School Well-Being and Academic Performance of Children With Juvenile Idiopathic Arthritis: A National Register-Based Study.

OBJECTIVE: We aimed to investigate how school well-being (SWB) and academic performance of children with juvenile idiopathic arthritis (JIA) compare to their peers on a national level using the Danish national registers. Further, we investigated the potential influence of socioeconomic status (SES). METHODS: A population-wide, register-based, cross-sectional study was performed. We compared the results of children with and without JIA in the Danish National Well-Being Questionnaire (DNWQ), the National Danish School Testing (NDST), and their ninth grade (aged approximately 16 yrs) final school marks in Danish and mathematics. The results were analyzed using adjusted ordinal logistic regression (SWB) and linear regression (tests and marks). RESULTS: In separate cohorts, we included a total of 505,340 children answering the DNWQ, 812,461 children with NDST results, and the ninth-grade final marks of 581,804 children. Of these children, 1042, 1541, and 1410, respectively, fulfilled the criteria of JIA. Children with JIA reported SWB comparable to their peers, except for the question "Do you perform well in school?" (odds ratio 0.89, 95% CI 0.81-0.99). In the NDST, the children with JIA in general did just as well as their peers. We found no differences in the ninth-grade final marks in either Danish or mathematics. Stratifying the analyses on SES showed no significant differences in the associations. CONCLUSION: Overall, children with JIA report SWB comparable to that of children without JIA and perform equally well in school as children without JIA.

The role of sleep in the pathophysiology of nocturnal enuresis.

Nocturnal enuresis (NE) is a common condition affecting 5-10% of all 7-year-old children. NE pathophysiology relies on three main factors, abnormal bladder function, excess urine production during sleep and the inability to awaken to the signals of a full bladder. The aim of this review is to evaluate the connection between sleep and its structure and the pathophysiology of NE. NE often occurs early at night and primarily in sleep stage 2 and "deep sleep". Although sleep stage distribution seems similar between NE and healthy children recent studies indicate differences in sleep microstructure. Several lines of research support the common notion among parents that children with NE are difficult to awaken. Moreover, children with NE and nocturnal polyuria differ in terms of hemodynamics and possibly autonomic activation at night compared to healthy controls and the hypothesis has formed that these changes are attributable to different sleep characteristics. In support of this hypothesis, children with NE often suffer sleep disordered breathing, as well as disturbed sleep due to awakenings and arousals. Periodic limb movements (PLM) have been seen in children with refractory enuresis but the clinical significance remains unclear.