Play and learn: Children's agency through the COVID‐19 pandemic in Mozambique

Social distancing, one of the measures adopted in the context of the COVID‐19 pandemic, profoundly impacted on the lives of children. The consequences were, however, not homogenous. By focusing on the daily practices of 41 Mozambican children aged 3–10, we consider how differences in socioeconomic backgrounds led children to respond to the social restrictions in ways that made sense to them. Inspired by Abebe (2019), we identify how the interruptions of daily routines enabled specific instances of agency on children's part. These, we argue, produce new forms of continuity.

Bear in a Window: Australian children's perspectives on lockdown and experiences of the COVID‐19 pandemic

This paper examines the reflections of a cohort of Australian children who lived through the 2020–21 COVID‐19 pandemic and experienced being in 'lockdown';a state of largely being confined to the home for long periods daily. We report how children reflect on their experiences and illustrate how reflections draw on similar topics focused on localised child concerns regarding health, education, family, digital engagement, mealtimes and food. Further, we argue for the importance of including children's own voices of lived experience in reports regarding life during the pandemic since these perspectives may differ from those reported by adults on children's behalf.

The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

Objectives: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods: A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

COVID-19: Impact of the Pandemic on Children's Lives

Introduction: The COVID-19 pandemic has had a considerable impact on the biopsychosocial elements of human beings, especially children and teenagers, as vulnerable groups. Social isolation can lead to psychiatric illness, obesity, and sleep disorders in adults. This study aimed to determine the impact of lockdown on children's sleep, diet, physical activity, and behavior. Methods: This was a retrospective observational study conducted from May 1, 2020, to March 31, 2021. Data were collected from four healthcare centers in Cascais (Lisbon, Portugal) by administering a questionnaire in person and online. Descriptive statistical analysis was conducted using Microsoft Excel® and the SPSS® software (version 23). Results: In total, 790 responses were collected (median age 9 years old) without gender predominance. Family routine and behavioral changes were found in 84% and 63% of children, respectively. In addition, dietary changes were observed in 43% of them, with 62% reporting an increase in quantities and 23% reporting weight gain (more than 5 kg in 18%). Regarding physical activity, 44% exercised more than three times a week before the lockdown. Following COVID-19, 18% maintained this routine, and 48% quit sporting activities. Finally, sleep changes occurred in 42%, including nightmares and difficulty falling asleep. Discussion: Childhood and adolescence are periods of considerable social and psychomotor development, and any routine disruption can cause profound changes in personal and interpersonal experience during this period. The findings of this study revealed that lockdown caused changes in children's behavior, diet, physical exercise, and sleep. It is essential to outline strategies to support children and teenagers with a multidisciplinary approach to reduce the effects of social isolation on their development. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2023.

COVID-19: Impact of the Pandemic on Children's Lives

Introduction: The COVID-19 pandemic has had a considerable impact on the biopsychosocial elements of human beings, especially children and teenagers, as vulnerable groups. Social isolation can lead to psychiatric illness, obesity, and sleep disorders in adults. This study aimed to determine the impact of lockdown on children's sleep, diet, physical activity, and behavior. Methods: This was a retrospective observational study conducted from May 1, 2020, to March 31, 2021. Data were collected from four healthcare centers in Cascais (Lisbon, Portugal) by administering a questionnaire in person and online. Descriptive statistical analysis was conducted using Microsoft Excel® and the SPSS® software (version 23). Results: In total, 790 responses were collected (median age 9 years old) without gender predominance. Family routine and behavioral changes were found in 84% and 63% of children, respectively. In addition, dietary changes were observed in 43% of them, with 62% reporting an increase in quantities and 23% reporting weight gain (more than 5 kg in 18%). Regarding physical activity, 44% exercised more than three times a week before the lockdown. Following COVID-19, 18% maintained this routine, and 48% quit sporting activities. Finally, sleep changes occurred in 42%, including nightmares and difficulty falling asleep. Discussion: Childhood and adolescence are periods of considerable social and psychomotor development, and any routine disruption can cause profound changes in personal and interpersonal experience during this period. The findings of this study revealed that lockdown caused changes in children's behavior, diet, physical exercise, and sleep. It is essential to outline strategies to support children and teenagers with a multidisciplinary approach to reduce the effects of social isolation on their development. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2023.

