Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 144
Filter
1.
Sensors (Basel) ; 24(2)2024 Jan 19.
Article in English | MEDLINE | ID: mdl-38276327

ABSTRACT

The development of consumer sleep-tracking technologies has outpaced the scientific evaluation of their accuracy. In this study, five consumer sleep-tracking devices, research-grade actigraphy, and polysomnography were used simultaneously to monitor the overnight sleep of fifty-three young adults in the lab for one night. Biases and limits of agreement were assessed to determine how sleep stage estimates for each device and research-grade actigraphy differed from polysomnography-derived measures. Every device, except the Garmin Vivosmart, was able to estimate total sleep time comparably to research-grade actigraphy. All devices overestimated nights with shorter wake times and underestimated nights with longer wake times. For light sleep, absolute bias was low for the Fitbit Inspire and Fitbit Versa. The Withings Mat and Garmin Vivosmart overestimated shorter light sleep and underestimated longer light sleep. The Oura Ring underestimated light sleep of any duration. For deep sleep, bias was low for the Withings Mat and Garmin Vivosmart while other devices overestimated shorter and underestimated longer times. For REM sleep, bias was low for all devices. Taken together, these results suggest that proportional bias patterns in consumer sleep-tracking technologies are prevalent and could have important implications for their overall accuracy.


Subject(s)
Actigraphy , Sleep Wake Disorders , Young Adult , Humans , Polysomnography/methods , Actigraphy/methods , Reproducibility of Results , Sleep , Sleep Stages
3.
J Clin Invest ; 133(18)2023 09 15.
Article in English | MEDLINE | ID: mdl-37712421

ABSTRACT

BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.METHODSWomen with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data.RESULTSThe most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94).CONCLUSIONUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.TRIAL REGISTRATIONClinicalTrials.gov NCT02097667.FUNDINGThe European Union, Rosetrees Trust, Mitchell Charitable Trust.


Subject(s)
Perinatal Death , Pregnancy Outcome , Female , Humans , Infant, Newborn , Pregnancy , Fetal Death , Fetal Growth Retardation/diagnostic imaging , Placenta Growth Factor
4.
Learn Mem ; 30(9): 237-244, 2023 09.
Article in English | MEDLINE | ID: mdl-37770106

ABSTRACT

Emotional memories are processed during sleep; however, the specific mechanisms are unclear. Understanding such mechanisms may provide critical insight into preventing and treating mood disorders. Consolidation of neutral memories is associated with the coupling of NREM sleep slow oscillations (SOs) and sleep spindles (SPs). Whether SO-SP coupling is likewise involved in emotional memory processing is unknown. Furthermore, there is an age-related emotional valence bias such that sleep consolidates and preserves reactivity to negative but not positive emotional memories in young adults and positive but not negative emotional memories in older adults. If SO-SP coupling contributes to the effect of sleep on emotional memory, then it may selectively support negative memory in young adults and positive memory in older adults. To address these questions, we examined whether emotional memory recognition and overnight change in emotional reactivity were associated with the strength of SO-SP coupling in young (n = 22) and older (n = 32) adults. In younger adults, coupling strength predicted negative but not positive emotional memory performance after sleep. In contrast, coupling strength predicted positive but not negative emotional memory performance after sleep in older adults. Coupling strength was not associated with emotional reactivity in either age group. Our findings suggest that SO-SP coupling may play a mechanistic role in sleep-dependent consolidation of emotional memories.


