National assessment of school resources in cystic fibrosis care centers

Background: Assessment of the prevalence and correlates of educational risk and school support needs of children with cystic fibrosis (CF) is limited. Educational support for people with CF has become even more pressing with the onset of COVID-19 and the dramatic changes seen in the education system nationally. Method(s): A cross-sectional needs assessment survey for pediatric and adult CF center care team members across the United States was distributed to assess student and family school needs, resources, services offered, and current processes for identification of concerns and intervention. Care teams were asked to complete the survey as a group or specify respondents who routinely provide school support. Result(s): The survey was sent to 3684 individuals within the CF care center network, on April 1, 2022, with a closure date of April 22, 2022. Preliminary results at time of this submission include 56 survey responses, completed primarily by social workers (40%) and physicians (23%), representing approximately 20% of all centers. Thirty-eight percent of respondents reported that their center administered a screening tool to assess general school functioning routinely or as needed. Specific school topics most widely assessed included need for CF care (treatments and medications) to occur at school (73%), concerns about emotional and behavioral functioning in the school setting (70%), CF daily care burden affecting school attendance and performance (63%), and CF-specific needs in university settings (63%). According to the care team report, families most often asked for help with school accommodations related to ability to carry enzymes (74%), carrying awater bottle (50%), additional bathroom passes (43%), and ability to step out of the classroom as needed for gastrointestinal problems (50%). Nurses, program coordinators, and social workers are the team members addressing school needs most often (55%, 42%, and 90%, respectively). Sixty-two percent of respondents reported having access to a hospital-based teacher for education support during inpatient stays, 10% had access to school services or educational support, and 5% had access to someone with a background or training in education or teaching (other than hospital-based teacher) for ambulatory care. Upon closure of the survey, the above data will be updated, and more complete identification of current resources and future needs will be described at the 2022 North American Cystic Fibrosis Conference. Conclusion(s): This survey will be the most comprehensive assessment to date of ongoing school services at CF centers nationally. Results will be used to identify specific areas of need to guide development of a roadmap addressing proactive monitoring of school functioning and resources in the CF care modelCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

School climate and culture impact on middle school students and their attendance

Numerous studies have been conducted on the impact school climate and culture has on student achievement, but little has been studied on how climate and culture impacts student attendance. This study focuses specifically on the teacher-student relationship, parent engagement, and school safety and how these three areas of emphasis affect student attendance. When students feel disconnected, parents are unengaged, and safety concerns are present within the school setting, attendance barriers are created for students. This mixed-methods explanatory approach provided researchers the opportunity to survey all middle school students and interview 10 individual students per grade level for further investigation into what barriers are present at Rural #0535 Middle School. Although the results from the student body were generally favorable, there were pockets of concern in each of the three areas that indicate the reasons why students are absent from school. With the impact of the COVID-19 pandemic, as well as chronic absenteeism, school leaders must identify ways to address the concerns identified within the investigations. Once identified, school administrators can begin to eliminate the obstacles that are hindering students from attending school. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Wellness center impact on classroom attendance at a New Jersey High School

In 2013, The Center for Disease Control and Prevention reported 13 - 20% of youth living in the United States experiencing a mental health disorder. Research indicated that mental health disorders can negatively affect an individual's cognitive, social, and emotional functions (National Institute of Mental Health, 2018). As a result, students experiencing mental health related stress have high rates of absenteeism (Sahin, Arseven, & Kihc, 2016). Schools have the unparalleled capacity to reach students and offer cognitive, social, and emotional support. This research study worked to answer the question: Can mental health support offered to high school students increase classroom attendance rates? Implementation of a wellness center took place at Cherokee High School in September 2020. The wellness center sign-in data and classroom attendance data were collected and analyzed for 44 days between March 1, 2021, and May 18, 2021, to determine if classroom attendance would increase for wellness center users ten days after a wellness center visit. This ten-day period was known as the enrollment period. The research found that seven of the eight students with a 504-plan associated with mental health related stress increased class attendance 5% or greater during the enrollment period. This study was implemented during the COVID 19 pandemic. The pandemic impeded the remote students' ability to attend the Cherokee Wellness Center. The attendance data collected included full-time in-person students and eliminated the remote students. The research is significant in that classroom attendance data can be increased with the correct student support for mental health related stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The association between home learning during COVID-19 lockdowns and subsequent school attendance among children with neurodevelopmental conditions.

