Study objectives To present psychometric data on a comprehensive, parent-report sleep screening instrument designed for school-aged children, the Children's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total score and eight subscale scores, reflecting key sleep domains that encompass the major medical and behavioral sleep disorders in this age group. Design Cross-sectional survey. Setting Three elementary schools in New England, a pediatric sleep disorders clinic in a children's teaching hospital. Participants Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disorders in a pediatric sleep clinic completed the CSHQ. Interventions N/A. Measurements and results The CSHQ showed adequate internal consistency for both the community sample (p=0.68) and the clinical sample (p=0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 (Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and from 0.56 (Parasomnias) to 0.93 (Sleep-Disordered Breathing) for the sleep clinic group. Test-retest reliability was acceptable (range 0.62 to 0.79). CSHQ individual items, as well as the subscale and total scores were able to consistently differentiate the community group from the sleep-disordered group, demonstrating validity. A cut-off total CSHQ score of 41 generated by analysis of the Receiver Operator Characteristic Curve (ROC) correctly yielded a sensitivity of 0.80 and specificity of 0.72. Conclusions The CSHQ appears to be a useful sleep screening instrument to identify both behaviorally based and medically-based sleep problems in school-aged children.

https://nationaljewish.org/njh/media/pdf/meltzer references/owens-(2000)-cshq-school-aged-children.pdf

The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children.

WHO Regional Office for Europe.

http://www.kvccdocs.com/KVCC/2013-Summer/PSY101-OL/content/L-04/sleep-loss.pdf

Sleep loss, learning capacity and academic performance

To attempt a categorization of sleep disorders in children, we developed a 27 item Likert-type rating scale (Sleep Disturbance Scale for Children: SDSC) and assessed the psychometric properties was developed. The scale was distributed to the mothers of 1304 children (1157 controls, mean age 9.8 y; 147 sleep disorder subjects, mean age 9.2y, composed of four clinical groups: Insomnia 39 subjects, Hypersomnia 12 subjects, Respiratory disturbances during sleep 25 subjects and Parasomnias 71 subjects). The internal consistency was high in controls (0.79) and remained at a satisfactory level in sleep disorder subjects (0.71); the test/retest reliability was adequate for the total (r = 0.71) and single item scores. The factor analysis (variance explained 44.21%) yielded six factors which represented the most common areas of sleep disorders in childhood and adolescence. Enuresis was the only item with a factor loading lower than 0.40 and with a low inter-item correlation and was therefore eliminated, resulting in a final scale of 26 items. The re-evaluation of the sample, using the factor scores, supported the validity and the discriminating capacity of the scales between controls and the four clinical groups. The correlation between factor scores corroborated the hypothesis that childhood sleep disturbances are not independent entities nor do they cluster into different groupings related to each other. The SDSC appears to be a useful tool in evaluating the sleep disturbances of school-age children in clinical and non-clinical populations.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2869.1996.00251.x

The Sleep Disturbance Scale for Children (SDSC) Construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence

http://sleepforscience.org/stuff/contentmgr/files/52a3d7d8fccfd8d14eb35108b5ef8f67/pdf/wolfson_carskadonsmr2003.pdf

Understanding adolescent's sleep patterns and school performance: a critical appraisal

