An examination of bedtime media and excessive screen time by Canadian preschoolers during the COVID-19 pandemic.

BACKGROUND: Risky media use in terms of accumulating too much time in front of screens and usage before bedtime in early childhood is linked to developmental delays, reduced sleep quality, and unhealthy media use in later childhood and adulthood. For this reason, we examine patterns of media use in pre-school children and the extent to which child and family characteristics contribute to media use during the COVID-19 pandemic. METHODS: A cross-sectional study of digital media use by Canadian preschool-aged children (mean age = 3.45, N = 316) was conducted at the start of the COVID-19 pandemic between April and August of 2020. Parents completed a questionnaire and 24-h recall diary in the context of an ongoing study of child digital media use. From these responses we estimated hours of average daily screen time, screen time in the past 24 h, average daily mobile device use, and media use before bedtime. Parents also answered questions about their child (i.e., age, sex, temperament), family characteristics (parental mediation style, parental screen time, education, income), and contextual features of the pandemic (ex., remote work, shared childcare). Daycare closures were directly assessed using a government website. RESULTS: Our results indicate that 64% of preschoolers used more than 2 h of digital media hours/day on average during the pandemic. A majority (56%) of children were also exposed to media within the hour before bedtime. Logistic and multinomial regressions revealed that child age and temperament, restrictive parental mediation, as well as parent digital media use, education, satisfaction with the division of childcare, remote work, and number of siblings and family income were all correlates of risky digital media use by preschoolers. CONCLUSIONS: Our results suggest widespread risky media use by preschoolers during the pandemic. Parenting practices that include using more restrictive mediation strategies may foster benefits in regulating young children's screen time.

Investigating the transmission risk of infectious disease outbreaks through the Aotearoa Co-incidence Network (ACN): a population-based study.

BACKGROUND: The emergence and re-emergence of infectious diseases presents a significant challenge to public health and broader society. This study utilises novel nationwide data to calculate the transmission risk and potential inequity of infectious disease outbreaks through use of network analysis. METHODS: Nationwide employment and education microdata (∼4.7 million individuals in Aotearoa New Zealand) were used to develop the Aotearoa Co-incidence Network (ACN). The ACN considers connections generated when individuals are employed at the same workplaces or enrolled at the same schools. Through forms of network analysis, connections between geospatial areas can be established and provide proxy measures of infectious disease transmission risk. The ACN was also overlayed with nationwide population vulnerability data based on the number of older adults (>65 years) and individuals with long-term health conditions. FINDINGS: We identify areas that have both high potential transmission risk (i.e., highly connected) and high vulnerability to infectious diseases. Community detection identified geographic boundaries that can be relevant to the application of regional restrictions for limiting infectious disease transmission. INTERPRETATION: Integrating novel network science and geospatial analytics provides a simple way to study infectious disease transmission risk and population vulnerability to outbreaks. Our replicable method has utility for researchers globally with access to such data. It can help inform equitable preparation for, and responses to infectious disease outbreaks. FUNDING: This project was funded by the Health Research Council of New Zealand (20/1442) and from the NZ Government via Ministry for Business Innovation and Employment and Department of Prime Minister and Cabinet.

The implementation of a new peri-operative pathway and prehabilitation programme in upper gi cancer patients

Introduction: The Introduction of two pilot projects at the Royal Marsden for the Upper GI cancer group, are demonstrating promising benefits. Initiated from October 2019, a restructured perioperative pathway, termed SUMMIT (Systematic Multi-disciplinary Management of Investigation and intervention), moving anaesthetic assessment upstream, with integration of patients into the MILE (My Integrated Lifestyle &Exercise) Prehabilitation programme are collaborative. Method: Retrospectively comparing the pathways and outcomes in the first year of the projects with those patients the year prior;looking at referral into prehabilitation pillars, and Length of Stay (LOS) outcomes. Results: Since MILE, the percentage of patients receiving iron infusions has increased, (from 14% to 50%), including post-operative infusion in the MILE group accounting for 20% of all iron infusions which was an adjustment to our anaemia service during COVID. Physiotherapy Assessment and referral to either home or group exercise classes also increased (from 40% to 70%). In addition, 100% of patients in MILE received advice and explanation of the importance of exercise and lifestyle change from an anaesthetist at the start of chemotherapy. The two other domains of MILE are Dietician and Psychological input. No change occurred in the referral to dieticians as this is established often upon patients initial clinic consultation so earlier in the pathway prior to SUMMIT. All patients are screened and offered wellbeing support, and in this time period 4 patients were referred for formal assessment. The improvement in LOS since the implementation of MILE is seen with Oesophagectomy patients, with a reduction in ICU stay (median 2 days) and a small reduction in overall hospital stay (median 1 day). Conclusion: Although these are small patient numbers, results are encouraging, and further assessment of postoperative complications may show us the real health benefits to an integrated Lifestyle &Exercise prehabilitation programme.