly individuals with prediabetes in rural communities in China: A STROBE-compliant article. Medicine (Baltimore) 2020; 99:e19560. [PMID: 32282705 PMCID: PMC7440255 DOI: 10.1097/md.0000000000019560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Evidence of the effect of lifestyle behaviors on health-related quality of life (HRQoL) is scarce or ambiguous. The objective of the present study was to explore the associations between multiple lifestyle behaviors and HRQoL among the elderly individuals with prediabetes.Four hundred thirty-four elderly individuals with prediabetes were included in this cross-sectional study. The Medical Outcomes Study 36-Item Short Form Health Survey Questionnaire (SF-36) was used to assess HRQoL. Multiple lifestyle behaviors, including smoking, alcohol consumption, physical activity, dietary habits, daily sedentary time and sleep duration were self-reported. The associations between HRQoL and multiple lifestyle behaviors were examined using a multivariate linear regression analysis.Lower-risk physical activities (β =3 .19, 95% CI: 1.32, 5.64), dietary habits (β = 2.60, 95% CI: 1.50, 4.72), and sedentary time (β = 2.49, 95% CI: 1.21, 4.81) were positively associated with the physical health component score (PCS) for HRQoL. Meanwhile, a lower-risk behavior, such as sleep duration (β = 2.64, 95% CI: 1.77, 4.51), was associated with a higher mental health component score (MCS) for HRQoL after adjusting for socio-demographic factors, chronic diseases, anthropometric data and all other lifestyle behaviors. Engaging in a greater number of lower-risk lifestyle behaviors was positively correlated with a better HRQoL.Multiple lifestyle behaviors were associated with HRQoL among the elderly individuals with prediabetes in rural areas. These results highlight the need for multiple lifestyle behavioral interventions to maintain and improve HRQoL in the elderly individuals with prediabetes.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University
| | - Lulu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Luwinga, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University
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van Markus-Doornbosch F, Peeters E, Volker G, van der Pas S, Vliet Vlieland T, Meesters J. Physical activity, fatigue and sleep quality at least 6 months after mild traumatic brain injury in adolescents and young adults: A comparison with orthopedic injury controls. Eur J Paediatr Neurol 2019; 23:707-715. [PMID: 31466810 DOI: 10.1016/j.ejpn.2019.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/27/2019] [Accepted: 08/05/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare physical activity (PA), fatigue and sleep quality in adolescents and young adults (AYAs) after mild TBI (mTBI) to persons of similar age after orthopedic injury (OI) on the longer term. SETTING Follow-up at least 6 months after visiting the emergency department of one of 2 general hospitals. PARTICIPANTS Forty-nine patients aged 12-25 years (mean 18.4 years), diagnosed with mTBI and 54 patients aged 12-25 years (mean 15.8 years) with OI. DESIGN Cross-sectional electronic survey study. MAIN OUTCOME MEASURES The Activity Questionnaire for Adults and Adolescents with results dichotomized for meeting/not meeting Dutch Health Enhancing PA recommendations (D-HEPA), the Checklist Individual Strength (range 20-140, low-high) measuring fatigue, and the Pittsburgh Sleep Quality Index (range 0-21, high-low) measuring sleep quality were administered. RESULTS Patients with mTBI less frequently met D-HEPA recommendations than patients with OI (49% vs. 70%; OR 2.87, 95%CI 1.07, 7.72) and reported more concentration-related fatigue problems (mean 19.1 (SD 8.0), mean 13.9 (SD 7.8), respectively; β 3.98, 95%CI 0.39, 7.56), after adjusting for potential confounders, sex, BMI, age and time since injury. No differences were found in sleep quality. CONCLUSIONS Identifying symptoms and limitations in activities is important after mTBI so that rehabiliation treatment can be initiated. Whether physical activity or fatigue is the best target for treatment remains to be established.
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Affiliation(s)
- Frederike van Markus-Doornbosch
- Basalt Rehabilitation, The Hague, the Netherlands; Leiden University Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, the Netherlands.