BACKGROUND: Children with neurodevelopmental conditions have high levels of school absence. During the COVID-19 pandemic, schools closed for many students. The relationship between home learning during school closures and subsequent school attendance requires attention to better understand the impact of pandemic education policy decisions on this population. This study aims to investigate the association between home learning, hybrid learning and school learning during school closures (in January-March 2021) with subsequent school attendance (in May 2021) in children with neurodevelopmental conditions. METHODS: An online survey was completed by 809 parents/carers of 5- to 15-year-old autistic children and/or children with intellectual disability. Regression models examined the association of learning location during school closures with subsequent school absence (i.e., total days missed, persistent absence and school refusal). RESULTS: Children who were learning from home during school closures later missed 4.6 days of a possible 19. Children in hybrid and school learning missed 2.4 and 1.6 school days, respectively. The rates of school absence and persistent absence were significantly higher in the home learning group even after adjusting for confounders. Learning location was not associated with subsequent school refusal. CONCLUSIONS: Policies for school closures and learning from home during public health emergencies may exacerbate school attendance problems in this group of vulnerable children.

School attendance and sexual and reproductive health outcomes among adolescent girls in Kenya: a cross-sectional analysis.

BACKGROUND: Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties. METHODS: This study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15-19 years participated in the baseline survey, of which 1810 were included in the present analysis. Multivariable logistic regression models were used to assess the association between school attendance (in- versus out-of-school) and ever having sex, condom use during last sex, and ever pregnant, controlling for age, orphan status, income generation, religion, county, relationship status, and correct SRH knowledge. RESULTS: Across the 1810 participants included in our study, 61.3% were in-school and 38.7% were out-of-school. Compared to adolescent girls who were in-school, those out-of-school were more likely (AOR 5.74 95% CI 3.94, 8.46) to report ever having sex, less likely (AOR: 0.21, 95% CI 0.16, 0.31) to have used a condom during their last sexual intercourse, and more likely (AOR: 6.98, 95% CI 5.04, 9.74) to have ever been pregnant. CONCLUSIONS: School attendance plays an integral role in adolescent girls' SRH outcomes, and it is imperative that policy actors coordinate with the government and community to develop and implement initiatives that support adolescent girls' school attendance and education.

Adolescent girls in Kenya experience poor sexual and reproductive health outcomes (SRH) and have low levels of educational attainment. In this study, we aimed to examine if school attendance was associated with sexual and reproductive health outcomes among adolescent girls aged 15 to 19 years in Homa Bay and Narok counties in Kenya. The study used data from the evaluation of the In Their Hands (ITH) program which occurred between September to October 2018. A total of 1840 adolescent girls years participated in the baseline survey, of which 1810 were included in this study. We found that compared to adolescent girls in-school, those who were out-of-school were significantly more likely to report ever having sex, less likely to have used a condom during their last intercourse, and more likely to have ever been pregnant. This study found that attending school plays an important protective role in the SRH of adolescent girls. Therefore, it is important to develop and implement initiatives to support adolescent girls' school attendance, and ultimately their education attainment.

Uneven impacts of COVID-19 on the attendance rates of secondary school students from different socioeconomic backgrounds in Australia: A quasi-experimental analysis of administrative data.

This paper contributes to the growing body of research that demonstrates uneven impacts of the COVID-19 pandemic on educational outcomes of students from different socioeconomic status (SES) backgrounds. We evaluate the early impacts of COVID-19 on student attendance in secondary school and show how these impacts depend on students' SES. We employ a quasi-experimental design, using difference-in-differences (DiD) estimation extended to incorporate third-order differences over time between low-SES and other students, and pre- versus during-COVID-19, leveraging robust administrative data extracted from the registers of the Tasmanian Department of Education. Using data from multiple cohorts of secondary school students in government schools in Tasmania (N = 14,135), we find that while the attendance rates were similar pre- and during-COVID-19 for high-SES students, there was a significant drop in attendance rates during COVID-19 among socioeconomically disadvantaged students, demonstrating the more pronounced impacts of COVID-19 for these students. The findings demonstrate that even "relatively short" lockdowns, as those in Tasmania in 2020 (30-40 days of home learning), can significantly affect the learning experiences of students from socioeconomically disadvantaged backgrounds. We discuss the implications of this for future pandemic planning in educational policy and practice and how this needs to be addressed in Australia's COVID-19 recovery.

Puberty health intervention to improve menstrual health and school attendance among adolescent girls in The Gambia: study methodology of a cluster-randomised controlled trial in rural Gambia (MEGAMBO TRIAL).

