Convergent validity of the child behavior checklist sleep items in children with moderate to severe traumatic brain injury.

AIM: The Child Behavior Checklist (CBCL) includes several sleep items. We aimed to examine the convergent validity of CBCL sleep scores with validated sleep measures, and to explore their functional correlates. METHODS: This cross-sectional study included 44 children with moderate to severe TBI, aged 6-15 years. Parents completed the CBCL and Sleep Disturbance Scale for Children (SDSC), and children wore actigraphy watches. RESULTS: We found significant, albeit differential, associations between CBCL and SDSC sleep scores. Specifically: (i) "trouble sleeping" with SDSC total score, (ii) "trouble sleeping" and "nightmares" with SDSC initiating and maintaining sleep, (iii) "talks/walks in sleep" with SDSC arousal, and (iv) "overtired," "sleeps more" and CBCL sleep composite with SDSC excessive somnolence. The CBCL item "sleeps less" was the only significant predictor of functioning; children who slept less had lower social competence. No associations were found between CBCL sleep scores and actigraphy. CONCLUSIONS: The CBCL does not provide a comprehensive assessment of sleep disturbances in children with moderate to severe TBI. Nevertheless, certain CBCL sleep items demonstrate initial convergent validity with subscales of the SDSC assessing select types of sleep disturbances. The CBCL may be useful in research and clinical situations when administration of more comprehensive assessment sleep tools is not viable.

The persistence of sleep disturbance and its correlates in children with moderate to severe traumatic brain injury: A longitudinal study.

OBJECTIVES: The primary aim was to examine whether sleep disturbances persist in children in the chronic stage of recovery from moderate or severe traumatic brain injury (TBI). The secondary aim was to examine whether memory difficulties and/or other previously identified factors relate to sleep disturbances in children with moderate to severe TBI. METHODS: This longitudinal study included 21 children with moderate to severe TBI, 8-18 years old, recruited from an urban tertiary paediatric specialised brain injury rehabilitation unit. Participants were seen 5 years and again 7 years post-injury, on average. Sleep disturbances were assessed with Sleep Disturbance Scale for Children (SDSC). Correlates that were considered included indicators of TBI severity, and questionnaires assessing everyday memory, fatigue, internalizing and externalizing behaviors and pain intensity. RESULTS: The SDSC scores of children with moderate to severe TBI indicated greater disturbances in initiating and maintaining sleep, arousal, sleep-wake transition, and excessive somnolence relative to the norms, at follow-up. The mean SDSC scores and the number of participants with subclinical to clinical sleep disturbances on the SDSC remained unchanged from baseline to follow-up. At follow-up, the SDSC initiating and maintaining sleep, and excessive somnolence scales were associated with poorer everyday memory and greater fatigue. CONCLUSIONS: Children with moderate to severe TBI experience ongoing sleep disturbances for years post-injury. Greater sleep disturbances are associated with worse functional outcomes. Further research into sleep disturbances and development of treatments is important, as it could improve the outcomes of children with TBI.

Fatigue in Children With Moderate or Severe Traumatic Brain Injury Compared With Children With Orthopedic Injury: Characteristics and Associated Factors.

OBJECTIVE: To characterize fatigue in children with moderate or severe traumatic brain injury (TBI) and to identify associated factors. SETTING: Urban tertiary pediatric healthcare facility. PARTICIPANTS: Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n = 38). DESIGN: Case-control study. MAIN MEASURES: (i) Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS), completed by parents and children; (ii) Sleep Disturbance Scale for Children, completed by parents. Data on injury-specific factors and other factors of interest were also collected. RESULTS: The 2 TBI groups did not differ on any of the fatigue outcomes (child or parent ratings). Relative to the OI group, parents rated children in both TBI groups as experiencing greater fatigue. However, on self-ratings, only children with moderate TBI endorsed greater fatigue. Sleep was commonly associated with fatigue, with child sleep disturbance and child sleep hygiene associated with parent-rated and self-rated child fatigue, respectively. Individually, there were no cases of "normal" fatigue coinciding with severe sleep disturbance. However, there were several cases of severe fatigue coinciding with normal sleep. Additional factors associated with fatigue were older age at injury, longer time since injury, and/or greater internalizing difficulties. CONCLUSION: Children with moderate and severe TBI experience greater fatigue than OI controls. Parent and child ratings of fatigue appear to be associated with different factors, indicating that fatigue management may require a broad range of treatments.

