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\"In February 1968, two African American sanitation workers were killed by unsafe equipment in Memphis, Tennessee. Outraged at the city's refusal to recognize a labor union that would fight for higher pay and safer working conditions, sanitation workers went on strike. The strike lasted two months, during which Dr. Martin Luther King Jr. was called to help with the protests ... He was assassinated in his Memphis hotel the day after delivering his 'I've Been to the Mountaintop' sermon in Mason Temple Church. Inspired by the memories of a teacher who participated in the strike as a child, author Alice Faye Duncan reveals the story of the Memphis sanitation strike from the perspective of a young girl with a ... combination of poetry and prose\"-- Provided by publisher.

Recently there have been initiatives to ban or reduce the use of smartphones in children and young people. While exemptions are typically made for those for whom smartphones constitute an essential medical device, these groups have not been sufficiently considered in discussions to date. These people include children living with type 1 diabetes and young carers, as well as some with heart conditions and epilepsy. Research urgently needs to examine the consequences of smartphone use and restriction in children in general, but this is particularly urgent when smartphones constitute an essential medical device. While restricting use and negative messaging surrounding campaigns could cause harm to these children, the negative impacts of devices (eg providing opportunities for bullying or distraction) may also be amplified in these populations. Four clinical and research recommendations on this topic are proposed.

This study examined relations between sleep, reading and mathematics, and inattention/hyperactivity in childhood and adolescence in a sample of Australian twins (maximum n = 5524; 51% female; 95% European ancestry; M age 8.6–14.6 years). Between and within models were used to assess if (a) differences between twins, or (b) differences between families, in five facets of sleep habits were associated with academic and behavioral measures. Some sleep measures uniquely predicted reading and mathematics in some grades, but overall, sleep quality, duration, bedtime regularity, daytime sleepiness, and snoring accounted for only ~1% of the academic variance. However, sleep measures accounted for up to 7% of the variance in inattention/hyperactivity. Post hoc analyses showed that inattention mediated most of the associations between sleep and reading and mathematics outcomes that were detected. This study adds to the literature showing small and inconsistent relations between sleep and academic performance in normative samples of children and adolescents.

Abstract Study Objectives Digital technology use is associated with poor sleep quality in adolescence and young adulthood although research findings have been mixed. No studies have addressed the association between the two using a genetically informative twin design which could extend our understanding of the etiology of this relationship. This study aimed to test: (1) the association between adolescents’ perceived problematic use of digital technology and poor sleep quality, (2) whether the association between problematic use of technology and poor sleep quality remains after controlling for familial factors, and (3) genetic and environmental influences on the association between problematic use of technology and poor sleep quality. Methods Participants were 2232 study members (18-year-old twins) of the Environmental Risk (E-Risk) Longitudinal Twin Study. The sample was 48.9% male, 90% white, and 55.6% monozygotic. We conducted regression and twin difference analyses and fitted twin models. Results Twin differences for problematic use of technology were associated with differences for poor sleep quality in the whole sample (p < 0.001; B = 0.15) and also when we limited the analyses to identical twins only (p < 0.001; B = 0.21). We observed a substantial genetic correlation between problematic use of technology and sleep quality (rA = 0.31), whereas the environmental correlation was lower (rE = 0.16). Conclusions Adolescent reported problematic use of digital technology is associated with poor sleep quality—even after controlling for familial factors including genetic confounds. Our results suggest that the association between adolescents’ sleep and problematic digital technology use is not accounted for by shared genetic liability or familial factors but could reflect a causal association. This robust association needs to be examined in future research designed to test causal associations. Graphical abstract Graphical Abstract

Background Evidence indicates the gut microbiome may be altered in ADHD, suggesting that targeting gut bacteria could alleviate symptoms. This study examined the effects of kefir supplementation on ADHD symptoms, sleep, attention, and gut microbiome composition in children diagnosed with ADHD. Methods A six-week, randomised, double-blind, placebo-controlled trial was conducted in UK children aged 8–13 years with ADHD. Participants were assigned either to a daily kefir or placebo drink group. The primary outcome was ADHD symptom severity measured by the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour (SWAN) scale. Secondary outcomes included gut microbiota composition (analysed using shotgun metagenomic sequencing), gastrointestinal symptoms, sleep (actigraphy, parent/self-report), attention and impulsivity. Results Fifty-three participants (mean age = 10.2 years, SD = 1.7) completed the study. Kefir had no significant overall effect on parent or teacher-rated ADHD symptom severity. A non-significant interaction was observed between baseline symptom severity and group for teacher-rated SWAN scores, with children in the kefir group who had the highest baseline ADHD symptoms showing lower scores at week six ( M  = 2.03, SE = 0.33 vs. 2.86, SE = 0.34), p  = 0.088. Actigraphy revealed the kefir group spent fewer minutes awake during the down period at week six ( M  = 70.10, SE = 0.09) than the placebo group ( M  = 89.72, SE = 0.07), p  = 0.04. However, the kefir group self-reported more sleep problems post-intervention ( M  = 39.81, SE = 0.75 vs. 37.40, SE = 0.65), p  = 0.02. For Go/NoGo RT variance, a non-significant interaction ( p  = 0.052) between baseline and post intervention scores was found. No other significant group differences were observed. Kefir supplementation did not significantly affect gut microbiota alpha or beta diversity. However, relative abundance of several species including bifidobacterium adolescentis, B. infantis , and B. longum and Alistipes sp021204515 and A. timonensi increased significantly in the kefir group. Conclusions Kefir supplementation may support modest improvements in sleep quality, in children with ADHD. These findings contribute to our understanding of the potential role of nutrition in ADHD management and may inform clinical guidance for practitioners working with neurodivergent individuals. Ethics Ethical approval for the study was granted by St Mary’s University Ethics Committee. Trial registration The trial protocol has been prospectively registered with ClinicalTrials.gov: NCT05155696. Registered on 13 December 2021.

