Weight status of children aged 2-5 years old, attending a paediatric outpatient clinic and its association with parental feeding style and parental perceptions of weight status

Background: A child’s weight status can allow health care professionals to assess their developmental growth. A child having a low or high weight for height could be due to an imbalance in nutrient intake occurring. It is important to balance dietary intake and physical activity to maintain a healthy weight status. Excessive consumption of food can lead to an overweight/obese weight status which is linked to non-communicable diseases. Parental feeding style can directly impact a child’s set of eating behaviours. Therefore, parents have a strong influence over a child’s growth pattern. In addition, parental awareness of childhood obesity is reported to be poor which could be a barrier to interventions. Aim: To determine; (1) the weight status of children aged 2-5 years attending Sligo University Hospital (SUH); (2) current parental feeding styles being utilised; (3) whether parents were able to correctly classify their own weight status and that of their child and if this was associated with parental misclassification of their own weight status and (4) whether parents are interested in further information in this area, and what form this information/guidance should take. Method: A cross-sectional study was conducted in a paediatric outpatient department between September 2018 and May 2019. Data collected included anthropometric measurements and demographic information as well as a validated parental feeding style questionnaire. Data analysis was conducted using SPSS version 24. Statistical significance was set at p \u3c.05. Results: Fifty parents and children were recruited. 72% of children were classified as having a normal weight status, 22% an overweight status and 6% an obese weight status. No parent correctly classified a child as having an overweight status. No association was found between parental misclassification of a child’s weight status and their own weight status. The majority of parents used an encouragement feeding style. 84% of parents reported to be interested in obtaining healthy lifestyle information. The preferred method of receiving this information is in the form of a leaflet. Discussion/Conclusion: The childhood overweight and obesity rates within this cohort are slightly above the national rates for childhood obesity. Parental awareness of childhood overweight/obesity was found to be poor as illustrated in previous studies. Interventions need to be implemented to improve parental classification of a child’s weight status. Parents expressed an interest in receiving health education material in this setting

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research