Few data currently exist concerning the sleep problems of preadolescents. A parent report questionnaire concerning sleep habits and problems was developed. The questionnaires were completed by the parents of 1000 unscreened elementary school children attending the third, fourth, and fifth grades. The schools were randomly selected from an urban area. Of the 1000 questionnaires, 972 were completed and could be used for statistical analysis. Among the parents, 24% reported sleeping poorly and 12% regularly relied on sedatives to induce sleep. Sleep difficulties lasting more than 6 months were present in 43% of the children. In 14% (132 of 972), sleep latency was longer than 30 minutes, and more than one complete arousal occurred during the night at least two nights per week. The following variables were seen among the poor sleepers: lower parental educational and professional status, parents who were more likely to be divorced or separated, and more noise or light in the rooms were they slept. They also presented a higher incidence of somnambulism, somniloquia, and night fears (nightmares and night terrors) than the children who slept well. Boys who slept poorly were significantly more likely to have insomniac fathers (P less than .010). Regular use of sedatives was described in 4% (5 of 132) of the children who slept poorly. Among the "poor sleepers," 21% (33 of 132) had failed 1 or more years at school. School achievement difficulties were encountered significantly more often among the poor sleepers than among the children without sleep problems (P = .001). Of the families with children suffering from sleep problems, 28% expressed a desire for counseling.(ABSTRACT TRUNCATED AT 250 WORDS)

Sleep problems in healthy preadolescents

Ultrasonography of the neck in a 28 week-old fetus suggested the presence of a goiter. Since sonographic evaluation of epiphyseal ossification centers showed no delayed bone maturation, the fetus was considered to have an euthyroid goiter, that allowed amniocentesis to be performed. The fetus was sonographically followed from 32 to 36 weeks: the development was normal. At birth, hormonal tests confirmed an euthyroid goiter. The authros consider that bone maturation should be monitored in utero especially when a thyroid dysfunction is suspected, in order to detect severe disease and to prompt treatment.

Goitre foetal: depistage et suivi echographique

Introduction. The final oncological and aesthetic results of breast-conserving surgery (BCS) are influenced by the precise localization of breast cancer (BC) tumors and by the quality of the intraoperative margin assessment technique. This study aimed to assess the effectiveness of the carbon localization (CL) technique by determining the success rate of BC identification and the proportion of adequate complete resection of BC lesions. Methods. We conducted a cross-sectional retrospective study of patients treated with primary BCS for invasive BC who underwent CL of their BC lesion at the Jules Bordet Institute between January 2015 and December 2017. Descriptive statistics with categorical and continuous variables were used. The success rate of tumor identification and the rate of adequate excision were calculated using the test of percentages for independent dichotomous data. Results. This study included 542 patients with 564 nonpalpable BC lesions. The median pathological tumor size was 12 mm. Of these, 460 were invasive ductal carcinomas. Most of the tumors were of the luminal subtype. CL was performed using ultrasound guidance in 98.5% of cases. The median delay between CL and surgery was 5 days, with 46% of the patients having CL one day before surgery. The lumpectomy weighed 38 g on average, with a median diameter of the surgical sample at 6 cm and a median volume of 44 cm3 (6–369). One-stage complete resection was successfully performed in 93.4% of cases. In 36% of cases, an intraoperative re-excision was performed, based on intraoperative macroscopic pathological margin evaluation. The tumor was identified in 98.9% of cases in the breast surgical specimen. Conclusion. This study demonstrated high success rates for BC tumor identification (99%) and one-stage complete resection (93.4%) after BCS and CL. These results show that CL is an effective, simple, and inexpensive localization technique for successful excision of BC lesions during BCS.

Effectiveness of Carbon Localization for Invasive Breast Cancer: An Institutional Experience

Background: The number of early-stage breast cancers (BC) continues to increase each year due to technical advances achieved by screening mammography. At least 25-35% of BC are non-palpable at diagnosis and require a localization procedure to guide intraoperative identification and surgical resection. The wire-guided localization (WGL) is considered the standard technique and is the most widely used technique for the localization of BC tumors. Carbon localization (CL) is an alternative procedure, first reported by Svane in 1983, and is the current procedure used for BC tumors localization at Institut Jules Bordet since 1990. 

Carine Van De Merckt

Papers

Sleep problems in healthy preadolescents

Goitre foetal: depistage et suivi echographique

Effectiveness of Carbon Localization for Invasive Breast Cancer: An Institutional Experience

Preoperative carbon localization of breast cancer tumors – an institutional experience

Pseudoangiomatous tumor of the breast