362 research outputs found
Sleep in Pediatric Primary Care: A Review of the Literature
Primary care is a critical setting for screening and management of pediatric sleep difficulties. This review summarizes studies examining the prevalence of sleep problems in primary care settings as well as current practices in screening, diagnosis, and management, including behavioral recommendations and medications. Potential barriers to effectively addressing sleep are also reviewed. Despite the high prevalence of pediatric sleep problems in primary care, rates of screening and management are low. Primary care providers receive minimal sleep training and have resulting gaps in knowledge and confidence. Parents similarly have gaps in knowledge and many factors contribute to their identification of sleep as problematic. Recommendations to improve the provision of sleep services in pediatric primary care are made in the areas of research, practice, and education
Real-World Implementation of Infant Behavioral Sleep Interventions: Results of a Parental Survey
Objective
To describe parental practices implementing behavioral sleep intervention (BSI) outside a clinical setting.
Study design
Parents (n = 652), recruited through a Facebook group designed as a peer support group for parents using BSI, completed an online survey about their experience using BSI with their infant or toddler.
Results
On average, parents implemented BSI when their infant was 5.6 (±2.77) months. Parents most often used modified (49.5%) or unmodified extinction (34.9%), with fewer using a parental presence approach (15.6%). Regardless of BSI type, more parents endorsed “a great deal of stress” during the first night (42.2%) than 1 week later (5.2%). The duration of infant crying was typically greatest the first night (reported by 45%; M = 43 minutes) and was significantly reduced after 1 week (M = 8.54 minutes). Successful implementation of BSI on the first attempt was reported by 83%, with a median and mode of 7 days until completion (79% by 2 weeks). Regardless of BSI type, after intervention parents reported their infant had less difficulty falling asleep, fewer night awakenings, and were more likely to sleep in their room and/or in their own crib/bed.
Conclusions
The majority of parents report successfully implementing BSI, with significantly reduced infant crying by the end of 1 week and success within 2 weeks. Few differences were found between behavioral approaches
Sibling sleep-What can it tell us about parental sleep reports in the context of autism?
Sleep problems are common in families raising children with Autism Spectrum Disorder (ASD). Clinicians often depend on parent reports of child sleep but minimal research exists to address the accuracy or biases in these reports. To isolate parent-report accuracy (from differences in sleep behaviors), the sleep of younger siblings were assessed within a two-group design. The present study compared parent diary reports of infant sibling sleep to videosomnography and actigraphy. In the high-risk group, families had at least one child with ASD and a younger sibling (n = 33). The low-risk comparison group had no family history of ASD (n = 42). We confirmed comparable sleep behaviors between the groups and used paired t tests, two-one-sided-tests (TOST), and Bland-Altman plots to assess parent report accuracy. The parameters of sleep onset, nighttime sleep duration, awakenings, morning rise time, and daytime sleep duration were evaluated. Diary and videosomnography estimates were comparable for nighttime sleep duration, morning rise time, and awakenings for both groups. Diary and actigraph estimates were less comparable for both groups. Daytime sleep duration estimates had the largest discrepancy with both groups reporting (on average) 40 additional minutes of sleep when compared to actigraphy estimates. In the present study, families raising children with ASD were just as accurate as other families when reporting infant sleep behaviors. Our findings have direct clinical implications and support the use of parent nighttime sleep reports
Multiple Imputation Ensembles (MIE) for dealing with missing data
Missing data is a significant issue in many real-world datasets, yet there are no robust methods for dealing with it appropriately. In this paper, we propose a robust approach to dealing with missing data in classification problems: Multiple Imputation Ensembles (MIE). Our method integrates two approaches: multiple imputation and ensemble methods and compares two types of ensembles: bagging and stacking. We also propose a robust experimental set-up using 20 benchmark datasets from the UCI machine learning repository. For each dataset, we introduce increasing amounts of data Missing Completely at Random. Firstly, we use a number of single/multiple imputation methods to recover the missing values and then ensemble a number of different classifiers built on the imputed data. We assess the quality of the imputation by using dissimilarity measures. We also evaluate the MIE performance by comparing classification accuracy on the complete and imputed data. Furthermore, we use the accuracy of simple imputation as a benchmark for comparison. We find that our proposed approach combining multiple imputation with ensemble techniques outperform others, particularly as missing data increases
Diversity in pediatric behavioral sleep intervention studies
