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Xie EB, Jung JW, Kaur J, Benzies KM, Tomfohr-Madsen L, Keys E. Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies. J Med Internet Res 2023; 25:e43219. [PMID: 37494086 PMCID: PMC10413237 DOI: 10.2196/43219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. OBJECTIVE This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. METHODS A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. CONCLUSIONS New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
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Affiliation(s)
| | - James Wonkyu Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jasleen Kaur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- School of Nursing, The University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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Hall WA, Keys E, Ou C. A call to action about nurses promoting healthy sleep. Sleep Med 2023; 108:53-54. [PMID: 37327660 DOI: 10.1016/j.sleep.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Wendy A Hall
- UBC School of Nursing, The University of British Columbia, T 201 2211 Wesbrook Mall, Vancouver, BC, V6T2B5, Canada. https://twitter.com/wendyha65734663
| | - Elizabeth Keys
- School of Nursing, Okanagan Campus, ART360 (Arts Building), 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
| | - Christine Ou
- School of Nursing, University of Victoria, B, Victoria, BC, V8P 5C2, Canada.
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Ipsiroglu OS, Bhathella J, Boldut RP, Elbe D, Hill O, Keys E, McWilliams S, Silvestri R, Wensley DF. Understanding patient characteristics and medication prescriptions in children with mental health and neurodevelopmental disorders referred to a sleep clinic-A quality improvement/quality assurance analysis. Front Psychiatry 2022; 13:878356. [PMID: 36440388 PMCID: PMC9684724 DOI: 10.3389/fpsyt.2022.878356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Motivated by challenges faced in outpatient sleep services for mental health and neurodevelopmental disorders (MHNDD) during the COVID-19 clinical shutdown, a pan-Canadian/international working group of clinicians and social scientists developed a concept for capturing challenging sleep and wake behaviours already at the referral stage in the community setting. METHODS In a quality improvement/quality assurance (QIQA) project, a visual logic model was the framework for identifying the multiple causes and possible interventions for sleep disturbances. Intake forms informed clinicians about situational experiences, goals/concerns, in addition to the questions from the Sleep Disturbances Scale for Children (SDSC), the ADHD Rating Scale-IV and medication history. Descriptive statistics were used to describe the sample. RESULTS 66% of the pilot study patients (n = 41) scored in the SDSC red domains (highest scoring) with highest sub-scores for insomnia (falling asleep 73%; staying asleep: 51%) and daytime somnolence (27%). A total of 90% of patients were taking at least one medication; 59% sleep initiation/sleep medications, 41% in combination with further non-stimulant medications, 9% with stimulants, 27% with antidepressants and 18% with antipsychotics. Polypharmacy was observed in 62% of all patients and in 73% of the ones medicated for sleep disturbances. Qualitative information supported individualisation of assessments. CONCLUSION Our intake process enabled a comprehensive understanding of patients' sleep and wake profiles prior to assessment, at the referral stage. The high prevalence of insomnia in patients, combined with polypharmacy, requires special attention in the triaging process at the community level.
