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Background: Twenty-four hour movement behaviors (ie, physical activity [PA], screen time [ST], and sleep) are associated with children's health outcomes. Identifying day-level contextual factors, such as child care, that positively influence children's movement behaviors may help identify potential intervention targets, like improving access to child care programs. This study aimed to examine the between- and within-person effects of child care on preschoolers' 24-hour movement behaviors. Methods: Children (N = 74, 4.7 [0.9] y, 48.9% girls, 63.3% White) wore an Axivity AX3 accelerometer on their nondominant wrist 24 hours per day for 14 days to measure PA and sleep. Parents completed surveys each night about their child's ST and child care attendance that day. Linear mixed effects models predicted day-level 24-hour movement behaviors from hours spent in child care. Results: Children spent an average of 5.0 (2.9) hours per day in child care. For every additional hour of child care above their average, children had 0.3 hours (95% CI, −0.3 to −0.2) less ST that day. Between-person effects showed that compared with children who attended fewer overall hours of child care, children who attended more hours had less overall ST (B = −0.2 h; 95% CI, −0.4 to 0.0). Child care was not significantly associated with PA or sleep. Conclusions: Child care attendance was not associated with 24-hour PA or sleep; however, it was associated with less ST. More research utilizing objective measures of ST and more robust measures of daily schedules or structure is necessary to better understand how existing infrastructure may influence preschool-aged children's 24-hour movement behaviors. In addition, future research should consider how access to child care may influence child care attendance. [ABSTRACT FROM AUTHOR]

Introduction: Limited data on 24-hour movement behaviors of children aged 5–8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region. Methods: Cross-sectional representative data from 1192 children aged 5–8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012–2014 Children's Healthy Living Program. Sleep and moderate- to vigorous-intensity PA were calculated from accelerometry. ST and sociodemographic data were collected from caregiver surveys. The percentage of children meeting the Asia-Pacific 24-hour movement guidelines for PA (≥60 min/d of moderate- to vigorous-intensity PA), sleep (≥9 and ≤ 11 h/d) and ST (≤2 h/d) were calculated. Generalized linear mixed models were used to examine associations with adiposity and sociodemographic variables. Results: Twenty-seven percent (95% confidence interval, 24.6–30.0) of children met integrated guidelines; 98% (96.2–98.0) met PA, 78% (75.4–80.0) met sleep, and 35% (32.6–38.0) met ST guidelines. Females (adjusted odds ratio = 1.40 [95% confidence interval, 1.03–1.91]) and those living in lower-middle-income jurisdictions (2.29 [1.49–3.54]) were more likely to meet ST guidelines. Overweight children (0.62 [0.40–0.96]), those aged 8 years (0.39 [0.22–0.69]), and children with caregivers of an education level of high school or beyond (0.44 [0.29–0.68]) were less likely to achieve ST guidelines. Children from midrange annual household incomes were less likely to meet combined guidelines (0.60 [0.39–0.92]). Conclusions: Three-quarters of children are not meeting integrated Asia-Pacific 24-hour movement guidelines. Future strategies for reducing ST and increasing integrated guidelines compliance are needed. [ABSTRACT FROM AUTHOR]

Background: Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic. Methods: We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression. Results: This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47–0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38–1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62–0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00–1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42–0.67). We observed no further mediational associations. Conclusion: Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior. [ABSTRACT FROM AUTHOR]

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3–4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3–4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers' adherence to the World Health Organization's guidelines for physical activity, sedentary behavior, and sleep; their associations with health indicators, and the feasibility of the SUNRISE International study in Mongolia. Methods: Preschool-aged children were recruited from 5 kindergartens in urban and rural areas of Ulaanbaatar city and Tuv province in Mongolia. Physical activity and sedentary behavior were measured by an ActiGraph accelerometer worn for 5 consecutive days. Screen time and sleep were reported by parents. The National Institute of Health and Early Years Toolboxes were used to assess motor skills and executive function, respectively. Results: One hundred and one children participated in the study (mean age = 4.82 y, boys = 58), with 88% (n = 89) having complete data for analysis. The proportion of children who met the recommendations for physical activity, sedentary screen time, and sleep was 61%, 23%, and 82%, respectively. Only 7% met all recommendations. Meeting the sleep recommendation individually (P =.032) and in combination with the physical activity recommendation was associated with better gross (P =.019) and fine (P =.042) motor skills. Spending more time in physical activity was positively correlated with motor development. Results confirmed that the SUNRISE study protocol was feasible, age-appropriate, and enjoyable for children. Conclusions: The results of the SUNRISE pilot study will help inform the SUNRISE Mongolia main study and lay the groundwork for future research into children's 24-hour movement behaviors in Mongolia. [ABSTRACT FROM AUTHOR]

Background: This study estimated the prevalence of Singapore infants and toddlers who met the new Singapore Integrated 24-Hour Activity Guidelines forEarly Childhood and examined its association with well-being. Methods: A total of 267 parents of children aged between 0 and 2 years completed an online questionnaire that consists of the Singaporean Children Lifestyle Questionnaire and either the Pediatric Quality of Life (PedsQL) Inventory Infant Scale or the Strength and Difficulties Questionnaire. Well-being of infants was measured through parent responses to PedsQL and that of toddlers was measured through Strength and Difficulties Questionnaire. Data were benchmarked against age-specific guidelines for physical activity, screen time, and sleep in the Singapore Integrated 24-Hour Activity Guidelines for Early Childhood. Results: A higher percentage of infants (37.3%) than toddlers (20.6%) had met 3 guidelines. In contrast, a lower percentage of infants than toddlers met at least one or did not meet any guidelines (3.8% and 0% for infants vs 22.4% and 1.8% for toddlers, respectively). Infants who met more guidelines had significantly higher parent-reported PedsQL total scale score than infants who met fewer guidelines (P <.05). However, the present study found that the number of guidelines met was not associated to infants' PedsQL scale score and toddlers' total difficulty score (P >.05). Conclusion: Adherence to this set of local guidelines should be widely publicized, so parents will have greater awareness and knowledge on cultivating good physical activity, screen time, and sleep habits for their child from a young age. [ABSTRACT FROM AUTHOR]

