Talk or something more? COVID-19 and youth discourses of participation

PurposePolitical participation of young people has been examined, but there is a lack of research about how these participation forms are interpreted and what counts as participation for young people. The study aims to identify discourses of political participation in Hungary, where the COVID-19 restrictions during 2020-2021 have confined young people's everyday interactions and political activism to the online space for an extended period. The authors' asteroid-effect hypothesis suggests that new discourses of political participation have become more widespread, which may have reinterpreted the previous dynamics between online and offline participation.Design/methodology/approachThe authors analyse the results of six focus groups and eight interviews with young people conducted between 2021-2022 through discourse analysis.FindingsThe qualitative results show that to intellectualise the everyday discourses of youth political participation, extending its classical theories is worthwhile. While online participation has not emerged as a paramount, positive interpretational framework, a new discourse of political participation has emerged, making conversation a fundamental act.Originality/valueWhile the results are limited to Hungarian youth, the strong appearance of participation as a communicative action can have consequences to theoretical approaches of political participation. The authors believe that COVID-19 restrictions had a significant role in this change, because family talks became more politicised.

Asteroid-Effect in Society: The Formation of a Mannheim-type Historical Generation Post-COVID-19

Our conceptual paper argues that the COVID-19 pandemic has created conditions for the constitution of a new historical generation in Mannheimian terms. Current attempts in the sociology of youth to reconcile structure and agency with the concept of generation provide good starting points for interpreting a historical event such as the COVID-19 pandemic. While generations are not to be understood as homogeneous groups, constituting events can be compared to an asteroid that changes the trajectory of each social group. Thus, the concept of asteroid-effect helps us to overcome oversimplifying generational interpretations and to examine the effects of generation-forming events with an eye on structural inequalities. Our study provides an overview of the classical generational theory of Mannheim in light of some contemporary approaches. Based upon existing information, we illustrate how the generation-forming events can be interpreted and how structural inequalities can be considered. © 2022, Polish Sociological Association. All rights reserved.

Complete resolution of cardiac sequelae is seen in patients treated for paediatric multisystem inflammatory syndrome (PIMS) by 12 months

Background and Aim: Paediatric multisystem inflammatory syn-drome (PIMS) was a new phenomenon which emerged during the coronavirus pandemic. Mostly affecting children and adoles-cents, PIMS symptoms were noted 2-4 weeks following the initial covid-19 infection as patients presented with persistent fever, evi-dence of inflammation and single or multi organ dysfunction. As previously described by our group, over half of patients with PIMS develop significant cardiac involvement including coronary artery dilatation/aneurysm, impaired cardiac function and pericardial effusion. This study aims to describe the outcomes of patients treated with PIMS over the first 12 months post illness. Method(s): 93 patients have so far presented within the Yorkshire and Humber region of the UK with evidence of PIMS. So far, we have six-month follow up data for 66% of these patients and an ever-increasing proportion of patients reaching 12 months. This study involved a retrospective case notes review to compare the cardiac involvement at presentation;6 weeks post illness and 12 months. Result(s): 52.2% of patients had significant cardiac involvement at presentation. This had decreased to just 14.5% at six weeks and all patients had a normal cardiac echo at 12 months post illness. Furthermore, no patients who had a normal echo during their acute admission developed cardiac changes during follow up. Conclusion(s): PIMS is associated with a relatively high incidence of significant cardiac involvement. The initial stage of the illness can be a worrying time with cardiac function impairment, valve incompetence and coronary artery changes in patients with no his-tory of congenital heart disease. The unknown prognosis for patients with these changes has provided much concern for patients, their families and clinicians. This study shows that although there may be worrying changes in the initial stages of the illness, there is complete resolution over the first-year post ill-ness. Furthermore, patients with a normal echo during the initial stage of the illness do not develop cardiac involvement at a later stage, indicating that these children can be discharged from cardi-ology follow up after resolution of the acute illness and followed up by their local paediatric team.