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Affiliation(s)
- Osman S Ipsiroglu
- H-Behaviours Research Lab (Previously Sleep/Wake-Behaviours Research Lab), BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Interdisciplinary Sleep Program, Divisions of Developmental Pediatrics, Respirology, and Child & Adolescent Psychiatry, Departments of Pediatrics and Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Juhi Bhathella
- H-Behaviours Research Lab (Previously Sleep/Wake-Behaviours Research Lab), BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Renee Paula Boldut
- H-Behaviours Research Lab (Previously Sleep/Wake-Behaviours Research Lab), BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Dean Elbe
- Healthy Minds Centre, BC Children's Hospital, Vancouver, BC, Canada.,Department of Pharmacy, Children's and Women's Health Centre of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Olivia Hill
- H-Behaviours Research Lab (Previously Sleep/Wake-Behaviours Research Lab), BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Interdisciplinary Sleep Program, Divisions of Developmental Pediatrics, Respirology, and Child & Adolescent Psychiatry, Departments of Pediatrics and Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Health and Social Development, School of Nursing, The University of British Columbia, Kelowna, BC, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Scout McWilliams
- H-Behaviours Research Lab (Previously Sleep/Wake-Behaviours Research Lab), BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Rosalia Silvestri
- Centro Interdipartimentale per la Medicina del Sonno UOSD di Neurofisiopatologia e Disordini del Movimento, Messina, Italy.,Dipartimento di Medicina Clinica e Sperimentale, AOU Messina, Messina, Italy
| | - David F Wensley
- Interdisciplinary Sleep Program, Division of Respirology, Department of Pediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Brockway ML, Keys E, Bright KS, Ginn C, Conlon L, Doane S, Wilson J, Tomfohr-Madsen L, Benzies K. Top 10 (plus 1) research priorities for expectant families and those with children to age 24 months in Alberta, Canada: results from the Family Research Agenda Initiative Setting (FRAISE) priority setting partnership project. BMJ Open 2021; 11:e047919. [PMID: 34887269 PMCID: PMC8663105 DOI: 10.1136/bmjopen-2020-047919] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The study objective was to identify the top 10 research priorities for expectant parents and caregivers of children up to age 24 months. DESIGN A priority setting partnership using a modified James Lind Alliance approach was implemented. First, a core steering committee was formed, consisting of 17 parents, clinicians and community agency representatives. Second, through in-person collaboration with steering committee members, we developed and distributed a survey to identify research priorities across 12 topics. In total, 596 participants consented and 480 completed the survey. Survey responses were grouped and themed into codes during a consensus-building workshop with steering committee members (n=18). Research and practice experts were consulted to provide feedback on which themes had already been researched. An in-person (n=21) workshop was used to establish the top 34 priorities, which were circulated to the broader steering committee (n=25) via an online survey. Finally, the core steering committee members (n=18) met to determine and rank a top 10 (plus 1) list of research priorities. SETTING This study was conducted in Alberta, Canada. PARTICIPANTS Expectant parents and caregivers of children up to age 24 months. RESULTS Survey results provided 3232 responses, with 202 unique priorities. After expert feedback and steering committee consensus, a list of 34 priorities was moved forward for final consideration. The final top 10 (plus 1) research priorities included three priorities on mental health/relationships, two priorities on each of access to information, immunity and child development, and one priority on each of sleep, pregnancy/labour and feeding. Selecting 11 instead of 10 priorities was based on steering committee consensus. CONCLUSIONS The findings will direct future maternal-child research, ensuring it is rooted in parent-identified priorities that represent contemporary needs. To provide meaningful outcomes, research in these priority areas must consider diverse socioeconomic backgrounds and experiences.
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Affiliation(s)
- Meredith Lee Brockway
- Pediatrics and Child Health, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Katherine Stuart Bright
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Outpatient Psychiatry, Alberta Health Services, Calgary, Alberta, Canada
| | - Carla Ginn
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Leslie Conlon
- FRAISE Steering Committee, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Doane
- FRAISE Steering Committee, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Lianne Tomfohr-Madsen
- Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
- Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Karen Benzies
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Paediatrics and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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MacKenzie NE, Keys E, Hall WA, Gruber R, Smith IM, Constantin E, Godbout R, Stremler R, Reid GJ, Hanlon-Dearman A, Brown CA, Shea S, Weiss SK, Ipsiroglu O, Witmans M, Chambers CT, Andreou P, Begum E, Corkum P. Children's Sleep During COVID-19: How Sleep Influences Surviving and Thriving in Families. J Pediatr Psychol 2021; 46:1051-1062. [PMID: 34472600 PMCID: PMC8522399 DOI: 10.1093/jpepsy/jsab075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has the potential to disrupt the lives of families and may have implications for children with existing sleep problems. As such, we aimed to: (1) characterize sleep changes during the COVID-19 pandemic in children who had previously been identified as having sleep problems, (2) identify factors contributing to sleep changes due to COVID-19 safety measures, and (3) understand parents' and children's needs to support sleep during the pandemic. METHODS Eighty-five Canadian parents with children aged 4-14 years participated in this explanatory sequential, mixed-methods study using an online survey of children's and parents' sleep, with a subset of 16 parents, selected based on changes in their children's sleep, participating in semi-structured interviews. Families had previously participated in the Better Nights, Better Days (BNBD) randomized controlled trial. RESULTS While some parents perceived their child's sleep quality improved during the COVID-19 pandemic (14.1%, n = 12), many parents perceived their child's sleep had worsened (40.0%, n = 34). Parents attributed children's worsened sleep to increased screen time, anxiety, and decreased exercise. Findings from semi-structured interviews highlighted the effect of disrupted routines on sleep and stress, and that stress reciprocally influenced children's and parents' sleep. CONCLUSIONS The sleep of many Canadian children was affected by the first wave of the COVID-19 pandemic, with the disruption of routines influencing children's sleep. eHealth interventions, such as BNBD with modifications that address the COVID-19 context, could help families address these challenges.