| | - Els Peeters
- Department of Neurology, Haga Teaching Hospital, The Hague, the Netherlands
| | | | | | - Thea Vliet Vlieland
- Basalt Rehabilitation, The Hague, the Netherlands; Leiden University Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, the Netherlands; Leiden University Medical Center, Department of Statistics, Leiden, the Netherlands
| | - Jorit Meesters
- Basalt Rehabilitation, The Hague, the Netherlands; Leiden University Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, the Netherlands
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Parmar A, Yeh EA, Korczak DJ, Weiss SK, Lu Z, Zweerink A, Toulany A, Murray BJ, Narang I. Depressive symptoms, sleep patterns, and physical activity in adolescents with narcolepsy. Sleep 2019; 42:5487461. [DOI: 10.1093/sleep/zsz111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 04/02/2019] [Indexed: 11/12/2022] Open
Abstract
AbstractStudy ObjectivesTo evaluate the association between depressive symptoms, sleep patterns (duration and quality), excessive daytime sleepiness (EDS), and physical activity (PA) in adolescents with narcolepsy.MethodsThis cross-sectional study included adolescents (ages 10–18 years) with narcolepsy attending a tertiary care facility (The Hospital for Sick Children, Toronto, Canada). Adolescents with narcolepsy completed questionnaires evaluating depressive symptoms (Children’s Depression Inventory-2nd edition [CDI-2]), sleep quality (Pittsburgh Sleep Quality Index), EDS (Epworth Sleepiness Scale), and PA (Godin Leisure-Time Exercise Questionnaire). Wrist-based actigraphy was worn by adolescents for 1 week to measure total sleep time (over 24 hr) and sleep efficiency percentage.ResultsThirty adolescents with narcolepsy (mean age = 13.8 ± 2.2 years, 76.7% male) participated. In this cohort of adolescents with narcolepsy, 23.3% had CDI-2 total scores in the elevated range. Greater CDI-2 total scores were associated with poor sleep quality (ρ = 0.571; p = 0.02), EDS (ρ = 0.360; p = 0.05), and lower self-reported PA levels (ρ = −0.512; p < 0.01).ConclusionsAdolescents with narcolepsy report experiencing depressive symptoms, which are associated with poor sleep quality, EDS, and low PA levels. Strategies to improve nocturnal sleep quality and symptoms of EDS as well as promoting increased PA levels in adolescents with narcolepsy may provide an opportunity to improve depressive symptoms in this population. Multidisciplinary care with mental health and sleep specialists for adolescents with narcolepsy is needed.
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Affiliation(s)
- Arpita Parmar
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - E Ann Yeh
- University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daphne J Korczak
- University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shelly K Weiss
- University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zihang Lu
- University of Toronto, Toronto, Ontario, Canada
| | - Allison Zweerink
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Alene Toulany
- University of Toronto, Toronto, Ontario, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brian J Murray
- University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Sunnybrook Health Sciences Centre, Department of Medicine, Toronto, Ontario, Canada Work Performed: The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Indra Narang
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
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Sousa E Silva GJ, Sammour SNF, Ferraro AA, Koch VHK. Study of the profile of behavioral problems and quality of life indexes in a pediatric cohort of monosymptomatic enuresis. J Pediatr (Rio J) 2019; 95:188-193. [PMID: 29428322 DOI: 10.1016/j.jped.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/30/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate and correlate, before and after the therapeutic intervention, the behavioral problem scores evaluated by the CBCL/6-18 questionnaire and the quality of life indexes evaluated by the PedsQL™ 4.0 in patients with monosymptomatic nocturnal enuresis. METHOD After the initial evaluation and completion of the CBCL/6-18 questionnaire, a multidisciplinary evaluation and completion of the PedsQL™ 4.0 questionnaire was performed. Of the initially evaluated 140 children and adolescents aged 6-16 years, 58 were excluded due to non-monosymptomatic enuresis or associated comorbidities. Of the initially included 82 patients, who were randomized to three treatment groups, 59 completed the CBCL/6-18 and PedsQL™ 4.0 questionnaires at the end of the treatment and were included in this study. The α error was set at 5% for ruling out the null hypothesis. RESULTS Of the total of 59 participants, 45.8% responded with total success, 23.7% were partially successful, 23.7% did not reach the improvement criteria, and 6.8% gave up the treatment. There was a significant increase in quality of life indexes and a reduction of post-intervention behavioral problem scores, in the three proposed modalities, in patients who had a total or partial response to treatment. There was no correlation between higher scores of pre-treatment behavior problems and therapeutic failure. CONCLUSIONS Only the participants who successfully responded to interventions showed improvement in quality of life and behavioral problems, which indicates that enuresis is a primary problem that has a negative impact on these parameters. The authors suggest that it is possible to achieve success in the treatment of monosymptomatic enuresis, even in patients with high pre-intervention behavioral problem scores.
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Affiliation(s)
| | - Simone Nascimento Fagundes Sammour
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, Hospital das Clínicas, Instituto da Criança (ICr), São Paulo, SP, Brazil
| | | | - Vera Hermina Kalika Koch
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil
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Sousa e Silva GJ, Sammour SNF, Ferraro AA, Koch VHK. Study of the profile of behavioral problems and quality of life indexes in a pediatric cohort of monosymptomatic enuresis. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Maternik M. Understanding of and misconceptions around monosymptomatic nocturnal enuresis: findings from patient and physician surveys. J Pediatr Urol 2019; 15:37.e1-37.e8. [PMID: 30340929 DOI: 10.1016/j.jpurol.2018.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/18/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Monosymptomatic nocturnal enuresis (MNE) is a common paediatric condition, caused by the interaction of multiple physiological mechanisms. The condition can lead to psychiatric comorbidities that are detrimental to quality of life but is under-recognised and misunderstood by society and healthcare providers. OBJECTIVE The objective of this study was to gather information from non-specialist physicians on their understanding of enuresis in selected European countries and from patients about the prevalence of MNE, its relationship with comorbidities and the burden of the condition. MATERIALS AND METHODS Between June 2016 and March 2017, physicians and patients in Alpe-Adria, Italy, Romania, Russia, Serbia and Slovakia were asked to complete different surveys on their understanding of the medical condition, its impact on the lives of patients and the prevalence of comorbidities. Surveys were translated into local languages. Survey responses were collated, and data were presented descriptively. RESULTS Overall, 261 physicians (paediatricians comprising nearly two-thirds) and 340 patients (approximately two-thirds were male) completed their respective surveys. Most physicians (67%) believed MNE to be caused by circadian variation of antidiuretic hormone but also mentioned psychological factors as a cause (48%). The most common explanation for MNE given by patients was psychological factors (26%), but 17% gave no explanation. For patients, difficulties related to enuresis were often behavioural (77%), including difficulties at school (61%) and with sleeping (40%). Physicians perceived low self-esteem (32%), anxiety (24%) and embarrassment (17%) as having the greatest impact on patients. There was disagreement among physicians about which discipline is best placed to treat MNE. Favoured treatments were not necessarily consistent with evidence-based guidelines, with lifestyle changes and pharmacological interventions cited most frequently. DISCUSSION The findings of these complementary surveys illustrate that the causes and best treatment of MNE are subject to misconceptions on the part of both the physician and the patient's caregiver. Overall, MNE is perceived as a psychological condition, rather than having a multifactorial pathophysiological basis with a substantial psychological impact. Educational initiatives for healthcare practitioners and the public should help to optimise the understanding of MNE and care of patients.