Sleep Disturbance in Children With Moderate or Severe Traumatic Brain Injury Compared With Children With Orthopedic Injury.

OBJECTIVES: To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors. SETTING: An urban tertiary pediatric healthcare facility. PARTICIPANTS: Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n =38) comparable in age, gender, and socioeconomic status. DESIGN: Cohort study. MEASURES: Primary: Sleep Disturbance Scale for Children (SDSC). Secondary: Injury-specific factors (TBI severity, age at injury, and time since injury), and other factors of interest (sleep hygiene; pain intensity; difficulties with internalizing, externalizing, or attention/hyperactivity; parental distress; and parental knowledge of TBI). RESULTS: On the SDSC, parents rated children with moderate TBI (but not severe TBI) as experiencing greater overall sleep disturbance, as well as excessive somnolence and sleep breathing disturbance, relative to OI controls. Children with severe TBI (but not moderate TBI) were rated as experiencing greater disturbance with initiating and maintaining sleep. The moderate and severe TBI groups did not differ on any of the sleep outcomes. Only 3 factors were associated with sleep disturbance in the combined TBI group: (1) lower TBI severity with greater excessive somnolence; (2) greater internalizing difficulties with greater overall sleep disturbance, and disturbance with initiating and maintaining sleep specifically; and (3) younger age at injury with greater overall sleep disturbance, and sleep breathing disturbance specifically. CONCLUSION: Children with moderate or severe TBI experience greater overall and/or specific forms of sleep disturbance. Different forms of sleep disturbance may be associated with different factors.

Sleep outcomes following sleep-hygiene-related interventions for individuals with traumatic brain injury: A systematic review.

BACKGROUND: Sleep disturbance is commonly reported following traumatic brain injury (TBI) and can adversely impact health and wellbeing and interfere with the rehabilitation process. As such, effective treatment of sleep disturbance is critical for overall recovery. Sleep hygiene, which is non-invasive, low cost, and low risk, could serve as a suitable first line of treatment for individuals experiencing sleep disturbance post-TBI. OBJECTIVE: To assess the efficacy of sleep hygiene on sleep outcomes post-TBI. DESIGN: PsycINFO, Medline and EMBASE databases were systematically searched using mesh terms and keywords related to 'traumatic brain injury', 'sleep' and 'treatment'. Studies that met inclusion criteria were assessed on their methodological quality using validated assessment tools. RESULTS: Ten studies met inclusion criteria, none of which contained a child or adolescent population. Their methodological quality varied. The following interventions were shown to improve sleep outcomes amongst adults with TBI: Cognitive Behaviour Therapy for Insomnia, blue light therapy, Problem Solving Treatment and combined sleep hygiene and Prazosin. There was mixed evidence for the efficacy of exercise on sleep outcomes. CONCLUSION: Preliminary findings suggest that some sleep-hygiene-related interventions, either in isolation or in combination with other treatments, may reduce sleep difficulties post-TBI.

Honey for nutrition and health: a review.

Due to the variation of botanical origin honey differs in appearance, sensory perception and composition. The main nutritional and health relevant components are carbohydrates, mainly fructose and glucose but also about 25 different oligosaccharides. Although honey is a high carbohydrate food, its glycemic index varies within a wide range from 32 to 85, depending on the botanical source. It contains small amounts of proteins, enzymes, amino acids, minerals, trace elements, vitamins, aroma compounds and polyphenols. The review covers the composition, the nutritional contribution of its components, its physiological and nutritional effects. It shows that honey has a variety of positive nutritional and health effects, if consumed at higher doses of 50 to 80 g per intake.

