ABSTRACT
OBJECTIVE: To explore the impact of the COVID-19 pandemic on the sleep-wake patterns of preschool children. METHODS: A cohort of preschoolers established before the COVID-19 pandemic was invited to participate in this study. Data including children's demographics, their own and parental sleep-wake patterns, physical activities, and screen time were collected through an online questionnaire from August to September 2020. A comparison was made on the collected data from the same cohort of children before and during the pandemic. RESULTS: The cohort which was established before the pandemic consisted of 3720 preschoolers. For this current study, 642 (17%) participated, and 497 (13%) children who fulfilled the eligibility criteria were included in the final analysis. They showed a delay in their bedtime and wake time on both weekdays and weekends with a 15-30 min increase in nocturnal sleep duration. However, with a reduction in nap time, the average daily sleep duration was shortened by 16.3 ± 64.3 min (p < 0.001) and 27.5 ± 72.9 min (p < 0.001) during weekdays and weekends, respectively. Screen time was increased while outdoor activity duration was decreased. Parental sleep/wake times were also delayed with an increase in sleep duration. Children's sleep habits were associated with screen time and parental sleep/wake patterns. CONCLUSION: Despite school suspension during the COVID-19 pandemic, preschoolers were not sleeping longer. Screen time and parental sleep/wake patterns were the major factors driving the preschoolers' sleep habits. Health education is required to control screen time in children and to promote sleep hygiene among all family members.
ABSTRACT
Aim: Conventionally, patients are gathered to watch an introductory video at the clinic before endoscopic investigations take place. This may arouse practical issues under the COVID pandemic. Our centre, in collaboration with students from a local secondary school, has designed a set of animations which patients can easily access to with a QR code using their own mobile devices, so as to avoid patient gathering and increase their flexibility to read the information. This study aims to evaluate patients' perception of the QR code-based introductory animations of esophagogastroduodenoscopy (OGD) and colonoscopy (CLN). Method(s): A QR code linking to the animation was attached to the appointment sheet. Patients were asked to watch the animation with their own mobile devices before the endoscopy. A questionnaire with 5 questions was distributed after completion of their procedures. Result(s): A total of 144 patients undergoing OGD and CLN were recruited in May-June, 2022 at Tin Shui Wai Hospital. The response rate was 91.7%. Positive feedback was received. 12 patients (8.3%) did not gain access to the animation. A majority of patients agreed or totally agreed that the animation offered them more flexibility to understand the procedures before their OGD (75.4%) and CLN (79.1%). The QR code-based animation was deemed easy-to-use (80.3%), appealing (78.0%) and educational (81.0%). Conclusion(s): With increasing accessibility to mobile devices, patient education in preparation for medical procedures is no longer confined to the hospital setting. QR code-based animation is shown to be an effective and welcoming tool to prepare patients for endoscopies.
ABSTRACT
Although cardiac rehabilitation (CR) is a cost-effective and evidence-based therapy for patients with acute myocardial infarction, heart failure, after percutaneous coronary intervention and bypass surgery, the major challenge remains to be suboptimal referral, uptake and compliance[1]. The remarkably lower density of CR programs relative to population is an additional unfavourable characteristic in Asia and other low and middle-income countries[2]. During the COVID-19 pandemic, inequality in access to CR service among different countries has been further aggravated[1]. Different barriers have been identified to explain the underuse of CR in different countries in Asia. In China, there is a lack of staff with interest, inadequate experience and training, financial limitation, space limitation and lack of patient awareness[3]. In India, patient disinterests and socioeconomic factors have been identified to be the barriers to referral for CR[4].With advancement in wearable, smartphone and communication technology, novel models of delivery of CR service have been implemented and studied[1]. In Hong Kong, community-based and home-based tele-cardiac rehabilitation programs have been conducted with preliminarily encouraging results.
ABSTRACT
Introduction: Tele-cardiac rehabilitation has demonstrated safety and efficacy in several clinical studies. With the outbreak of COVID-19, the centered-based CR service was totally suspended. To facilitate patients to exercise at home while being monitored. A pilot home-based cardiac tele-rehabilitation program was developed with a structured protocol at Princess Margaret Hospital (PMH) and rolled out from October 2020. Objectives: 1. To minimize the impact of suspension of in-hospital CR service due to outbreak of COVID-19. 2. To evaluate the effects and develop a home-based CR program for remote rehabilitation, based on advanced technological infrastructure and complementary clinical protocols. Methodology: Target patients: Low risk cardiac patients who fulfil the intake criteria, able and willing to use digital monitoring devices including blood pressure machine, smart watch and smart phone. Program design: The program will last for 12 weeks and consists of education, exercise training and relaxation training. Each consenting patient will be given a training kit containing a training log-book, informative educational leaflets and a set of QR codes to access our home-made education, exercise training & relaxation practice videos. Individual phone consultation by multidisciplinary will be scheduled once a week at the first five weeks. Patients can view the video at their own convenience, and then discuss or ask questions during phone follow-up. Individualized exercise will be prescribed according to patients' age, mobility and cardio fitness level. Patients can follow the designated video to do exercise at home. They will be instructed to measure and record their blood pressure, heart rate, and rate perceived exertion (RPE) before and after exercise. Physiotherapist will phone call patient to monitor and coach patients. Evaluation: All patients will undergo a detailed face-to-face assessment at baseline and at 12-week. They are including 6-minute walk test, body mass index (BMI), waist circumference, blood test for lipid profile, etc. In addition, patients will also request to fill in a set of questionnaires to measure the physical activity level, functional performance and psychological fitness. Conclusion: It believes that tele-rehabilitation is a more cost-effective model compared to center-based CR. It enables a new direction for the CR program.
ABSTRACT
Background: Influenza or acute myocardial infarction (AMI) is seasonal with usual upsurge in winter months. Influenza might be a trigger of AMI. The outbreak of COVID-19 in China led to population wide masking, practice of hand hygiene and social distancing in Hong Kong starting from late January 2020. Methods: Our study aimed to look at the relationship between influenza activity and ST-segment elevation myocardial infarction (STEMI) incidence as well as the epidemiological impact of universal infection control measures. Patients with a diagnosis of acute STEMI from January 2014 to March 2020 were retrieved from the Hospital Authority Clinical Data Analysis and Reporting System. We also downloaded data of influenza activity and air pollution from Centre for Health Protection and Environmental Protection Department respectively. Results: With few exceptions, the STEMI incidence per standardized month basically mirrored the influenza activity from 2014 to 2020. During the winter of 2014-15, 2015-16, 2017-18 and 2018-19, the number of STEMI cases went up with the influenza activity. The rise in the number of STEMI cases in December 2016 and January 2017 was not obvious mirroring the inconspicuous rise in influenza activity of the same period. The surge of influenza during the summer of 2015 and 2017 was not accompanied by an increase in the number of STEMI cases. Influenza activity is a predictor of STEMI incidence after adjusting for air pollution and time factors. We observed an abbreviated peak and narrow base of the influenza activity curve for the winter of 2019-20. The number of STEMI cases rose to 220 in December 2019 but then dropped significantly from January to March 2020 mimicking the influenza activity curve. Conclusion: Our observation agrees with the hypothesis of AMI triggered by influenza infection and cold weather. Furthermore, population wide infection control measures during the COVID-19 pandemic might have contained influenza activity and possibly reduced the population risk of STEMI.