COVID-19 Enfeksiyonuna Bağlı Gelişen Serum Transaminaz Yüksekliği

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement including respiratory, cardiovascular, gastrointestinal, neurological, hematological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, immun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfusion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection.

How nurses can safeguard children from polio: Nurses can ask people, especially those from communities with low uptake, if their children are vaccinated for polio

Polio is a serious infection that is rare in the UK due to the vaccination programme. It is only found in a few countries worldwide and the chances of getting it in the UK are extremely low, according to the NHS.

Viral Respiratory Infections in Children in a Resource Limited Setting

Background Children under 5 years of age bear the highest burden of severe disease from respiratory illness. Surveillance of respiratory viral infections in hospitalized children informs local burden of disease and may assist in identifying potential sources of epidemics. In resource-limited countries, like Haiti, lack of infrastructure, resources, and oversight are barriers for such surveillance programs. Just before the onset of the pandemic in December 2019, we completed the preparation to implement a respiratory surveillance program at Hôpital Saint Damien (HSD). Furthermore, other major events such as a 7.2 magnitude earthquake and the assassination of the president of Haiti had an impact on the political and economic stability of the country, impacting the hospital and this study. Despite these challenges, we report the preliminary findings of a hospital-based surveillance program of severe acute respiratory illness (SARI) in children at a mother and child hospital in Tabarre, Haiti. Method Participants were included if they were < 18 years of age;met the World Health Organization definition for SARI, which includes presence of 1) cough, 2) history of fever or measured fever ≥ 38 C°, 3) onset within the last 10 days, and 4) requirement of hospitalization;and consented to participate. We collected demographic and clinical data for enrolled patients and obtained a nasopharyngeal swab sample. Samples were rapid tested for influenza A, influenza B, respiratory syncytial virus (RSV), and SARS-CoV-2 and stored and shipped for genomic sequencing. Results As of January 6th, 2022, we had enrolled and tested 143 patients who presented to the hospital with SARI. Of these cases, 31 were RSV-positive, 7 were positive for influenza B-positive, 1 was positive for influenza A-positive, and 1 was SARS-CoV-2-positive. 97 cases are currently available for descriptive analysis, with 10 RSV-positive cases, 2 influenza B-positive cases, and 1 SARS-CoV-2-positive case. 55% (n= 53) of participants are male, with an average age of 2 years (standard deviation = 2.8 years). Along with fever and cough, 18% (n=17) presented with wheezing, 60% (n=58) presented with shortness of breath, 37% (n=36) presented with tachypnea, 7% (n=7) presented with nasal congestion, 1% (n=1) had a sore throat, 2% (n=2) had nausea, 7% (n=7) were lethargic, and 9% (n=9) had diarrhea. Nearly all enrolled children, 99% (n=96) live in households where coal or biofuel is used for cooking indoors. In regard to type of respiratory tract infection (RTI), 18% (n=17) were upper RTI, 30% (n=29) were lower RTI, and 53% (n=51) were both upper and lower RTI. While sequencing of influenza A and B isolates remains to be conducted, sequencing for the SARS-CoV-2 sample revealed the isolate to be of P.1 lineage. Conclusion In children requiring hospital admission for SARI, our limited testing identified 40 children with respiratory viruses that were circulating during the SARS-CoV-2 pandemic. Identifying these viruses can support healthcare providers to provide better preventions measures, including compliance with vaccination, and administering appropriate therapeutics, such as antibiotics. Further testing with additional primers against other pathogens will be conducted to identify other potential causes of illness.

[Impacted battery in the nose of a four-year-old girl]

In this case report, it was suspected that a four-year-old girl had an impacted toy in her nose. Initially, she was refused consultation due to a COVID-19 positive parent. Three days later she presented with nasal secretion and facial oedema. At the hospital, an examination revealed an impacted battery and consequent necrosis of nasal structures. The battery was removed in general anesthesia. Afterwards, the girl made fine recovery but developed a permanent septal perforation. Frequent alterations in COVID-19 guidelines challenge doctors to distinguish conditions crucial for evaluation. Batteries are uncommon for nasal impaction but may lead to severe morbidity if left undiscovered.

