Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review

ObjectivesLittle is known about how health behaviors such as physical activity (PA) and sedentary behaviors (SB) may be associated with psychosocial well-being during the crucial early childhood period. The aim of this study was to undertake a systematic review of associations between PA, SB and psychosocial well-being during early childhood.MethodsIn February 2013, MEDLINE, PsycINFO, SPORTDiscus and Embase electronic databases were searched. Inclusion criteria were: 1. peer-reviewed publication since 1980 in English; 2. children aged birth–5 years; 3. PA or SB measured during early childhood; 4. an indicator of child psychosocial well-being; and 5. association between PA/SB and psychosocial well-being reported. Studies could be observational or interventions. Data were extracted by one author and entered into a standardized form in February and March 2013.Results19 studies were identified: four examined PA, 13 examined SB and two examined PA and SB. No interventions met the inclusion criteria; all included studies were observational. In total, 21 indicators of psychosocial well-being were examined, 13 only once with the remaining eight reported in more than one study. Some dose–response evidence was identified suggesting that PA is positively, and SB inversely, associated with psychosocial well-being.ConclusionsToo few studies exist to draw conclusions regarding associations. Future high-quality cohort and intervention studies are warranted particularly investigating dose–response associations

Differences between mothers and fathers of young children in their Use of the internet to support healthy family lifestyle behaviors : Cross-sectional study

Background: In early life, both mothers and fathers are important influences on their children’s diet, active play, and obesity risk. Parents are increasingly relying on the internet and social media as a source of information on all aspects of parenting. However, little is known about the use of Web-based sources of information relevant to family lifestyle behaviors and, in particular, differences between mothers’ and fathers’ use and sociodemographic predictors. Objective: The objective of this study was to examine if mothers and fathers differ in their use of the internet for information on their own health and their child’s health, feeding, and playing and to examine sociodemographic predictors of the use of the internet for information on these topics. Methods: We conducted a secondary analysis on data collected from mothers (n=297) and fathers (n=207) participating in the extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) when their children were 36 months of age. The main outcome variables were the use of the internet for information gathering for parents’ own health and child health, feeding, and playing. Binary logistic regression was used to examine the sociodemographic predictors of outcomes. Results: Compared with fathers (n=296), a higher proportion of mothers (n=198) used the internet for information on their own health (230, 78.5% vs 93, 46.5%), child health (226, 77.1% vs 84, 42.4%), child feeding (136, 46.3% vs 35, 17.5%), and child play (123, 42.1% vs 28, 14.0%) and intended to use Facebook to connect with other parents (200, 74.9% vs 43, 30.5%). Despite the high use of the internet to support family health behaviors, only 15.9% (47/296) of mothers reported consulting health practitioners for advice and help for their own or their child’s weight, diet, or physical activity. Sociodemographic predictors of internet use differed between mothers and fathers and explained only a small proportion of the variance in internet use to support healthy family lifestyle behaviors. Conclusions: Our findings support the use of the internet and Facebook as an important potential avenue for reaching mothers with information relevant to their own health, child health, child diet, and active play. However, further research is required to understand the best avenues for engaging fathers with information on healthy family lifestyle behaviors to support this important role in their child’s life. Trial Registration: ISRCTN Registry ISRCTN81847050; http://www.isrctn.com/ISRCTN8184705

Informing Active Play and Screen Time Behaviour Change Interventions for Low Socioeconomic Position Mothers of Young Children: What Do Mothers Want?