Subject(s)
Memory Consolidation , Young Adult , Humans , Aged , Sleep , Emotions , Memory , Recognition, Psychology , Electroencephalography
5.
BMC Public Health ; 23(1): 1126, 2023 06 13.
Article in English | MEDLINE | ID: mdl-37308842

ABSTRACT

BACKGROUND: Physical activity participation among preschoolers in childcare settings are low, and interventions to increase physical activity levels have produced mixed results. The Physical Literacy in the Early Years (PLEY) project implemented a six-month childcare-based outdoor loose parts play intervention in childcare centres in Nova Scotia, Canada. The purpose of this study was to examine the impact of the PLEY project on the development of domains of physical literacy (physical activity, physical competence, confidence and motivation, knowledge and understanding) in preschoolers attending childcare centres using mixed-methods. METHODS: Preschoolers (3-5 years) were recruited from 19 childcare centres in Nova Scotia and centres were randomized (parallel design) to the outdoor loose parts play intervention group (n = 11) or control (n = 8) group for 6 months. Participants, early childhood educators, and assessors were not blinded to group assignment. Quantitative and qualitative measures were used to comprehensively assess the impact of the PLEY project on all domains of physical literacy. At 3- and 6-months, early childhood educators participated in focus groups to assess how the intervention supported the development of 4 physical literacy domains: physical activity, physical competence, confidence and motivation, and knowledge and understanding. Physical activity and physical competence were also assessed with accelerometry and the Test of Gross Motor Development-3, respectively. RESULTS: Two hundred and nine preschoolers participated in the study (intervention group: n = 115; control group: n = 94). Accelerometer data showed that while baseline physical activity was similar between groups, children in the intervention group had higher physical activity at 3- (F(1,187) = 8.30, p = 0.004) and 6-months (F(1,187) = 9.90, p = 0.002) post-intervention. There was no intervention effect on physical competence scores. Thematic analysis of focus group data revealed that outdoor loose parts play contributed to development in all 4 physical literacy domains, including increased movement repertoires, social development, and enjoyment of physical activity. No adverse events or side effects of the intervention were reported. CONCLUSIONS: Participation in the PLEY project was associated with increased development of various domains of physical literacy and perceived physical literacy among preschoolers, and outdoor loose parts play may be encouraged as an effective strategy to increase physical literacy in early learning settings. TRIAL REGISTRATION: Biomed Central (ISRCTN14058106), 20/10/2017.


Subject(s)
Child Health , Literacy , Child , Humans , Child, Preschool , Accelerometry , Learning , Nova Scotia
6.
Arch Dis Child Fetal Neonatal Ed ; 108(6): 599-606, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37185272

ABSTRACT

OBJECTIVE: To quantify the risks of mortality, morbidity and postnatal characteristics associated with extreme preterm fetal growth restriction (EP-FGR). DESIGN: The EVERREST (Do e s v ascular endothelial growth factor gene therapy saf e ly imp r ove outcome in seve r e e arly-onset fetal growth re st riction?) prospective multicentre study of women diagnosed with EP-FGR (singleton, estimated fetal weight (EFW) <3rd percentile, <600 g, 20+0-26+6 weeks of gestation). The UK subgroup of EP-FGR infants (<36 weeks) were sex-matched and gestation-matched to appropriate for age (AGA) infants born in University College London Hospital (1:2 design, EFW 25th-75th percentile). SETTING: Four tertiary perinatal units (UK, Germany, Spain, Sweden). MAIN OUTCOMES: Antenatal and postnatal mortality, bronchopulmonary dysplasia (BPD), sepsis, surgically treated necrotising enterocolitis (NEC), treated retinopathy of prematurity (ROP). RESULTS: Of 135 mothers recruited with EP-FGR, 42 had a stillbirth or termination of pregnancy (31%) and 93 had live births (69%). Postnatal genetic abnormalities were identified in 7/93 (8%) live births. Mean gestational age at birth was 31.4 weeks (SD 4.6). 54 UK-born preterm EP-FGR infants (<36 weeks) were matched to AGA controls. EP-FGR was associated with increased BPD (43% vs 26%, OR 3.6, 95% CI 1.4 to 9.4, p=0.01), surgical NEC (6% vs 0%, p=0.036) and ROP treatment (11% vs 0%, p=0.001). Mortality was probably higher among FGR infants (9% vs 2%, OR 5.0, 95% CI 1.0 to 25.8, p=0.054). FGR infants more frequently received invasive ventilation (65% vs 50%, OR 2.6, 95% CI 1.1 to 6.1, p=0.03), took longer to achieve full feeds and had longer neonatal stays (median difference 6.1 days, 95% CI 3.8 to 8.9 and 19 days, 95% CI 9 to 30 days, respectively, p<0.0001). CONCLUSIONS: Mortality following diagnosis of EP-FGR is high. Survivors experience increased neonatal morbidity compared with AGA preterm infants. TRIAL REGISTRATION NUMBER: NCT02097667.


