Background: For optimal health benefits, the Canadian 24-Hour Movement Guidelines for Children and Youth (aged 5-17 years) recommend an achievement of high levels of physical activity (≥60 min of moderate-to-vigorous physical activity), low levels of sedentary behaviour (≤2 h of recreational screen time), and sufficient sleep (9-11 h for children or 8-10 h for adolescents) each day. The objective of this systematic review was to examine how combinations of physical activity, sedentary time, and sleep duration relate to depressive symptoms and other mental health indicators among children and adolescents. Methods: Literature was obtained through searching Medline, EMBASE, PsycINFO, and SportDiscus up to September 30, 2019. Peer-reviewed studies published in English or French were included if they met the following criteria: population (apparently healthy children and adolescents with a mean age of 5-17 years), intervention/ exposure (combinations of physical activity, sedentary time, and sleep duration), and outcomes (depressive symptoms and other mental health indicators). A risk of bias assessment was completed for all included studies using the methods described in the Cochrane Handbook. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the quality of evidence for each health indicator. Narrative syntheses were employed to describe the results due to high levels of heterogeneity across studies.

Introduction To continue to inform sleep health guidelines and the development of evidence-based healthy sleep interventions for children and adolescents, it is important to better understand the associations between sleep timing (bedtime, wake-up time, midpoint of sleep) and various health indicators. The objective of this systematic review was to examine the associations between sleep timing and 9 health indicators in apparently healthy children and adolescents 5 to 18 years old. Methods Studies published in the 10 years preceding January 2021 were identified from searches in four electronic databases. This systematic review followed the guidelines prescribed in PRISMA 2020, the methodological quality and risk of bias were scored, and the summary of results used a best-evidence approach for accurate and reliable reporting. Results Forty-six observational studies from 21 countries with 208 992 unique participants were included. Sleep timing was assessed objectively using actigraphy in 24 studies and subjectively in 22 studies. The lack of studies in some of the health outcomes and heterogeneity in others necessitated using a narrative synthesis rather than a metaanalysis. Findings suggest that later sleep timing is associated with poorer emotional regulation, lower cognitive function/academic achievement, shorter sleep duration/ poorer sleep quality, poorer eating behaviours, lower physical activity levels and more sedentary behaviours, but few studies demonstrated associations between sleep timing and adiposity, quality of life/well-being, accidents/injuries, and biomarkers of cardiometabolic risk. The quality of evidence was rated as “very low” across health outcomes using GRADE. Conclusion The available evidence, which relies on cross-sectional findings, suggests that earlier sleep timing is beneficial for the health of school-aged children and adolescents. Longitudinal studies and randomized controlled trials are needed to better advance this field of research. (PROSPERO registration no.: CRD42020173585)The pandemic has negatively impacted a substantial portion of the Defence Team. When responding to future crises, it is recommended that leaders of organizations provide additional supports to higher-risk groups and to supervisors who are ideally positioned to support employees during challenging times.

Introduction Physical distancing (PD) is an important public health strategy to reduce the transmission of COVID-19 and has been promoted by public health authorities through social media. Although youth have a tendency to engage in high-risk behaviors that could facilitate COVID-19 transmission, there is limited research on the characteristics of PD messaging targeting this population on social media platforms with which youth frequently engage. This study examined social media posts created by Canadian public health entities (PHEs) with PD messaging aimed at youth and young adults aged 16–29 years and reported behavioral change techniques (BCTs) used in these posts. Methods A content analysis of all social media posts of Canadian PHEs from Facebook, Twitter, Instagram and YouTube were conducted from April 1st to May 31st, 2020. Posts were classified as either implicitly or explicitly targeting youth and young adults. BCTs in social media posts were identified and classified based on Behavior Change Technique Taxonomy version 1 (BCTTv1). Frequency counts and proportions were used to describe the data. Results In total, 319 youth-targeted PD posts were identified. Over 43% of the posts originated from Ontario Regional public health units, and 36.4 and 32.6% of them were extracted from Twitter and Facebook, respectively. Only 5.3% of the total posts explicitly targeted youth. Explicit posts were most frequent from federal PHEs and posted on YouTube. Implicit posts elicited more interactions than explicit posts regardless of jurisdiction level or social media format. Three-quarters of the posts contained at least one BCT, with a greater portion of BCTs found within implicit posts (75%) than explicit posts (52.9%). The most common BCTs from explicit posts were instructions on how to perform a behavior (25.0%) and restructuring the social environment (18.8%). Conclusions There is a need for more PD messaging that explicitly targets youth. BCTs should be used when designing posts to deliver public health messages and social media platforms should be selected depending on the target population.