O30 Food Insecurity Rates Among WIC Participants During COVID-19

The WIC program serves low-income, pregnant and breastfeeding women and children under 5. The COVID-19 pandemic has increased food insecurity and reduced access to healthy foods essential during critical periods of growth and development, thereby increasing health disparities. To determine the effects of the COVID-19 pandemic on food insecurity and food access in an online/virtual nutrition education program conducted in partnership with the WIC Program in Ventura County, CA. Mixed methods were used in a pilot study with adult English- and Spanish-speaking WIC clients (n = 358) utilizing the Family Kitchen online cooking education program to meet their WIC nutrition education requirements. Surveys were self-administered before and after watching an online cooking education video. Descriptive statistics and bivariate relationships including Chi-square analyses were conducted to determine the association between demographic variables (e.g,. age, education, race/ethnicity, income, and language spoken at home) with rates of food insecurity measured using the USDA six-item short-form food security (FS) scale and a question about the impact of COVID-19 on food access. Responses regarding food access were coded for themes and subthemes using thematic analysis. A total of 47.5% of study participants were food insecure (35.5% low FS, 12.1% very low FS) and 36.1% reported difficulty with food access. Older study participants (30+ years) were more food insecure than younger participants (18-29 y) - 51.7% versus 38.8% (P =.05). Spanish-speakers experienced greater difficulty accessing food during the pandemic than English-speakers - 44.1% versus 31.4% (P = 0.02). Major themes identified for these difficulties included fear of leaving the house, lack of food available at local stores, loss of employment, and increased childcare responsibilities. Low-income, Spanish-speakers are particularly at-risk for higher rates of food insecurity and more difficulty accessing food, due in part to minimal resources and fragile work-life relationships. Increasing cooking skills among WIC parents may support better outcomes. and merits further research. Share our Strength/No Kid Hungry.

News

The article presents the discussion on world news briefs. Topics include Royal College of Surgeons of England welcoming the plans for expanding water fluoridation schemes across England for improving children's oral health;and reduction in the number of children undergoing dental treatment under general anaesthesia.

Parents' and Childcare Workers' Perspectives Toward SARS-CoV-2 Test and Surveillance Protocols in Pre-school Children Day Care Centers: A Qualitative Study Within the German Wü-KiTa-CoV Project.

Background: Feasibility of surveillance through continuous SARS-CoV-2 testing in pre-school children and childcare workers (CCWs) to prevent closure of day care centers (DCCs) was proven in the Wü-KiTa-CoV study. The purpose of this study was to describe the factors that facilitate or hinder the implementation of continuous SARS-CoV-2 testing from the perspective of parents and CCWs involved in the study. Methods: A total of 148 semi-structured telephone interviews, repeated before and after the implementation of the surveillance protocols, were conducted with parents and CCWs belonging to the DCCs involved in Wü-KiTa-CoV and analyzed using qualitative content analysis. Results: Five main topical categories that influences implementation of surveillance protocols for SARS-CoV-2 in DCCs emerged: Generating valuable knowledge, Impact on daily life, Communication and information, Children's wellbeing and the Sense of security. Smooth integration in daily routines, quickly delivered test results, and efficient communication and information between the study team and the participants were identified as factors that had a positive impact on implementation. To ensure children's wellbeing, the introduction of non-invasive testing procedures such as saliva testing, parental involvement to motivate, and prepare children for the procedure, the creation of a child-friendly environment for testing, and use of child-friendly explanations were considered critical. The surveillance was found to increase the sense of security during the pandemic. Conversely, reliability of tests in the surveillance protocols, low participation rates, non-transparent communication, the need to travel to testing sites, fear of quarantine in case of positive test results, concerns about higher workloads, the fear of unpleasant feelings for children, their young age, and changing test teams were considered as hindering factors. Conclusion: This qualitative study of parents of children in day care and DCC staff under surveillance through continuous testing for SARS-CoV-2 in nine German DCCs identified several factors that facilitate or hinder its implementation. These should be considered when planning screening interventions to prevent the spread of SARS-CoV-2 or other infectious diseases in pre-school children DCCs.

Relationship between Mother's emotional intelligence, negative parenting behaviour, Preschooler's attachment instability, and smart device overdependence.