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Affiliation(s)
- M Maternik
- Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Dębinki 7, 80-211, Gdansk, Poland.
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15
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Örengül AC, Ucuz İ, Oner Battaloglu N, Ozek G, Gormez V. Prevalence of psychiatric disorders and suicidality among children and adolescents with thalassemia major—A Turkish sample. CHILDRENS HEALTH CARE 2019. [DOI: 10.1080/02739615.2018.1500290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - İlknur Ucuz
- Child and Adolescent Psychiatry Clinic, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Nergiz Oner Battaloglu
- Pediatric Hematology and Oncology Clinic, Losante Child and Adult’s Hospital, Ankara, Turkey
| | - Gulcihan Ozek
- Pediatric Hematology and Oncology Clinic, Manisa Merkezefendi Public Hospital, Manisa, Turkey
| | - Vahdet Gormez
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, MRCPsych, Istanbul, Turkey
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Ma J, Li S, Jiang F, Jin X, Zhang Y, Yan C, Tian Y, Shen X, Li F. Relationship between sleep patterns, sleep problems, and childhood enuresis. Sleep Med 2018; 50:14-20. [DOI: 10.1016/j.sleep.2018.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/06/2018] [Accepted: 05/07/2018] [Indexed: 01/18/2023]
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17
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The Effectiveness of Response Inhibition Cognitive Rehabilitation in Improving the Quality of Sleep and Behavioral Symptoms of Children with Attention-Deficit/Hyperactivity Disorder. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/jkums.77114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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18
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Ma Y, Liu X, Shen Y. Behavioral factors for predicting severity of enuresis and treatment responses in different compliance groups receiving behavioral therapy. Pak J Med Sci 2017; 33:953-958. [PMID: 29067072 PMCID: PMC5648971 DOI: 10.12669/pjms.334.12922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To investigate behavioral factors for predicting severity of nocturnal enuresis and compare response rates in different compliance groups of behavioral interventions. Methods: Three hundred eleven children diagnosed with nocturnal enuresis were enrolled. This study was conducted at Beijing Children’s Hospital affiliated to the Capital Medical University from September 2016 to December 2016. Correlation of severity of enuresis and behavioral factors was investigated. All patients were treated with desmopressin based on behavioral interventions. After twomonth treatment, the patients were grouped according to the compliance of behavioral therapy. Then response rates in different compliance groups were compared. Results: Multivariate analysis revealed stool frequency, drinking water before going to bed, awaking the child to toilet at night, and appetite were independent risk factors affecting the severity of enuresis. The complete response rate of enuresis and partial response ratein fullcompliance group are higher than thoseof partial compliance and non-compliance group(21.9% vs 11.3%, 78.1% vs 59.8%; 21.9% vs 0%, 78.1% vs 49.1%; P<0.01). The complete response rate and partial response rate of partial compliance group are higher than those of the non-compliance group (P<0.01). Conclusions: Stool frequency, drinking water before going to bed, awaking the child to toilet at night, and appetite are independent predictive factors affecting the severity of enuresis. Good compliance of behavioral interventions may have a crucial role for better therapeutic outcomes.
