ABSTRACT
Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides. Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior. Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions. Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist. Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.
ABSTRACT
Background. Anti-inflammatory therapy is used to achieve and maintain asthma control, as well as respiratory function indicators monitoring. Telemedicine technologies can be used for this purpose, and it became particularly essential during the COVID-19 pandemic. Objective. The aim of the study is to analyze efficacy of the mobile technology MedQuizBot for asthma monitoring, to estimate patient compliance to use such instruments of self-control via the bot and without it, and bot's functioning satisfaction. Methods. 6-month prospective observational comparative study in patients with asthma from 4 to 17 years old was conducted. All patients were divided into two groups: patients who have used MedQuizBot and patients who have used any other self-control tools. Patients had to enter peakflowmetry data daily and undergo asthma control tests monthly. Patients were able to communicate with their doctor remotely via the chat bot. Main study indicators: determining the efficacy of MedQuizBot in patients with asthma by estimating the compliance to self-control tools at using the bot. Secondary study indicators: estimation of patients satisfaction on using the MedQuizBot and determination of level of asthma control due to the obtained data results. Results. 41 patients have used MedQuizBot, 27 patients were in the control group. Patients who used the bot more often answered asthma control test questions. Patients over 12 years old have completed the asthma control test less often than young children: ACT was filled on average in 1.5 times, САСТ — 1.8 times. 51% of patients filled in data on peakflowmetry via the new technology, patients from control group did not start the picflowmetry diary. Patients under 12 years old, who filled up the test with their parents, has entered picflowmetry data 7 times more often than adolescents. The asthma was under control in 70% of patients. The data was entered into the system 2.5 times more often during the lockdown period due to COVID-19 pandemic and during the tree flowering season in comparison to other periods of 2020. Patients noted the usability of the MedQuizBot and agreed to use it in future. Conclusion. MedQuizBot is effective in achieving asthma control mainly during the period of need — in case of insufficient control over the disease itself (exposure to pollen allergens, acute respiratory diseases), during the limitations in medical care availability.
ABSTRACT
The COVID-19 infection caused by the new coronavirus SARS-CoV-2 has become the real pandemic. Children account for 1-6% of all diagnosed COVID-19 cases. Generally, children have mild disease in comparison to adults, and their mortality rates are extremely low. Despite the fact that all the main efforts of the medical and political community are now focused on preventing the pandemic spread and organizing medical care for patients with moderate and severe COVID-19 course, we still have to remember to implement adequate help for patients with chronic diseases, especially for children with allergic diseases. The pandemic period coincided with natural weather period of dusting of causative plants, that led to annual escalation of both allergic rhinitis and asthma in patient group with specific sensitization to tree pollen. Leading experts of allergology (adapting to modern conditions) have created key guidelines on management of children with allergic diseases during the COVID-19 pandemic. These guidelines are based on the data and results from the Union of Pediatricians of Russia, Russian Association of Allergologists and Clinical Immunologists, European Academy of Allergy and Clinical Immunology (EAACI), European Respiratory Society (ERS), American Thoracic Society (ATS), Global Strategy for Asthma Management (GINA), Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA/MACVIA).