A COHORT OF 79 CHILDREN WITH PAEDIATRIC MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH COVID-19

Background/Aims COVID-19 can manifest as a significant lung inflammation in adults. Although the course of disease is usually mild in children, it occasionally results in Paediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS). We present a cohort of 79 children treated for PIMS-TS in Yorkshire, UK between May 2020 and September 2021. Methods This retrospective multicentre cohort study includes children fulfilling the case definition of PIMS-TS according to Royal College of Paediatrics and Child Health criteria. The collected data include demographics, clinical symptoms, laboratory results, echocardiographic findings, treatment and outcomes. Results Out of 79 PIMS-TS cases, 50 were male, 29 female. Ages were between 3 months and 16 years (median 7 years). 45 children were within the normal weight range for age, 4 underweight, 30 overweight. 41 children were Caucasian, 34 Asian, 2 African and 2 Afro-Caribbean origin. The median duration of admission was 7 days with range 0-21 days. All children had fever. In 51 cardiac involvement was detected (impaired cardiac function, pericardial effusion or changes on coronary arteries by echocardiographic examination). In 51 children a skin rash was observed (usually macular blanching confluent non-pruritic), 48 children had gastrointestinal symptoms such as abdominal pains, vomiting or diarrhoea, 39 children had non-purulent conjunctivitis, 13 children enlarged cervical lymph nodes. All patients initially received antibiotics and all but two were treated with an anti-platelet dose of aspirin, a small number early on with an anti-inflammatory dose of aspirin, 31 were treated with 3 consecutive infusions of intravenous methylprednisolone (IVMP) 10 mg/kg daily followed by a weaning dose of oral prednisolone, 35 by IVMP and intravenous immunoglobulins (IVIG), 9 by IVIG only. The duration of treatment by oral prednisolone was 3-35 days with median 15 days. Inotropic support for hypotension was needed in 18 cases and oxygen therapy in 11 cases. All children had a good outcome and are being followed-up in our Paediatric Rheumatology / Cardiology clinics at 1-2 weeks, 6 weeks, 6 months and 12 months. To date, follow-up at 12 months has shown resolution of cardiac abnormalities including initial mild dilatation of coronary arteries;most of our patients have fully recovered within 6 weeks. No patients had any thromboembolic event identified. After discharge from hospital self-limiting musculoskeletal pains, lethargy, peeling of palms and/or headaches were common. 3 patients received psychology support. Conclusion We report 100% survival in our cohort of patients with PIMS-TS. None of the patients represented with flare of the symptoms. The majority were treated by corticosteroids alone, or in combination with IVIG. We believe that advance knowledge of PIMS-TS (from colleagues in other regions in the UK, affected earlier), prompt treatment and structured follow-up approach by multi-disciplinary team contributed to the good outcomes so far.

Admission serological markers can be used to predict significant cardiac involvement in children with paediatric multisystem inflammatory syndrome

Introduction: Paediatric multisystem inflammatory syndrome (PIMS) began to present in April 2020 midway through the covid-19 pandemic. Occurring 2-4 weeks after initial covid-19 infection, patients presented with persistent fever, evidence of inflammation and single or multiorgan dysfunction1. The Yorkshire and Humber congenital heart disease network is made up of the Leeds congenital heart unit and 18 peripheral hospitals2.With limited local paediatric cardiology availability, the vast majority of children presenting with PIMS required transfer to Leeds. This presentation aims to describe the cohort of children that were seen within the network as well as to identify any markers of significant cardiac involvement which could beusedto reduce the frequency of unnecessary inter hospital transfers. Methods: This was a retrospective case notes review of all patients treated within the Yorkshire and Humber network with symptoms of PIMS between 1st May and 30th November 2020. Patients were classified as to whether or not they had significant cardiac involvement (defined as at least one of: inotrope requirement, ejection fraction <50%, pericardial effusion, coronary artery changes and significant ECG abnormalities). Cardiac markers were analysed at presentation and throughout the hospital admission including plasma NT pro-BNP, LDH, CRP, d-dimer and troponin. Statistical tests (Fisher's exact test for categorical variables, ttest for continuous variables) were used to identify which factors were indicative of significant cardiac involvement (SCI). Results: 22 patients met the inclusion criteria (Table 1). 14/22 patients (63.6%) were judged to have SCI. Markers that were found to be indicative of SCI included CRP and plasma NT pro-BNP (Table 2). Furthermore, when using a threshold of 2000ng/L, plasma NT pro-BNP was found to be 71% sensitive and 80% specific for SCI. In addition, when combined with a CRP threshold of 100mg/L, there was a positive predictive value of 85% and negative predictive value of 75%. Conclusions: PIMS is an important new syndrome affecting paediatric patients across the Yorkshire and Humber region. A significant proportion of the affected patients have cardiac involvement and require management in a specialist centre. Early identification of these patients using serological markers facilitates rapid treatment preventing long term sequelae whilst also reducing unnecessary interhospital transfers.