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Affiliation(s)
- Yanli Ma
- Yanli Ma, Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Chronic Kidney Disease andBlood Purification of Children. No.56, South Lishi Road, Xicheng District, Beijing, China
| | - Xiaomei Liu
- Xiaomei Liu, Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Chronic Kidney Disease andBlood Purification of Children. No.56, South Lishi Road, Xicheng District, Beijing, China
| | - Ying Shen
- Ying Shen, Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Chronic Kidney Disease andBlood Purification of Children. No.56, South Lishi Road, Xicheng District, Beijing, China
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Jonsson U, Alaie I, Löfgren Wilteus A, Zander E, Marschik PB, Coghill D, Bölte S. Annual Research Review: Quality of life and childhood mental and behavioural disorders - a critical review of the research. J Child Psychol Psychiatry 2017; 58:439-469. [PMID: 27709604 DOI: 10.1111/jcpp.12645] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND An individual's subjective perception of well-being is increasingly recognized as an essential complement to clinical symptomatology and functional impairment in children's mental health. Measurement of quality of life (QoL) has the potential to give due weight to the child's perspective. SCOPE AND METHODOLOGY Our aim was to critically review the current evidence on how childhood mental disorders affect QoL. First, the major challenges in this research field are outlined. Then we present a systematic review of QoL in children and adolescents aged 0-18 years formally diagnosed with a mental and behavioural disorder, as compared to healthy or typically developing children or children with other health conditions. Finally, we discuss limitations of the current evidence base and future directions based on the results of the systematic review and other relevant literature. FINDINGS AND CONCLUSIONS The systematic review identified 41 eligible studies. All were published after the year 2000 and 21 originated in Europe. The majority examined QoL in neurodevelopmental disorders, including attention-deficit hyperactivity disorder (k = 17), autism spectrum disorder (k = 6), motor disorders (k = 5) and intellectual disability (k = 4). Despite substantial heterogeneity, studies demonstrate that self-reported global QoL is significantly reduced compared to typical/healthy controls across several disorders and QoL dimensions. Parents' ratings were on average substantially lower, casting doubt on the validity of proxy-report. Studies for large diagnostic groups such as depressive disorders, anxiety disorders, (early onset) schizophrenia and eating disorders are largely lacking. We conclude that representative, well-characterized normative and clinical samples as well as longitudinal and qualitative designs are needed to further clarify the construct of QoL, to derive measures of high ecological validity, and to examine how QoL fluctuates over time and is attributable to specific conditions or contextual factors.
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Affiliation(s)
- Ulf Jonsson
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna Löfgren Wilteus
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Eric Zander
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Peter B Marschik
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,iDN - Interdisciplinary Developmental Neuroscience, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.,Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Sven Bölte
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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Erwin AM, Bashore L. Subjective Sleep Measures in Children: Self-Report. Front Pediatr 2017; 5:22. [PMID: 28243584 PMCID: PMC5303893 DOI: 10.3389/fped.2017.00022] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/26/2017] [Indexed: 11/24/2022] Open
Abstract
The American Academy of Sleep Medicine (AASM) recently published a consensus statement on the recommended number of hours of sleep in infants and children. The AASM expert panel identified seven health categories in children influenced by sleep duration, a component of sleep quality. For optimal health and general function, children require a certain number of hours of sleep each night. Limited data exist to subjectively assess sleep in this population. Practitioners must evaluate overall sleep quality not simply sleep duration. The purpose of this article is to provide a mini-review of the self-report sleep measures used in children. The authors individually completed a review of the literature for this article via an independent review followed by collaborative discussion. The subjective measures included in this mini-review have been used in children, but not all measures have reported psychometrics. Several tools included in this mini-review measure subjective sleep in children but with limited reliabilities or only preliminary psychometrics. Accurate measurement of self-reported sleep in children is critical to identify sleep problems in this population and further detect associated health problems. Ongoing studies are warranted to establish reliable and valid measures of self-reported sleep in children to accurately detect health problems associated with poor sleep quality. This mini-review of the literature is an important first step to identify the most reliable subjective sleep measures in children.
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Affiliation(s)
- Andrea M Erwin
- Texas Christian University Harris College of Nursing and Health Sciences , Fort Worth, TX , USA
| | - Lisa Bashore
- Texas Christian University Harris College of Nursing and Health Sciences , Fort Worth, TX , USA
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21
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Sinha R, Raut S. Management of nocturnal enuresis - myths and facts. World J Nephrol 2016; 5:328-338. [PMID: 27458562 PMCID: PMC4936340 DOI: 10.5527/wjn.v5.i4.328] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/28/2016] [Accepted: 05/11/2016] [Indexed: 02/06/2023] Open
Abstract
Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of
treatment.
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Caldwell PHY, Sureshkumar P, Kerr MI, Hamilton S, Teixeira-Pinto A, Macaskill P, Craig JC. A randomised controlled trial of a code-word enuresis alarm. Arch Dis Child 2016; 101:326-31. [PMID: 26646854 DOI: 10.1136/archdischild-2015-308564] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 11/01/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare a novel code-word alarm with a commercially available wireless alarm for treating enuresis. SETTING A tertiary paediatric centre. PATIENTS Children aged 6-18 with at least 3 wet nights per week in the previous 6 months referred by doctors. OUTCOMES Primary outcome: the proportion who achieved a full response (14 consecutive dry nights) by 16 weeks. Secondary outcomes: change in frequency of wetting, duration of alarm training, percentage of wet nights that the child woke to the alarm, adherence to treatment, adverse events and satisfaction with treatment. RESULTS Of the 353 participants, 176 were assigned to the code-word alarm and 177 to control. At 16 weeks, 54% (95% CI 47% to 61%) in the experimental group and 47% (95% CI 40% to 55%) in the control group had achieved a full response (p=0.22), with 74% and 66%, respectively, attaining a 50% or more reduction in wetting frequency (p=0.14). The experimental group woke more often than the control group (median percentage of waking 88% vs 77%, p=0.003) and had a greater reduction in wet nights (median reduction of 10 vs 9 nights per fortnight). Fewer in the experimental group discontinued therapy before achieving a full response (27% vs 37% discontinued, p=0.04). There were no significant differences in relapse rates at 6 months, adverse events or satisfaction between the two alarms. CONCLUSIONS Although the code-word alarm increased waking, no difference in full response rates was demonstrated between the two alarms. TRIAL REGISTRATION NUMBER ACTRN12609000070235.
