Sleep patterns in children with atopic eczema

The following case is presented to illustrate the necessity of arthrotomy of the hip when an iliopsoas abscess lies adjacent to the hip joint capsule. Arthrotomy of the hip through a separate incision adds minimal morbidity, does not expose the hip to the abscess, and assures the surgeon that the hip has been debrided. This is important considering the 15% incidence of communication of the iliopsoas bursa with the hip joint.     

Young school-age sexually aggressive children.

As the full spectrum of sexual abuse sequelae is becoming known, a subset of child victims has been noted to exhibit sexually aggressive behavior. Their sexual behavior far exceeds the mutual exploratory behavior normally seen in young children and resembles more closely the behavior of older sex offenders. We present data from the psychological evaluation of twenty-two 4- to 11-year-old children referred for sexually aggressive behavior, including intellectual, behavioral, projective, and parent–child relational quality. Behavior problem data from these children are contrasted with data from twenty-two 5- to 13-year-old boys who completed a sexual abuse treatment program. Some differences appear related to the development of sexual aggression (e.g., aggression level, nature of the abuse, and family functioning) and are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of family-role concepts in school-age children.

50 White middle-class 6–13 yr olds were tested for a predicted, 8-step sequence of family role concepts. Dolls representing typical family roles were used as props, and questions were asked of each S concerning role explanations and increasingly abstract family definitions. The sequence was scalable and age-related. At 6 yrs, most Ss could intersect 2 family roles by explaining how 2 family-role relations could occur simultaneously for the same 2 people (e.g., both parental and spousal role relations for a man and a woman). By 9 yrs, most Ss could define a traditional family in terms of family-role intersections across 2 or more generations. By 12 yrs, most Ss could compare a traditional family with a childless couple or a single-parent family in terms of the similarities and differences in spousal and parental-role relations. Only some of the older Ss could generate a general definition for all families. Results demonstrate that the predicted sequence is developmental and that a central aspect to the development of family-role concepts (and possibly other similar social-cognitive concepts) is an addition-construction process such as that described by K. W. Fischer (see record 1981-02339-001). (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep disorders in children.

Many children experience some type of sleep problem. Often, these are transient problems with no long-lasting sequelae. But in certain cases, sleep problems may significantly impact on functioning and well-being. Sleep disorders in children can be classified into 2 major categories. Dyssomnias include those disorders that result in difficulty either initiating or maintaining sleep or involve excessive sleepiness. Parasomnias are disorders that disrupt sleep after it has been initiated but do not result in complaints of insomnia or excessive sleepiness. Even though sleep disorders in children are common, not enough is known. This article reviews the dyssomnias and parasomnias experienced by children, discusses methodological limitations of the studies reviewed, and presents future directions for research in this field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's objective and subjective sleep disruptions: Links with afternoon cortisol levels.

Objective: The purpose of this study was to determine possible relations between the quality and amount of children's sleep and cortisol in healthy children. Design: Children's sleep was monitored with actigraphs for 7 nights. Children came to the laboratory to provide saliva samples, which were used to assess cortisol. Children reported on their sleepiness and sleep/wake problems. Sixty-four healthy children participated (M = 8.75 years; SD = .55). Main Outcome Measures: Self-reported sleepiness and sleep/wake problems, actigraphy-measured total sleep minutes, sleep efficiency, minutes awake after sleep onset, and sleep activity, and afternoon cortisol levels. Results: After controlling for demographic variables and child characteristics, higher levels of cortisol were related to increased subjective sleep problems and objective measures of shorter sleep duration and poorer sleep quality. Conclusion: These findings are of importance for understanding critical facets of children's health and well-being, and are noteworthy given the high prevalence of sleep disruptions in otherwise normally developing children in the United States. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child emotional insecurity and academic achievement: The role of sleep disruptions.