Background and aimsThe precise roles of screen media activity (SMA) and sleep problems in relation to child/adolescent psychopathology remain ambiguous. We investigated temporal relationships among sleep problems, SMA, and psychopathology and potential involvement of thalamus-prefrontal-cortex (PFC)-brainstem structural covariation.MethodsThis study utilized data from the Adolescent Brain Cognitive Development study (n = 4,641 ages 9-12) at baseline, Year1, and Year2 follow-up. Cross-Lagged Panel Models (CLPMs) investigated reciprocal predictive relationships between sleep duration/problems, SMA, and psychopathology symptoms. A potential mediating role of baseline Thalamus-PFC-brainstem covariation on SMA-externalizing relationships was examined.ResultsParticipants were divided into discovery (n = 2,359, 1,054 girls) and replication (n = 2,282, 997 girls) sets. CLPMs showed 1) bidirectional associations between sleep duration and SMA in late childhood, with higher frequency SMA predicting shorter sleep duration (β = -0.10 [95%CI: -0.16, -0.03], p = 0.004) and vice versa (β = -0.11 [95%CI: -0.18, -0.05], p < 0.001); 2) externalizing symptoms at age 10-11 predicting sleep problems (β = 0.11 [95%CI: 0.04, 0.19], p = 0.002), SMA (β = 0.07 [95%CI: 0.01, 0.13], p = 0.014), and internalizing symptoms (β = 0.09 [95%CI: 0.05, 0.13], p < 0.001) at age 11-12; and 3) externalizing behavior at age 10-11 partially mediating the relationship between baseline thalamus-PFC-brainstem covariation and SMA at age 11-12 (indirect effect = 0.032 [95%CI: 0.003, 0.067], p-value = 0.030). Findings were replicable.ConclusionWe found bi-directional SMA-sleep-duration associations in late childhood. Externalizing symptoms preceded future SMA and sleep disturbances and partially mediated relationships between structural brain covariation and SMA. The findings emphasize the need for understanding individual differences and developing and implementing integrated strategies addressing both sleep concerns and screen time to mitigate potential impacts on psychopathology.

BACKGROUND: According to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence. METHODS: This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10-15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000-6,000), medium (> 6,000-12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0-4), medium (> 4-8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured. RESULTS: The analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83-6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24-6.11) and low (B = 7.64, 95% CI 4.07-11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL). CONCLUSIONS: Combinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.

ObjectiveScreen time has been reported to be associated with binge-eating disorder (BED) among adolescents in the US; however, potential mediators remain unclear. This study aimed to evaluate depression symptoms as a mediator of the prospective association between screen time and BED.MethodWe utilized data from 9465 children (aged 9-11 years at baseline) from the Adolescent Brain Cognitive Development (ABCD) study (2016-2021). A generalized structural equation model was used to examine the prospective association between average daily screen time at baseline and BED at year 2, adjusting for baseline BED diagnosis, and other potential covariates (e.g., age, sex, and income). Mediation was examined using bias-corrected (BC) 95% confidence intervals for the indirect effect of baseline screen time on year 2 BED through depression symptoms (change from baseline to year 1).ResultsOne hundred and one participants (42.7% male, 49.4% racial/ethnic minority) met the criteria for BED in year 2. Participants were 9.9 years of age on average at baseline, 51.3% identified as male, and 43.1% identified as a racial/ethnic minority. Adjusting for covariates, screen time was prospectively associated with BED (OR = 1.09, 95% CI [1.03, 1.14], p = .005). Depression symptoms (B = .19, BC 95% CI [0.10, 0.28]) partially mediated (9.2%) the prospective association between screen time and BED.DiscussionAmong US adolescents, higher baseline screen time was prospectively associated with BED diagnosis at year 2, and this relationship was partially mediated by increased depression symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents.Public significanceAmong U.S. adolescents, higher screen time was prospectively associated with the incidence of BED. This association was partially mediated by the change in depressive symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents.

This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen. [ABSTRACT FROM AUTHOR]

Background: Academic achievement (AA) is an important issue not only during the school period since it is a strong predictor of long-term professional and social success. Physical fitness (PF) components are associated with AA, and previous studies were conducted with relatively small samples, lack of statistical power, and the conclusions are based on simple correlational analyses. The objective of this study was to analyze the association between PF (single and clustered) with AA in a large and representative sample of high school students. Methods: Cross-sectional design study conducted with 911 students, aged 13–15 years (38.52% boys) enrolled in the first year of high school. Cardiorespiratory fitness (20-m shuttle run test), muscular strength (dynamometer), and body composition (skinfolds) were measured. PF components were clustered (Z-cardiorespiratory fitness + Z-muscular strength – Z-body fatness). AA was analyzed through standard math tests. Hierarchical linear regression analysis was applied to verify the independent contribution of each single component and PF's cluster on AA. Age, screen time, maternal education, race, and type of residence were used as covariates. Results: Among boys, cardiorespiratory fitness was negatively associated with AA (β = −0.137; P =.041), while strength was positively associated with AA (β = 0.188; P =.004). There was no association between clustered PF indicators and AA (β = 0.064; P =.297). There was a negative association between age and AA in girls (β = −0.151; P =.003) and in boys (β = −0.128; P =.045). Conclusions: These results support current literature, indicating an association between PF's component, namely muscular strength and AA (mathematics) in adolescents, even when controlled for several covariates. [ABSTRACT FROM AUTHOR]

Children and adolescents with cerebral palsy (CP) show a reduced physical activity (PA) level compared with their typically developed peers. This study aimed to identify potential predictors of objectively evaluated habitual PA using data from a national clinical registry—the Cerebral Palsy Follow-Up Program (CPFP)—and proxy-reported questionnaires. Data from the CPFP database showed that female sex was associated with a lower PA level. Additional questionnaire data revealed age, popliteal angle limitation, Pediatric Outcomes Data Collection Instrument–Sports and Physical Functioning Scale score, screen time, Functional Mobility Scale score at 50 m, and fatigue as predictors. The proposed models can be used for the prediction and early detection of the PA level and consequently for the potential improvement among ambulant/semiambulant individuals with CP. Further research should investigate the predictive impact of personal, social, and environmental factors on the PA level and the gap in PA levels between girls and boys. [ABSTRACT FROM AUTHOR]

Objectives: Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. Methods: This multicenter cross-sectional study included 3591 adolescents (aged 12–17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. Results: The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = −0.08; 95% confidence interval, −0.38 to −0.02) and anti- (adiponectin, β = −0.31; 95% confidence interval, −2.13 to −0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). Conclusion: Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators. [ABSTRACT FROM AUTHOR]