Subject(s)
Bronchopulmonary Dysplasia , Retinopathy of Prematurity , Infant , Infant, Newborn , Female , Pregnancy , Humans , Fetal Growth Retardation/epidemiology , Fetal Growth Retardation/diagnosis , Infant, Premature , Prospective Studies , Stillbirth , Gestational Age , Retinopathy of Prematurity/epidemiology
7.
J Physiol ; 601(22): 4973-4988, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37070801

ABSTRACT

In high income countries, approximately 10% of pregnancies are complicated by pre-eclampsia (PE), preterm birth (PTB), fetal growth restriction (FGR) and/or macrosomia resulting from gestational diabetes (GDM). Despite the burden of disease this places on pregnant people and their newborns, there are still few, if any, effective ways of preventing or treating these conditions. There are also gaps in our understanding of the underlying pathophysiologies and our ability to predict which mothers will be affected. The placenta plays a crucial role in pregnancy, and alterations in placental structure and function have been implicated in all of these conditions. As extracellular vesicles (EVs) have emerged as important molecules in cell-to-cell communication in health and disease, recent research involving maternal- and placental-derived EV has demonstrated their potential as predictive and diagnostic biomarkers of obstetric disorders.  This review will consider how placental and maternal EVs have been investigated in pregnancies complicated by PE, PTB, FGR and GDM and aims to highlight areas where further research is required to enhance the management and eventual treatment of these pathologies.


Subject(s)
Diabetes, Gestational , Extracellular Vesicles , Pre-Eclampsia , Premature Birth , Pregnancy , Infant, Newborn , Female , Humans , Placenta , Fetal Growth Retardation
9.
Child Dev ; 94(3): 721-733, 2023 05.
Article in English | MEDLINE | ID: mdl-36593656

ABSTRACT

Early childhood naps support emotional memory, but benefits are only observed after overnight sleep. Whether emotional memory consolidation occurs during naps, or whether napping only prepares memories for overnight consolidation is unknown. We investigated whether naps protect emotional memories from interference, indicating consolidation. Between 2018 and 2020, 63 children in western Massachusetts preschools (30 female, 33 male; 33-67 months; 23.8% Hispanic, 87.3% White) learned faces paired with negative or neutral descriptions, followed by nap or wake. Before delayed recognition, half completed an interference task. Without interference, napping benefited recognition. With interference, children recognized fewer negative faces post-nap (compared to wake), with overnight sleep attenuating this difference. Results suggest that naps initially destabilize emotional memories, possibly reflecting partial processing that promotes long-term consolidation.


Subject(s)
Memory Consolidation , Memory , Child , Humans , Male , Child, Preschool , Female , Sleep , Learning , Recognition, Psychology
10.
Pediatr Res ; 93(1): 207-216, 2023 01.
Article in English | MEDLINE | ID: mdl-35449394