Aims To examine the prevalence, temporal changes, and impact of the National Institute of Health (NIH) Sex as a Biological Variable (SABV) policy on sex and gender reporting and analysis in cardiac resynchronization therapy (CRT) cohort studies. Methods and results We searched MEDLINE, EMBASE, and Web of Science for cohort studies reporting the effectiveness and safety of CRT in heart failure patients from January 2000 to June 2020, with no language restrictions. Segmented regression analysis was used for policy analysis. We included 253 studies. Fourteen per cent considered sex in the study design. Outcome data disaggregated by sex were only reported in 17% of the studies. Of the studies with statistical models (n = 173), 57% were adjusted for sex. Sixty‐eight per cent of those reported an effect size for sex on the outcome. Sex‐stratified analyses were conducted in 13% of the studies. Temporal analysis shows an increase in sex reporting in background, statistical models, study design, and discussion. Besides statistical models, NIH SABV policy analysis showed no significant change in the reporting of sex in study sections. Gender was not reported or analysed in any study. Conclusions There is a need to improve the study design, analysis, and completeness of reporting of sex in CRT cohort studies. Inadequate sex integration in study design and analysis may potentially hinder progress in understanding sex disparities in CRT. Deficiencies in the integration of sex in studies could be overcome by implementing guidance that already exists.

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Introduction Pour continuer à éclairer les lignes directrices sur la santé concernant le sommeil ainsi qu’à favoriser l’élaboration d’interventions fondées sur des données probantes en faveur d’un sommeil sain chez les enfants et les adolescents, il est important de mieux comprendre les associations entre l’horaire de sommeil (heure du coucher, heure du lever, point médian du sommeil) et divers indicateurs de santé. L’objectif de la revue systématique dont fait état cet article était d’analyser les associations entre l’horaire de sommeil et neuf indicateurs de santé chez des enfants et des adolescents de 5 à 18 ans apparemment en bonne santé. Méthodologie Les études publiées dans les 10 années précédant janvier 2021 ont été recensées à partir de recherches effectuées dans quatre bases de données électroniques. La revue systématique a été réalisée selon le modèle PRISMA 2020 (Preferred Reporting Items of Systematic Reviews and Meta‑Analyses) et nous avons évalué la qualité méthodologique et le risque de biais de chaque étude. La synthèse des résultats repose sur une démarche axée sur les meilleurs éléments probants en vue de rapports précis et fiables. Résultats Quarante-six études observationnelles de 21 pays portant sur 208 992 participants ont été incluses. L’horaire de sommeil a été évalué objectivement au moyen de l’actigraphie dans 24 études et subjectivement dans 22 études. En raison, d’une part, de l’absence d’études quant à certains de nos critères de résultats en matière de santé et, d’autre part, de l’hétérogénéité des études quant à d’autres critères, nous avons effectué une synthèse narrative plutôt qu’une méta-analyse. D’après nos constatations, un horaire de sommeil tardif serait associé à une moins bonne régulation des émotions, à un rendement scolaire et des fonctions cognitives plus faible, à une durée de sommeil plus courte, à une qualité de sommeil plus faible, à des comportements alimentaires moins bons, à des niveaux d’activité physique plus faibles et à des comportements plus sédentaires. Peu d’études ont porté sur les associations entre l’horaire de sommeil et l’adiposité, la qualité de vie et le bien‑être, les accidents/blessures et les biomarqueurs du risque cardiométabolique. En fonction de l’approche GRADE (Grading of Recommendations Assessment, Development and Evaluation), la qualité des données probantes a été jugée « très faible » pour tous les critères de résultats en matière de santé. Conclusion D’après les données probantes disponibles, qui reposent sur des résultats transversaux, un horaire de sommeil précoce est bénéfique pour la santé des enfants et adolescents d’âge scolaire. Des études longitudinales et des essais contrôlés randomisés sont nécessaires pour améliorer nos connaissances dans ce domaine de recherche. (no d’enregistrement dans PROSPERO : CRD42020173585)