This study investigated how broader parental factors including parental happiness, parental play engagement, and parenting stress are related to Korean childrens happiness and weight status across three years via indirect pathways through the childrens energy-related behaviors of healthy and unhealthy food intake, physical activity, and screen time. Data from 1551 Korean parent pairs and 7-year-old children in the Panel Study on Korean Children were analyzed. A path analysis and gender-based multi-group analysis were conducted. Maternal happiness was negatively related to child screen time. Maternal play engagement showed positive concurrent associations with child healthy food intake and physical activity and negative associations with screen time. Maternal parenting stress was negatively related to child healthy eating. There was one significant finding related to fathers role on childrens energy-related behaviors, happiness, and weight status: the positive association between parental happiness and boys unhealthy food intake. Child screen time was positively related to child weight status and negatively to child happiness at each age. Broader maternal parenting factors can serve as a protective factor for childhood happiness and weight status in 7-to-9-year-olds through being associated with a reduction in child screen time.

Youth screen media activity is a growing concern, though few studies include objective usage data. Through the longitudinal, U.S.-based Adolescent Brain Cognitive Development (ABCD) Study, youth (mage = 14; n = 1415) self-reported their typical smartphone use and passively recorded three weeks of smartphone use via the ABCD-specific Effortless Assessment Research System (EARS) application. Here we describe and validate passively-sensed smartphone keyboard and app use measures, provide code to harmonize measures across operating systems, and describe trends in adolescent smartphone use. Keyboard and app-use measures were reliable and positively correlated with one another (r = 0.33) and with self-reported use (rs = 0.21-0.35). Participants recorded a mean of 5 h of daily smartphone use, which is two more hours than they self-reported. Further, females logged more smartphone use than males. Smartphone use was recorded at all hours, peaking on average from 8 to 10 PM and lowest from 3 to 5 AM. Social media and texting apps comprised nearly half of all use. Data are openly available to approved investigators ( https://nda.nih.gov/abcd/ ). Information herein can inform use of the ABCD dataset to longitudinally study health and neurodevelopmental correlates of adolescent smartphone use.

Objective: Longitudinal changes in physical activity (PA) and sedentary behavior patterns from preconception to postpartum are not fully characterized. We examined changes and baseline sociodemographic/clinical correlates of PA and sedentary behavior in women from preconception to postpartum. Methods: The Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohort recruited 1032 women planning pregnancy. Participants completed questionnaires at preconception, 34 to 36 weeks gestation, and 12 months postpartum. Repeated-measures linear regression models were used to analyze changes in walking, moderate to vigorous PA (MVPA), screen time, and total sedentary time, and to identify sociodemographic/clinical correlates associated with these changes. Results: Of the 373 women who delivered singleton live births, 281 provided questionnaires for all time points. Walking time increased from preconception to late pregnancy but decreased postpartum (adjusted means [95% CI]: 454 [333–575], 542 [433–651], and 434 [320–547] min/wk, respectively). Vigorous-intensity PA and MVPA decreased from preconception to late pregnancy but increased postpartum (vigorous-intensity PA: 44 [11–76], 1 [−3–5], and 11 [4–19] min/wk, MVPA: 273 [174–372], 165 [95–234], and 226 [126–325] min/wk, respectively). Screen time and total sedentary time remained consistent from preconception to pregnancy but decreased postpartum (screen: 238 [199–277], 244 [211–277], and 162 [136–189] min/d, total: 552 [506–598], 555 [514–596], and 454 [410–498] min/d, respectively). Individual characteristics of ethnicity, body mass index, employment, parity, and self-rated general health significantly influenced women's activity patterns. Conclusion: During late pregnancy, walking time increased, while MVPA declined significantly, and partially returned to preconception levels postpartum. Sedentary time remained stable during pregnancy but decreased postpartum. The identified set of sociodemographic/clinical correlates underscores need for targeted strategies. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the relationship between the changes in parent-related factors and preschoolers exceeding screen time (ST) recommendations. Methods: A longitudinal analysis using 2-year follow-up data from 4 kindergartens (n = 409) was conducted in Zhejiang, China, from 2019 to 2021. Multivariate logistic regression models were used to determine the potential parental modifiable predictors. Results: The significant associations of baseline ST, change in screen accessibility, and the interaction of preschooler ST with maternal ST change with preschooler follow-up ST were observed. For preschool-aged children with baseline ST ≤ 1 hour per day, the follow-up of preschoolers with ST > 1 hour per day increased significantly when parental clarity of their ST rules decreased or remained low. For preschool children with baseline ST > 1 hour per day, follow-up ST increased significantly when their father kept ST >2 hours per day, when the screen accessibility became or remained easy, or when parental awareness of the ST decreased. Conclusions: Changes in parental correlates played an important role in preschooler ST based on 2-year longitudinal data. Early interventions should focus on improving the clarity of parental rules and perceptions, as well as on reducing parental ST and accessibility of home screens. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of the current study were to identify risk profiles for nonadherence among children and youth (5–17 y) at the 6-month mark of the COVID-19 pandemic and to discuss similarities and differences between risk profiles identified in the current study and those identified at the 1-month mark of the pandemic. Methods: Data were part of a nationally representative sample of 1143 parents (Mage = 43.07 y, SD = 8.16) of children and youth (5–17 y) living in Canada. Survey data were collected in October 2020. Results: Results showed that 3.8% met all movement behavior recommendations, 16.2% met the physical activity recommendation, 27% met the screen time recommendation, and 63.8% met the sleep recommendation. Characteristics associated with nonadherence to all movement behaviors included low parental perceived capability to restrict screen time and decreased overall time spent outdoors. Characteristics associated with nonadherence to the physical activity and screen time recommendations included youth (12–17 y), low parental perceived capability to restrict screen time, decreased time spent outdoors, and increased screen time. Conclusion: Results emphasized the importance of parental perceived capability to restrict screen time and children's and youth's outdoor time and showed that pandemic-related factors have impacted children and youth differently. [ABSTRACT FROM AUTHOR]

