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Aims: To evaluate the associations between bedtime initiations, sleeping sufficiency and objective academic performance in a large sample of second secondary students.Methods: Thestudy sample consisted of 900 adolescents; 450boysand 450 girls in the second secondary class at Hail city in the Kingdom of Saudi Arabia.Participants filled a questioner about their socioeconomic factors as bedtime, sleeping duration, mental games practicing, and physical activity.Weight and heightwere measured to assess body mass index (kg/m2). Data extracted from the questioner used to study the contribution of the concomitant factors on academic achievement.Results: The mean weight was 73.57±8.34kg IQR (44-126) while the mean height was (170.38±6.45) cm IQR (141-192). The mean BMI was 33.57±14.79(IQR 21.0–38.8). The overall prevalence of childhood obesity was 460 (49.6%; 95% CI: 55.3–66.8%) while the prevalence of overweight was 85 (9.04%; 95%CI: 7.3 –11.4%). The mean ministry academic score for the second secondary class was 70±9.99 IQR (44-99) while the school academic score was 88.07±7.44 IQR (60-99).51.6% of the students went to bed between 10-12 pm and only 17.6% slept between 8 and 10 hours.Conclusion: We can summarize, the independent variables as bedtime, sleeping duration, and obesity ameliorate academic achievement in a counteractive way; high BMI above 35 and prolonged sleeping duration more than 10 hours significantly curb the total academic score, whereas, healthy bedtime of 8-10 pm concomitantly augment the academic achievement
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Problemas de sono são frequentes na infância e estão associados a problemas de comportamento. O objetivo deste estudo foi avaliar o efeito de um tratamento multicomponente para a insônia infantil nos padrões, rotina e hábitos de sono das crianças. Participaram 57 crianças com problemas comportamentais relacionados ao sono e suas mães. As mães receberam educação sobre o sono infantil e orientações sobre o estabelecimento de horários e rotinas para dormir e sobre o uso de técnicas de extinção e reforço positivo. Os dados foram avaliados antes e após a intervenção por diários de sono e pela Escala UNESP de Hábitos e Higiene do Sono Versão Crianças. Nossos resultados apontaram que crianças com problemas de sono apresentam em sua maioria, hábitos e rotinas inadequadas antes de dormir e que uma intervenção que focasse na modificação destes hábitos, somada a estratégias de extinção para comportamentos inadequados e reforço positivo para comportamentos adequados no momento de dormir podem ter contribuído na melhora do sono. Espera-se que este trabalho possa estimular a produção de pesquisas nacionais sobre o tema, servindo como incentivo para o desenvolvimento de medidas preventivas e interventivas para os problemas de sono na infância.
Sleep problems are common in childhood and are associated with behavioral problems. The aim of this study was to evaluate the effect of a multicomponent treatment for childhood insomnia on children's patterns, routine and sleep habits. 57 children with behavioral problems related to sleep and their mothers participated. The mothers were educated on their child's sleep, received guidance on the establishment of sleeping schedules and routines and on the use of extinction and positive reinforcement techniques. The data were evaluated before and after the intervention by sleep diaries and by the Escala UNESP de Hábitos e Higiene do Sono Versão Crianças. Our results showed that children with sleep problems mostly present inadequate habits and routines before bedtime and that an intervention that focused on changing these habits, added to extinction strategies for inappropriate behaviors and positive reinforcement for adequate behaviors at bedtime may have contributed to improved sleep. It is hoped that this work can stimulate the production of national research on the subject, serving as an incentive for the development of preventive and interventional measures for childhood sleep problems.
Los problemas de sueño son comunes en la infancia y están asociados con problemas de comportamiento. El objetivo de este estúdio fue evaluar el efecto de um tratamiento multicomponente para el insomnio infantil em los patrones, la rutina y los hábitos de sueño de los niños. Participaron 57 niños con problemas de conducta relacionados com el sueño y sus madres. Las madres recibieron educación sobre el sueño infantil y orientación sobre como estabelecer horarios y rutinas de sueño y sobre el uso de técnicas de extinción y refuerzo positivo. Los datos fueron evaluados antes y después de la intervención por diarios de sueño y por la Escala UNESP de Hábitos e Higiene do Sono - Versão Crianças. Nuestros resultados mostraron que los niños con problemas de sueño em su mayoría presentan hábitos y rutinas inadecuados antes de acostarse y que una intervención que se centróen cambiar estos hábitos, se agregó a las estrategias de extinción por conductas inapropiadas y refuerzo positivo para conductas adecuadas antes de acostarse puede haber contribuido a mejorar el sueño. Se espera que este trabajo pueda estimular la producción de investigación nacional sobre el tema, sirviendo como un incentivo para el desarrollo de medidas preventivas e intervencionistas para los problemas del sueño infantil.