Studies designed to assess the efficacy of behavioral sleep interventions for infants and young children often report sleep improvements, but the generalization to children and families of diverse backgrounds is rarely assessed. The present study describes a systematic review of the racial, ethnic, and socioeconomic diversity of behavioral sleep intervention studies for young children. Thirty-two behavioral sleep intervention studies (5474 children) were identified using PRISMA guidelines. Each study was coded for racial and ethnic composition, parental educational attainment (an index of socioeconomic resources), and country of origin. Racial or ethnic information was obtained for 19 studies (60%). Study participants were primarily White and from predominantly White countries. Overall, 21 (66%) of the included studies provided information on parental education. Most of these studies had samples with moderate to high educational attainment. Behavioral sleep intervention studies to date include samples with insufficient diversity. Overall, this study highlights a critical gap in pediatric sleep intervention research and supports a call to further include families from diverse backgrounds when assessing behavioral sleep interventions
Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings
Objectives In the midst of large-scale changes across our nation’s health care system, including the Affordable Care Act and Patient-Centered Medical Home initiatives, integrated primary care models afford important opportunities for those in the field of pediatric psychology. Despite the extensive and growing attention, this subspecialty has received in recent years, a comprehensive set of core professional competencies has not been established. Methods A subset of an Integrated Primary Care Special Interest Group used two well-established sets of core competencies in integrated primary care and pediatric psychology as a basis to develop a set of integrated pediatric primary care-specific behavioral anchors. Conclusions The current manuscript describes these behavioral anchors and their development in the context of professional training as well as with regard to Triple Aim goals and securing psychology’s role in integrated pediatric primary care settings
Flow diagnostics and visualization in wind tunnels and flight
The Langley Research Center has a concentrated and directed effort under way to develop both conventional and non-intrusive diagnostic instrumentation. These instruments are being developed to operate over large Mach number, total temperature, and total pressure ranges. Efforts are being made to evaluate the measurements made by the various instruments to determine the most accurate and reliable instrument to be used under a given flow environment. Although only one flow visualization technique was described, there are many different types presently being used at Langley Research Center
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In-Plant Testing of High-Efficiency Hydraulic Separators
Hydraulic separators are commonly used for particle size classification and gravity concentration of minerals and coal. Unfortunately, the efficiency of these processes can be quite low due to poor equipment design and variations in feed consistency. To help alleviate these problems, an industry-driven R&D program has been undertaken to develop a new generation of hydraulic separators that are more efficient and less costly to operate and maintain. These units, which are commercially called the CrossFlow separator and HydroFloat separator, have the potential to improve performance (separation efficiency and throughput) and reduce operating costs (power consumption, water and reagent usage). In Phase I of this project, laboratory and pilot-scale test units were evaluated at various industrial sites in both the coal and mineral industries. Based on promising results obtained from Phase I, full-scale prototypes were purchased and installed by a major U.S. phosphate producer and a large eastern U.S. coal company. The test data obtained from these sites demonstrate that significant performance improvements can be realized through the application of these high-efficiency separators
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In-Plant Testing of High-Efficiency Hydraulic Separators
The mineral processing industry has commonly utilized hydraulic separators throughout history for classification and gravity concentration of various minerals. More commonly referred to as hindered-bed or fluidized-bed separators, these units make use of differential particle settling rates to segregate particles according to shape, size, and/or density. As with any equipment, there are inefficiencies associated with its operation, which prompted an industry driven research program to further evaluate two novel high-efficiency hindered bed separators. These units, which are commercially called the CrossFlow separator and HydroFloat separator, have the potential to improve performance (separation efficiency and throughput) and reduce operating costs (power consumption, water and reagent usage). This report describes the results of Phase I activities (laboratory and pilot-scale tests) conducted with the CrossFlow and HydroFloat separators at several locations in the minerals and coal industries. Details of the testing programs (equipment setup, shakedown testing and detailed testing) associated with four coal plants and two phosphate plants are summarized in this work. In most of these applications, the high-efficiency units proved to provide a higher quality product at reduced costs when compared against the performance of conventional separators. Based on promising results obtained from Phase I, full-scale prototypes will be purchased by several mining companies for use in Phase II of this project. Two of the prototype units, which will be constructed by Eriez Manufacturing, are expected to be installed by a major U.S. phosphate producer and a large eastern U.S. coal company. Negotiations are also underway to purchase and install additional prototype units by a mineral sands producer and a second phosphate producer. The data obtained from the full-scale evaluations will be used to further promote commercialization and industrial applications of these innovative technologies
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