BackgroundIt is unknown if young children’s parent-reported physical activity and sedentary time are correlated with direct measures. The study objectives were to compare parent-reported physical and sedentary activity versus directly measured accelerometer data in early childhood.MethodsFrom 2013 to 2014, 117 healthy children less than 6 years of age were recruited to wear Actical accelerometers for 7 days. Accelerometer data and questionnaires were available on 87 children (74 %). Average daily physical activity was defined as the sum of activity ≥100 counts per minute, and sedentary time as the sum of activity <100 counts per minute during waking hours. Parents reported daily physical activity (unstructured free play in and out of school, and organized activities) and selected sedentary behaviors (screen time, stroller time, time in motor vehicle). Spearman correlation coefficients and Bland–Altman plots were used to assess the validity of parent-reported measures compared to accelerometer data.ResultsTotal physical activity was significantly greater when measured by accelerometer than parent-report; the median difference was 131 min/day (p < 0.001). Parent-reported child physical activity was weak to moderately correlated with directly measured total physical activity (r = 0.39, 95 % CI 0.19, 0.56). The correlations between types of physical activity (unstructured free play in and outside of school/daycare, and organized structured activity) and accelerometer were r = 0.30 (95 % CI 0.09, 0.49); r = 0.42 (95 % CI 0.23, 0.58); r = 0.26 (95 % CI 0.05, 0.46), respectively. There was no correlation between parent-reported and accelerometer-measured total sedentary time in children (r = 0.10, 95 % CI −0.12, 0.33). When the results were stratified by age group (<18, 18–47, and 48–70 months of age) no statistically significant correlations were observed and some inverse associations were observed.ConclusionsThe correlation between parent-report of young children’s physical activity and accelerometer-measured activity was weak to moderate depending on type of activity and age group. Parent-report of children’s sedentary time was not correlated with accelerometer-measured sedentary time. Additional validation studies are needed to determine if parent-reported measures of physical activity and sedentary time are valid among children less than 6 years of age and across these young age groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1648-0) contains supplementary material, which is available to authorized users.

Daily cow's milk intake of >2 cups, longer breast-feeding duration, and a higher body mass index z score were modifiable risk factors associated with iron deficiency. Eating meat according to recommendations may be a promising additional target for the prevention of iron deficiency in early childhood.

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Background Patients presenting to the emergency department who require inpatient care are either admitted to our tertiary care inpatient units or transferred directly to a community hospital. When patients appropriate for community care cannot be transferred due to a lack of community beds and instead remain in a tertiary care bed, there are palpable downstream effects on patient flow. A pre-study audit confirmed that, once admitted, transfers from the inpatient unit to a community bed are rare. This project aimed to improve access to tertiary care beds by increasing inpatient transfers to community hospitals. Objectives The project aimed to transfer 25% of all eligible patients from the Paediatric Medicine inpatient units to community hospitals over a 4-month period by identifying eligible patients and streamlining the transfer process. Design/Methods An Ishikawa diagram with input from inpatient physicians and nurses and community hospital colleagues identified 4 modifiable barriers. A process map was created along with a simplified transfer process. Medical teams and nurse leaders were provided with the charts of contact numbers, geographic locations and levels of care for community hospitals. Intake nurses tracked eligible patients. Encrypted text messages were sent to inpatient physicians on their mobile devices every morning reminding them to assess specific patients for transfer. The outcomes of all identified patients including process and balancing measures were tracked. Results Multiple PDSA cycles focused on improving the success of identifying eligible patients at multiple points in the process. The study’s outcome measure was the rate of successful inpatient transfers for all eligible patients. From November 2018 to March 2019, 120 patients were identified as eligible for transfer at the time of admission: 45 (37.5%) were discharged within 24 hours, 42 (35%) were not considered clinically appropriate for transfer by the attending physician and 33 were considered appropriate for transfer. Twenty-four were approached for transfer (72.7%); 9 were not approached for non-clinical reasons. Six (18.2%) refused transfer and 10 (30%) were successfully transferred. These rates were sustained over the study period. Conclusion A streamlined transfer process can improve patient flow, optimize utilization of tertiary care beds and provide care closer to home. A more robust method of tracking patients that could flag patients and send physicians electronic reminders is needed. Most importantly, optimal use of tertiary care beds requires a culture shift to ensure every patient is considered for transfer to the community when medically appropriate.

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