For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study analyzed the association of leisure-time physical activity (PA) and sedentary behavior (SB), nonleisure PA and SB, and total PA and SB in different time segments of the day with mental health among Dutch adolescents and young adults. Methods: A total of 881 participants aged 16–25 years completed an online survey. Mental health was assessed using the Mental Health Inventory-5, and participants also reported sex, age, and income. They filled out a questionnaire of types of PA and SB for each hour of the day. Activities were categorized into nonleisure and leisure, during the morning, afternoon, evening, and for the whole day. Results: Participants (52.8% female, on average 20.8 y) generally engaged in more leisure-time PA and SB during weekends compared with weekdays, and more nonleisure activities on weekdays. Associations varied between time segments and days of the week. Positive associations of leisure-time and total PA during the whole day and evenings with mental health were observed on weekdays. Total, leisure-time, and nonleisure-time SB were associated with worse mental health. Nonleisure PA was not associated with mental health. Conclusions: Leisure-time PA was found to have a favorable association with mental health, particularly in the evenings of weekdays and afternoons of weekend days. On the other hand, leisure SB was associated with poorer mental health in most of the time segments analyzed, and nonleisure SB in the evenings was also related to worse mental health. The type and timing of PA and SB behaviors play an important role in the relationship with mental health. [ABSTRACT FROM AUTHOR]

Background: Dads and Daughters Exercising and Empowered (DADEE) is a program targeting fathers/father-figures to improve their daughters' physical activity and well-being. Previous randomised controlled efficacy and effectiveness trials of DADEE demonstrated meaningful improvements in a range of holistic outcomes for both fathers and daughters in the short-term. This study aims to assess the long-term impact (12-months) of the program when delivered in the community by trained facilitators. Methods: Fathers/father-figures and their primary school-aged daughters were recruited from Newcastle, Australia into a single-arm, non-randomised, pre-post study with assessments at baseline, 10-weeks (post-intervention) and 12-months. The 9-session program included weekly 90-min educational and practical sessions, plus home-based tasks. The primary outcome was fathers' and daughters' days per week meeting national physical activity recommendations (≥ 30 min/day of MVPA for fathers, ≥ 60 min/day MVPA for daughters). Secondary outcomes included physical activity, screen time, self-esteem, father-daughter relationship, social-emotional well-being, parenting measures, and process outcomes (including recruitment, attendance, retention and program acceptability). Results: Twelve programs were delivered with 257 fathers (40.0 ± 9.2 years) and 285 daughters (7.7 ± 1.9 years). Mixed effects regression models revealed significant intervention effects for the primary outcome, with fathers increasing the days/week meeting physical activity recommendations by 27% at 10-weeks (p < 0.001) and by 19% at 12-months (p < 0.001) compared with baseline. Likewise, for daughters there was a significant increase by 25% at 10-weeks (p < 0.001) and by 14% at 12-months (p = 0.02) when compared to baseline. After conducting a sensitivity analysis with participants unaffected by COVID-19 lockdowns (n = 175 fathers, n = 192 daughters), the primary outcome results strengthened at both time-points for fathers and at 12-months for daughters. Additionally, the sensitivity analysis revealed significant intervention effects at post-program and 12-months for all secondary outcomes in both fathers and daughters. Furthermore, the process outcomes for recruitment capability, attendance, retention and satisfaction levels were high. Conclusions: Findings provide support for a sustained effect of the DADEE program while delivered in a community setting by trained facilitators. Further investigation is required to identify optimised implementation processes and contextual factors to deliver the program at scale. Trial registration: ACTRN12617001450303. Date registered: 12/10/2017. [ABSTRACT FROM AUTHOR]

Background: Meeting the 24-hour movement behavior (24-HMB) guideline helps enhance quality of life (QOL) of adolescents. This study aimed to assess the associations between the 24-HMB (physical activity, screen time, sleep) and QOL among adolescents with idiopathic scoliosis. Methods: A cross-sectional study was conducted between September 2021 and September 2023. 24-HMB, QOL and demographic variables were collected through a self-reported questionnaire. Linear regression models and stratified analyses were used to explore statistical associations between the 24-HMB and QOL. Results: A total of 1073 participants aged 10–18 years with a spinal Cobb angle between 10° and 40° were included. Overall, 20 participants (1.9%) met all three behavioral guidelines, and 272 participants (25.3%) met none. Compared to those who did not meet any of the guidelines, adolescents meeting both screen time and sleep duration (β = 4.10, 95% CI: 2.02–6.18, P < 0.001) and all 3 guidelines (β = 4.39, 95% CI: 0.27–8.51, P = 0.037) had higher QOL scores. Stratified analyses showed that the above associations were more pronounced in adolescents without back pain or with good self-image. Conclusions: These findings highlight the importance of adopting and maintaining healthy behavioral habits in order to improve QOL among adolescents with idiopathic scoliosis, especially in those without back pain or with good self-image. [ABSTRACT FROM AUTHOR]

Background: The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. Objective: To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. Methods: We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. Results: Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6–18]. Mean BMI was 18.8 ± 4.2 [15.8–35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p < 0.00 (LBP) respectively. A significant association was found between the presence of spine pain and school absenteeism, participation in sports, consultation with a doctor or physiotherapist/chiropractor (p < 0.0001 respectively). Conclusion: The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors. [ABSTRACT FROM AUTHOR]

Background: Previous studies indicated that excessive engagement in digital devices could lead to negative psychological impacts in general population. We aimed to determine the association of electronic screen exposure with depression among women in early pregnancy. Methods: A cross-sectional study was conducted from June 2021 to June 2022. A total of 665 women in early pregnancy were recruited and the information included socio-demographic characteristics, screen exposure and Patient Health Questionnaire − 9 depression scale. Results: Among the women in early pregnancy, the total daily smartphone viewing time was the longest (median [P25-P75], 5 [3–6] hours/day) in the three types of electronic screen exposure. The total daily smartphone viewing time (P = 0.015, OR[95%CI] = 1.09[1.11–1.18]), smartphone (P = 0.016, OR[95%CI] = 1.24[1.04–1.47]) and television viewing time (P = 0.006, OR[95%CI] = 1.35[1.09–1.67]) before nocturnal sleep were significantly associated with depression among women in early pregnancy. The thresholds calculated by receiver operator characteristic curves were 7.5 h/day, 1.5 h/day and 1.5 h/day, respectively. In addition, women with higher scores of smartphone addiction were more susceptible to depression (P<0.001, OR[95%CI] = 1.11[1.07–1.16]). The top three smartphone usages in women with depression were watching videos (22.0%), listening to music (20.9%) and playing games (16.7%). Conclusions: In conclusion, electronic screen exposure, including screen viewing time, smartphone addiction and problematic smartphone use was associated with depression among women in early pregnancy. Further studies are warranted to verify the conclusions. [ABSTRACT FROM AUTHOR]