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Affiliation(s)
| | - Elizabeth Keys
- Department of Psychology and Neuroscience, Dalhousie
University, Canada
| | - Wendy A Hall
- School of Nursing, University of British
Columbia, Canada
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, and
Attention Behavior and Sleep Lab, Douglas Mental Health University Institute,
McGill University, Canada
| | - Isabel M Smith
- Departments of Psychology & Neuroscience and
Pediatrics, Dalhousie University, Canada
| | - Evelyn Constantin
- Department of Pediatrics, Montreal
Children’s Hospital, McGill University Health Centre,
Canada
| | - Roger Godbout
- Sleep Laboratory & Clinic, Department of
Psychiatry, Université de Montréal, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University
of Toronto, Canada
| | - Graham J Reid
- Departments of Psychology, Family Medicine &
Paediatrics, The University of Western Ontario, Canada
| | | | - Cary A Brown
- Faculty of Rehabilitation Medicine, University of
Alberta, Canada
| | - Sarah Shea
- Department of Pediatrics, Dalhousie University, IWK
Health Centre, Canada
| | - Shelly K Weiss
- Division of Neurology, Department of Pediatrics,
Hospital for Sick Children, University of Toronto, Canada
| | | | - Manisha Witmans
- Faculty of Medicine & Dentistry, University
of Alberta, Canada
| | - Christine T Chambers
- Departments of Psychology & Neuroscience and
Pediatrics, Dalhousie University, Canada
| | - Pantelis Andreou
- Department of Community Health and Epidemiology,
Faculty of Medicine, Dalhousie University, Canada
| | - Esmot Begum
- Department of Psychology and Neuroscience, Dalhousie
University, Canada
| | - Penny Corkum
- Department of Psychology and Neuroscience, Dalhousie
University, Canada
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MacKinnon AL, Madsen JW, Dhillon A, Keys E, Giesbrecht GF, Williamson T, Metcalfe A, Campbell T, Mrklas KJ, Tomfohr-Madsen L. Sleeping for two: study protocol for a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnant women. Trials 2021; 22:532. [PMID: 34384459 PMCID: PMC8358257 DOI: 10.1186/s13063-021-05498-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Insomnia and sleep disturbances are common in pregnancy and have potentially significant consequences for both maternal and infant health. There is limited research examining the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) during pregnancy. With increased distress and limited access to services during the COVID-19 pandemic, there is also an unprecedented need for telehealth delivery of treatment programs for pregnant women. The aims of this trial are to evaluate the impact of the Sleeping for Two adaptation of CBT-I in pregnancy (in-person or telehealth) versus treatment as usual (TAU) in reducing symptoms of insomnia (primary outcome), as well as increasing gestational length and reducing symptoms of depression (secondary outcomes). METHODS A two-arm, single-blinded, parallel group randomized controlled trial (RCT) design with repeated measures will be used to evaluate the impact of CBT-I compared to TAU among a sample of 62 pregnant women, enrolled between 12 and 28 weeks of gestation, who self-identify as experiencing insomnia. Five weekly individual sessions of CBT-I will be delivered in person or via telehealth depending on physical distancing guidelines. Assessment of insomnia diagnosis by structured interview, self-reported insomnia symptom severity and sleep problems, and sleep quantity and quality as measured by a daily diary and actigraphy will occur at 12-28 weeks of pregnancy (T1), 1 week post-treatment (T2), and 6 months postpartum (T3). DISCUSSION CBT-I delivered in pregnancy has the potential to reduce symptoms of insomnia and depression and could lead to reduced risk of preterm birth, all of which can minimize risk of negative maternal and child health and developmental consequences in the short (e.g., infant death) and long terms (e.g., developmental delays). This RCT builds on a successful open pilot trial conducted by our team and will provide further evaluation of a novel evidence-based treatment for pregnancy-related insomnia, which can be widely disseminated and used to treat individuals that are most in need of intervention. Findings will enhance understanding of pregnancy-related sleep problems, as well as means by which to improve the health and sleep of mothers and their children. TRIAL REGISTRATION ClinicalTrials.gov NCT03918057. Registered on 17 April 2019.