BACKGROUND: Menstrual health (MH) is a recognised global public health challenge. Poor MH may lead to absence from school and work, and adverse health outcomes. However, reviews suggest a lack of rigorous evidence for the effectiveness of MH interventions on health and education outcomes. The objective of this paper is to describe the methods used in a cluster-randomised controlled trial to estimate the effect of a multi-component intervention to improve MH and school attendance in The Gambia. METHODS: The design ensured half the schools (25) were randomised to receive the intervention which comprised of the following components: (i) Peer education camps and menstrual hygiene laboratories in schools, (ii) Mother's outreach sessions, (iii) Community meetings, and (iv) minor improvements of school Water Sanitation and Hygiene (WASH) facilities and maintenance. The intervention was run over a three-month period, and the evaluation was conducted at least three months after the last intervention activity was completed in the school or community. The other 25 schools acted as controls. Of these 25 control schools one Arabic school dropped out due to COVID-19. The primary outcome was the prevalence of girls missing at least one day of school during their last period. Secondary outcomes included: Urinary Tract Infection (UTI) symptoms, biochemical markers of UTI in urine, Reproductive Tract Infection symptoms, self-reported menstruation related wellbeing, social support and knowledge, perceptions and practices towards menstruation and MH in target school girls. In addition, a process evaluation using observations, routine monitoring data, survey data and interviews was undertaken to assess dose and reach (quantitative data) and assess acceptability, fidelity, context and possible mechanisms of impact (qualitative data). Cost and cost-effectiveness of the intervention package will also be assessed. CONCLUSION: Results will add to scarce resources available on effectiveness of MH interventions on school attendance. A positive result may encourage policy makers to increase their commitment to improve operation and maintenance of school WASH facilities and include more information on menstruation into the curriculum and help in the reporting and management of infections related to adolescent menstruation. Trial Registration PACTR, PACTR201809769868245, Registered 14th August 2018, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3539.

An Innovative Model for Chronic Pain Management at the Evelina

Introduction/Background: Chronic pain is persistent pain lasting more than three months, impacting many aspects of a person's life. 20- 30% of UK adolescents experience chronic pain (although studies vary greatly). The previous pathway through our service was unclear, which meant young people were not accessing all available resources or being seen promptly. We aimed to create a model that optimised available resources, including local networks and ensured equitable access to our service across the region. We wanted to target critical barriers such as mental health, school attendance and sleep, and delivering asset-based care. Description/Method: We followed the plan, do, study, act PDSA cycle for this quality improvement project (QIP). The initial evaluation involved multidisciplinary team (MDT) meetings, site visits, and the MDT experience using other models of care. Patient cases were reviewed for weaknesses in existing models. Discussions highlighted the need to match resources to needs instead of a onesize- fits-all approach. Changes include creating our own model for Chronic Pain, introducing a specialist physiotherapy Triage Clinic to the pathway, converting our Pain Education Workshop (PEW) to virtual and utilising local resources by expanding our network. PEW seeks to empower patients and families to understand their pain. It is also offered to local healthcare professionals to increase confidence in supporting patients. We adapted the Thrive Mental Health Model to create a Triaged Model for Chronic Pain. We needed to streamline the service, as some patients became lost within the original pathway, not attending PEW and being on long waiting lists. We needed to manage difficulties faced with an increased patient cohort and case complexity, including mental health. Feedback demonstrated some patients found it difficult coming to MDT appointments without knowing who would be present. Triage Clinic helped to mitigate this. Young people with a lower level of need can be assessed virtually, have symptoms validated, receive advice and be discharged to appropriate care. Those with pain not managed by this reassurance are assessed within our service including, One-Stop-Shop, Adolescent Clinic for Rheumatology patients and Biomechanical clinic. Those requiring more support are referred to the MDT for intervention and education for serial day-case rehabilitation or more intensive intervention (PRIME). Ongoing challenges, such as severe mental health difficulties, mean some may not be ready to access support. We liaise with local services such as CAMHS, and patients may be reintroduced to the team later if appropriate. Discussion/Results: Our model showed improved outcomes compared to our previous service. We looked at data from 2018-2019 and 2021, removing the years involving the initial waves of the pandemic as the service adapted to the changes this brought. The physiotherapy Triage Clinic utilised our new Triage Model for the service. Following this we can discharge a portion of our patients to other services, some remain under the physiotherapy team, and the majority are seen in the Chronic Pain MDT clinic. It has been an opportunity, on initial consultation, to engage YP and their families and validate their pain. 22% of our patients had full school attendance on their initial review by our team. The average was a 59% attendance. There was an increase in 83% of those with initially reduced attendance following intervention with the chronic pain team. On average, attendance went from 44% to 71%. We saw a rise in the number of local services involved with young people under our care. Other services involved safeguarding teams, allied healthcare professionals and CAMHS teams. In 2018 on average, 1.4 services were involved;this increased to 1.8 in 2019 and 2.4 in 2021. This may be due to increased complexity of the cases we see or due to more local support requirements. Our plans following the MDT clinic increasingly show more specific goals and activities of daily living targets year on year, from 53% in 2018 to 0% having this as part of their plan in 2021. There have been regional development over the past three years of the service. We now have over 100 staff, including 43 local physiotherapists working collaboratively with our team in supporting the young people and their parents in our care. The Evelina team aims to lead regional meetings and communities of practice. Key learning points/Conclusion: With the limited available resources, our team is continuing to work towards managing a complex cohort of patients successfully. We were shortlisted for a British Society of Rheumatology Award for Best Practice following the changes made within our department. This QIP and our new model can be adapted to many other specialities and teams. Changes we have made are especially relevant following the impacts of the Covid-19 pandemic and continued pressure with reduced resources and increased demand. The virtual PEW allows for increased access for young people that previously struggled to attend face-to-face workshops in a timely fashion. The young people and their families benefit from improving their understanding of their pain and learning new strategies to manage it. Some patients find the virtual setting more practical as they miss less school and do not have to pay for costly transport to attend. Others miss the face-to-face interaction with peers who have similar difficulties. Both individual peer support and expert patients are areas we would like to explore as a service allowing the ripple effect of our model to continue. While improving the efficiency of some aspects of our service, we know that a further challenge is managing other 'bottle necks' created. From this conference, we hope our new model will be critically appraised and answer questions from our peers in other services. We look forward to learning from the experience of our colleagues who also work with this often complex cohort of patients.

