Screen time and young children: Promoting health and development in a digital world

Position statement from the Canadian Paediatric Society

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Image source: r. nial bradshaw – Flickr // CC BY 2.0

The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children under 5 years old, focusing on developmental, psychosocial and physical health. Evidence-based guidance to optimize and support children’s early media experiences involves four principles: minimizing, mitigating, mindfully using and modelling healthy use of screens. Knowing how young children learn and develop informs best practice strategies for health care providers.

Read the full statement here

Using Technology to Reduce Childrens’ Anxiety Throughout the Perioperative Period

Goldschmidt, K. & Woolley, A. Journal of Pediatric Nursing | Published online: 27 April 2017

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In the U.S. each year, approximately 5 million children undergo a surgical procedure (Perry, Hooper, & Masiongale, 2012). Surgery is one of the most stressful medical procedures that a child can experience. In fact, approximately 50% of children are reported to experience significant anxiety in the preoperative period (Perry et al., 2012). Pediatric nurses know the importance of incorporating parents into the child’s plan of care and understand that the child is comforted by the presence of someone that they know and love.

Read the abstract here

New resource to reduce barriers to breastfeeding

Public Health England (PHE) and NHS England have conducted a survey which found that of the three-quarters of the new mums who start breastfeeding, only 40% were still breastfeeding two months later.

To help dispel some of the concerns women have about breastfeeding, PHE’s Start4 life programme has launched a new interactive Breastfeeding Friend (BFF) ChatBot. The BFF can be accessed through Facebook messenger and provides personal support for mothers at any time of the day or night. The ChatBot works as a live chat tool which is able to respond to questions about breastfeeding posed by the user.

Read more on this at Public Health England

Self-management and social welfare of children with cystic fibrosis

Calvo-Lerma, J. et al. (2017) Innovative approach for self-management and social welfare of children with cystic fibrosis in Europe: development, validation and implementation of an mHealth tool (MyCyFAPP). BMJ Open. 7:e014931

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Introduction: For the optimal management of children with cystic fibrosis, there are currently no efficient tools for the precise adjustment of pancreatic enzyme replacement therapy, either for advice on appropriate dietary intake or for achieving an optimal nutrition status. Therefore, we aim to develop a mobile application that ensures a successful nutritional therapy in children with cystic fibrosis.

Methods and analysis: A multidisciplinary team of 12 partners coordinate their efforts in 9 work packages that cover the entire so-called ‘from laboratory to market’ approach by means of an original and innovative co-design process. A cohort of 200 patients with cystic fibrosis aged 1–17 years are enrolled. We will develop an innovative, clinically tested mobile health application for patients and health professionals involved in cystic fibrosis management. The mobile application integrates the research knowledge and innovative tools for maximising self-management with the aim of leading to a better nutritional status, quality of life and disease prognosis. Bringing together different and complementary areas of knowledge is fundamental for tackling complex challenges in disease treatment, such as optimal nutrition and pancreatic enzyme replacement therapy in cystic fibrosis. Patients are expected to benefit the most from the outcomes of this innovative project.

Read the full protocol here

Smartphone-based behavioural intervention alleviates children’s anxiety during anaesthesia induction

Cumino, D. et al. European Journal of Anaesthesiology. Published online: 18 January 2017

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Background: Preoperative anxiety negatively influences children’s anaesthetic and surgical experience, and results in postoperative complications, such as emergence delirium and behavioural changes. Nonpharmacological management using alternative therapies that alleviate psychological stress can be as important as pharmacological ones in reducing children’s anxiety. Nevertheless, their validity as an effective anxiety-reducing strategy in children remains controversial.

Conclusions: The behavioural distraction strategies using smartphones were effective in preventing an increase in children’s anxiety during anaesthesia induction.

Read the full abstract here

Tackling food marketing to children in a digital world

Children’s rights, evidence of impact, methodological challenges, regulatory options and policy implications for the WHO European Region

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Image source: WHO Europe

For the first time, researchers and health experts have undertaken a comprehensive analysis of the concerning situation in the WHO European Region of digital marketing to children of foods high in fats, salt and sugars. The findings are published in a new report from the WHO Regional Office for Europe, Tackling food marketing to children in a digital world: trans-disciplinary perspectives, which calls for immediate action by policy-makers to recognize and address the growing issue of marketing targeted to children via digital media.

“Our governments have given the prevention of childhood obesity the highest political priority. Nevertheless, we consistently find that children – our most vulnerable group – are exposed to countless numbers of hidden digital marketing techniques promoting foods high in fat, sugar and salt,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “Parents might be unaware of or underestimate the harmful impact of digital marketing, but this report makes clear the effect of such marketing on our children. It is the responsibility of policy-makers to recognize the new threat presented by digital marketing of food to children and to act swiftly.”

In the absence of effective regulation of digital media in many countries, children are increasingly exposed to persuasive, individually tailored marketing techniques through, for example, social media sites and “advergames”. This trend persists, although stubbornly high rates of childhood obesity are found almost throughout the WHO European Region.

Read the full overview here

Read the full report here

Bedtime use of media devices more than doubles the risk of poor sleep in children

Carter, B. et al. JAMA Pediatrics. Published online: October 31 2016.

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Objective  To conduct a systematic review and meta-analysis to examine whether there is an association between portable screen-based media device (eg, cell phones and tablet devices) access or use in the sleep environment and sleep outcomes.

 

Data Extraction and Synthesis  Of 467 studies identified, 20 cross-sectional studies were assessed for methodological quality. Two reviewers independently extracted data.

Results  Twenty studies were included, and their quality was assessed. The studies involved 125 198 children (mean [SD] age, 14.5 [2.2] years; 50.1% male). There was a strong and consistent association between bedtime media device use and inadequate sleep quantity (odds ratio [OR], 2.17; 95% CI, 1.42-3.32) (P < .001, I2 = 90%), poor sleep quality (OR, 1.46; 95% CI, 1.14-1.88) (P = .003, I2 = 76%), and excessive daytime sleepiness (OR, 2.72; 95% CI, 1.32-5.61) (P = .007,I2 = 50%). In addition, children who had access to (but did not use) media devices at night were more likely to have inadequate sleep quantity (OR, 1.79; 95% CI, 1.39-2.31) (P < .001, I2 = 64%), poor sleep quality (OR, 1.53; 95% CI, 1.11-2.10) (P = .009, I2 = 74%), and excessive daytime sleepiness (OR, 2.27; 95% CI, 1.54-3.35) (P < .001, I2 = 24%).

Conclusions and Relevance  To date, this study is the first systematic review and meta-analysis of the association of access to and the use of media devices with sleep outcomes. Bedtime access to and use of a media device were significantly associated with the following: inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. An integrated approach among teachers, health care professionals, and parents is required to minimize device access at bedtime, and future research is needed to evaluate the influence of the devices on sleep hygiene and outcomes.

Read the full review article here