Background A robust insomnia screening and measuring tool is essential for accurately assessing and diagnosing insomnia in research and clinical settings. The Sleep Condition Indicator (SCI) is an initial screening tool designed to assess insomnia complaints according to the DSM-5 criteria. This study aims to systematically evaluate item content, psychometric performance, diagnostic performance, and overall application of the SCI through a methodological quality assessment of original validation studies. These findings offer valuable information for optimizing insomnia diagnosis, assessment, and monitoring. Methods A comprehensive search was conducted for finding studies published from 2012 to 2024, in PubMed, EMBASE, CINAHL, and MEDLINE electronic databases, and citation searching in PubMed, SCOPUS, Web of Science, and Google Scholar. Full-text articles focusing on the translation, validation, and application of the SCI were included. The psychometric studies were assessed regarding their measurement properties and methodological quality, using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The diagnostic studies were assessed using the Standard for Reporting of Diagnostic Accuracy (STARD) guidelines. Finally, studies in which the SCI was used for assessment or screening purposes provided general information on the application of the scale. Results We identified 285 studies with over 720,000 participants that used the SCI, and 13 language versions of the SCI were employed across at least 31 regions. The most commonly assessed measurement properties of the SCI within 19 studies were structural validity, internal consistency, criterion validity, and reliability, with findings supporting a stable two-factor structure and credible overall psychometric properties. The SCI demonstrated adequate sensitivity and specificity in 14 studies evaluating its diagnostic performance, and a cut-off value of 16 was recommended for screening insomnia. Finally, the studies showed that the SCI is widely used across clinical and non-clinical settings and provides valuable information for assessing insomnia risks. Conclusions The SCI includes items that align with the most current diagnostic criteria for insomnia disorder from the DSM-5. This tool demonstrates excellent psychometric performance and strong diagnostic performance. Overall, the SCI provides useful information for screening, diagnosing, and monitoring insomnia, making it a valuable tool in both research and clinical settings. Highlights • The DSM-5 criteria-based SCI can be used to screen for and diagnose insomnia. • This systematic review was the first to examine the use of the SCI from a global perspective. • The SCI is available in 13 languages and was evaluated in 285 studies in 31 regions. • The SCI assessment adhered to rigorous the PRISMA-COSMIN and STARD guidelines. • This review demonstrated strong psychometric and diagnostic performance of the SCI.

Abstract Study Objectives There is a well-established association between poor sleep quality and internalizing traits. This relationship has previously been studied using a twin design. However, when it comes to adolescence, there is a paucity of twin studies that have investigated this relationship, despite the importance of this developmental stage for both the development of poor sleep quality and internalizing symptoms. Additionally, anxiety sensitivity, which is commonly associated with poor sleep quality, has not been studied in this context. Our objective was to estimate genetic and environmental influences on the relationships between insomnia, poor sleep quality, and internalizing symptoms in adolescence. Methods Insomnia, poor sleep quality, depression, anxiety, and anxiety sensitivity traits were measured in a sample of 5111 twin pairs from the Twins Early Development Study, born between 1994 and 1996 (mean age 16.32 years [SD = 0.68]). Results A moderate proportion of the variance for the different variables (.29–.42) was explained by genetic factors. Associations between sleep and internalizing variables were moderate (r = .34–.46) and there was a large genetic overlap between these variables (rA= .51–.73). Conclusion This study adds novel information by showing that there are large genetic correlations between sleep disturbances and internalizing symptoms in adolescence.