'She didn't know how to go back': School attendance problems in the context of the COVID-19 pandemic-A multiple stakeholder qualitative study with parents and professionals.

BACKGROUND: The COVID-19 pandemic resulted in school closures worldwide and unexcused absences have increased since schools reopened. AIMS: Drawing on multiple stakeholders' perspectives, we aimed to (i) develop a detailed understanding of how school attendance problems (SAPs) have manifested for primary school-aged children in the context of COVID-19; and (ii) identify promising community-based intervention strategies. METHODS: We used a qualitative design with two sequential phases of data collection. Phase 1 involved insight generation using qualitative surveys with parents and professionals working in primary education settings. These results were used to guide in-depth stakeholder interviews in Phase 2. SAMPLE: Phase 1 included 29 parents of primary-school children experiencing SAPs and 19 professionals. Phase 2 included 10 parents and 12 professionals. Parents were recruited through social media; professionals were identified through schools and associated networks in Southern England. RESULTS: Attendance was particularly challenging for children with special educational needs and pre-existing anxiety problems. Compounding factors included COVID-related anxiety, difficulties adapting to new school routines, poor home-school communication and collaboration, and concerns about academic catch-up. Effective support was characterized by schools and families working closely together. Recommendations for practice improvements centred on early intervention, re-building parent-school relationships, peer support for parents, and improving special educational provision. CONCLUSION: New interventions for SAPs must be sensitive to the ongoing COVID-19 context. Help should be easily accessible in the community and address modifiable risk and protective factors for individual children, in family systems, and at the home-school interface.

School closures during COVID-19: Impact on childhood hunger and opportunities for long-term solutions

Millions of children face food insecurity in the United States. Schools play a major role in addressing the problem of food insecurity through the National School Lunch Program and the School Breakfast Program which provide meals to children at little to no cost. During the COVID-19 pandemic, schools abruptly closed leaving students without their primary source of nutrition. This chapter highlights responses from federal, state, and local agencies. Additionally, responses from local organizations and school districts are discussed. The researchers review a partnership built to address emergency food relief after the school closures. Data from an impact and need study conducted by the South Texas community partnership demonstrate gaps in programs which left the most vulnerable populations in severe need of assistance. This study reinforces the need for and importance of community partnerships to identify and address gaps in the current programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

School climate and culture impact on middle school students and their attendance

Numerous studies have been conducted on the impact school climate and culture has on student achievement, but little has been studied on how climate and culture impacts student attendance. This study focuses specifically on the teacher-student relationship, parent engagement, and school safety and how these three areas of emphasis affect student attendance. When students feel disconnected, parents are unengaged, and safety concerns are present within the school setting, attendance barriers are created for students. This mixed-methods explanatory approach provided researchers the opportunity to survey all middle school students and interview 10 individual students per grade level for further investigation into what barriers are present at Rural #0535 Middle School. Although the results from the student body were generally favorable, there were pockets of concern in each of the three areas that indicate the reasons why students are absent from school. With the impact of the COVID-19 pandemic, as well as chronic absenteeism, school leaders must identify ways to address the concerns identified within the investigations. Once identified, school administrators can begin to eliminate the obstacles that are hindering students from attending school. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Did We Deliver Quality Education in Online Sessions during Covid 19 Lock Down? Learner’s Perspective from a Developing Country