The authors examined children's sleep as an intervening variable in the connection between emotional insecurity in the family and academic achievement. The role of ethnicity (African American and European American) and socioeconomic status (SES) in moderating the examined relations was assessed. One hundred sixty-six children (8- and 9-year-olds) reported their emotional insecurity, and the quantity and quality of children's sleep were examined through actigraphy and self-report. Decreased amount and quality of sleep were intervening variables in the relations between insecurity in the marital relationship and children's achievement. The effects of disrupted sleep on achievement were more pronounced for both African American children and children of lower SES. Results highlight the importance of the contemporaneous examinations of family and sleep functioning in the prediction of child outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-care and deviance in elementary school-age children

Fourth-, fifth- and sixth-grade students were surveyed to investigate whether self-care was related to self-reports of behavioral or attitudinal deviance, liking for school, or both. The Child Self-Care Measure (CSCM), a multiscale self-report instrument, measured self-care as a developmental task with four major dimensions: temporal, physical, structural, and psychological. Self-care in general was not linked to deviance. However, increases in psychological self-care were strongly correlated with reductions in children's liking for school. Additionally, children in self-care who cared for younger siblings for more than a year reported more deviant behaviors than those without responsibility for younger siblings; children in the care of older siblings less than 16 years old for more than 4 years reported more tolerance for deviance than peers in self-care without older sibling caregivers. Findings support earlier speculations that children in self-care may not be developmentally ready to take responsibility for elementary school-aged siblings. Results also indicated that although girls in self-care manifest problems earlier than boys, long term self-care may be more problematic for boys than girls.     

Relations between feeding and sleep patterns in the rat.

A concomitant analysis of sleep and feeding patterns in 11 male Wistar rats was carried out over 8 days, using continuous EEG recording. The proportion of slow-wave sleep and paradoxical sleep within an intermeal interval was constant and varied only in relation to the time of the day. During the dark period only, there were significant correlations between meal size and amount of time spent in both stages of sleep in the following intermeal interval. These correlations were even stronger between meal size and sleep duration in the intermeal interval that followed the next meal. Circadian variations in satiety ratios (i.e., units of subsequent intermeal interval and sleep per units of food ingested) and in deprivation ratios (i.e., units of feeding per units of prior intermeal interval and sleep) suggest that division of 24-hr data into 3 8-hr periods rather than 2 12-hr periods reveals distinct correlations between meal size and pre- and postmeal sleep and might reflect more accurately the underlying metabolic events. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal outcomes of Haemophilus influenzae meningitis in school-age children.

The purpose of this study was to investigate long-term outcomes of Haemophilus influenzae Type b meningitis in a cohort of school-age survivors. Findings from an initial assessment at mean age 10 years revealed neuropsychological, achievement, and behavioral sequelae in the children with neurologic complications during the acute-phase illness (H. Taylor, C. Schatschneider, & D. Rich, 1992). Here, the cohort was reassessed 1 and 2 years after the initial evaluation to investigate age-related influences on disease sequelae. After excluding children with hearing loss, the sample was divided into 2 groups: an affected group of 39 children with acute-phase neurologic complications and an unaffected group of 73 children without these complications. Growth-curve modeling showed poorer outcomes at the final assessment and less rapid improvement at follow-up for the affected group. Later age at assessment and later age at illness were associated with larger group differences in some outcomes. Results suggest that children with diffuse early brain insults are at risk for later-emerging sequelae. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extremely low-birth-weight children and their peers. A comparison of school-age outcomes