ABSTRACT

BACKGROUND: We hypothesised that the clinical characteristics of hospitalised children and young people (CYP) with SARS-CoV-2 in the UK second wave (W2) would differ from the first wave (W1) due to the alpha variant (B.1.1.7), school reopening and relaxation of shielding. METHODS: Prospective multicentre observational cohort study of patients <19 years hospitalised in the UK with SARS-CoV-2 between 17/01/20 and 31/01/21. Clinical characteristics were compared between W1 and W2 (W1 = 17/01/20-31/07/20,W2 = 01/08/20-31/01/21). RESULTS: 2044 CYP < 19 years from 187 hospitals. 427/2044 (20.6%) with asymptomatic/incidental SARS-CoV-2 were excluded from main analysis. 16.0% (248/1548) of symptomatic CYP were admitted to critical care and 0.8% (12/1504) died. 5.6% (91/1617) of symptomatic CYP had Multisystem Inflammatory Syndrome in Children (MIS-C). After excluding CYP with MIS-C, patients in W2 had lower Paediatric Early Warning Scores (PEWS, composite vital sign score), lower antibiotic use and less respiratory and cardiovascular support than W1. The proportion of CYP admitted to critical care was unchanged. 58.0% (938/1617) of symptomatic CYP had no reported comorbidity. Patients without co-morbidities were younger (42.4%, 398/938, <1 year), had lower PEWS, shorter length of stay and less respiratory support. CONCLUSIONS: We found no evidence of increased disease severity in W2 vs W1. A large proportion of hospitalised CYP had no comorbidity. IMPACT: No evidence of increased severity of COVID-19 admissions amongst children and young people (CYP) in the second vs first wave in the UK, despite changes in variant, relaxation of shielding and return to face-to-face schooling. CYP with no comorbidities made up a significant proportion of those admitted. However, they had shorter length of stays and lower treatment requirements than CYP with comorbidities once those with MIS-C were excluded. At least 20% of CYP admitted in this cohort had asymptomatic/incidental SARS-CoV-2 infection. This paper was presented to SAGE to inform CYP vaccination policy in the UK.


Subject(s)
COVID-19 , Coronavirus Infections , Humans , Child , Adolescent , SARS-CoV-2 , COVID-19/epidemiology , Pandemics , Prospective Studies , United Kingdom/epidemiology
11.
Article in English | MEDLINE | ID: mdl-38798902

ABSTRACT

Background: Early childhood is important for cognitive and social-emotional development, and a time in which to promote healthy movement behaviors (sedentary behavior, physical activity, and sleep). Movement behaviors may have interactive influences on cognition and social-emotional factors in young children, but most previous research has explored them independently. The purpose of this study was to determine if movement behaviors are associated with measures of cognitive and social-emotional health in young children and if so, to describe optimal compositions of movement behaviors of a daily cycle for such outcomes. Methods: Children (n = 388, 33 to 70 months, 44.6% female) from a clinical trial (ClinicalTrials.gov ID: NCT03285880, first posted September 18, 2017) wore accelerometers on their wrists for 24-h for 9.56 ± 3.3 days. Movement behavior compositions consisted of time spent in sedentary behaviors, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sleep. Outcomes were cognitive (receptive vocabulary, declarative and procedural memory, and executive attention) and social-emotional measures (temperament and behavioral problems). Compositional linear regression models with isometric log ratios were used to investigate the relations between the movement behavior composition and the cognitive and social-emotional health measures. If a significant association was found between the composition and an outcome, we further explored the "optimal" 24-h time-use for said outcome. Results: Movement behavior compositions were associated with receptive vocabulary. The composition associated with the predicted top five percent of vocabulary scores consisted of 12.1 h of sleep, 4.7 h of sedentary time, 5.6 h of light physical activity, and 1.7 h of MVPA. Conclusions: While behavior compositions are related to vocabulary ability in early childhood, our findings align with the inconclusiveness of the current evidence regarding other developmental outcomes. Future research exploring activities within these four movement behaviors, that are meaningful to cognitive and social-emotional development, may be warranted. Supplementary Information: The online version contains supplementary material available at 10.1186/s44167-023-00016-6.

