Parents' behaviour in individual-level prevention in children during the COVID-19 pandemic in Surabaya.

Objectives: To assess parental preventive behaviour related to children related to the coronavirus disease-2019. Method: The descriptive-analytical, cross-sectional study was conducted from November to December 2021 in Kalirungkut, Surabaya, Indonesia, after approval from the ethics review committee of the Faculty of Nursing, Universitas Airlangga, Surabaya. The sample comprised parents of children aged <5. Data was collected using the Indonesian version of the Champion's Health Belief Model Scale questionnaire. RESULTS: Of the 125 subjects, 57(45.6%) were mothers and 68(54.4%) were fathers. Majority 63(50.3%) were aged 26-35 years, 82(85.6%) had completed senior high school, and 64(51.2%) had 2 children. Perceived susceptibility (p=0.044, rho=0.181), perceived severity (p=0.000, rho=0.363), perceived benefits (p=0.036, rho = 0.188), cues to action (p=0.018, rho=0.211) and self-efficacy (p=0.000, rho=0.345) were significantly related to parental behaviour, while perceived barrier was not significantly related (p=0.094, rho=-0.150). CONCLUSIONS: All factors in the Health Belief Model were found to be related to parental preventive behaviour except perceived barriers.

Stratification in parents' selection of developmentally appropriate books for children: register-based evidence from Danish public libraries

This paper studies socioeconomic gradients in parents' selection of developmentally appropriate children's books from public libraries. I draw on developmental gradients research to hypothesize that families with high socioeconomic status (SES) select a higher share of books that match children's developmental stage in order to best improve children's learning environments. Based on Danish registry data on all books borrowed from public libraries in 2020, I find that highly educated families are more likely to use libraries and borrow more books, but they do not select a larger share of developmentally appropriate books;in fact, they select a slightly lower share. In contrast, high-income families borrow both a little more books and a little higher share of developmentally appropriate books, than low-income families. The supplementary analyses show that results are robust across families with children of different ages and to account for nonrandom selection into the sample of library users, socioeconomic differences in children's reading skills, and the impact of library lockdowns due to Covid-19. I conclude that stratification in library book selection is more prominent concerning the voraciousness with which highly educated parents provide reading inputs (more books) than how discriminating they are in terms of selecting developmentally appropriate books.

School bells are ringing, but can parents attend? Responses from employed parents of children with SEND

ABSTRACTThis study's purpose is to examine the work-family conflict of employed parents of children with special educational needs and disabilities (SEND) and those parents' engagement in the schooling of their children. Prior to the COVID-19 outbreak, 206 parents from the United Kingdom completed a questionnaire about their school engagement and their work-family strain. Response data were examined employing descriptive and correlation analyses, as well as hierarchical moderated regression. Findings reveal that the higher the parents' work-family conflict, the lower their school engagement. Moreover, the age of children with SEND moderates the relationship between employed parents' work-family conflict and engagement in their children's schooling. Specifically, for parents with younger children, the negative impact of work-family conflict on parental school engagement is not as prevalent as it is for those with older-aged children. Drawing on Hobfoll's conservation of resources theory, we explore parents' dilemma when they determine where to expend their limited reservoir of resources. Because children with SEND benefit in multiple ways when their parents are engaged in their schooling, we provide recommendations regarding how schools and organizations can operate to promote parental school engagement.

Alterations of adipokines, pancreatic hormones and incretins in acute and convalescent COVID-19 children.

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), accountable for Coronavirus disease 2019 (COVID-19), may cause hyperglycemia and additional systemic complexity in metabolic parameters. It is unsure even if the virus itself causes type 1 or type 2 diabetes mellitus (T1DM or T2DM). Furthermore, it is still unclear whether even recuperating COVID-19 individuals have an increased chance to develop new-onset diabetes. METHODS: We wanted to determine the impact of COVID-19 on the levels of adipokines, pancreatic hormones, incretins and cytokines in acute COVID-19, convalescent COVID-19 and control children through an observational study. We performed a multiplex immune assay analysis and compared the plasma levels of adipocytokines, pancreatic hormones, incretins and cytokines of children presenting with acute COVID-19 infection and convalescent COVID-19. RESULTS: Acute COVID-19 children had significantly elevated levels of adipsin, leptin, insulin, C-peptide, glucagon and ghrelin in comparison to convalescent COVID-19 and controls. Similarly, convalescent COVID-19 children had elevated levels of adipsin, leptin, insulin, C-peptide, glucagon, ghrelin and Glucagon-like peptide-1 (GLP-1) in comparison to control children. On the other hand, acute COVID-19 children had significantly decreased levels of adiponectin and Gastric Inhibitory Peptide (GIP) in comparison to convalescent COVID-19 and controls. Similarly, convalescent COVID-19 children had decreased levels of adiponectin and GIP in comparison to control children. Acute COVID-19 children had significantly elevated levels of cytokines, (Interferon (IFN)) IFNγ, Interleukins (IL)-2, TNFα, IL-1α, IL-1ß, IFNα, IFNß, IL-6, IL-12, IL-17A and Granulocyte-Colony Stimulating Factors (G-CSF) in comparison to convalescent COVID-19 and controls. Convalescent COVID-19 children had elevated levels of IFNγ, IL-2, TNFα, IL-1α, IL-1ß, IFNα, IFNß, IL-6, IL-12, IL-17A and G-CSF in comparison to control children. Additionally, Principal component Analysis (PCA) analysis distinguishes acute COVID-19 from convalescent COVID-19 and controls. The adipokines exhibited a significant correlation with the levels of pro-inflammatory cytokines. CONCLUSION: Children with acute COVID-19 show significant glycometabolic impairment and exaggerated cytokine responses, which is different from convalescent COVID-19 infection and controls.