Subject(s)
Humans , Male , Female , Child, Preschool , Sleep , Sleep Initiation and Maintenance Disorders , Child, Preschool , Sleep HygieneABSTRACT
Objective@#By implementing the best practice of bedtime and position after diagnostic adult lumbar puncture,we hope to establish a scientific and standardized nursing routine for lumbar puncture, shorten the bed-rest time after lumbar puncture, and improve the comfort of patients.@*Methods@#By reviewing literatures related to positions after adult lumbar puncture and post-dural puncture headache, six best practice were concluded. By combining the best evidence and the clinical circumstances, the evidenced-based criteria were established and then applied in the Neurology Department.@*Results@#After two rounds of reviews, the results showed that except the 93.3% compliance with the new evidence, all other four criteria had 100% complacence. Comparing before and after applying the evidence, there was no statistically significant difference for the occurrence of post-dural puncture headache or dizziness(P>0.05), there was a statistically significant reduction of back pain from 28.3%(30/106) to 15.1%(18/119)(χ2 value was 5.799, P<0.05) when the evidence was applied.@*Conclusions@#The best practice shows that patients needn′t lie on bed for 4 to 6 hours after lumbar puncture, the occurrence of back pain is lowered and the comfort level of the patient is improved in those who rest with pillow or activities.
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Background:Nocturnal gastroesophageal reflux (nGER)is associated with severe complication of gastroesophageal reflux disease (GERD),such as esophagitis,esophageal stricture and Barrett's esophagus,and has certain effect on quality of life. Aims:To study the characteristics of nGER and its influencing factor in patients with GERD. Methods:GERD patients with typical reflux symptoms (heartburn or/ and regurgitation)and nGER confirmed by MII-pH monitoring were included. Effects of gender,age,BMI,DBI on nGER were analyzed. Results:In 130 patients with GERD,97 (74. 6%)had nGER. Of the 97 patients with nGER,only 18 (18. 6%)patients complained nocturnal heartburn or/ and regurgitation. During nocturnal period,female and elderly GERD patients had delayed bolus clearance time. Percentage of time with pH < 4 and acid reflux of GERD patients with BMI≥25 kg/ m2 were significantly higher than patients with normal BMI. Nocturnal acid reflux was much lower in patients with DBI≥2. 5 hours than patients with DBI < 2. 5 hours. The weakly acidic reflux could significantly decrease along with the getting longer of DBI. Conclusions:nGER is prevalent in GERD patients,and weakly acidic reflux is the leading type,however,only a small part of patients having nocturnal reflux symptom. The female and elderly GERD patients have delayed bolus clearance time during nocturnal period. BMI≥25 kg/m2 is associated with nGER. DBI≥2. 5 hours could significantly reduce acid reflux during nocturnal period. DBI should be as long as possible for reducing weakly acidic reflux.
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Background:Nocturnal gastroesophageal reflux (nGER)is associated with severe complication of gastroesophageal reflux disease (GERD),such as esophagitis,esophageal stricture and Barrett's esophagus,and has certain effect on quality of life. Aims:To study the characteristics of nGER and its influencing factor in patients with GERD. Methods:GERD patients with typical reflux symptoms (heartburn or/ and regurgitation)and nGER confirmed by MII-pH monitoring were included. Effects of gender,age,BMI,DBI on nGER were analyzed. Results:In 130 patients with GERD,97 (74. 6%)had nGER. Of the 97 patients with nGER,only 18 (18. 6%)patients complained nocturnal heartburn or/ and regurgitation. During nocturnal period,female and elderly GERD patients had delayed bolus clearance time. Percentage of time with pH < 4 and acid reflux of GERD patients with BMI≥25 kg/ m2 were significantly higher than patients with normal BMI. Nocturnal acid reflux was much lower in patients with DBI≥2. 5 hours than patients with DBI < 2. 5 hours. The weakly acidic reflux could significantly decrease along with the getting longer of DBI. Conclusions:nGER is prevalent in GERD patients,and weakly acidic reflux is the leading type,however,only a small part of patients having nocturnal reflux symptom. The female and elderly GERD patients have delayed bolus clearance time during nocturnal period. BMI≥25 kg/m2 is associated with nGER. DBI≥2. 5 hours could significantly reduce acid reflux during nocturnal period. DBI should be as long as possible for reducing weakly acidic reflux.
