Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management in children in Italy.

AIM: To identify subgroups regarding paediatricians' awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA). METHODS: A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables influenced latent class membership. Analyses were performed using R 3.5.2 software. A p-value<0.05 was considered statistically significant. RESULTS: Two classes were identified: Class 1 (n = 368, 36.29%) "Untrained and poorly satisfied" and Class 2 (n = 646, 63.71%) "Trained and satisfied." Involving paediatric pneumologists or otorhinolaryngologists in clinical practice was associated with an increased probability of Class 2 membership (OR = 5.88, 95%CI [2.94-13.19]; OR = 15.95, 95% CI [10.92-23.81] respectively). Examining more than 20 children with SDB during the last month decreased the probability of Class 2 membership (OR = 0.29, 95% CI [0.14-0.61]). FCPs showed a higher probability of Class 2 membership than PHPs (OR = 4.64, 95% CI [3.31-6.55]). CONCLUSIONS: These findings suggest that the LCA approach can provide important information on how education and training could be tailored for different subgroups of paediatricians. In Italy standardized educational interventions improving paediatricians' screening of SDB are needed in order to guarantee efficient management of children with SDB and reduce the burden of disease

Polimorfismi genetici e fattori ambientali modificabili per ridurre il rischio di SIDS

La sindrome della morte improvvisa del lattante ( Sudden Infant death syndrome) consiste nella morte improvvisa di un bambino al di sotto dell'anno di vita, non prevedibile in base all'anamnesi e insipiegabile anche dopo accurato esame comprendente un'autopsia completa, l'analisi della scena del decesso e la revisione della storia clinica del caso . La SIDS \ue8 da considerare una conseguenza estrema dell'interazione tra genetice ed ambiente. non a caso l'introduzione di norme comportamentali ne ha ridotto notevolmente l'incidenza, chestatisticamente \ue8 massima nel weekend. Al momento attuale le norme comportamentali per ridurre i fattori di rischio ambientali e l'identificazione precoce di lattanti a rischio sono ancora le uniche possibilit\ue0 disponibili per cercaredi cambiare la storiaclinica. Anche se la genetica apre nuove prospettive ezio-patogenetich

Increased parental perception of sleep disordered breathing in a cohort of infants with ALTE/BRUE events

BACKGROUND: An apparent life-threatening event (ALTE) describes an acute, unexpected change in an infant\u2019s breathing, aspect, or behavior frightening to the parent or caretaker. According to the new recent terminology, clinicians should use the term Brief Resolved Unexplained Event (BRUE) to describe an event occurring in an infant <1 year of age when the observer reports a sudden, brief, and now resolved episode. The aims of the present study in infants were: to investigate sleep disturbances in both ALTE event and after their classification according the new BRUE criteria. METHODS: We enrolled (from April to May 2016) 32 consecutive infants referred to our ambulatory for sleep disorders for follow-up after an ALTE episode and 32 pair healthy controls. We administered to parents the adapted questionnaire \u201cSleep Disturbance Scale for Children \u2013SDSC\u201d. RESULTS: Among enrolled infants with ALTE, there were 26 infants in line with the new BRUE definition, of which 10 at low risk and 16 at the high-risk event. CONCLUSIONS: Infants with ALTE and BRUE had more referred-by-parents\u2019 sleep symptoms than controls. In particular, sleep disordered breathing wa prevalent in both, requiring a longer follow-up for this disturbance