Composition of stingles bee honey: setting quality standards

Se compilaron datos de composición de 152 mieles de abejas sin aguijón (Meliponini) en estudios realizados desde 1964, y se evaluaron para proponer requisitos de calidad para este producto. Dado que la miel de abejas sin aguijón tienen una composición distinta a la de Apis mellifera, algunos parámetros físico-químicos fueron presentados según la especie abejas sin aguijón. El origen entomológico de la miel se asignó a 17 especies de Meliponini de Brasil, una de Costa Rica, seis de México, 27 de Panamá, una de Surinam, dos de Trinidad & Tobago, y siete de Venezuela, mayormente del género Melipona. Los resultados variaron así: humedad (19,9-41,9g/100g), pH (3,15-4,66), acidez libre (5,9-109,0meq/Kg), cenizas (0,01-1,18g/100g), actividad de la diastasa (0,9-23,0DN), conductividad eléctrica (0,49-8,77mS/cm), HMF (0,9-78,4mg/Kg), actividad de la invertasa (19,8-90,1IU), nitrógeno (14,34-144,00mg/100g), azúcares reductores (58,0-75,7g/100g) y sacarosa (1,1-4,8g/100g), El contenido de humedad de las mieles de abejas sin aguijón es generalmente superior al máximo de 20 por ciento establecido para la miel de A. mellifera. Las directrices ofrecidas pueden ayudar a la expansión consistente de la base de datos físico-químicos de miel de abejas sin aguijón, para establecer sus requisitos de calidad en un futuro. El análisis de polen debería dirigirse hacia el reconocimiento de las mieles uniflorales producidas por las abejas sin aguijón, a fin de obtener productos estandarizados según las especies botánicas. Se necesita una campaña de control de calidad de miel tanto para los recolectores de miel de abejas sin aguijón como para los meliponicultores, junto con la armonización de los métodos analíticos

Authentication of the botanical and geographical origin of honey by front-face fluorescence spectroscopy.

Front-face fluorescence spectroscopy, directly applied on honey samples, was used for the authentication of 11 unifloral and polyfloral honey types (n = 371 samples) previously classified using traditional methods such as chemical, pollen, and sensory analysis. Excitation spectra (220-400 nm) were recorded with the emission measured at 420 nm. In addition, emission spectra were recorded between 290 and 500 nm (excitation at 270 nm) as well as between 330 and 550 nm (excitation at 310 nm). A total of four different spectral data sets were considered for data analysis. Chemometric evaluation of the spectra included principal component analysis and linear discriminant analysis; the error rates of the discriminant models were calculated by using Bayes' theorem. They ranged from <0.1% (polyfloral and chestnut honeys) to 9.9% (fir honeydew honey) by using single spectral data sets and from <0.1% (metcalfa honeydew, polyfloral, and chestnut honeys) to 7.5% (lime honey) by combining two data sets. This study indicates that front-face fluorescence spectroscopy is a promising technique for the authentication of the botanical origin of honey and may also be useful for the determination of the geographical origin within the same unifloral honey type.

Authentication of the botanical origin of honey by near-infrared spectroscopy.

Fourier transform near-infrared spectroscopy (FT-NIR) was evaluated for the authentication of eight unifloral and polyfloral honey types (n = 364 samples) previously classified using traditional methods such as chemical, pollen, and sensory analysis. Chemometric evaluation of the spectra was carried out by applying principal component analysis and linear discriminant analysis. The corresponding error rates were calculated according to Bayes' theorem. NIR spectroscopy enabled a reliable discrimination of acacia, chestnut, and fir honeydew honey from the other unifloral and polyfloral honey types studied. The error rates ranged from <0.1 to 6.3% depending on the honey type. NIR proved also to be useful for the classification of blossom and honeydew honeys. The results demonstrate that near-infrared spectrometry is a valuable, rapid, and nondestructive tool for the authentication of the above-mentioned honeys, but not for all varieties studied.

Authentication of the botanical and geographical origin of honey by mid-infrared spectroscopy.

The potential of Fourier transform mid-infrared spectroscopy (FT-MIR) using an attenuated total reflectance (ATR) cell was evaluated for the authentication of 11 unifloral (acacia, alpine rose, chestnut, dandelion, heather, lime, rape, fir honeydew, metcalfa honeydew, oak honeydew) and polyfloral honey types (n = 411 samples) previously classified with traditional methods such as chemical, pollen, and sensory analysis. Chemometric evaluation of the spectra was carried out by applying principal component analysis and linear discriminant analysis, the error rates of the discriminant models being calculated by using Bayes' theorem. The error rates ranged from <0.1% (polyfloral and heather honeys as well as honeydew honeys from metcalfa, oak, and fir) to 8.3% (alpine rose honey) in both jackknife classification and validation, depending on the honey type considered. This study indicates that ATR-MIR spectroscopy is a valuable tool for the authentication of the botanical origin and quality control and may also be useful for the determination of the geographical origin of honey.

Authentication of the botanical origin of honey by front-face fluorescence spectroscopy. A preliminary study.

