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Background Postoperative delirium (POD) is common after non-cardiac surgery in older adults and can result in increased risk of adverse outcomes including postoperative cognitive dysfunction (POCD). Pain after surgery is also frequent and can persist as chronic postsurgical pain (CPSP). Evidence is inconsistent and controversial on whether acute and chronic postsurgical pain, and different postoperative pain management strategies (including opioid versus opioid-sparing strategies), is associated with the occurrence of POD and POCD. In this protocol, we propose a series of systematic reviews to answer the following research questions: In adults undergoing non-cardiac surgery, (1) is acute postsurgical pain associated with POD and/or POCD? (2) Are opioid-sparing/avoidance strategies of acute postoperative pain management associated with lower incidence and/or severity of POD and POCD, compared to predominantly opioid-based strategies? (3) Is CPSP associated with POCD? (4) Are opioid-sparing management strategies of CPSP associated with lower incidence and/or severity of POCD compared to standard of care or strategies not aiming at reduced opioid use? Methods We will search MEDLINE, EMBASE, Cochrane (CENTRAL), CINAHL, and PSYCHINFO. According to the research question, we will include cohort and case-control studies (questions 1 and 3) or randomized controlled trials and non-randomized studies (questions 2 and 4). The risk of bias will be assessed independently and in duplicate using the revised Cochrane risk-of-bias tool, the Newcastle-Ottawa Scale, and the Joanna-Briggs Institute critical appraisal checklist. Disagreements will be resolved by a third reviewer. Findings will be reported narratively, and where possible and appropriate, meta-analyses will be performed. Certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We will conduct the reviews in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols. Discussion Our systematic reviews will summarize available evidence to date on the association of postoperative pain and its management strategies with the incidence of POD and POCD in non-cardiac surgery. We will evaluate the existing evidence and its limitations and inform the design of future interventional studies comparing the effects of different pain management strategies on postoperative neurocognitive outcomes. Systematic review registration PROSPERO CRD42021192105

Cerebral palsy (CP) refers to a group of disorders in which atypical muscle tone impairs movement, balance, and posture. Resources available to support children and families affected by CP include therapies, assistive technologies, educational supports, and familial and social services. However, the COVID-19 pandemic has disrupted usual access to many of these resources, making it difficult for children with CP and their families to receive necessary support for optimal development. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) is a framework used by various stakeholders, such as healthcare workers, caregivers, and educators, to measure health and functioning in children. Additionally, the Ecological Systems Theory, which was created by Urie Bronfenbrenner, provides a powerful lens to examine how a child’s development is influenced by their surroundings. This paper provides an overview of the literature about relevant forms of support for those affected by CP and evidence-informed insights about how such supports may be adapted to better fit healthcare needs evolving as a result of the pandemic.

Although the merits of in person learning outweigh those of virtual learning for elementary students, online learning is often implemented in response to rising cases of COVID-19. As such, the significant number of barriers to remote learning must be addressed in order to promote effective and health conscious learning for students during the pandemic. Students have been facing challenges with self-regulation, work management and lack of socio-emotional connections while teachers have been facing obstacles related to effectively using technology to deliver content and engage students. Parents have struggled to understand and fulfill their role supporting their children within the online school environment. Considering the perspectives presented in the literature, efforts should be made to promote connectedness and support for families during this difficult time. A resource toolkit is suggested for caregivers of children enrolled in online school to implement strategies at home to assist their children in their education.