OBJECTIVE: To document 7-year developmental and educational outcomes in a cohort of predominantly white, middle-class, extremely low-birth-weight (ELBW, < 1000 g) children to address the incidence of increased developmental disability and the need for special educational services. DESIGN: Observational study. PATIENTS: Fifty-four ELBW children and 58 comparison children, who were matched for race, gender, and socio-economic status (30 with low birth weights [1500-2500 g] and 28 with birth weights > 2500 g). The ELBW cohort was drawn from 104 presurfactant survivors born between 1984 and 1986 and cared for in a single hospital. SETTING: Suburban, university-based tertiary referral center. MAIN OUTCOME MEASURES: Teachers' reports of classroom placement and special education services and tests of cognitive, motor, language, and visual-motor integration abilities were studied. RESULTS: Twenty-seven (50%) of 54 ELBW children were in regular classrooms with no special services compared with 21 (70%) of 30 in the low-birth-weight group and 27 (93%) of 28 in the full-term group, indicating a significant trend toward increasing need for special services with decreasing birth weight across the 3 groups (P < .001). The ELBW group scored significantly lower than the comparison groups on all tests, although generally within the average range. Seventy-nine percent of ELBW children had average cognitive scores, but they averaged 14 to 17 points lower than the 2 comparison groups. Twenty percent of the ELBW children had significant disabilities including cerebral palsy, mental retardation, autism, and low intelligence with severe learning problems. CONCLUSIONS: Even with optimal socioeconomic environments, 20% of ELBW children are significantly disabled, and 1 of every 2 ELBW children requires special educational services. Objective testing pinpointed weakness on all measures compared with matched peer groups.     

Health and environmental effects on the academic readiness of school-age children.

Secondary analysis was used to examine how health and environmental risk affect mathematics and reading readiness in a sample of 867 5- and 6-year-old children from the National Longitudinal Survey of Youth. Measures of risk included low birth weight, length of hospitalization at birth, rehospitalization during the first year of life, family income, maternal education, and the quality of the home environment. Although academic readiness was largely explained by environmental risk, child morbidity had a significant independent impact on reading performance. Furthermore, interaction analyses indicated that child morbidity was predictive of poor mathematics performance only for children from impoverished homes. In contrast, results also indicated that low birth weight children may be less able to benefit from higher levels of maternal education in terms of reading performance. These findings are discussed in the context of developmental risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep inertia varies with circadian phase and sleep stage in older adults.

The purpose of our analysis was to determine if older adults show sleep inertia effects on performance at scheduled wake time, and whether these effects depend on circadian phase or sleep stage at awakening. Using the Digit Symbol Substitution Test, effects of sleep inertia on performance were assessed over the first 30 min after wake time on baseline days and when sleep was scheduled at different circadian phases. Mixed model analyses revealed that performance improved as time awake increased; that beginning levels of performance were poorest when wake time was scheduled to occur during the biological night; and that effects of sleep inertia on performance during the biological night were greater when awaking from non-REM (NREM) sleep than from REM sleep. Based on our current understanding of sleep inertia effects in young subjects, and previous reports that older subjects awaken at an earlier circadian phase and are more likely to have their final awakening from NREM sleep than younger adults, our findings suggest older adults may be more vulnerable to sleep inertia effects than young adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep patterns of children sleeping in residential care, in kibbutz dormitories and at home--a comparative study

The present study compares sleep patterns of two groups of children sleeping away from their families, in residential care (n = 31, age 3.7 +/- 1.7 years) and kibbutz (n = 29, age 3.7 +/- 1.8 years) dormitories, with age-matched children sleeping at home (n = 21, age 3.7 +/- 1.8 years). Sleep was monitored by wrist-worn actigraphs for three consecutive nights and assessed by sleep questionnaires, which were completed by parents of the kibbutz children and caretakers at residential care. Children in the residential care settled to sleep significantly earlier and slept longer than those children living in a kibbutz or at home. The longest period of uninterrupted sleep was more extended for children sleeping at home, compared to those sleeping in communal dormitories. Correlation analysis between various assessments of sleep and waking behaviors revealed a different pattern for kibbutz and residential care children. For the kibbutz children, there were significant correlations between difficulties falling asleep and various attributes of daytime tiredness. Conversely, in the residential care, difficulties falling asleep were significantly and positively correlated with parameters associated with daytime alertness. This pattern of correlations and the actigraphic data indicate that difficulties in falling asleep for children in residential care are probably a consequence of being put to bed too early and according to a rigid schedule, and not the result of emotional factors.     

Discomforting talk and speech disruptions.