Background: Glaesserella parasuis (G. parasuis) is the causative agent of Glässer's disease, which causes significant economic losses in the swine industry. However, research on the pathogenesis of G. parasuis has been hampered by the lack of a simple and efficient marker-free knockout system. Results: In this study, a marker-free knockout system was developed for G. parasuis using a temperature-sensitive vector. By alternating the incubation of transformants at 30°C and 37°C, we optimized the screening process for this system. The system was successfully applied to knockout the KanR cassette from JS0135ΔnanH::KanR, achieving a knockout efficiency of 90% in the final round of screening. To confirm that temperature variation was a key factor, we proceeded with knocking out the nanH and apd genes in the CF7066 strain. The knockout efficiency reached up to 100%, with the shortest screening time being only four days. The knockout of the nanH gene resulted in a significant reduction in the growth vitality of the strains, while the knockout of the apd gene led to an approximate 56% improvement in the adhesion rate. Additionally, we observed that the expression of recombinant genes in transformants was higher at 30℃ than at 37℃, with the recC gene being upregulated approximately 7-fold. In contrast, there was almost no difference in the expression of recombinant genes between 30℃ and 37℃ in the wild-type strains. This discrepancy was likely due to an elevated copy number of target plasmids at 30℃, which may have resulted in the enhanced expression of recombinant genes. Conclusions: In conclusion, this newly developed gene knockout system for G. parasuis presents a valuable tool for advancing research on this organism. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Physical fitness is one of the most important health indicators in children. Although appropriate body composition or certain lifestyle factors such as frequent physical activity are thought to improve physical fitness, results of previous studies are inconsistent, and most studies were from Western countries.We investigated associations of body composition and modifiable lifestyle factors such as physical activity, screen time, diet and sleep duration with physical fitness in Japanese primary school children.2308 children (age 10–12 years old) in 12 primary schools were analysed in this cross‐sectional study. Physical fitness was evaluated by sports battery tests conducted routinely and annually at schools. The total score of sports battery tests, 20‐m shuttle run (laps) and grip strength (kg) were selected as outcomes. Information about lifestyle factors was collected by two questionnaires. Associations between lifestyle factors and physical fitness were assessed by multivariable linear mixed models by sex.Frequent exercise was related to better overall physical fitness. Regarding the 20‐m shuttle run, many unfavourable lifestyle factors such as higher BMI in boys (β −7.37, 95% confidence interval [CI] −8.39, −6.35) and girls (β −3.54, 95% CI −4.50, −2.58), longer screen time (β −4.31, 95% CI −7.29, −1.34) in boys and girls (β −5.65, 95% CI −9.01, −2.30); shortest (reference) versus longest, breakfast skipping in boys (β −5.24, 95% CI −8.71, −1.77) and girls (β −3.57, 95% CI −6.84, −0.30); consumers (reference) versus skippers were associated with worse performance. Better quality of diet was associated with better results in the 20‐m shuttle run only in girls (β 2.58, 95% CI 0.24, 4.93); lowest (reference) versus highest.Frequent exercise was related to better physical fitness. Higher BMI and unfavourable lifestyle factors such as longer screen time and breakfast skipping were associated with worse results of the 20‐m shuttle run. [ABSTRACT FROM AUTHOR]

Purpose: Emerging research evidence suggests positive relationships between higher screen time and eating disorders. However, few studies have examined the prospective associations between screen use and eating disorder symptoms in early adolescents and how problematic screen use may contribute to symptom development. Methods: We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,246, 2016–2020, ages 9–14). Logistic regression analyses were used to estimate the longitudinal associations between baseline self-reported screen time and eating disorder symptoms in year two. Logistic regression analyses were also used to estimate cross-sectional associations between problematic screen use in year two (either problematic social media or mobile phone use) and eating disorder symptoms in year two. Eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) included fear of weight gain, self-worth tied to weight, engaging in compensatory behaviors, binge eating, and distress with binge eating. Results: Each additional hour of total screen time and social media use was associated with higher odds of fear of weight gain, self-worth tied to weight, compensatory behaviors to prevent weight gain, binge eating, and distress with binge eating two years later (odds ratio [OR] 1.05–1.55). Both problematic social media and mobile phone use were associated with higher odds of all eating disorder symptoms (OR 1.26–1.82). Conclusions: Findings suggest greater total screen time, social media use, and problematic screen use are associated with more eating disorder symptoms in early adolescence. Clinicians should consider assessing for problem screen use and, when high, screen for disordered eating. Level of evidence: Level III: Evidence obtained from well-designed cohort or case–control analytic studies. [ABSTRACT FROM AUTHOR]

Parental mediation (PM) and parental phubbing (PP) are two pivotal factors that influence children's screen media use. This study used response surface analysis to examine the combined effect of PM and PP on screen time among preschool children. A total of 3,445 parents with preschool-aged children participated in this study, providing self-reported data on PM, PP, and their children's screen time (CST). The results revealed that CST decreased when parents enhanced their mediation behaviors and reduced phubbing behaviors in the cases of congruence between PM and PP. In instances of incongruence, reduced screen time was observed when parents exhibited lower frequency in mediating their CST and displayed fewer phubbing behaviors compared with situations where parents mediated their children more frequently but engaged in higher levels of phubbing behaviors. The findings suggest that PM play a significant role in mitigating preschool-aged children's excessive screen time. Moreover, it is critical to establish positive role modeling by reducing PP behaviors. [ABSTRACT FROM AUTHOR]

This article explores the intricate relationship between smartphone usage and mental health and the unintended consequences of the rapid integration of this technology into daily life. It explores the ways in which smartphones disrupt opportunities for introspection and self-reflection, decrease engagement in external reality, increase engagement with realities of the virtual world, precipitate ego destabilization, and interfere with sleep and dreaming. The author explores ways in which the split between the real self and the ideal self is impacted by social media. The influence of smartphones on mental health is a complex and evolving issue, demanding ongoing research, understanding, and a heightened awareness of the potentially deleterious consequences of overusing technology in our ever-changing world. [ABSTRACT FROM AUTHOR]