BACKGROUND: As smart device overdependence among preschoolers could adversely affect their overall development, it is essential to understand the related factors of such overdependence. Mothers have a large influence on preschoolers; however,, the relationship between mothers' emotional intelligence, negative parenting behaviour, preschoolers' attachment instability, and smart device overdependence remain unclear. This study aims to develop and test a structural model to explain smart device overdependence among preschoolers. METHODS: The study collects and analyses data from January to May 2021 from 283 mothers raising children aged 3-6 years in South Korea. Questionnaires regarding mothers' emotional intelligence and negative parenting behaviour, as well as preschoolers' attachment instability and smart device overdependence, were used to collect data. The data were analysed by SPSS23.0 and AMOS 23.0 software and a structural equation model was constructed; p ≤ 0.05 was taken as significant. RESULTS: Mothers' emotional intelligence had a direct negative relationship with mothers' negative parenting behaviour (ß = - 0.44) and an indirect negative relationship with preschoolers' attachment instability (ß = - 0.25) and preschoolers' smart device overdependence (ß = - 0.24). Mothers' negative parenting behaviour had a direct positive relationship with preschoolers' attachment instability (ß = 0.56) and both direct and indirect positive relationships with preschoolers' smart device overdependence (ß = 0.55). Preschoolers' attachment instability had a direct positive relationship with preschoolers's smart device overdependence (ß = 0.46). CONCLUSIONS: Mothers' emotional intelligence, negative parenting behaviour, and preschoolers' attachment instability are associated with preschoolers' vulnerability to smart device overdependence. These results are shown that more attention is needed to these variables in order to reduce preschoolers' overdependence on smart devices. Additionally, we propose to develop and provide interventions based on these results.

Screen time and associated factors among preschoolers in Wuxi during COVID-19 outbreak / 中国学校卫生

Objective@#To investigate the current status of screen time in preschoolers during the outbreak of Corona Virus Disease 2019 (COVID-19), and the influences of parent-child active play and school online education on screen time.@*Methods@#A total of 2 370 preschoolers were chosen through clustering sampling from 7 kindergartens in Wuxi urban areas. Questionnaire survey was administered to parents for child screen time, active play, online education as well as characteristics information.@*Results@#A total of 1 428(60.3%) preschoolers reported more than 1 hour screen time a day, and 1 915(80.8%) preschoolers reported more than 20 minutes consecutive screen time. Compared with the weekend before the COVID-19 outbreak, 1 551(65.4%) preschoolers reported an increase of 10 minutes in screen time perday, and 1 444(60.9%) reported an increase of 5 minutes for one sersion. Logistic regression analysis showed that after controlling for confounding factors, high frequency of parent-child active play, parents’ exercise habits, online education from kindergartens and children’s active participation in the online education were negatively associated with preschoolers’ excessive and increased screen time during this period(OR=0.39-0.79, P<0.05).@*Conclusion@#During the COVID-19 outbreak, preschoolers’ media use in Wuxi city is worrisome. Parent-child active play, parents’ exercise and online education from kindergartens may play a positive role in reducing preschoolers’ media use.

Pneumonia in children admitted to the national referral hospital in Bhutan: A prospective cohort study.

OBJECTIVES: The study aim was to describe the etiological profile and clinical characteristics of pneumonia among children hospitalized in Thimphu, Bhutan. METHODS: This prospective study enrolled children aged 2-59 months admitted to the Jigme Dorji Wangchuck National Referral Hospital with World Health Organization (WHO)-defined clinical pneumonia. Demographic and clinico-radiological data were collected through questionnaires, physical examination, and chest radiography. Blood samples and nasopharyngeal washing were collected for microbiological analysis including culture and molecular methods. RESULTS: From July 2017 to June 2018, 189 children were enrolled, of which 53.4% were infants. Pneumonia-related admissions were less frequent over the winter. Chest radiographies were obtained in 149 children; endpoints included pneumonia in 39 cases (26.2%), other infiltrates in 31 (20.8%), and were normal in 79 children (53.0%). Non-contaminated bacterial growth was detected in 8/152 (5.3%) blood cultures, with only two cases of Streptococcus pneumoniae. Viral detection in upper respiratory secretions was common, with at least one virus detected in 103/115 (89.6%). The three most-commonly isolated viruses were respiratory syncytial virus (52/115; 45.2%), rhinovirus (42/115; 36.5%), and human parainfluenza virus (19/115; 16.5%). A third of patients with viral infections showed mixed infections. Case fatality rate was 3.2% (6/189). CONCLUSION: Respiratory viral infections predominated among this cohort of WHO-defined clinical pneumonia cases, whereas bacterial aetiologies were uncommon, highlighting the epidemiologic transition that Bhutan seems to have reached.