Introduction There is abundant evidence for sex differences in the diagnosis, implantation, and outcomes for cardiac resynchronization therapy (CRT) devices. Controversial data suggesting women are less likely to receive the device regardless of the greater benefit. The aim of this review is to assess sex differences in the implantation rate, clinical effectiveness, and safety of patients receiving CRT devices. Methods We will conduct a systematic literature search of MEDLINE, Embase, and Web of Science to identify cohort studies that meet our eligibility criteria. Title and full text screening will be conducted in duplicate independently. Eligible studies report clinical effectiveness or safety of patients receiving CRT device while providing sex-disaggregated data. Implantation rate will be extracted from the baseline characteristics tables of the studies. The effectiveness outcomes include the following: all-cause death, hospitalization, peak oxygen consumption (pVO2), quality of life (QoL), 6-min walk test, NYHA class reduction, LVEF, and heart failure hospitalization. The complication outcomes include the following: contrast-induced nephropathy, pneumothorax, pocket-related hematoma, pericardial tamponade, phrenic nerve stimulation, device infection, death, pulmonary edema, electrical storm, cardiogenic shock, and hypotension requiring resuscitation. Description of included studies will be reported in detail and outcomes will be meta-analyzed and presented using forest plots when feasible. Risk of bias will be assessed using the Newcastle-Ottawa Scale (NOS) by two review authors independently. GRADE approach will be used to assess the certainty of evidence. Discussion The aim of this review is to determine the presence of differences in CRT implantation between women and men as well as differences in clinical effectiveness and safety of CRT after device implantation. Results from this systematic review will provide important insights into sex differences in CRT devices that could contribute to the development of sex-specific recommendations and inform policy. Systematic review registration PROSPERO CRD42020204804

Introduction: There is abundant evidence for sex differences in the diagnosis, implantation and outcomes for Cardiac Resynchronization Therapy (CRT) devices. Controversial data suggesting women are less likely to receive the device regardless of the greater benefit. The aim of this review is to assess sex differences in the Implantation rate, clinical effectiveness and safety of patients receiving CRT devices.Methods: We will conduct a systematic literature search of MEDLINE, Embase and Web of Science to identify cohort studies that meet our eligibility criteria. Title and full text screening will be conducted in duplicate independently. Eligible studies report clinical effectiveness or safety of patients receiving CRT device while providing sex-disaggregated data. Implantation rate will be extracted from the baseline characteristics tables of the studies. The effectiveness outcomes include: All cause death, Hospitalization, Peak oxygen consumption (pVO2), Quality of life (QoL), 6 min walk test, NYHA class reduction, LVEF, Heart failure hospitalization. The complication outcomes include: Contrast-induced nephropathy, Pneumothorax, Pocket-related Hematoma, Pericardial tamponade, Phrenic nerve stimulation, Device Infection, Death, Pulmonary edema, Electrical storm, cardiogenic shock, Hypotension requiring resuscitation. Description of included studies will be reported in detail and outcomes will be meta-analyzed and presented using forest plots when feasible. Risk of Bias will be assessed using Newcastle-Ottawa Scale (NOS) by two review authors independently. GRADE approach will be used to assess the certainty of evidence.Discussion: The aim of this review is to determine the presence of differences in CRT implantation between women and men as well as differences in clinical effectiveness, safety of CRT after device implantation. Results from this systematic review will provide important insights into sex differences in CRT devices that could contribute to the development of sex-specific recommendations and inform policy.PROSPERO registration number: CRD42020204804