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Study Objectives: Sleep and affect are closely related. Whether modifiable cognitive factors moderate this association is unclear. This study examined whether Dysfunctional Beliefs and Attitudes about Sleep moderate the impact of sleep on next-day affect in young people., Methods: Four hundred and sixty-eight young people (205 adolescents, 54.1% female, M ± SD age =16.92 ± 0.87; 263 emerging adults, 71.9% female, M±SD age =21.29 ± 1.73) self-reported sleep and affect, and wore an actigraph for 7-28 days, providing >5000 daily observations. Linear mixed-effects models tested whether Dysfunctional Beliefs and Attitudes about Sleep moderated daily associations between self-reported and actigraphic sleep duration, sleep efficiency, and next-day affect on between- and within-person levels. Both valence (positive/negative) and arousal (high/low) dimensions of affect were examined. Covariates included age, sex, race/ethnicity, day of week, and previous-day affect., Results: Dysfunctional Beliefs and Attitudes about Sleep significantly moderated sleep and high arousal positive affect associations on between- but not within-person levels. Individuals with higher Dysfunctional Beliefs and Attitudes about Sleep (+1 SD) and lower average sleep duration (actigraphic: p = .020; self-reported: p = .047) and efficiency (actigraphic: p = .047) had significantly lower levels of high arousal positive affect. After adjusting for multiple comparisons, Dysfunctional Beliefs and Attitudes about Sleep did not moderate relationships between sleep duration and low arousal positive affect (p ≥ .340)., Conclusions: Young people with more unhelpful beliefs about sleep and shorter, or poorer, sleep may experience dampened levels of high arousal positive affect. DBAS may constitute a modifiable factor increasing affective vulnerability on a global but not day-to-day level. Intervention studies are needed to determine if changing Dysfunctional Beliefs and Attitudes about Sleep may reduce sleep-related affect disturbances in young people., Competing Interests: Declaration of conflict of interest None. All authors have approved the final article., (Copyright © 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Existing patient-reported outcome measures cannot comprehensively capture the full impact of living with a dermatological condition. The aim of this study was to develop a conceptual framework on which to build a new Patient-Reported Impact of Dermatological Diseases (PRIDD) measure. Adults (≥ 18 years of age) living with a dermatological condition, worldwide and/or representatives from a patient organization recruited via a global patient organization network, were invited to an individual or group interview. Data were analyzed thematically. Sixty-five people from 29 countries, representing 29 dermatological conditions, participated. Key themes were: (i) impacts at the individual, organizational and societal levels; (ii) impacts were point-in-time and cumulative; and (iii) impact is a multifaceted construct, with two subthemes (iiia) common impacts and (iiib) psychological and social impacts are most significant. The conceptual framework shows that impact is a multifaceted concept presenting across physical, psychological, social, financial, daily functioning and healthcare, and provides the basis for co-constructing the PRIDD with patients.

Background: The quality of dermatology consultations is partly determined by how clinicians approach patient care. The term 'Personal Models' describes the explanatory frameworks of thoughts, feelings and experiences that drive behaviour. One study found that clinicians' personal models, specifically their beliefs about autonomy and patient self-management, influenced the degree to which clinicians engage patients in shared decision making during consultations. Further research is needed to further explore how clinicians' personal models inform and affect the quality of patient care., Objectives: To explore how clinicians' personal models inform shared decision making and consultation style in managing people living with psoriasis in the context of a new treatment, Apremilast., Methods: A framework analysis of qualitative semi-structured telephone interviews with 13 dermatologists from the UK and Germany who participated in a novel medicine trial for psoriasis called APPRECIATE., Results: Two themes were derived from the data. Theme 1, 'personal working models of patient care', comprised two subthemes: 'patient-centredness: a continuum' and 'stereotypes and assumptions'. Theme 2, 'impact of personal working models on patient care', included three subthemes: 'shared decision making: a continuum', 'consultation skills' and 'impact of concerns about Apremilast on prescribing behaviour'., Conclusions: Although many dermatologists endorsed a patient-centred approach, not all reported working in this way. Clinicians' personal models, their beliefs, stereotypes, personal perceptions and assumptions about patients are likely to affect their prescribing behaviour and shared decision making. Additional specialized training and education could increase patient-centredness and whole-person management., (© 2022 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)

