Implementation and Effects of an Online Intervention Designed to Promote Sleep During Early Infancy: A Randomized Trial.

Objective: Examine the implementation and effects of an interactive online intervention designed to support new parents with their young infants' sleep.

Design: First-time parents were enrolled when infants were ~6 weeks old and randomized to a sleep intervention or general baby care control group, with intervention content provided weekly between infant ages 2 to 4 months, primarily as brief videos and infographics in private online groups.

Methods: Parents (n=74) completed online surveys at baseline (infant age ~6 weeks), midpoint (3 months), post-intervention (4 months), and follow-up (7 months), reporting on infant sleep duration and night wakings (via Brief Infant Sleep Questionnaire), as well as their own sleep duration (via Pittsburgh Sleep Quality Index), and parenting satisfaction and self-efficacy (via Perceived Sense of Competence Scale).

Pilot study comparing sleep logs to a commercial wearable device in describing the sleep patterns of physicians-in-training.

With the increasing burden of professional burnout in physicians, attention is being paid to optimizing sleep health, starting in training. The multiple dimensions of physicians' sleep are not well described due to obstacles to easily and reliably measuring sleep. This pilot study tested the feasibility of using commercial wearable devices and completing manual sleep logs to describe sleep patterns of medical students and residents.

Performing polysomnography in pre-school aged children: challenging parts of the procedure and risk factors for lead intolerance.

Purpose: Pediatric sleep apnea begins in toddlerhood when sleep is vital for neurocognitive development and rapid somatic growth. As polysomnography (PSG) can be challenging in this age group, this study described the first PSG for children aged 2 to 6 years old in regards to completion and risk-factors for intolerance.

Methods: Single center chart review in a pediatric-only hospital-based sleep center.

Validation of the Survey of Sleep Quality in the Pediatric Intensive Care Unit (SSqPICU).

Study Objectives: Observational data suggest pediatric intensive care unit-related sleep and circadian disruption (PICU-SCD) affects many critically ill children. Multicenter trials exploring PICU-SCD have been impractical because measuring sleep in this setting is challenging. This study validates a questionnaire for caregivers to describe children's sleep in the PICU.

Comparison of Epworth Sleepiness Scale and OSA-18 Scores With Polysomnography in Children.

Objective: Our goal is to determine if there is a correlation between Modified Epworth Sleepiness Scale (M-ESS) scores, obstructive sleep apnea (OSA)-18 scores, and polysomnography (PSG) outcomes in children.

Study Design: Retrospective chart review.

Setting: Pediatric otolaryngology clinic.

Pediatric Intensive Care Unit related Sleep and Circadian Dysregulation: a focused review.

The pediatric intensive care unit (PICU) is bright, loud, and disruptive to children. Strategies to improve the sleep of adults in the ICU have improved delirium and mortality rates. Children need more sleep than adults for active growth, healing, and development when well; this is likely true when they are critically ill.

Urinary biomarkers as indicators of acute kidney injury in critically ill children exposed to vancomycin.

Study Objective: The standard of care for detecting acute kidney injury (AKI) is change in serum creatinine (SCr) and urine output, which are limited. This study aimed to compare urinary biomarkers neutrophil gelatinase-associated lipocalin (uNGAL) with kidney injury molecule-1 (uKIM-1) in critically ill children exposed to vancomycin who did and did not develop AKI as defined by changes in SCr.

Design: Single-center, prospective, clinical, observational cohort study.

Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study.

Study Objectives: Reduced sleep duration and work hour variability contribute to medical error and physician burnout. This study assesses the relationships between physician performance, burnout, and the dimensions of sleep beyond hours slept.

Methods: This was an ancillary analysis of 3 years of data from an international prospective cohort study: the Intern Health Study.

How Pediatric Sleep Disordered Breathing Impacts Parental Fatigue.

Objective: Previous research has indicated that sleep disordered breathing (SDB) can lead to a decreased quality of life in children and their families as compared to children who do not have SDB. The purpose of this study was to examine fatigue levels in parents who had young children who were impacted by sleep symptoms as determined by the OSA-18 scale.

Study Design: Survey.

Parental survey of the sleep patterns and screen time in US school children during the first 6 months of the COVID-19 pandemic.

Background: This study compared sleep duration, screen exposure and sleep quality in school-aged children before COVID-19 to that during school closures and again when schools re-opened in fall 2020.

Methods: Cross-sectional anonymous, online survey of parents of children 5-13 years old. Questions elicited information about sleep timing and quality, screen time, and schooling at three distinct periods: before the pandemic, when schools first closed and then re-opened in the fall.

Parental Knowledge of Obstructive Sleep Apnea Symptoms and Tonsillectomy in Children.