The potential of front-face fluorescence spectroscopy for the authentication of unifloral and polyfloral honey types (n = 57 samples) previously classified using traditional methods such as chemical, pollen, and sensory analysis was evaluated. Emission spectra were recorded between 280 and 480 nm (excit: 250 nm), 305 and 500 nm (excit: 290 nm), and 380 and 600 nm (excit: 373 nm) directly on honey samples. In addition, excitation spectra (290-440 nm) were recorded with the emission measured at 450 nm. A total of four different spectral data sets were considered for data analysis. After normalization of the spectra, chemometric evaluation of the spectral data was carried out using principal component analysis (PCA) and linear discriminant analysis (LDA). The rate of correct classification ranged from 36% to 100% by using single spectral data sets (250, 290, 373, 450 nm) and from 73% to 100% by combining these four data sets. For alpine polyfloral honey and the unifloral varieties investigated (acacia, alpine rose, honeydew, chestnut, and rape), correct classification ranged from 96% to 100%. This preliminary study indicates that front-face fluorescence spectroscopy is a promising technique for the authentication of the botanical origin of honey. It is nondestructive, rapid, easy to use, and inexpensive. The use of additional excitation wavelengths between 320 and 440 nm could increase the correct classification of the less characteristic fluorescent varieties.

Validated methods for the quantification of biologically active constituents of poplar-type propolis.

The validation of rapid, low-cost spectrophotometric procedures for the quantification of the three main groups of bioactive substances (flavones and flavonols, flavanones and dihydroflavonols, and total phenolics) in poplar-type propolis has been performed. A spectrophotometric assay based on the formation of an aluminium chloride complex was applied for the quantification of total flavones and flavonols using galangin as standard. Because of the high amount of flavanones and dihydroflavonols in "poplar type" propolis, the introduction of a distinct procedure for their quantification was considered of special significance and the DAB9 colorimetric method was applied for the purpose. Total phenolic content was measured by the Folin-Ciocalteu procedure using a mixture of pinocembrin and galangin as a reference. The procedures were validated using a model mixture of compounds representing the poplar-type propolis composition as found in previous studies. The accuracy (recovery) varied in the range 84-109%, and the relative standard deviation was 0.5-6.2%. The developed spectrophotometric procedures were applied to six poplar type propolis samples. The results were verified independently by a HPLC procedure. The two sets of results agreed satisfactory, as proven by Student's t-test.

Chemical composition of European propolis: expected and unexpected results.

Ten propolis samples from Bulgaria, Italy and Switzerland were analyzed by GC-MS. As expected, most samples displayed the typical chemical pattern of "poplar" propolis: they contained pinocembrin, pinobanksin and its 3-O-acetate, chrysin, galangin, prenyl esters of caffeic and ferulic acids. Two samples differed significantly: one from the Graubünden Alpine region, Switzerland, rich in phenolic glycerides, and one from Sicily which contained only a limited number of phenolics and was rich in diterpenic acids.

Calidad de la miel de abejas y estándares de control: revisión realizada por la comisión internacional de la miel: sugerencias para las normas venezolanas / Quality of bee honey and standard of control: revition realized with International Comition of Honey: suggestions for the venezuelan norm

Los estándares internacionales de la miel de abejas especificados en una Directiva Europea de la Miel y en los Estándares para Miel del Codex Alimentarius, se encuentran en revisión. En este trabajo se discute el conocimiento actual de los diferentes criterios de calidad de la miel. Los borradores de trabajo son los documentos de referencia para la revisión de los estándares y de los métodos sugeridos para determinar los siguientes factores de calidad: humedad, cenizas, acidez, hidroximetilfurfural, azúcares reductores, sacarosa aparente, actividad diastásica y sólidos insolubles en agua. Durante los pasados 30 años se han publicado pocos trabajos sobre contenido de azúcares reductores y cenizas en mieles; siendo los azúcares específicos y la conductividad eléctrica más utilizados. Basados en esta información, se proponen estándares internacionales de la miel basados en la suma del contenido de glucosa y fructosa, de sacarosa y la conductividad eléctrica. Además, se discute el uso de otros factores de calidad de la miel, como actividad de la invertase; prolina y rotación específica; utilizados en numerosos países. Finalmente, se presentan sugerencias para actualizar las normas venezolanas para control de calidad de miel de abejas