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Objective@#To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality.@*Method@#Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance.@*Result@#The children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01).@*Conclusion@#The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.
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El propósito de este trabajo es realizar una primera aproximación teórica, a fin de describir a la rutina para la conciliación del sueño como una ocupación cotidiana y significativa en los primeros años de vida del niño. Esta ocupación sienta sus bases en la habilidad de autorregulación de la activación del niño e impacta en su desempeño ocupacional presente y futuro. El trabajo focalizará en el desarrollo de la conciliación del sueño desde una co-ocupación, hacia la conformación de una ocupación significativa y con propósito. A fin de describir esta progresión, se analizarán tres puntos: la conciliación del sueño dentro del ciclo sueño-vigilia; las principales características del niño, cuidador primario y el ambiente en esta progresión; y las características del proceso que llevan a la conciliación del sueño desde una co-ocupación a una ocupación. El proceso de consolidación de la conciliación desde coocupación a ocupación sería evolutivo, sincrónico, orquestado con las demás ocupaciones cotidianas, flexible, y dependiente de la implicancia del cuidador en dicho proceso.
The aim of this first theoretical approach is to describe bedtime routine as a daily and meaningful occupation in the attainment of falling to sleep within the child´s first years of life. This occupation is based on the child´s ability to perform arousal self- regulation and has an important impact on present and future occupational performance. The study will focus on bedtime routine progression from co-occupation to the establishment of a meaningful and purposeful occupation. In order to show this progression, three important issues will be described: the placement of bedtime routine within a sleep-wake cycle; the main characteristics of the child, primary caregiver, and the environment; and, features of the process that drives bedtime routine from co-occupation to occupation. The consolidation process of bedtime routine from co-occupation to occupation would be progressive, synchronized, orchestrated with other daily occupations, flexible and dependent on the goodness-of-fit with the caregiver.
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Humans , Child , Child Development , Circadian Rhythm , Homeostasis , Occupational Therapy , Sleep/physiology , Caregivers , WakefulnessABSTRACT
Morning surge in blood pressure is an independent cardiovascular risk factor in the middleaged and the elderly. Whether such a surge occurs in young subjects is not known. Eighty normotensive subjects (age: 21.8 ± 1.3 yr) measured their own blood pressure (BP) using an automatic device (Omron HEM-7080,) on going to bed and on waking up, for 2 consecutive days. In contrast to large morning BP surges reported for older age groups, there was much smaller but significant (P<0.002) rise only in the DBP (1.9 ± 5 mm Hg) on waking up on day 2 in young subjects. The duration of sleep and the time the subjects slept influence the sleep-wake BP change.
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Objective To investigate the association of insulin dose with clinical factors of type 2 diabetes. Methods We reviewed the data of 214 type 2 diabetic patients who received insulin regimens.We compared the insulin dose and period at the targeted blood glucose levels among 6 groups according to different type of oral hypoglycemic agents. Results There existed statistically significant correlations of the glucose-targeted insulin dose with course,FPG,BMI,combination therapy with oral hypoglycemic agent(P<0.1,test level P=0.1).Merely metformin failure group took less insulin than the group admitted due to combination therapy failure (P=0.016, 0.53(0.35～0.62)U/kg and 0.63(0.51～0.75)U/kg respectively).The longest targeted period existed in the later. Relationship between the targeted bedtime insulin NPH dose and FPG level can be demonstrated by equation Y=0.255X+7.8. Conclusions The targeted insulin dose is influenced by synthetic factors. Patients admitted due to combination oral hypoglycemic drug failure have the maximal targeted insulin dose and the longest titration period. The final bedtime insulinNPH dose can be predicted by FPG level.