The article discusses the impacts of screen time on education and wellbeing, as highlighted by the House of Commons Education Select Committee. The committee found that extended screen time has become increasingly normal for young children and teenagers, with a significant increase in children's screen time between 2020 and 2022. While there are benefits to being online, such as creating communities and reducing loneliness, there are also risks, including exposure to violent pornography and online bullying. The committee welcomed the government's mobile phone ban in schools but recommended implementing a formal monitoring mechanism to measure its effectiveness. They also called for guidance for parents on managing screen time and for regulations on AI and children's data protection. [Extracted from the article]

Purpose: To investigate diabetic retinopathy (DR) as a potential marker of cardiovascular disease (CVD) in adults with type 1 diabetes attending the Danish DR‐screening programme and non‐diabetes adults. Methods: In this registry‐based matched case–cohort study, we identified 16 547 adults with type 1 diabetes, who were registered in the Danish Registry of Diabetic Retinopathy (DiaBase). Each case was age‐ and sex‐matched by five non‐diabetes individuals (n = 82 399), and odds ratios (ORs) and hazard ratios (HRs) were estimated for incident and upcoming CVD in multivariable models. Results: Adults with type 1 diabetes (median age 44.5 years, 57.6% male) were more likely to have prevalent CVD (OR 1.29; 95% CI, 1.20–1.38) and to develop CVD within 5 years (HR 1.19; 95% CI, 1.08–1.30) as compared to non‐diabetes control. However, adults without DR were less likely to develop CVD (HR 0.84; 95% CI, 0.72–0.97) compared to the reference population. For adults with type 1 diabetes, there was an increasing risk for incident CVD for increasing levels of DR (HR 1.33, 1.95, 1.71 and 2.39 for DR‐levels 1–4, respectively). Patients with CVD at the time of the first screening had a higher risk to develop DR during follow‐up (HR 1.23; 95% CI, 1.02–1.49). Conclusion: In a nationwide matched case–cohort study adjusted for potential confounders, DR was identified as an independent marker of prevalent and incident CVD in type 1 diabetes with increasing risk demonstrated for higher levels of DR. Likewise, CVD also independently predicted the risk of incident DR. [ABSTRACT FROM AUTHOR]

Primary objectives were to examine: (1) changes in movement behaviours (i.e., outdoor play (OP), organized physical activity (PA), screen time (ST), sleep) across the first 2 years of coronavirus disease-2019 (COVID-19) among Canadian toddlers and preschoolers, and (2) intrapersonal, interpersonal, community, and policy moderators of change in movement behaviors. Participants were 341 Canadian parents of children (start of study: 1–4 years; 48% female). Participants completed online questionnaires regarding their children's movement behaviours and intrapersonal, interpersonal, and community factors at five time-points before and throughout the pandemic (T1–T5). Data from government websites were also used for some community and policy factors. Linear mixed models were conducted. Compared to pre-COVID-19 (T1): OP was on average 30 min/day higher at T2 and T3; organized PA was on average 62, 44, and 37 min/day lower at T2, T3, and T4, respectively; ST was on average 67, 17, 38, and 52 min/day higher at T2, T3, T4, and T5, respectively; and sleep was on average 30, 36, and 82 min/day lower at T3, T4, and T5, respectively. Significant moderating variables were observed for OP (parental education, parental work inside home, COVID-19 restriction severity), organized PA (children's sex, started kindergarten, nonparental care, parental education, household income, parental employment status, house type, indoor home space and support for PA), ST (nonparental care, parental marital status) and sleep (children's T1 age group, started kindergarten, parental place of birth, parental employment status). All movement behaviors changed across the first 2 years of COVID-19 but patterns and moderators were behaviour-specific. Children from lower socioeconomic status families had the least optimal patterns. [ABSTRACT FROM AUTHOR]

Early menarche has been associated with adverse health outcomes, such as depressive symptoms. Discovering effect modifiers across these conditions in the pediatric population is a constant challenge. We tested whether movement behaviours modified the effect of the association between early menarche and depression symptoms among adolescents. This cross-sectional study included 2031 females aged 15–19 years across all Brazilian geographic regions. Data were collected using a self-administered questionnaire; 30.5% (n = 620) reported having experienced menarche before age 12 years (i.e., early menarche). We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing any moderate–vigorous physical activity during leisure time, limited recreational screen time, and having good sleep quality were the exposures investigated. Adolescents who experienced early menarche and met one (B: –4.45, 95% CI: (–5.38, –3.51)), two (B: –6.07 (–7.02, –5.12)), or three (B: –6.49 (–7.76, –5.21)), and adolescents who experienced not early menarche and met one (B: –5.33 (–6.20; –4.46)), two (B: –6.12 (–6.99; –5.24)), or three (B: –6.27 (–7.30; –5.24)) of the movement behaviour targets had lower PHQ-9 scores for depression symptoms than adolescents who experienced early menarche and did not meet any of the movement behaviours. The disparities in depressive symptoms among the adolescents (early menarche vs. not early menarche) who adhered to all three target behaviours were not statistically significant (B: 0.41 (–0.19; 1.01)). Adherence to movement behaviours modified the effect of the association between early menarche and depression symptoms. [ABSTRACT FROM AUTHOR]

Objective: To examine whether the responsiveness of young children to simple sounds was associated with entertainment screen time (EST), opportunities for social interaction, and social and communication skills. Design: Parents completed a questionnaire covering, for years one and two, the number of times the child met with other children; the number of words the child spoke; and the daily amount of EST. Social, attention and communication skills were assessed. Study sample: Participants were 118 children, aged 15 to 46 months. They were initially assessed behaviourally using simple sounds. Children who responded to such sounds were denoted the Responsive group. Children who did not were assessed using familiar songs and denoted the Unresponsive group. Results: The two groups did not differ significantly in mean age or the number of opportunities to meet other children. The Unresponsive group had significantly fewer words than the Responsive group at 12 and 24 months and had significantly higher EST than the Responsive group for years 1 and 2. The Unresponsive group showed lower social, attention and communication skills than the Responsive group. Conclusions: High EST was associated with poorer auditory and social skills. Hence, it may be wise to limit the EST of young children. [ABSTRACT FROM AUTHOR]