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Jemcov A, Keys E, Corkum P. Evaluating the feasibility of the ABCs of SLEEPING mobile application: Exploring implementation, acceptability, and limited efficacy. Clinical Practice in Pediatric Psychology 2021. [DOI: 10.1037/cpp0000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Abstract
Introduction
Poor sleep quality is common during pregnancy and can increase the risk of adverse obstetric and fetal outcomes. Existing research on the association between prenatal sleep and infant sleep is scarce and has focused on other aspects of prenatal sleep such as sleep duration, chronotype, and insomnia symptoms. To our knowledge, no studies have examined the association between prenatal sleep quality and infant sleep outcomes. Thus, this study aimed to investigate whether maternal sleep quality during pregnancy was prospectively associated with infant sleep dimensions, independent of relevant covariates.
Methods
Participants were a subset of 272 mother-infant dyads enrolled in an ongoing cohort study. Maternal prenatal sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) in early to mid- (M gestational age = 15.12 ± 3.56 weeks) and late- (M gestational age = 32.44 ± 0.99 weeks) pregnancy. Mothers completed the Brief Infant Sleep Questionnaire (BISQ) at 3, 6, and 12 months postpartum. The following infant sleep parameters were assessed: sleep duration (day, night, 24-hour), number of night awakenings, and wake after sleep onset. Prenatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at both pregnancy time points. Other covariates included maternal age at enrollment, infant age, parity, and co-sleeping status.
Results
Generalized estimating equations (GEE) models revealed that poorer maternal sleep quality during early-to-mid pregnancy did not significantly predict infant sleep parameters after adjustment for covariates (p > .05). However, in late pregnancy, poorer maternal sleep quality significantly predicted shorter 24-hour sleep duration and longer wake after sleep onset, but not daytime sleep duration, nighttime sleep duration, and number of night awakenings (p < .05).
Conclusion
Study findings advance our understanding of the prospective link between maternal prenatal sleep quality and infant sleep. Results indicate that maternal sleep quality during late gestation may play a role in the development of infant sleep patterns. These findings have important implications for intervention efforts targeting maternal sleep quality during pregnancy. Future research should use objective measures of sleep, such as actigraphy, to better elucidate the effects of prenatal sleep quality on infant sleep outcomes.