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Affiliation(s)
- Patrina H Y Caldwell
- Discipline of Paediatrics and Child Health, University of Sydney Clinical School, The Children's Hospital at Westmead, Sydney, New South Wales, Australia Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Premala Sureshkumar
- Discipline of Paediatrics and Child Health, University of Sydney Clinical School, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Marianne I Kerr
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Sana Hamilton
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Petra Macaskill
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Kovacevic L, Wolfe-Christensen C, Lu H, Lulgjuraj M, Abdulhamid I, Thottam PJ, Madgy DN, Lakshmanan Y. Adenotonsillectomy improves quality of life in children with sleep-disordered breathing regardless of nocturnal enuresis outcome. J Pediatr Urol 2015; 11:269.e1-5. [PMID: 26116409 DOI: 10.1016/j.jpurol.2015.03.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Nocturnal enuresis (NE) and sleep-disordered breathing (SDB) have both been associated with impaired health-related quality of life (HRQoL). The following were investigated: (1) whether tonsillectomy and/or adenoidectomy (T&A) significantly affect the HRQoL in children with NE and SDB, and 2) differences in HRQoL between children with NE persistence versus resolution post-T&A. METHODS This was a prospective study comparing the HRQoL of children with SDB and NE (study group) pre- and 4 weeks post-T&A, and the HRQoL of children with SDB without NE (control group) (independent t-tests). HRQol was assessed using the Obstructive Sleep Apnea Quality of Life 18 questionnaire (OSAS-18), a validated measure containing five subscales that combine to create a total score. Individual items were scored on a Likert-type scale ranging from 1 (none of the time) to 7 (all of the time). Symptoms of SDB were evaluated using the validated Pediatric Sleep Questionnaire (PSQ). Mixed ANOVA was conducted to evaluate changes in the measures between the wet and dry children post-T&A. Pre- and post-T&A change scores were calculated for both the PSQ and the OSAS-18. RESULTS There were 30 children in the study group (18 male, mean age 9.07 years, SD 2.19), and 30 age-matched controls (16 male). There were no statistically significant differences between the two groups in regards to OSAS-18 total, PSQ total, BMI, diagnosis of snoring or OSAS on sleep study, or race. Overall, OSAS-18 and PSQ scores significantly improved in all children post-surgery (p < 0.001; p < 0.001, respectively), with no significant differences between dry and wet children post-T&A. The correlation between the pre- and post-T&A change scores on the OSAS-18 and PSQ was significant (r(29) = 0.58, p = 0.001), suggesting that a reduction in SDB symptoms post T&A is related to improved HRQoL. CONCLUSIONS T&A significantly improved HRQoL in all children with SDB and NE, regardless of NE outcomes. These findings support recommendations for T&A in children with SDB with or without NE.
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Affiliation(s)
- Larisa Kovacevic
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA.
| | | | - Hong Lu
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
| | - Mark Lulgjuraj
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
| | - Ibrahim Abdulhamid
- Department of Sleep Medicine, Children's Hospital of Michigan, Detroit, MI, USA
| | - Prasad J Thottam
- Department of ENT, Children's Hospital of Michigan, Detroit, MI, USA
| | - David N Madgy
- Department of ENT, Children's Hospital of Michigan, Detroit, MI, USA
| | - Yegappan Lakshmanan
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
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Van Herzeele C, Dhondt K, Roels SP, Raes A, Groen LA, Hoebeke P, Vande Walle J. Periodic limb movements during sleep are associated with a lower quality of life in children with monosymptomatic nocturnal enuresis. Eur J Pediatr 2015; 174:897-902. [PMID: 25567793 DOI: 10.1007/s00431-014-2474-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/25/2014] [Accepted: 12/09/2014] [Indexed: 01/15/2023]
Abstract
UNLABELLED The study investigates whether cortical arousals and periodic limb movements during sleep are related to daytime psychological functioning in children with monosymptomatic nocturnal enuresis with associated nocturnal polyuria. Psychological functioning is evaluated on five domains: attention deficit hyperactivity disorder-inattentive problems, quality of life, internalizing problems, externalizing problems, and executive functioning. This multi-informant (parents, teachers, and children) and multi-method study included overnight video-polysomnography, questionnaires, and neuropsychological testing. Thirty children (7 girls) 6 to 16 years (mean 10.43 years, SD 3.08) were selected in a tertiary enuresis center. A high index of periodic limb movements during sleep was associated with a lower quality of life, according to the child. No significant correlations were found with attention deficit hyperactivity disorder-inattentive problems, internalizing problems, externalizing problems, and executive functioning. CONCLUSION This study clarifies the relationship between sleep parameters and psychological functioning of the children with monosymptomatic nocturnal enuresis and associated nocturnal polyuria according to the child, the parents, and the teachers. Periodic limb movements during sleep are associated with a lower quality of life of the child.