Sleep disturbances are common in attention deficit hyperactivity disorder (ADHD) and associated with poor outcomes. We tested whether, in children with ADHD, (1) polygenic liability for sleep phenotypes is over- or under-transmitted from parents, (2) this liability is linked to comorbid sleep disturbances, and (3) ADHD genetic risk is associated with comorbid sleep disturbances. We derived polygenic scores (PGS) for insomnia, chronotype, sleep duration, and ADHD, in 758 children (5–18 years old) diagnosed with ADHD and their parents. We conducted polygenic transmission disequilibrium tests for each sleep PGS in complete parent–offspring ADHD trios ( N  = 328) and an independent replication sample of ADHD trios ( N  = 844). Next, we tested whether insomnia, sleep duration, and ADHD PGS were associated with co-occurring sleep phenotypes (hypersomnia, insomnia, restless sleep, poor sleep quality, and nightmares) in children with ADHD. Children’s insomnia and chronotype PGS did not differ from mid-parent average PGS but long sleep duration PGS were significantly over-transmitted to children with ADHD. This was supported by a combined analysis using the replication sample. Insomnia, sleep duration, and ADHD PGS were not associated with comorbid sleep disturbances. There is weak evidence that children with ADHD over-inherit polygenic liability for longer sleep duration and do not differentially inherit polygenic liability for insomnia or chronotype. There was insufficient evidence that childhood sleep disturbances were driven by polygenic liability for ADHD or sleep traits, suggesting that sleep disturbances in ADHD may be aetiologically different to general population sleep phenotypes and do not index greater ADHD genetic risk burden.

Exploding head syndrome is a sensory parasomnia characterized by the perception of loud noises and/or a sense of explosion in the head that occurs when transitioning to or from sleep. Despite receiving little attention from both researchers and clinicians, studies suggest that approximately 10%-15% of individuals have episodes, with significant levels of fear occurring in a subset of cases. Using two independent samples, we examine sleep and well-being variables associated with exploding head syndrome. We focused on insomnia symptoms, life stress, anxiety and depression symptoms, and sleep experiences such as sleep paralysis as potential factors associated with exploding head syndrome. Study 1 consisted of 199 female undergraduate students. We found a lifetime prevalence of 37.19%, with 6.54% experiencing at least one episode a month. All variables were associated with exploding head syndrome in univariate analyses, but only insomnia symptoms and sleep paralysis frequency were significantly associated with exploding head syndrome in multiple logistic regression models. Study 2 was an international sample of 1683 participants (age range 18-82, 53.00% female). Lifetime prevalence was 29.59%, with monthly episodes occurring in 3.89% of participants. The same set of variables was investigated as in Study 1, with dissociative experiences during wakefulness and a larger range of sleep experiences also included. Study 2 replicated the results of Study 1. In addition, dissociative experiences during wakefulness and other sleep experiences such as nightmares were associated with exploding head syndrome in multiple logistic regression models. These studies provide valuable first insights into variables associated with exploding head syndrome.Clinical trial information: Study 1 constitutes a planned exploratory outcome of a pilot feasibility study conducted to provide information useful for designing a clinical trial: Name: STOP-pilot. URL: https://clinicaltrials.gov/ct2/show/NCT03062891?term=NCT03062891&rank=1, Registration: NCT03062891.

Background There is significant health inequity in the United Kingdom (U.K.), with different populations facing challenges accessing health services, which can impact health outcomes. At one London National Health Service (NHS) Trust, data showed that patients from deprived areas and minority ethnic groups had a higher likelihood of missing their first outpatient appointment. This study’s objectives were to understand barriers to specific patient populations attending first outpatient appointments, explore systemic factors and assess appointment awareness. Methods Five high-volume specialties identified as having inequitable access based on ethnicity and deprivation were selected as the study setting. Mixed methods were employed to understand barriers to outpatient attendance, including qualitative semi-structured interviews with patients and staff, observations of staff workflows and interrogation of quantitative data on appointment communication. To identify barriers, semi-structured interviews were conducted with patients who missed their appointment and were from a minority ethnic group or deprived area. Staff interviews and observations were carried out to further understand attendance barriers. Patient interview data were analysed using inductive thematic analysis to create a thematic framework and triangulated with staff data. Subthemes were mapped onto a behavioural science framework highlighting behaviours that could be targeted. Quantitative data from patient interviews were analysed to assess appointment awareness and communication. Results Twenty-six patients and 11 staff were interviewed, with four staff observed. Seven themes were identified as barriers – communication factors, communication methods, healthcare system, system errors, transport, appointment, and personal factors. Knowledge about appointments was an important identified behaviour, supported by eight out of 26 patients answering that they were unaware of their missed appointment. Environmental context and resources were other strongly represented behavioural factors, highlighting systemic barriers that prevent attendance. Conclusion This study showed the barriers preventing patients from minority ethnic groups or living in deprived areas from attending their outpatient appointment. These barriers included communication factors, communication methods, healthcare the system, system errors, transport, appointment, and personal factors. Healthcare services should acknowledge this and work with public members from these communities to co-design solutions supporting attendance. Our work provides a basis for future intervention design, informed by behavioural science and community involvement.