Background: During adolescence, sleep and circadian timing shift later, contributing to restricted sleep duration and irregular sleep-wake patterns. The association of these developmental changes in sleep and circadian timing with cognitive functioning, and consequently academic outcomes, has not been examined prospectively. The role of ambient light exposure in these developmental changes is also not well understood. Here, we describe the protocol for the Circadian Light in Adolescence, Sleep and School (CLASS) Study that will use a longitudinal design to examine the associations of sleep-wake timing, circadian timing and light exposure with academic performance and sleepiness during a critical stage of development. We also describe protocol adaptations to enable remote data collection when required during the COVID-19 pandemic., Methods: Approximately 220 healthy adolescents aged 12-13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires., Discussion: The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents., Ethics and Dissemination: Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media., Study Dates: Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023., Competing Interests: Competing interests: JES, MR, EC, AJH, SL, JW, MAC and BB have no conflicts to declare. AJKP was an investigator on projects supported by the CRC for Alertness, Safety and Productivity, and he has received research funding from Versalux and Delos. EBK reports (non-government, non-university): Travel support from World Conference of Chronobiology, Gordon Research Conference, Sleep Research Society, Santa Fe Institute, German Sleep Society (DGSM); Consulting/grant reviews income from Puerto Rice Science, Technology, and Research Trust, National Sleep Foundation, Sanofi-Genzyme; Family member owns Chronsulting. SWL has had a number of commercial interests in the last 2 years (2019–2021). His interests were reviewed and managed by Mass General Brigham in accordance with their conflict of interest policies. No interests are directly related to the research or topic reported in this paper but, in the interests of full disclosure, are outlined below. SWL has received consulting fees from the EyeJust, Rec Room, Six Senses, and Stantec; and has current consulting contracts with Akili Interactive; Apex 2100; Consumer Sleep Solutions; Hintsa Performance AG; KBR Wyle Services, Light Cognitive; Lighting Science Group Corporation/HealthE; Look Optic; Mental Workout/Timeshifter and View. He has received honoraria and travel or accommodation expenses from MIT, Roxbury Latin School, and University of Toronto, and travel or accommodation expenses (no honoraria) from Wiley; and royalties from Oxford University Press. He holds equity in iSleep Pty. He has received an unrestricted equipment gift from F. Lux Software LLC, and holds an investigator-initiated grant from F. Lux Software. He has a Clinical Research Support Agreement and a Clinical Trials Agreement with Vanda Pharmaceuticals. He is an unpaid Board Member of the Midwest Lighting Institute (non-profit). He was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, through an adjunct professor position at Monash University (2015–2019). He is currently a part-time faculty member at the University of Surrey. He has served as a paid expert in legal proceedings related to light, sleep and health. SMWR was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, and currently serves as the Chair of the Sleep Health Foundation. SMWR reports grants from Vanda Pharmaceuticals, Philips Respironics, Cephalon, Rio Tinto and Shell and receiving equipment support and consultancy fees through his institution from Vanda, Circadian Therapeutics, Optalert, Tyco Healthcare, Compumedics, Mental Health Professionals Network and Teva Pharmaceuticals, which are not related to this paper., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

During the COVID-19 pandemic, schools around the world rapidly transitioned from in-person to remote learning, providing an opportunity to examine the impact of in-person vs remote learning on sleep, circadian timing, and mood. We assessed sleep-wake timing using wrist actigraphy and sleep diaries over 1-2 weeks during in-person learning (n = 28) and remote learning (n = 58, where n = 27 were repeat assessments) in adolescents (age M ± SD = 12.79 ± 0.42 years). Circadian timing was measured under a single condition in each individual using salivary melatonin (Dim Light Melatonin Onset; DLMO). Online surveys assessed mood (PROMIS Pediatric Anxiety and Depressive Symptoms) and sleepiness (Epworth Sleepiness Scale - Child and Adolescent) in each condition. During remote (vs in-person) learning: (i) on school days, students went to sleep 26 minutes later and woke 49 minutes later, resulting in 22 minutes longer sleep duration (all P < .0001); (ii) DLMO time did not differ significantly between conditions, although participants woke at a later circadian phase (43 minutes, P = .03) during remote learning; and (iii) participants reported significantly lower sleepiness (P = .048) and lower anxiety symptoms (P = .006). Depressive symptoms did not differ between conditions. Changes in mood symptoms were not mediated by sleep. Although remote learning continued to have fixed school start times, removing morning commutes likely enabled adolescents to sleep longer, wake later, and to wake at a later circadian phase. These results indicate that remote learning, or later school start times, may extend sleep and improve some subjective symptoms in adolescents., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)