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Affiliation(s)
- Charlotte Van Herzeele
- Department of Pediatric Nephrology/Urology, University Hospital Ghent, De Pintelaan 185, 9000, Ghent, Belgium,
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Al-Zaben FN, Sehlo MG. Punishment for bedwetting is associated with child depression and reduced quality of life. CHILD ABUSE & NEGLECT 2015; 43:22-29. [PMID: 25435105 DOI: 10.1016/j.chiabu.2014.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 11/08/2014] [Accepted: 11/11/2014] [Indexed: 06/04/2023]
Abstract
This study assessed the relationship between parental punishment and depression as well as quality of life in children with primary monosymptomatic nocturnal enuresis (PMNE). A consecutive sample of 65 children (7-13 years) with PMNE and 40 healthy children, selected as controls (Group III), were included in the study. The children with PMNE were further sub-classified into two groups: Group I, which included children who received parental punishment for enuresis and Group II, which comprised children who were not punished for bedwetting. Depression and health-related quality of life (HRQL) were assessed among the three groups. The number of wet nights per week was significantly increased in Group I compared with Group II (P<.001). In addition, the severity of depressive symptoms increased in Group I as compared to the other two groups (P<.001). Similarly, the psychosocial HRQL lower in Group compared to the control group (Group III) (P<.001). Prior parental discipline, including corporal punishment (B=0.55, P=.008), as well as the frequency (B=0.73, P<.001) and duration of punishment (B=0.33, P=.02) were strong predictors of increased depressive symptom severity. It was also found that prior punishment (B=-0.42, P=.01) and the frequency (B=-0.62, P<.001) and duration of punishment (B=-0.34, P=.02) were strong predictors for poor psychosocial HRQL. Overall, parental punishment has a poor outcome in children with PMNE.
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Affiliation(s)
- Faten Nabeel Al-Zaben
- Department of Medicine, Psychiatry Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Gamal Sehlo
- Department of Medicine, Psychiatry Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Psychiatry, Zagazig University, Zagazig, Egypt
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Goessaert AS, Everaert K, Hoebeke P, Kapila A, Walle JV. Nocturnal enuresis and nocturia, differences and similarities - lessons to learn? Acta Clin Belg 2015; 70:81-6. [PMID: 25379877 DOI: 10.1179/2295333714y.0000000055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This review highlights the current views on and differences and similarities between nocturnal enuresis (NE) in children and nocturia in adults, which might be a guidance to elucidate the missing links in our knowledge. In both conditions, a genetic factor is suspected. Reduced bladder capacity and nocturnal polyuria are the main underlying lower urinary tract-related conditions. There is a link with sleep disorders, although it is not clear whether this is a cause or consequence. Physical and mental health are comprised in both conditions, however, in different ways. In NE, constipation and attention deficit disorder are the most important comorbidities and the effect on mental health and quality of life is mainly through the negative impact on self-esteem. In nocturia, cardiovascular disease and fall injuries are important comorbidities, mainly affecting the older nocturia population; personal distress and depression are consequences of the related poor sleep quality. For both conditions, treatment is often inadequate and a more individualized approach seems to be necessary. The main difference between NE and nocturia seems to be the difference in arousal to bladder stimuli, suggesting that sleep characteristics might be a key factor in these conditions.
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Factor analysis of the pediatric symptom checklist in a population of children with voiding dysfunction and/or nocturnal enuresis. J Clin Psychol Med Settings 2014; 21:72-80. [PMID: 24158241 DOI: 10.1007/s10880-013-9375-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The research objective was to identify the factor structure of the pediatric symptom checklist (PSC) in children with voiding dysfunction and/or nocturnal enuresis who were seen in a pediatric urology clinic. Retrospective chart reviews were conducted for 498 consecutive patients, ages 6-16, who were seen over a 13-month period. The PSC, a 35-item measure used to screen for psychosocial difficulties, was completed by the patient's caregiver. Confirmatory factor analyses using three previous models were conducted. A four factor model comprised of internalizing, externalizing, attention problems, and chronic illness factors represented the best fit to the data. Within this population, the PSC appears to capture internalizing and externalizing problems, difficulties with attention, and possible side effects of a medical condition. This information could aid clinicians in assessing adjustment difficulties within this population and concurrently allow researchers to examine whether these specific factors are related to other relevant outcomes.
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Carona C, Silva N, Moreira H. Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines. Expert Rev Pharmacoecon Outcomes Res 2014; 15:47-70. [DOI: 10.1586/14737167.2015.972377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Noone DM, Willis TA, Cox J, Harkness F, Ogilvie J, Forbes E, Sterr A, Gregory AM. Catastrophizing and poor sleep quality in early adolescent females. Behav Sleep Med 2014; 12:41-52. [PMID: 23473103 DOI: 10.1080/15402002.2013.764528] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Catastrophizing about sleeplessness has been investigated in adults and children, but little is known about adolescents. This article aimed to (a) investigate whether early adolescent girls catastrophized about consequences of sleeplessness, (b) describe topics in catastrophizing sequences, (c) examine the association between sleep quality and catastrophizing, and (d) assess whether puberty moderated this association. Girls (n = 115) between 11 and 12 years old completed adapted versions of the Pittsburgh Sleep Quality Index, the Pubertal Developmental Scale, and the Catastrophizing Interview. Twenty-four (21%) participants produced catastrophizing sequences, including concerns about school and mood. Sleep quality was associated with catastrophizing (β = 0.19, p = .042); however, puberty did not moderate this association (β = 0.15, p = .126). Findings highlight the importance of sleep-related cognitions in adolescent girls.
