Covid-19 lockdown: Ethnic differences in children's self-reported physical activity and the importance of leaving the home environment; a longitudinal and cross-sectional study from the Born in Bradford birth cohort study

YesIn England, the onset of COVID-19 and a rapidly increasing infection rate resulted in a lockdown (March-June 2020) which placed strict restrictions on movement of the public, including children. Using data collected from children living in a multi-ethnic city with high levels of deprivation, this study aimed to: (1) report children's self-reported physical activity (PA) during the first COVID-19 UK lockdown and identify associated factors; (2) examine changes of children's self-reported PA prior to and during the first UK lockdown. This study is part of the Born in Bradford (BiB) COVID-19 Research Study. PA (amended Youth Activity Profile), sleep, sedentary behaviours, daily frequency/time/destination/activity when leaving the home, were self-reported by 949 children (9-13 years). A sub-sample (n = 634) also self-reported PA (Physical Activity Questionnaire for Children) pre-pandemic (2017-February 2020). Univariate analysis assessed differences in PA between sex and ethnicity groups; multivariable logistic regression identified factors associated with children's PA. Differences in children's levels of being sufficiently active prior to and during the lockdown were examined using the McNemar test; and multivariable logistic regression was used to identify factors explaining change. During the pandemic, White British (WB) children were more sufficiently active (34.1%) compared to Pakistani Heritage children (PH) (22.8%) or 'Other' ethnicity children (O) (22.8%). WB children reported leaving the home more frequently and for longer periods than PH and O children. Modifiable variables related to being sufficiently active were frequency, duration, type of activity, and destination away from the home environment. There was a large reduction in children being sufficiently active during the first COVID-19 lockdown (28.9%) compared to pre-pandemic (69.4%). Promoting safe extended periods of PA everyday outdoors is important for all children, in particular for children from ethnic minority groups. Children's PA during the first COVID-19 UK lockdown has drastically reduced from before. Policy and decision makers, and practitioners should consider the findings in order to begin to understand the impact and consequences that COVID-19 has had upon children's PA which is a key and vital behaviour for health and development.The Health Foundation Covid‑19 Award (2301201). ESRC/ MRC and British Heart Foundation (BHF). Sport England’s Local Delivery Pilot – Bradford. Wellcome Trust. UK Medical Research Council (MRC) and UK Economic and Social Science Research Council a British Heart Foundation Clinical Study grant [CS/16/4/32482] the National Institute for Health Research under its Applied Research Collaboration Yorkshire and Humber [NIHR200166]; ActEarly UK Prevention Research Partnership Consortium [MR/S037527/1]; NIHR Clinical Research Network through research delivery support for this study; UKRI Covid19 Research & Innovation Call, Medical Research Council

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effect of temperature and ration size on carbon and nitrogen stable isotope trophic fractionation

1. Stable isotope data are widely used to track the origins and transformations of materials in food webs. Reliable interpretation of these data requires knowledge of the factors influencing isotopic fractionation between diet and consumer. For practical reasons, isotopic fractionation is often assumed to be constant but, in reality, a range of factors may affect fractionation. 2. To investigate effects of temperature and feeding rate on fractionation of carbon and nitrogen stable isotopes in a marine predator, we reared European sea bass Dicentrarchus labrax on identical diets at 11 and 16°C on three ration levels for 600 days. 3. Nitrogen trophic fractionation (?d15N) was affected by temperature. Bass ?d15N was 4.41‰ at 11°C and 3.78‰ at 16°C. 4. Carbon fractionation (?d13C) was also affected by temperature. Bass ?d13C was 1.18‰ at 11°C and 1.64‰ at 16°C. The higher lipid content in the tissues of bass reared at cooler temperatures accounted for the temperature effect on ?d13C. When ?d13C was determined using mathematically defatted values, there was a direct effect of ration size and ?d13C was 2.51, 2.39 and 2.31‰ for high, medium and low rations, respectively. 5. Reported ?d15N for all treatments exceeded the mean of 3.4‰ widely used in ecological studies of fish populations and communities. This would confound the interpretation of d15N as an indicator of trophic level when comparing populations that are exposed to different temperatures. 6. The ?d13C of 0-1‰ commonly applied in food web studies did not hold under any of the temperature or feeding regimes considered and a value of 2‰ would be more appropriate