Introduction. This study investigated views of mothers from disadvantaged urban and regional areas (i.e., beyond major capital cities) as potential end users of child active play and screen time behaviour change interventions, with a focus on text messaging and web-based delivery platforms. Methods. Thirty-two mothers (22 urban; 10 regional) were interviewed. Purpose-designed questions covered topics regarding mothers' preferences for accessing and receiving information related to parenting and child active play and screen time. Data from transcribed interviews were analysed to identify responses and key themes. Results. Mothers reported frequently accessing parenting-and child-related information online. Regional mothers reported seeking information by talking with other people less frequently than urban mothers and seemed to have a stronger preference for receiving information online. There were few differences between responses from low and high educated mothers. The majority of mothers reported that they would be happy to receive text messages containing information about active play and screen time and that they would find a dedicated website with this information useful. Conclusions. Mothers in this study held favourable views on the potential of receiving information via new communication technologies. Future interventions targeting socioeconomically disadvantaged mothers may benefit from delivering intervention messages via these technologies

Feasibility and efficacy of a parent-focused, text message-delivered intervention to reduce sedentary behavior in 2- to 4-year-old children (Mini Movers): pilot randomized controlled trial

BACKGROUND: Despite public health guidelines to limit sedentary behavior, many young children spend large amounts of time sedentary (eg, screen and sitting time) during waking hours. OBJECTIVE: The objective of this study was to test the feasibility and efficacy of a parent-focused, predominantly text message-delivered intervention to support parents to reduce the amount of time their children spend in sedentary behavior. METHODS: Mini Movers was a pilot randomized controlled trial delivered to parents of 2- to 4-year-old children in Melbourne, Australia. Participants were recruited through playgroups, social media, and snowball sampling. Eligibility criteria were having an ambulatory child (2-4 years), English literacy, and smartphone ownership. Participants were randomized to intervention or wait-list control on a 1:1 ratio after baseline data collection. The 6-week intervention was predominantly delivered via text messages, using a Web-based bulk text message platform managed by the interventionist. Intervention strategies focused on increasing parental knowledge, building self-efficacy, setting goals, and providing reinforcement, and were underpinned by the Coventry, Aberdeen &amp; London-Refined taxonomy of behavior change techniques and social cognitive theory. The primary outcome was intervention feasibility, measured by recruitment, retention, intervention delivery, and fidelity; process evaluation questionnaires; and qualitative interviews with a subsample of participants. Secondary outcomes were children\u27s screen and restraint time (parent report), sitting time (parent report, activPAL), and potential mediators (parent report). Linear regression models were used to determine intervention effects on secondary outcomes, controlling for the child\u27s sex and age and clustering by playgroup; effect sizes (Cohen\u27s d) were calculated. RESULTS: A total of 57 participants (30 intervention; 27 wait-list control) were recruited, and retention was high (93%). Process evaluation results showed that the intervention was highly acceptable to parents. The majority of intervention components were reported to be useful and relevant. Compared with children in the control group, children in the intervention group had significantly less screen time postintervention (adjusted difference [95% CI]=-35.0 [-64.1 to -5.9] min/day; Cohen\u27s d=0.82). All other measures of sedentary behavior were in the expected direction, with small to moderate effect sizes. CONCLUSIONS: Mini Movers was shown to be a feasible, acceptable, and efficacious pilot intervention for parents of young children, warranting a larger-scale randomized control trial. <br /

A mobile technology intervention to reduce sedentary behaviour in 2- to 4-year-old children (Mini Movers): study protocol for a randomised controlled trial