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Affiliation(s)
- Deirdre M Noone
- a Department of Psychology , Goldsmiths, University of London
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30
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Üçer O, Gümüş B. Quantifying subjective assessment of sleep quality, quality of life and depressed mood in children with enuresis. World J Urol 2013; 32:239-43. [PMID: 24150187 PMCID: PMC3901928 DOI: 10.1007/s00345-013-1193-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 10/11/2013] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this study was to compare a group of children who has monosymptomatic nocturnal enuresis (MNE) with a healthy control group by assessing their depression scales, quality of life and sleep quality. METHODS Hundred and one children with MNE and 38 healthy controls are included in the study, aged between 8 and 16 years old. All participants were performed the Pediatric Quality of Life Inventory (PedsQL 4.0), Depression Scale for Children (CES-DC) and The Pittsburgh Sleep Quality Index (PSQI) tests. The two groups were compared for their demographic factors and for the results of the tests above. RESULTS There were no significant differences between the two groups according to age, gender and other demographic factors. Quality of life, depression and sleep quality scores implied worse health in the patient group. The PedsQL scores were assessed as 1,659.90 ± 296.01 in the patient group and 1,818.42 ± 227.92 in the control group (p = 0.001). The CES-DC scores were 11.74 ± 6.11 in the patient group and 7.00 ± 3.97 in the control group (p < 0.001). And the PSQI scores were 2.58 ± 2.48 in the patient group, 1.15 ± 1.10 in the control group (p < 0.001). Also in the patient group, there was a positive correlation between participants' ages and the PedsQL (p = 0.010; r = 0.256), the CES-DC (p = 0.000; r = 0.382), the PSQI (p = 0.000; r = 0.403) scores. The success parameters at school were significantly worse in the patient group (p = 0.05). CONCLUSION All our findings show us that the children with nocturnal enuresis were affected negatively because of their disease; especially when they grow up the scores get worse health, so we suggest that treatment must be started at suitable age according to guidelines.
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Affiliation(s)
- Oktay Üçer
- Uşak State Hospital, Urology Clinic, Uşak, Turkey,
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31
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Abou-Khadra MK, Amin OR, Ahmed D. Association between sleep and behavioural problems among children with enuresis. J Paediatr Child Health 2013. [PMID: 23198684 DOI: 10.1111/jpc.12017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study was conducted to describe sleep problems in a sample of children with enuresis and to investigate the association between sleep and behavioural problems. METHODS In this cross-sectional study, 100 children with enuresis were recruited from paediatric enuresis clinic. The children's sleep problems and behaviours were assessed by the Children's Sleep Habits Questionnaire and Child Behaviour checklist. RESULTS The most frequently reported sleep problems were in daytime sleepiness, bedtime resistance and sleep anxiety subscales. Children with T-scores ≥ 60 in internalising, externalising and total behavioural problems had higher scores on daytime sleepiness subscale and total score than children with T-scores < 60. Multivariate logistic regression analysis revealed that daytime sleepiness subscale was significantly related to behavioural disturbances. CONCLUSIONS Sleep problems are common among this sample of children with enuresis, and the presence of sleep disturbance such as daytime sleepiness could explain the association between enuresis and disturbed daytime behaviour.
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Affiliation(s)
- Maha K Abou-Khadra
- Department of Paediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Siu YF, Chan S, Wong KM, Wong WS. The Comorbidity of Chronic Pain and Sleep Disturbances in a Community Adolescent Sample: Prevalence and Association with Sociodemographic and Psychosocial Factors. PAIN MEDICINE 2012; 13:1292-303. [DOI: 10.1111/j.1526-4637.2012.01473.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Okur M, Ruzgar H, Erbey F, Kaya A. The evaluation of children with monosymptomatic nocturnal enuresis for attention deficit and hyperactivity disorder. Int J Psychiatry Clin Pract 2012; 16:229-32. [PMID: 22122653 DOI: 10.3109/13651501.2011.620129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Monosymptomatic nocturnal enuresis (MNE) and attention deficit and hyperactivity disorder (ADHD) are multifactorial disorders and biological, social, and psychological factors may play significant roles in the development of both. Children with enuresis display a higher prevalence of ADHD compared to the normal population. This study aimed to evaluate the relationship between MNE and ADHD. METHODS A total of 64 children between the ages of 6 and 13 years who were referred due to primary MNE, their parents, and 42 healthy control cases, were evaluated in terms of attention deficit and hyperactivity by a child psychiatrist using the DSM-IV-2000-TR diagnosic scale. RESULTS Of the children with enuresis, 17 had predominantly inattentive type (26.6%), nine had predominantly hyperactive-impulsive type (14.1%), and eight had combined type (12.5%). In the control group, two cases had predominantly inattentive type (4.8%), two cases had predominantly hyperactive-impulsive type (4.8%), and one had combined type (2.4%). CONCLUSIONS The prevalence of ADHD is higher in children with MNE compared to the normal population. As attention deficit may also negatively effect the treatment of enuresis, children with MNE should be evaluated in terms of attention deficit and those with positive symptoms should be provided with psychosocial support.