Support (if any)
The Canadian Institutes of Health Research (CIHR)
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Affiliation(s)
- Rebecca Burdayron
- Department of Educational & Counselling Psychology, McGill University
| | | | - Elizabeth Keys
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia
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Keys E, Benzies K, Kirk V, Duffett-Leger L. Effectiveness of play2sleep with mothers and fathers of infants aged 5 months: a mixed methods study examining the effect of an intervention designed to improve parent-child interaction on infant sleep. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Keys E, Benzies KM, Kirk V, Duffett-Leger L. Using Play to Improve Infant Sleep: A Mixed Methods Protocol to Evaluate the Effectiveness of the Play2Sleep Intervention. Front Psychiatry 2018; 9:109. [PMID: 29719517 PMCID: PMC5913340 DOI: 10.3389/fpsyt.2018.00109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/19/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND One in four Canadian families struggle with infant sleep disturbances. The aim of this study is to evaluate Play2Sleep in families of infants with sleep disturbances. In addition to parental education on infant sleep, Play2Sleep uses examples from a video-recorded, structured play session with mothers and fathers separately to provide feedback on parent-infant interactions and their infant's sleep-related social cues. The quantitative phase will answer the research question: Does one dose of Play2Sleep delivered during a home visit with mothers and fathers of infants aged 5 months reduce night wakings at age 7 months? The qualitative phase will answer the research question: What are parental perceptions of family experiences, processes, and contexts related to Play2Sleep and infant sleep? The overarching mixed methods research question is as follows: How do parental perceptions of family experiences, processes, and contexts related to infant sleep explain the effectiveness of Play2Sleep? METHOD AND ANALYSIS An explanatory sequential mixed methods design will be used. In the quantitative phase, a randomized controlled trial and RM-ANOVA will compare night wakings in infants whose parents receive Play2Sleep versus standard public health nursing information. Sixty English-speaking families (mothers and fathers) of full-term, healthy, singleton, 5-month-old infants who perceive that their infant has sleep disturbances will be recruited. The primary outcome measure will be change in the number of night wakings reported by parents. The qualitative component will use thematic analysis of family interviews to describe parental perceptions and experiences of infant sleep. Mixed methods integration will use qualitative findings to explain quantitative results. DISCUSSION Play2Sleep is a novel approach that combines information about infant sleep with personalized feedback on parent-infant interactions and infant cues. Including fathers and mixed methods should capture complex family experiences of infant sleep disturbances and Play2Sleep. If effective, Play2Sleep has possible application for preventing infant sleep disturbance and tailoring for other populations. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, identifier: NCT02742155. Registered on 2016 April 23.
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Affiliation(s)
- Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Valerie Kirk
- Alberta Children’s Hospital/University of Calgary, Calgary, AB, Canada
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Gunasekara L, Al-Saiedy M, Green F, Pratt R, Bjornson C, Yang A, Michael Schoel W, Mitchell I, Brindle M, Montgomery M, Keys E, Dennis J, Shrestha G, Amrein M. Pulmonary surfactant dysfunction in pediatric cystic fibrosis: Mechanisms and reversal with a lipid-sequestering drug. J Cyst Fibros 2017; 16:565-572. [DOI: 10.1016/j.jcf.2017.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/31/2017] [Accepted: 04/25/2017] [Indexed: 01/21/2023]
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Affiliation(s)
- Francis H. Y. Green
- Department of Pathology and Laboratory Medicine University of Calgary Calgary, Alberta, Canada T2N 4N1
| | - Elizabeth Keys
- Pathology and Laboratory Medicine Calgary Health Region Calgary, Alberta, Canada T2W 3N2
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Keys E, Brownlee C, Ruff M, Baxter C, Steele L, Green FHY. How Well Do We Communicate Autopsy Findings to Next of Kin? Arch Pathol Lab Med 2008; 132:66-71. [DOI: 10.5858/2008-132-66-hwdwca] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2007] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—A failure of communication among families, physicians, and pathologists is recognized as a major cause of declining autopsy rates and may be involved in increased litigation.
Objective.—To determine how effectively autopsy results are communicated to the next of kin and how satisfied families are with the process from consent to relaying of the results.
Design.—A retrospective telephone survey of next of kin of 106 consecutive patients autopsied at a major teaching hospital. The family was asked questions on the process of obtaining consent and the information they received back from health care providers.
Results.—Thirty-two percent of relatives indicated that they were not adequately informed as to the purpose of the autopsy. Eighty percent of respondents were notified of or obtained the results. The ways in which the autopsy findings were communicated varied, but 54% were involved in a discussion of the results with a medical professional. More than half of the families wished to have a copy of the results. Two-thirds felt they were satisfied with the explanation of the results, but an important cause of dissatisfaction was the use of unfamiliar medical terminology. When the family's understanding of the cause of death was compared with the diagnoses on the autopsy reports, 65% of families demonstrated an accurate knowledge of the autopsy findings, 28% had a general understanding, and for only 8% was their knowledge judged inaccurate. Overall, 92% of notified respondents felt the autopsy had served a useful purpose, mostly for personal reasons.