Children have a right to play, as outlined by the United Nations, due to its important role in holistic development. However, as with many other human rights, children’s access to their right to play was disrupted by the COVID-19 pandemic and associated restrictions. With several studies demonstrating the ways in which children’s play changed during times of restriction, this research aimed to explore whether these changes continued to be observed once restrictions had lifted. A mixed methods design was utilised: a 22-item questionnaire was distributed by schools in England to 124 caregivers who shared their observations of their children’s play during times of restriction and the six months prior to data collection. Quantitative analysis demonstrates that increases in time to play, adult-child play, and outdoor play during the pandemic had been counteracted since restrictions were lifted; however, device play remained elevated. Qualitative comments highlight the impact of children’s affect on their play, the activities children chose to pursue, and the extent of increases in screen time. The implications of these findings are discussed, including a need to place greater value on play in the home and the role of educational psychologists in supporting this. [ABSTRACT FROM AUTHOR]

Summary: Background: The prevalence of childhood obesity in the U.S. has increased, likely due to decreased physical activity, increased sedentary behaviour and unhealthy diets. Little is known about the relationships between these factors and weight gain in those under the age of three. Objectives: This study aimed to understand the longitudinal associations of weight gain over 6‐month intervals with child and parent characteristics as children develop from 6 to 36 months. Methods: Mother and infant data were collected at 6‐month intervals from 6 to 36 months. Weight (kg) was the primary outcome variable, and potential explanatory variables included child and parent characteristics, physical activity, motor development, diet and sleep. Structural equation modelling was used to assess associations between explanatory variables and 6‐month weight gain. Results: Weight increased ~1 kg per 6‐month interval (p < 0.001) from 6 to 36 months. Childcare outside of the home at 12 months was associated with 0.272 kg (p = 0.002) greater weight gain at 18 months, while children's physical activity was associated with 0.228 kg (per 2 SD, p = 0.051) less weight gain during the same time period. Mother's TV and screen media use (0.102 kg per hour/day, p = 0.046) and child's intake of high‐energy beverages at 18 months (0.387 kg, p = 0.037) were both associated with greater weight gain at 24 months. Conclusion: Childcare, physical activity, screen media use and high‐energy beverage consumption might affect weight gain at different time points in early childhood. These insights can inform efforts to prevent excessive weight gain and childhood obesity effectively. [ABSTRACT FROM AUTHOR]

Despite research demonstrating sleep disturbance in children with Tourette syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy control subjects, and its associated demographic, clinical, and behavioral factors. Participants were 384 parents or caregivers of children aged three to 17 years, including 192 with current TS and 192 matched healthy control subjects drawn from the 2020-2021 cycle of the National Survey of Children's Health. Parents completed questions assessing demographic (i.e., age, race, sex), clinical (i.e., attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health condition-related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS. Children with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy control subjects. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep. Findings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the risk factors associated with diabetes mellitus (DM) among Brazilian adults. Cross-sectional study. Data of 75,860 Brazilian adults (≥18 years) were collected using the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) (2020–2023). Variables assessed included self-reported medical diagnosis of DM, sociodemographic factors (sex, age, schooling, marital status) and DM risk factors (regular consumption of sweetened beverages (≥5 times/week), infrequent consumption of fruits and vegetables, and beans (<5 times/week), insufficient physical activity, prolonged screen time on cell phones, computers, tablets (CCT), and television (TV), smoking, heavy episodic drinking, excess weight, and obesity). Logistic regression models estimated crude and adjusted odds ratio (aOR) (adjusted for sociodemographic characteristics) for the association between the risk factors and the presence of DM. The overall prevalence of self-reported DM in the population was 9.2%. There was a lower chance of regular consumption of sweetened beverages (aOR 0.79; 95% CI: 0.65–0.97) and heavy episodic drinking (aOR 0.77; 95% CI: 0.65–0.93) and a greater chance of insufficient physical activity (aOR 1.40; 95% CI: 1.25–1.55), prolonged TV screen time (aOR 1.22; 95% CI: 1.09–1.36), excess weight (aOR 1.62; 95% CI: 1.44–1.82) and obesity (aOR 1.87; 95% CI: 1.67–2.10) among individuals with DM. There was a lower chance of regular consumption of sweetened beverages and heavy episodic drinking among individuals with DM and a greater chance of insufficient physical activity, prolonged TV screen time, excess weight, and obesity, among that. [ABSTRACT FROM AUTHOR]

Background: Emergency department triage is a vital and complex decision‐making process. There is limited knowledge about nurses' experiences with triage decision support systems in emergency departments. Aim: This study was conducted to examine nurses' experiences with a computer‐based triage decision support system in the emergency department. Study Design: This is a qualitative and phenomenological study. Data were collected through interviews from 14 triage nurses who used a triage decision support system in the emergency department of a university hospital. The nurses were recruited for semi‐structured interviews. All interviews were recorded on a voice recorder and then transcribed. Data were analysed with the inductive content analysis method. The interviewer asked comprehensive questions about the nurses' experiences with the triage decision support system. Results: Three main and 11 sub‐themes were elicited as a result of the analysis of the in‐depth interviews: (a) the facilitating the triage decision theme, which included help in case of a dilemma, team collaboration, monitoring/supervision, and error reduction sub‐themes; (b) the contribution to professionalism theme, which included ease of learning and teaching triage, professional autonomy, creating a database, and evidence‐based practice sub‐themes; (c) the areas that need improvement theme, which included reducing screen clicks, the effect of the hospital automation system performance, and clinical descriptors not included in the algorithm sub‐themes. Conclusion: Triage nurses stated that the decision support system was beneficial and facilitated decision‐making. The decision support system enabled triage nurses to make their own decisions using their clinical knowledge and experience, without a restriction on their professional autonomy, and this was perceived positively. It was emphasized that this system could be a support tool in educating nurses new to triage. However, nurses stated that the pace of the decision support system was affected by the performance of the hospital automation system and that the large number of steps used for electing items caused a waste of time. They also added that these were technical areas that needed improvement. Relevance to Clinical Practice: The study provides important data that will help healthcare organizations and professionals better understand the emergency department nurse triage decision support system and gain a versatile, comprehensive, and general understanding. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the frequency of irritable bowel syndrome (IBS) and the influencing factors in children aged 4 to 9. The cross-sectional descriptive study included 1176 children between the ages of 4 and 9 who applied for Family Medicine Centers between March 1, 2017 and April 30, 2017 for various reasons. Pediatric Gastrointestinal Symptoms Questionnaire, Roma III Version (QPGS-RIII) was applied to the volunteers (children's parents or caregivers), and Beck Anxiety Scale was applied to the mothers accompanying their children. A total of 603 (51.9%) of the children included in the study were female and 559 (48.1%) were male. When the applied QPGS-RIII was evaluated with IBS diagnostic criteria, IBS was found in 137 children and IBS frequency was found to be 11.8% (95% confidence interval [CI]). Significant differences were found in socioeconomic level, eating habits, TV-watching habits, and IBS status (P <.05). [ABSTRACT FROM AUTHOR]

Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability. A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender. The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms. An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed. [ABSTRACT FROM AUTHOR]

Objective: To analyze the relationships between sociodemographic, behavioral, breastfeeding, body composition, physical fitness, and insulin biomarkers before and after a multicomponent intervention among adolescents with overweight and obesity using network analysis. Methods: This was a quasi-experimental study with 37 adolescents with overweight/obesity (17 and 20 participants in the intervention and control groups, respectively). The program lasted 6 months, with three weekly sessions comprising physical exercises and nutritional and psychological orientation. The assessment of body composition, physical fitness, insulin biomarkers, and lifestyle indicators was performed before and after the intervention. The network analysis was carried out using three centrality indicators: proximity, strength, and expected influence; which identify the most influential or central nodes or edges, indicating their importance or crucial role in the structure and dynamics of the network. Results: Two networks, one each for before and after the intervention, were generated. Before the intervention, the results were as follows: for closeness, sex (1.059) and pubertal stage (1.268); for strength, pubertal stage (1.268), physical activity (1.160), and screen time (1.388); for expected influence, age (1.658), HOMA-IR (1.171), glucose (1.304), and waist circumference (1.394). After the intervention, for closeness, sex (1.102), type of school (1.221), and waist/hip ratio (1.221); for strength, breastfeeding (1.099), screen time (1.465), waist/hip ratio (1.131), and groups (1.280); for expected influence, breastfeeding (1.574), HOMA-IR (1.017), resistin (2.276), body mass index (1.008), and waist circumference (1.154). Conclusion: The multicomponent intervention demonstrated beneficial relationships by modifying and approximating the clusters of factors of body composition, physical fitness, and insulin biomarkers. [ABSTRACT FROM AUTHOR]

Sleep is impaired in children with attention-deficit/hyperactivity disorder (ADHD). However, population-based examination of indicators of sleep insufficiency and bedtime irregularity is limited. This investigation examined associations between ADHD, weeknight sleep insufficiency, and bedtime irregularity in a nationally-representative child sample, and indicators of these sleep outcomes in ADHD. Parents of children aged 3–17 years with ADHD (n = 7671) were surveyed through the 2020–2021 National Survey of Children's Health. Inverse probability of treatment weighting generated a weighted matched control sample (n = 51,572). Weighted generalized linear models were performed without and with age-stratification to examine associations between ADHD and sleep, adjusting for sociodemographics in the full sample, and between nineteen sociodemographic and clinical variables and sleep in ADHD. Having ADHD was associated with increased odds of sleep insufficiency and bedtime irregularity relative to controls, even after adjusting for sociodemographic variables. In ADHD, older age was associated with lower sleep insufficiency and greater bedtime irregularity. Black race, increased poverty, higher ADHD severity, depression, and increased screen time were associated with greater sleep insufficiency and bedtime irregularity. Adverse childhood experiences (ACEs) were associated with greater sleep insufficiency. Behavioral/conduct problems, female sex, and absence of both ADHD medication use and ASD diagnosis were associated with poorer bedtime irregularity. Age-stratified results are reported in text. Children with ADHD face heightened risk for insufficient sleep and irregular bedtimes. Findings suggest intervention targets (e.g., Black race, poverty, depression, screen time) to improve both sleep insufficiency and bedtime irregularity. Results highlight ACEs and behavioral/conduct problems as targets to improve sleep insufficiency and bedtime regularity, respectively. Age-stratified findings are discussed. • ADHD was associated with greater sleep insufficiency and bedtime irregularity relative to healthy controls in children. • In ADHD, Black race, poverty, ADHD severity, depression, and screentime indicated sleep insufficiency and bedtime irregularity. • ACEs were associated with sleep insufficiency. Female sex, behavioral or conduct problems were associated with bedtime irregularity. • Interventions addressing sociodemographic context, psychiatric symptoms, and screen use may improve sleep in child ADHD. • Additional age-stratified findings are discussed. [ABSTRACT FROM AUTHOR]

Screens have become increasingly prevalent in children's lives. This study examined the longitudinal association between screen time and aggressive behaviour by investigating the mediating and moderating roles of language ability and parenting stress, respectively. The analysed data consisted of 1,319 children, aged 5 to 15, from the Fragile Families and Child Wellbeing Study. Results found that children's language ability (age 9) significantly mediated the relationship between screen time (age 5) and aggressive behaviour (age 15), and this mediating pathway was significantly moderated by parenting stress (age 5). Furthermore, the moderated mediation pathway was only significant among groups with medium or high parenting stress. Thus, the negative effects of screen time on aggressive behaviour through poor language ability amplified as the level of parenting stress increased. [ABSTRACT FROM AUTHOR]

Poor sleep and chronic pain are commonly related in adolescents. Only 5% of adolescents meet recommendations for physical activity and screen time, both of which impact the experience of sleep and pain disturbances. Research is needed to better understand the sleep-pain relationship in adolescents and to identify potential protective factors, such as activity-related health behaviors. This study examined sleep, behaviors that influence activity (i.e., physical activity, screen time), and their interaction as predictors of pain in a sleep-disordered sample of 105 adolescents aged 12–18 presenting for polysomnography. A hierarchical multiple linear regression was conducted to examine these relationships. Consistent with hypotheses, worse insomnia predicted worse pain. However, other activity-related health behaviors did not influence this relationship, ps >.05. Findings suggest that sleep should be the focus of treatment for adolescents with primary sleep disorders to prevent the onset or exacerbation of pain. [ABSTRACT FROM AUTHOR]