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Affiliation(s)
- Mesut Okur
- Duzce University School of Medicine, Department of Pediatrics, Duzce, Turkey.
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Prevalence and quality of life of slovenian children with primary nocturnal enuresis. Int J Nephrol 2012; 2012:509012. [PMID: 22934181 PMCID: PMC3426229 DOI: 10.1155/2012/509012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 06/11/2012] [Accepted: 06/25/2012] [Indexed: 01/29/2023] Open
Abstract
Aim. To get epidemiologic data about primary nocturnal enuresis (PNE) and its influence on the quality of life of Slovenian children and adolescents and to find out the knowledge about the disorder among school population. Methods. Prospective epidemiologic study was performed in Slovenia in 2011 and supported with two questionnaires. The first questionnaire was distributed among primary school population that included 1248 children. The second questionnaire included 44 children, who have been treated for PNE in Nephrology Unit of our Department of Paediatrics. Results. PNE was diagnosed in 12.4% of children, in 11.8% of girls and in 13.0% of boys. There was evident linkage between the appearance of PNE in children and their relatives. The study showed that PNE influences the quality of life in less than half of the investigated children. Disorder restricts them mostly in relations with coevals. Knowledge about PNE among children in elementary schools was found to be insufficient. Conclusion. We found out that the prevalence of PNE in Slovenia is comparable to prevalence in other countries. More than half of children questioned in a survey think that PNE does not affect their lives significantly. General lack of knowledge about PNE is still a problem.
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Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S. Practical consensus guidelines for the management of enuresis. Eur J Pediatr 2012; 171:971-83. [PMID: 22362256 PMCID: PMC3357467 DOI: 10.1007/s00431-012-1687-7] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 01/25/2012] [Indexed: 02/07/2023]
Abstract
UNLABELLED Despite the high prevalence of enuresis, the professional training of doctors in the evaluation and management of this condition is often minimal and/or inconsistent. Therefore, patient care is neither optimal nor efficient, which can have a profound impact on affected children and their families. Once comprehensive history taking and evaluation has eliminated daytime symptoms or comorbidities, monosymptomatic enuresis can be managed efficaciously in the majority of patients. Non-monosymptomatic enuresis is often a more complex condition; these patients may benefit from referral to specialty care centers. We outline two alternative strategies to determine the most appropriate course of care. The first is a basic assessment covering only the essential components of diagnostic investigation which can be carried out in one office visit. The second strategy includes several additional evaluations including completion of a voiding diary, which requires extra time during the initial consultation and two office visits before treatment or specialty referral is provided. This should yield greater success than first-line treatment. CONCLUSION This guideline, endorsed by major international pediatric urology and nephrology societies, aims to equip a general pediatric practice in both primary and secondary care with simple yet comprehensive guidelines and practical tools (i.e., checklists, diary templates, and quick-reference flowcharts) for complete evaluation and successful treatment of enuresis.
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Affiliation(s)
- Johan Vande Walle
- Pediatric Nephrology Unit, Ghent University Hospital, Ghent, Belgium
- Pediatric Nephrology UZ Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - Soren Rittig
- Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark
| | - Stuart Bauer
- Department of Urology, Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Paul Eggert
- University Children’s Hospital, Kiel, Germany
| | | | - Serdar Tekgul
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
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Roeser K, Eichholz R, Schwerdtle B, Schlarb AA, Kübler A. Relationship of sleep quality and health-related quality of life in adolescents according to self- and proxy ratings: a questionnaire survey. Front Psychiatry 2012; 3:76. [PMID: 22969731 PMCID: PMC3432511 DOI: 10.3389/fpsyt.2012.00076] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 08/13/2012] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Sleep disturbances are common in adolescents and adversely affect performance, social contact, and susceptibility to stress. We investigated the hypothesis of a relationship between sleep and health-related quality of life (HRQoL), and applied self- and proxy ratings. MATERIALS AND METHODS The sample comprised 92 adolescents aged 11-17 years. All participants and their parents completed a HRQoL measure and the Sleep Disturbance Scale for Children (SDSC). Children with SDSC T-scores above the normal range (above 60) were classified as poor sleepers. RESULTS According to self- and proxy ratings, good sleepers reported significantly higher HRQoL than poor sleepers. Sleep disturbances were significantly higher and HRQoL significantly lower in self- as compared to parental ratings. Parent-child agreement was higher for subscales measuring observable aspects. Girls experienced significantly stronger sleep disturbances and lower self-rated HRQoL than boys. DISCUSSION Our findings support the positive relationship of sleep and HRQoL. Furthermore, parents significantly underestimate sleep disturbances and overestimate HRQoL in their children.
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Affiliation(s)
- Karolin Roeser
- Department of Psychology I, University of Würzburg Würzburg, Germany
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