Objective: Obstructive sleep apnea (OSA) is present in approximately 2% to 5% of children; however, only 15% of parents are reported to be knowledgeable about OSA in children. Sleep apnea in children can lead to cardiopulmonary disease, abnormal weight gain, failure to thrive, or learning difficulties. The purpose of our study is to assess parental knowledge of pediatric OSA to identify any knowledge gaps.

Renal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.

Context: Renal dysfunction is associated with poor outcomes in critically ill children.

Objective: To evaluate the current evidence for criteria defining renal dysfunction in critically ill children and association with adverse outcomes. To develop contemporary consensus criteria for renal dysfunction in critically ill children.

Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.

Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) expert panel to summarize data characterizing single and multiple organ dysfunction and to derive contemporary criteria for pediatric organ dysfunction. The panel was composed of 88 members representing 47 institutions and 7 countries.

Sleep patterns of US healthcare workers during the first wave of the COVID-19 pandemic.

Purpose: During the first few months of the COVID-19 outbreak, healthcare workers (HCW) faced levels of personal risk, emotional distress, and professional strain not seen in their lifetimes. This study described how these stressors influenced various aspects of their sleep patterns.

Methods: From May 19 to June 20, 2020, an electronic, cross-sectional survey was administered to a convenience sample of in- and outpatient HCW in a large, nonprofit healthcare system.

Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.

Objective: Our institution performed an educational initiative targeting previously identified barriers to pediatric sepsis recognition and treatment. We hypothesized that provider knowledge, attitude, and behavior would be improved 1 year after implementation.

Methods: This was a prospective, observational study of a multi-faceted quality initiative introduced to providers in the Emergency Department, inpatient wards, and Pediatric Intensive Care Unit of a tertiary care children's hospital.

Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study.

Objectives: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist with trial design. We aimed to develop and validate mortality prediction models for patients with pediatric acute respiratory distress syndrome.

Design: Leveraging additional data collection from a preplanned ancillary study (Version 1) of the multinational Pediatric Acute Respiratory Distress syndrome Incidence and Epidemiology study, we identified predictors of mortality.

Selecting a pharmacotherapy regimen for patients with chronic insomnia.

Introduction: Chronic insomnia, whether it is primary or in combination with another medical or psychiatric disorder, is a prevalent condition associated with significant morbidity, reduced productivity, increased risk of accidents, and poor quality of life. Pharmacologic and behavioral treatments have equivalent efficacy with each having its own advantages and limitations.

Areas Covered: The purpose of this perspective is to delineate the limitations encountered in implementing cognitive behavioral therapy (CBT) and to review the pharmacological treatments designed to target the different phenotypes of insomnia.

Early Use of Adjunctive Therapies for Pediatric Acute Respiratory Distress Syndrome: A PARDIE Study.

Few data exist to guide early adjunctive therapy use in pediatric acute respiratory distress syndrome (PARDS). To describe contemporary use of adjunctive therapies for early PARDS as a framework for future investigations. This was a preplanned substudy of a prospective, international, cross-sectional observational study of children with PARDS from 100 centers over 10 study weeks.

Guideline Adherence and Antibiotic Utilization by Community Pediatricians, Private Urgent Care Centers, and a Pediatric Emergency Department.

Pediatric antibiotic prescriptions originate from an increasingly broad range of ambulatory settings. In this retrospective study, pharyngitis, otitis media, sinusitis, pneumonia, and upper respiratory infection cases, at 11 primary care offices, 2 independent urgent care centers (UCCs), and a pediatric emergency department in Western New York, were analyzed relative to medical society practice guidelines and antibiotic utilization. Of 2358 eligible visits across all sites, 25% were for study diagnoses, with 38% at UCC ( < .

Predictors of Negative Pressure Ventilation Response in Pediatric Acute Respiratory Failure.

Background: Use of negative pressure ventilation is neither well described nor widespread in pediatric critical care; existing data are from small, specialized populations. We sought to describe a general population of critically ill subjects with acute respiratory failure supported with negative pressure ventilation to find predictors of response or failure.

Methods: We conducted a retrospective cohort study of subjects 0-18 y old admitted to a single (non-cardiac) pediatric ICU who received acute respiratory failure support via negative pressure ventilation from May 2015 through May 2016.

Identifying Hesitation and Discomfort with Diagnosing Sepsis: Survey of a Pediatric Tertiary Care Center.

Objective: Pediatric sepsis remains a significant cause of morbidity and mortality despite the development of strategies proven to improve diagnosis and treatment. Specifically, early recognition and urgent therapy initiation are consistently associated with improved outcomes. However, providers bring these principles inconsistently to the bedside.

Self-Reported Management of IV Fluids and Fluid Accumulation in Children With Acute Respiratory Failure.

Objectives: Observational studies have shown that fluid overload is independently associated with increased morbidity in critically ill children, especially with respiratory pathology. It is unknown if recent evidence has influenced clinical practice. We sought to describe current IV fluid management in pediatric acute respiratory distress syndrome.