12.
Sci Rep ; 12(1): 21198, 2022 12 08.
Article in English | MEDLINE | ID: mdl-36482180

ABSTRACT

The objective was to determine if, in preschool-aged children, (1) nap habituality is associated with sedentary time and physical activity (movement behaviors), (2) nap physiology is associated with movement behaviors, and (3) if missing a nap, compared to taking a nap, affects movement behaviors on the same day and subsequent day. A within-subjects (44 children; 4.2 ± 0.6 years; 55.6% female), at-home study examined two experimental conditions (one afternoon each of nap- and wake-promotion with order counterbalanced) one week apart. Movement behaviors were derived from wrist-worn actigraphy (12.1 ± 3.1 days). Average movement behaviors were calculated from the overall study period with experimental days excluded. Movement behaviors were also extracted for the same day and the subsequent day of the two experimental conditions. Polysomnography was recorded during the nap-promoted condition. Children were classified as non-, intermediate-, or habitual-nappers. Although average movement behaviors were different between nap habituality groups, differences were not significant. There were no associations between movement behaviors and nap sleep stages, and no effects for nap condition or condition by nap habituality on same or next day movement behaviors. Findings do not suggest that naps and movement behaviors are related in children. Although a single missed nap was not detrimental to same or next day movement behaviors, future studies should explore effects of multiple days of subsequent nap restriction to examine potential cumulative effects.


Subject(s)
Exercise , Sedentary Behavior , Child , Humans , Child, Preschool , Female , Male
13.
Article in English | MEDLINE | ID: mdl-36430030

ABSTRACT

The purpose of this micro-longitudinal study was to explore daily associations between daytime movement behaviors (sedentary time and physical activity) and nap sleep in young children. In 298 children (age = 51.0 ± 9.6 months, 43.6% female), wrist-based actigraphy (mean wear time = 10 days) assessed sedentary time, total physical activity, and provided an estimate of nap sleep duration and efficiency. Multilevel logistic and linear regression models were used to examine temporal within-person relations between wake behaviors and nap sleep, and adjusted for overnight sleep duration between days of interest, age, sex, and socioeconomic status. Movement behaviors were not related to the likelihood of next-day napping, but when children were less sedentary (OR = 0.96; p < 0.001) or more active (OR = 1.01; p = 0.001) in the morning, they were more likely to nap that same day. Movement behaviors were not associated with nap sleep duration or efficiency. Conversely, on days children napped, they were less sedentary (B = -2.09, p < 0.001) and more active (B = 25.8, p < 0.001) the following day. Though napping and movement behaviors had some reciprocal relations, effect sizes in the present study were small. Further studies should examine children with more diverse sleep health and from different childcare settings.


Subject(s)
Actigraphy , Sleep , Child , Humans , Child, Preschool , Female , Male , Longitudinal Studies , Sedentary Behavior , Exercise
14.
Proc Natl Acad Sci U S A ; 119(44): e2123415119, 2022 11.
Article in English | MEDLINE | ID: mdl-36279436

ABSTRACT

The transition from multiple sleep bouts each day to a single overnight sleep bout (i.e., nap transition) is a universal process in human development. Naps are important during infancy and early childhood as they enhance learning through memory consolidation. However, a normal part of development is the transition out of naps. Understanding nap transitions is essential in order to maximize early learning and promote positive long-term cognitive outcomes. Here, we propose a novel hypothesis regarding the cognitive, physiological, and neural changes that accompany nap transitions. Specifically, we posit that maturation of the hippocampal-dependent memory network results in more efficient memory storage, which reduces the buildup of homeostatic sleep pressure across the cortex (as reflected by slow-wave activity), and eventually, contributes to nap transitions. This hypothesis synthesizes evidence of bioregulatory mechanisms underlying nap transitions and sheds new light on an important window of change in development. This framework can be used to evaluate multiple untested predictions from the field of sleep science and ultimately, yield science-based guidelines and policies regarding napping in childcare and early education settings.


Subject(s)
Memory Consolidation , Sleep , Child, Preschool , Humans , Sleep/physiology , Memory Consolidation/physiology , Learning/physiology , Cognition , Brain/physiology , Wakefulness/physiology
15.
J Clin Pharmacol ; 62 Suppl 1: S67-S78, 2022 09.
Article in English | MEDLINE | ID: mdl-36106777

