Key Points Question Do children with atopic dermatitis experience impaired sleep duration and sleep quality throughout childhood, and do disease severity and activity affect their sleep? Findings In this longitudinal cohort study of 13 988 children, atopic dermatitis was statistically significantly associated with impaired sleep quality but not sleep duration throughout childhood. Sleep impairment was more common among children with more severe disease and with comorbid asthma or allergic rhinitis, and the risk remained elevated even among children with mild and inactive atopic dermatitis. Meaning These findings suggest that clinicians should consider sleep quality among all children with atopic dermatitis, especially those with comorbid asthma or allergic rhinitis and severe disease; it appears interventions to improve sleep quality are needed for this population.
highlighted associations between atopic dermatitis (AD) and mental health conditions in adults. However, literature on the development of mental health comorbidities in children is limited despite the large burden of pediatric AD worldwide.OBJECTIVE To examine the association between AD and internalizing behaviors and symptoms of depression at multiple points across childhood and adolescence and to explore potential mediating factors, including asthma/rhinitis, sleep, and inflammation. DESIGN, SETTING, AND PARTICIPANTSThis longitudinal, population-based birth cohort study included children followed up from birth for a mean (SD) duration of 10.0 (2.9) years from the
This longitudinal cohort study analyzes data collected across 11 years to assess the association between the presence and severity of atopic dermatitis in children and maternal sleep disturbance among a population-based UK cohort of mother-child pairs.
Background Pediatric heart transplant recipients have high‐risk cardiovascular profiles that can affect their long‐term outcomes; however, promoting exercise and healthy diet has not been a major focus in the field. The objective of this study was to test the feasibility and impact of a supervised exercise and diet intervention delivered via live videoconferencing in this population. Methods and Results Patients 8 to 19 years of age at least 1 year post heart transplantation were enrolled. The 12‐ to 16‐week intervention phase included live video–supervised exercise (×3/week) and nutrition (×1/week) sessions. The 12‐ to 16‐week maintenance phase included ×1/week live video–supervised exercise and nutrition sessions and ×2/week self‐directed exercise sessions. Cardiac, vascular, nutritional, and functional health indices were obtained at baseline, after intervention, and after maintenance. Fourteen patients (median age, 15.2; interquartile range, 14.3–16.7 years) at a median of 3.3 (interquartile range, 1.5–9.7) years after heart transplant completed the intervention. Patients attended 89.6±11% of exercise and 88.4±10% of nutrition sessions during the intervention and 93.4±11% of exercise and 92.3±11% of nutrition sessions during maintenance. After intervention, body mass index percentile (median, −27%; P =0.02), endothelial function (median, +0.29; P =0.04), maximum oxygen consumption (median, +2 mL/kg per minute; P =0.002). Functional Movement Screening total score (median, +2.5; P =0.002) and daily consumption of saturated fat (median, −6 g; P =0.02) improved significantly. After maintenance, improvements in maximum oxygen consumption (median, +3.2 mL/kg per minute; P =0.02) and Functional Movement Screening total score (median, +5; P =0.002) were sustained. Conclusions In pediatric heart transplant recipients, a live video–supervised exercise and diet intervention is feasible. Our results demonstrate excellent adherence with significant improvements in cardiovascular and functional health. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02519946.
Perinatal loss, including fetal and infant death, is a devastating experience for parents, resulting in long-term adverse physical and psychosocial outcomes. However, little is known about what services might best support grieving parents. We aimed to understand the role of professional bereavement photography in assisting the grieving process of parents who have lost a fetus or infant, by examining the perspectives of bereaved parents, professional photographers, and health care professionals. Twenty semistructured interviews were conducted, and interview transcripts were analyzed using modified grounded theory. Twenty-three individuals participated, including 6 bereaved parents, 8 photographers, and 9 health care professionals. Analyses generated 5 major themes describing ways in which the photographs were valuable to parents: validation of the experience, permission to share, creation of a permanent and tangible legacy, creation of positive memories, and moving forward after the loss. Hospitals should consider incorporation of professional bereavement photography services into palliative care and bereavement programs.
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