Epidemiology, Clinical Profile, Intensive Care Needs and Outcome in Children with SARS-CoV-2 Infection Admitted to a Tertiary Hospital During the First and Second Waves of the COVID-19 Pandemic in India.

OBJECTIVES: To compare the epidemiological, clinical profile, intensive care needs and outcome of children hospitalized with SARS-CoV-2 infection during the first and second waves of the pandemic. METHODS: This was a retrospective study of all children between 1 mo and 14 y, admitted to a dedicated COVID-19 hospital (DCH) during the first (1st June to 31st December 2020) and second waves (1st March to 30th June 2021). RESULTS: Of 217 children, 104 (48%) and 113 (52%) were admitted during the first and second waves respectively. One hundred fifty-two (70%) had incidentally detected SARS-CoV-2 infection, while 65 (30%) had symptomatic COVID-19. Comorbidities were noted in 137 (63%) children. Fifty-nine (27%) and 66 (30%) children required high-dependency unit (HDU) and ICU care respectively. Severity of infection and ICU needs were similar during both waves. High-flow oxygen (n = 5, 2%), noninvasive ventilation [CPAP (n = 34, 16%) and BiPAP (n = 8, 5%)] and invasive ventilation (n = 45, 21%) were respiratory support therapies needed. NIV use was more during the second wave (26% vs. 13%; p = 0.02). The median (IQR) length (days) of DCH stay among survivors was longer during the first wave [8 (6-10) vs. 5.5 (3-8); p = 0.0001]. CONCLUSIONS: Disease severity, associated comorbidities, PICU and organ support need and mortality were similar in the first and second waves of the pandemic. Children admitted during the second wave were younger, had higher proportion of NIV use and shorter length of COVID-19 hospital stay.

Reduced physical activity and increased sedentary behaviour: the damage on young people during the COVID-19 pandemic

Healthy childhood development is fostered through movement behaviours, including sufficient physical activity. This article reviews some of the recently published global studies that have examined the impact of COVID-19 on children's physical activity and sedentary behaviours, the majority of which have indicated that children's physical activity behaviours have lessened significantly during these times, while their sedentary behaviours have risen significantly. The authors make some suggestions for ways to encourage and foster physical activity in both children and their families, for example by showing people different ways of staying active and offering other opportunities for physical activity, as well as ensuring the feeling of staying safe and being protected.

Asymptomatic and Mild SARS-CoV-2 Infections Elicit Lower Immune Activation and Higher Specific Neutralizing Antibodies in Children Than in Adults.

Background: The immune response plays a pivotal role in dictating the clinical outcome in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected adults, but it is still poorly investigated in the pediatric population. Methods: Of 209 enrolled subjects, 155 patients were confirmed by PCR and/or serology as having coronavirus disease 2019 (COVID-19). Blood samples were obtained at a median of 2.8 (interquartile, 2.1-3.7) and 6.1 (5.3-7.2) months after baseline (symptom onset and/or first positive virus detection). The immune profiles of activation, senescence, exhaustion, and regulatory cells were analyzed by flow cytometry. Neutralizing antibodies (nAbs) were detected by a plaque reduction neutralization test. In available nasopharyngeal swabs at baseline, SARS-CoV-2 levels were quantified by digital droplet PCR (ddPCR). Results: Overall, COVID-19 patients had higher levels of immune activation, exhaustion, and regulatory cells compared to non-COVID-19 subjects. Within the COVID-19 group, activated and senescent cells were higher in adults than in children and inversely correlated with the nAbs levels. Conversely, Tregs and Bregs regulatory cells were higher in COVID-19 children compared to adults and positively correlated with nAbs. Higher immune activation still persisted in adults after 6 months of infection, while children maintained higher levels of regulatory cells. SARS-CoV-2 levels did not differ among age classes. Conclusions: Adults displayed higher immune activation and lower production of anti-SARS-CoV-2 nAbs than children. The different immune response was not related to different viral load. The higher expression of regulatory cells in children may contribute to reduce the immune activation, thus leading to a greater specific response against the virus.

COVID-19 Pediatric Dermatology.

Children are a unique subset of patients in relation to the COVID-19 pandemic, often presenting asymptomatically, mildly, or atypically. Manifestations of the skin may be a primary (or the only) presenting sign. Recognizing cutaneous manifestations of COVID-19 in the pediatric population is important to guiding precautions, testing, and management for patients and close contacts. Whereas some dermatologic signs in children overlap with those in adults, other skin findings are reported with higher frequency in children and may be clues to multisystemic sequelae. This article describes presentation, pathophysiologic theories, and management strategies for cutaneous manifestations of COVID-19 in children.

Acute pulmonary embolism in a child following SARS-CoV-2 infection: a case report.

In children, coronavirus disease 2019 infection is rarely symptomatic. Severe forms with respiratory distress are rare, thromboembolic complications are exceptional. We report a rare case of a 14 years old girl with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was admitted to the hospital for bilateral pulmonary embolism with intracardiac thrombus. The girl progressed well on anticoagulation.