ABSTRACT

Delivering safe clinical trials of novel therapeutics is central to enable pregnant women and their babies to access medicines for better outcomes. This review describes clinical monitoring of fetal well-being and safety. Current pregnancy surveillance includes regular antenatal checks of blood pressure and urine for signs of gestational hypertension. Fetal and placental development is assessed routinely using the first-trimester "dating" and mid-trimester "anomaly" ultrasound scans, but the detection of fetal anomalies can continue throughout pregnancy using targeted sonography or magnetic resonance imaging (MRI). Serial sonography can be used to assess fetal size, well-being, and placental function. Carefully defined reproducible imaging parameters, such as the head circumference (HC), abdominal circumference (AC), and femur length (FL), are combined to calculate an estimate of the fetal weight. Doppler analysis of maternal uterine blood flow predicts placental insufficiency, which is associated with poor fetal growth. Fetal doppler analysis can indicate circulatory decompensation and fetal hypoxia, requiring delivery to be expedited. Novel ways to assess fetal well-being and placental function using MRI, computerized cardiotocography (CTG), serum circulating fetoplacental proteins, and mRNA may improve the assessment of the safety and efficacy of maternal and fetal interventions. Progress has been made in how to define and grade clinical trial safety in pregnant women, the fetus, and neonate. A new system for improved safety monitoring for clinical trials in pregnancy, Maternal and Fetal Adverse Event Terminology (MFAET), describes 12 maternal and 18 fetal adverse event (AE) definitions and severity grading criteria developed through an international modified Delphi consensus process. This fills a vital gap in maternal and fetal translational medicine research.


Subject(s)
Hypertension, Pregnancy-Induced , Ultrasonography, Prenatal , Female , Fetus/diagnostic imaging , Humans , Infant , Infant, Newborn , Placenta , Pregnancy
16.
Prenat Diagn ; 42(12): 1554-1561, 2022 11.
Article in English | MEDLINE | ID: mdl-36097373

ABSTRACT

OBJECTIVE: We aimed to determine foetal losses for DCDA and MCDA twins following transabdominal CVS or amniocentesis performed <22+0  weeks. METHODS: Retrospective cohort study conducted in the UK and Belgium 01/01/00-01/06/20. Cases with unknown chorionicity, monochorionic complications or complex procedures were excluded. Uncomplicated DCDA and MCDA twins without invasive procedures were identified as controls. We reported foetal losses <24+0  weeks and losses of genetically and structurally normal foetuses. RESULTS: Outcomes were compared for DCDA foetuses; 258 after CVS with 3406 controls, 406 after amniocentesis with 3390 controls plus MCDA foetuses, 98 after CVS with 1124 controls, and 160 after amniocentesis with 1122 controls. There were more losses <24+0  weeks with both procedures in DCDA (CVS RR 5.54 95% CI 3.38-9.08, amniocentesis RR 2.36 95% CI 1.22-4.56) and MCDA twins (CVS RR 5.14 95% CI 2.51-10.54, amniocentesis RR 7.01 95% CI 3.86-12.74). Losses of normal foetuses were comparable to controls (DCDA CVS RR 0.39 95% CI 0.05-2.83, DCDA amniocentesis RR 1.16 95% CI 0.42-3.22, MCDA CVS RR 2.3 95% CI 0.71-7.56, and MCDA amniocentesis RR 1.93 95% CI 0.59-6.38). CONCLUSIONS: This study indicates increased foetal losses for DCDA and MCDA twins following CVS and amniocentesis with uncertain risk to normal foetuses.


Subject(s)
Amniocentesis , Chorionic Villi Sampling , Pregnancy , Female , Humans , Chorionic Villi Sampling/adverse effects , Amniocentesis/adverse effects , Pregnancy, Twin , Retrospective Studies , Fetus
17.
Kinesiol Rev (Champaign) ; 11(2): 121-137, 2022.
Article in English | MEDLINE | ID: mdl-35873529

ABSTRACT

The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.

18.
Dev Cogn Neurosci ; 56: 101130, 2022 08.
Article in English | MEDLINE | ID: mdl-35779333

ABSTRACT

Sleep supports healthy cognitive functioning in adults. Over the past decade, research has emerged advancing our understanding of sleep's role in cognition during development. Infancy and early childhood are marked by unique changes in sleep physiology and sleep patterns as children transition from biphasic to monophasic sleep. Growing evidence suggests that, during development, there are parallel changes in sleep and the brain and that sleep may modulate brain structure and activity and vice versa. In this review, we survey studies of sleep and brain development across childhood. By summarizing these findings, we provide a unique understanding of the importance of healthy sleep for healthy brain and cognitive development. Moreover, we discuss gaps in our understanding, which will inform future research.