Conclusions.—We conclude that the autopsy fulfills an important need for many families; however, the purpose of the autopsy and the findings need to be more effectively communicated.
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Affiliation(s)
- Elizabeth Keys
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
| | - Carolyn Brownlee
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
| | - Monica Ruff
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
| | - Cynthia Baxter
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
| | - Lisa Steele
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
| | - Francis H. Y. Green
- From the Department of Pathology and Laboratory Medicine (Ms Keys and Drs Brownlee, Steele, and Green) and the Respiratory Research Group (Ms Keys, Ms Ruff, Ms Baxter, and Dr Green), Faculty of Medicine, University of Calgary, Calgary, Alberta; and Calgary Laboratory Services, Calgary, Alberta (Dr Steele). Ms Keys is now with the Child and Women's Health Portfolio, Calgary Health Region, Calgary,
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Ma A, Clark S, Tavener S, Patel K, Chakrabarti S, Sinclair G, Keys E, Allen-Vercoe E, DeVinney R, Doig C, Green F, Kubes P. Role for platelet toll-like receptor 4 (TLR4) in the formation of Neutrophil Extracellular Traps (NETs) in sepsis (44.22). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.44.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
It has been known for many years that LPS, neutrophils and platelets all participate in the pathogenesis of severe sepsis, but the inter-relationship between these players is completely unknown. Using flow chambers in vitro we suggest a novel innate immune response leading to enhanced trapping of bacteria in blood vessels. The mechanism involved platelet TLR4 detecting LPS in blood and inducing a unique response, specifically platelet binding to adherent neutrophils, but not platelet aggregation or P-selectin expression. Subsequently, the platelets stimulated very robust neutrophil activation leading to formation of NETs. These NETs retained their integrity under flow conditions and functioned to ensnare bacteria within the vasculature. Plasma from severely septic patients also induced TLR4-dependent platelet-neutrophil interactions leading to the production of NETs. We propose that this novel bacterial trapping mechanism would only occur under extreme conditions such as severe sepsis and platelet TLR4 (not leukocyte TLR4) functioned as the threshold switch for this innate immune response to occur. With the advent of antibiotics perhaps reducing the need for NET formation, we would propose that inhibiting platelet activation with TLR4 inhibitors may inhibit NET formation and reduce inadvertent tissue injury.
This work was funded by: CIHR and AHFMR
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Affiliation(s)
| | | | | | - Kamala Patel
- 1Physiology and Biophysics,
- 2Biochemistry and Molecular Biology,
| | | | - Gary Sinclair
- 2Biochemistry and Molecular Biology,
- 3Pathology and Laboratory Medicine,
| | | | - Emma Allen-Vercoe
- 4Microbiology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada,
| | - Rebekah DeVinney
- 4Microbiology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada,
| | - Christopher Doig
- 5Medicine and Community Health, Foothills Hospital, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
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Reeves J, Dan AJ, Keys E, Hennein S. [Application of the negotiated process method to primary health care for women]. Bol Oficina Sanit Panam 1989; 107:93-100. [PMID: 2529871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Since 1984 the University of Illinois School of Public Health in Chicago has been offering the course "Women's Health: A Primary Health Care Method." The objectives of the course are to develop a model to meet the health needs of urban women in industrialized countries and to teach post-graduate students from various health-related programs to work as members of interdisciplinary teams with groups of women in communities. This activity involves the use of the negotiated process method, the purpose of which is to train students and the community group to work together and separately on solutions to identified health problems. During the course given in 1985 this method was applied to analyzing the problem of battered women in a Latin American community. Although the results were satisfactory, other similar experiments should be conducted to determine its usefulness more precisely.
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