Laboratory studies over the past 20 yrs have shown a general relationship between a speaker's discomfort and the occurrence of speech disruptions, but critical task variables have not been clear. The present study examined the S's speech disruptions in describing 4 different experiences that had once made the S angry. 62 undergraduates served as Ss. By asking about different targets of anger (e.g., a family member), the interviewer varied the sensitivity of the episode. Various measures showed that the 4 tales varied in their sensitivity, and the results show increasingly more speech disruptions for more sensitive tales. Implications for psychotherapeutic mechanisms are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Actigraphic home-monitoring of the sleep patterns of in vitro fertilization children and their matched controls

The sleep patterns of 35 in vitro fertilization (IVF) children aged 19 to 57 months and their matched controls were evaluated by actigraphic home-monitoring for three consecutive nights. Actigraphic data were analysed by an automated scoring procedure developed in the authors' laboratory. There were no significant differences in activity levels between IVF multiple-birth subjects and their matched controls or between IVF singletons and their matched controls. In contrast, multiple-birth subjects had higher activity levels during sleep and lower sleep efficiency than singletons in both IVF and control groups. Sleep measures showed night-to-night stability in all groups.     

Relationship between sleep patterns and human colonic motor patterns

BACKGROUND/AIMS: The precise relationships among colonic motor patterns, depth of sleep, and awakening are incompletely understood. The aim of this study was to correlate human colonic motor patterns with sleep stage, nocturnal arousals, and waking. METHODS: We monitored sleep and correlated sleep stage, arousals, and waking with pressures (area under curve and propagating contractions) recorded from the entire colon in 11 healthy volunteers. RESULTS: Propagating contraction frequency (P = 0.01) and area under the curve (P = 0.001) were significantly reduced at night. There was a highly significant correlation between depth of sleep and suppression of area under curve (P = 0.001) and propagating contraction frequency (P = 0.0001). Propagating contractions were eliminated during slow-wave sleep. During rapid eye movement sleep, colonic pressure and propagating contraction frequency increased sharply to levels comparable with those found in stage 2 sleep. Transient arousal from stable sleep, with or without waking, was a potent and immediate stimulus for colonic propagating contractions. CONCLUSIONS: Sleep per se has a profound inhibitory effect on propagating and nonpropagating activity and is the major determinant of diurnal variation of colonic motility. Propagating contractions are eliminated in slow-wave sleep. Rapid eye movement sleep, arousals, and waking have immediate stimulatory effects on colonic motility.     

Stress reaction of school-age children to the bombardment by SCUD missiles.

Stress reactions of 5th-, 7th-, and 10th-grade children (N?=?492) exposed to missile attacks during the Persian Gulf War were examined a month after the war by a questionnaire that assessed level of exposure to trauma and psychological symptoms. Higher stress responses were obtained in areas hit and were influenced by proximity to sites or individuals involved in actual damage. Gender, age, and region interacted such that 5th-grade boys reported the highest stress reactions regardless of region, whereas 5th-grade girls reported the highest stress responses only in regions hit. Gender, age, and objective and subjective stress correctly identified 75% of the children as potential clinical or nonclinical candidates. The possible mediating coping responses and applications for high-risk groups are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statewide assessment of school-age children with asthma in Delaware

In Delaware, asthma affects almost 14,000 children. The American Lung Association of Delaware and the University of Delaware surveyed school nurses to identify the needs of children with asthma and the services and accommodations available for these children. Researchers developed a survey instrument that was mailed to all Delaware schools (N = 324). The response rate was 38.6% (n = 125). According to respondents, a variety of protocols were in place regarding the administration of asthma medications. Respondents also reported that several measures had been taken to modify the school environment to improve air quality and reduce asthma triggers. Most respondents (77%) indicated they did not have asthma education programs in their schools. Findings from this study sparked development of a multidisciplinary Delaware Asthma Committee, an Asthma Education Center, and a statewide system for communicating with the parents of children with asthma.