BackgroundSedentary behaviour (e.g. television viewing, sitting time) tracks over time and is associated with adverse health and developmental outcomes across the lifespan. Young children (5 years or younger) spend up to 12 h/day sedentary, of which around 2 h is spent in screen time (e.g. watching television). Interventions to reduce sedentary behaviour in early childhood report mixed results and many have limited potential for scalability. Mobile phones offer a wide-reaching, low-cost avenue for the delivery of health behaviour programmes to parents but their potential to reduce young children&rsquo;s sedentary behaviour has not been widely tested. This study aims to test the feasibility and efficacy of a parent-focused, predominantly mobile telephone-delivered intervention to support parents to minimise the amount of time their child spends using screens and in overall sitting time.Methods/designMini Movers is a pilot randomised controlled trial recruiting 100 parents and children. Inclusion criteria include having a child aged between 2 and 4 years, being able to speak, read and write English, and smartphone ownership. Participants will be randomised to the intervention or a wait-list control group at a 1:1 ratio. Intervention group parents will receive printed materials including a content booklet and goal-checking magnet and will participate in a one-on-one discussion with the interventionist to plan two goals to reduce their child&rsquo;s sedentary behaviour. Subsequently, the intervention will be delivered over 6 weeks via personalised and interactive text messages promoting positive health behaviours (strategies for decreasing screen time and overall sitting time), goal setting and self-monitoring. Outcomes to be assessed include intervention feasibility and children&rsquo;s screen time and objectively-assessed sitting time.DiscussionFew studies have used mobile phone technology to deliver health behaviour programmes to parents of young children. Findings will inform the development of larger-scale interventions to reduce sedentary behaviour during early childhood.<br /

Do the correlates of screen time and sedentary time differ in preschool children?

BackgroundPreschool children can spend up to 12 h a day in sedentary time and few meet current recommendations for screen time. Little is known about ecological correlates that could be targeted to decrease specific versus total sedentary behaviour. This study examined whether the correlates of screen time and sedentary time differ in preschool boys and girls.MethodsParents participating in the HAPPY Study in 2008/09 in Melbourne, Australia reported their child&rsquo;s usual screen time and potential individual, social and physical environment correlates. Children wore ActiGraph GT1M accelerometers for eight days to objectively assess sedentary time (&lt;100 counts.min&minus;1). Multivariable linear regression analyses were performed, stratified by sex and controlling for child age, preschool/childcare attendance and clustering by centre of recruitment. Correlates significantly associated with screen time or sedentary time in individual models (p &lt; 0.05) were included in final combined models.ResultsChildren were sedentary for 301.1 (SD 34.1) minutes/day and spent 108.5 (SD 69.6) minutes/day in screen time. There were no sex differences in screen or sedentary time. In the final models, sleep duration was inversely associated with girls&rsquo; sedentary time and boys&rsquo; screen time. The only other consistent correlates for boys and girls were parental self-efficacy to limit screen time and screen time rules, which were inversely associated with screen time for both sexes. Parents reporting that they get bored watching their child play was inversely associated and maternal television viewing was positively associated with boys&rsquo; screen time. Paternal age was positively associated with boys&rsquo; sedentary time. Maternal ethnicity was inversely associated and paternal education, child preferences for sedentary behaviour, and parental concerns about child&rsquo;s physical activity and sedentary behaviour were positively associated with girls&rsquo; screen time.ConclusionsThe modifiable correlates of total sedentary and screen time identified in this study could be targeted in interventions to reduce these behaviours. With correlates differing for screen and sedentary time, and between boys and girls, interventions may also benefit from including behaviour- and sex-specific strategies.<br /

A recurrent germline PAX5 mutation confers susceptibility to pre-B cell acute lymphoblastic leukemia

Somatic alterations of the lymphoid transcription factor gene PAX5 (also known as BSAP) are a hallmark of B cell precursor acute lymphoblastic leukemia (B-ALL)1–3, but inherited mutations of PAX5 have not previously been described. Here we report a new heterozygous germline variant, c.547G>A (p.Gly183Ser), affecting the octapeptide domain of PAX5 that was found to segregate with disease in two unrelated kindreds with autosomal dominant B-ALL. Leukemic cells from all affected individuals in both families exhibited 9p deletion, with loss of heterozygosity and retention of the mutant PAX5 allele at 9p13. Two additional sporadic ALL cases with 9p loss harbored somatic PAX5 substitutions affecting Gly183. Functional and gene expression analysis of the PAX5 mutation demonstrated that it had significantly reduced transcriptional activity. These data extend the role of PAX5 alterations in the pathogenesis of pre-B cell ALL and implicate PAX5 in a new syndrome of susceptibility to pre-B cell neoplasia

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care