Sleep alterations associated with adulthood ADHD are poorly understood. Here, we conducted the first meta-analysis of sleep studies in adults with ADHD. Based on a pre-registered protocol (PROSPERO-CRD42017065407), we searched Pubmed, Ovid and Web of Knowledge databases through August 3rd, 2017, with no language or publication type restrictions, and contacted study authors for unpublished data/information. From a pool of 8812 references, we retained 13 studies. Random-effects models were performed and study quality was rated using the Newcastle-Ottawa Scale. Compared to adults without ADHD, those with ADHD significantly differed in seven out of nine subjective parameters (Standardized Mean Difference, SMD, ranging from 0.56 to 1.55) and two out of five actigraphic parameters [SMD (95% CI): sleep onset latency: 0.80 (0.46-1.14); sleep efficiency: -0.68 (-1.03, -0.34)]. No significant differences were detected for polysomnographic parameters. We conclude that, whereas subjectively reported sleep problems are significantly associated with ADHD in adults and should be systematically screened during the clinical interview, additional research is needed to understand if they are underpinned by objective sleep alterations.
39.3% for those mothers that continued to breastfeed until within two months of returning to work.For those mothers that express on return to work, infants receive breast milk to an average age of 18.4 months. This compares to an average age of 16.6 months for those mothers that breastfed but did not express at work. Despite this, 34.6% mothers that expressed at work stated that they stopped breastfeeding sooner than anticipated as a direct result of work and 60% women who intentionally gave up breastfeeding stated that they stopped sooner than they anticipated as a direct result of returning to work.The most cited work-related reasons for stopping breastfeeding were long, busy shifts and night shifts (48%); inadequate expressing facilities in the workplace (38%) and a lack of protected time to express (25%).
Comments included 'Open and honest colleagues. Happy to call friends now' 'Brilliant group! Supportive, non-judgemental, definitely exceeded expectations. Without this group I would definitely have done much worse. Reduced my workload and made me practice. Great group-thank you!' 'A very supportive group who share their knowledge willingly and able to give honest constructive feedback. Will be extremely useful to have this support even after finishing START' 'Brilliant support, lovely to meet others at the same grade. Would have loved groups like this for other assessments/difficult times of my career. Maybe throughout my career! Thank you so much! ' Conclusion This is a unique multi-deanery collaboration between senior Paediatric trainees in the UK who continue to support each other. Acknowledgements 1. All trainees who filled in the survey to support this write up. Declarations No conflict of interest.
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