Subject(s)
Brain , Sleep , Adult , Child , Child, Preschool , Cognition/physiology , Head , Humans , Sleep/physiology
19.
Ther Innov Regul Sci ; 56(6): 976-990, 2022 11.
Article in English | MEDLINE | ID: mdl-35881237

ABSTRACT

The exclusion of pregnant populations, women of reproductive age, and the fetus from clinical trials of therapeutics is a major global public health issue. It is also a problem of inequity in medicines development, as pregnancy is a protected characteristic. The current regulatory requirements for drugs in pregnancy are being analyzed by a number of agencies worldwide. There has been considerable investment in developing expertise in pregnancy clinical trials (for the pregnant person and the fetus) such as the Obstetric-Fetal Pharmacology Research Centers funded by the National Institute of Child Health and Human Development. Progress has also been made in how to define and grade clinical trial safety in pregnant women, the fetus, and neonate. Innovative methods to model human pregnancy physiology and pharmacology using computer simulations are also gaining interest. Novel ways to assess fetal well-being and placental function using magnetic resonance imaging, computerized cardiotocography, serum circulating fetoplacental proteins, and mRNA may permit better assessment of the safety and efficacy of interventions in the mother and fetus. The core outcomes in women's and newborn health initiative is facilitating the consistent reporting of data from pregnancy trials. Electronic medical records integrated with pharmacy services should improve the strength of pharmacoepidemiologic and pharmacovigilance studies. Incentives such as investigational plans and orphan disease designation have been taken up for obstetric, fetal, and neonatal diseases. This review describes the progress that is being made to better understand the extent of the problem and to develop applicable solutions.


Subject(s)
Cardiotonic Agents , Pregnant Women , Child , Female , Fetus , Humans , Infant, Newborn , Placenta , Pregnancy , RNA, Messenger
20.
Ann Behav Med ; 56(11): 1131-1143, 2022 11 05.
Article in English | MEDLINE | ID: mdl-35551585

ABSTRACT

BACKGROUND: Fear of cancer recurrence (FCR) and sleep disturbance are common in cancer survivors. Yet, little research has examined their relationship, and even less is known about what links may exist between these variables among the intimate partners of cancer survivors. PURPOSE: This study examines the relationship between FCR and sleep disturbance in breast cancer survivors and their partners. Using daily sleep data collected at two distinct periods early in survivorship-the completion of adjuvant treatment and the first post-treatment mammogram-higher survivor and partner FCR was hypothesized to predict greater sleep disturbance. METHODS: Breast cancer survivors and intimate partners (N = 76 couples; 152 individuals) each reported sleep duration, sleep quality, sleep onset latency, and wake after sleep onset each morning of two 21-day sleep diary bursts during the first year post-diagnosis. Three validated measures formed latent FCR factors for survivors and partners, which were used to predict average daily sleep. RESULTS: Across both sleep diary bursts, survivor FCR was associated with their own reduced sleep duration, reduced sleep quality, and greater sleep onset latency. Survivor FCR was also associated with their partners' reduced sleep quality and greater sleep onset latency. Partner FCR was associated with their own reduced sleep duration, reduced sleep quality, and greater sleep onset latency. Partner FCR was also associated with survivors' reduced sleep quality. CONCLUSIONS: Findings revealed intrapersonal and interpersonal associations between FCR and sleep disturbance, addressing gaps in knowledge on FCR and an outcome with known short- and long-term implications for health and mortality.


Subject(s)
Breast Neoplasms , Sleep Wake Disorders , Humans , Female , Neoplasm Recurrence, Local , Fear , Adaptation, Psychological , Sleep
SELECTION OF CITATIONS
SEARCH DETAIL
...