Objective: COVID-19 pandemic pushed unprepared educational institutes towards online sessions. Though equivalence of online sessions proved already in many studies before pandemic, unplanned sessions and inexperienced teachers with networking issues and novice software for online sessions could not meet the standard of teaching that was expected or experienced during these sessions. We planned this study to know perspective of learners to measure quality of online sessions and to find out factors which could improve these sessions in future. Design: Prospective questionnaire based study Place & duration of study: Hitec IMS Dental College, from 10th Feb 2022 to 10th March 2022 Methodology: Questionnaire was distributed to 150 students of BDS who has attended online session during COVID-19 pandemic. Results: 85% of the responders appreciated online sessions happening during pandemic to avoid wastage of time but as high as 50% students were of the opinion that teachers could not maintain standard of teaching as in on campus session. Factors for this dis-satisfaction of students included issues like connectivity issues, gadgets of students as well as teachers, novelty to softwares to attend online class, and psychological issues like depression. So at the end 83% of students preferred on-campus sessions on on-line sessions. Conclusion: On the basis of findings of this study, it is recommended that we should continue activity of online teaching with improvement in resources and train our staff and students even in the absence of such emergency.

Inequalities in Access to Care for the London Post Covid Syndrome Pathway for Children and Young People (Cyp)

Aims The London Post COVID Syndrome Pathway was set up in October in 2020 in order to meet the needs of children affected by persistent symptoms after SARS-CoV-2 infection. The UK CLoCk study (1), 11-17 years, showed high symptom prevalence, increasing from time of testing to 3 months (35.4% to 66.5% in SARS-CoV-2 positive cases and 8.3% to 53.3% in controls). ONS (2) data from a large, randomly selected population survey (April 2020 to August 2021) reported symptom prevalence 4-8 weeks after infection of 3.3% in primary aged children (vs 3.6% in negative controls) and 4.6% (vs 2.9%) in secondary aged. The Zoe Kings study (3) showed 1.8% of children had symptoms beyond 8 weeks after infection. The COVID pandemic has affected ethnic minorities and those in deprived communities the most. Here, we aimed to describe referral patterns and ascertain factors influencing inequalities in access to care. Methods We collected demographic and clinical data from our Post COVID clinics, from October 2020 to January 2022. Deprivation deciles were based on the Index of Multiple Deprivation (IMD 2019). Decile 1 represents the most deprived 10% (decile) in England and Decile 10 represents the least deprived 10%. Analyses were descriptive. Results A total of 86 patients were referred with persistent symptoms (median age 14, range 7-18). The female:male ratio was 1.5:1 (52:34). Ethnicity data was available for n=74. Of those 5% identified from Black backgrounds (expected 13.30%);9% Asian (vs 18.50%);12% Other Ethnic Groups (vs 3.40%), 7% Mixed Ethnic Groups (vs 5%) and 53% White (vs 59.80%). Median IMD score was 6, with mode =7 (London mean 3, mode =1). Conclusion Our data suggests children from more affluent (less deprived) areas are accessing the service, with an underrepresentation of males. A small number of patients were referred compared to those reporting persistent symptoms in national surveys. This may be due to a relatively lower number having impairment and/or a lack of awareness amongst professionals. Ethnicity data shows a lower number than expected Black (40% less) and Asian (50% less) backgrounds are accessing support. Since schools re-opened in September 2021 reduced school attendance has been reported for many children. Persistent symptoms are common post viral infection, and most children recover. However, for some these can be debilitating. If children have reduced school attendance due to persistent symptoms they need prompt access to care. Our study raises concern about access to Post COVID services for all children (particularly males and those from minority backgrounds), raising lack of awareness amongst GPs and schools as a possibility. Proactive case finding is needed, particularly in hardly-reached groups. NHS England has recommended a lead for supporting equality to help this and is in post. The numbers of children accessing care is smaller than the number reporting symptoms, an area that requires further study.

Assessment of eye pain symptoms among pediatric students during the COVID-19 pandemic

Purpose : Computer Vision Syndrome (CVS) is a form of asthenopia that manifests with symptoms such as eye pain/discomfort, headache, and blurred vision, among others. Early identification of CVS is especially relevant during the COVID-19 pandemic, which has led to an increase in virtual schooling and digital screen time among children worldwide. This study seeks to evaluate differences in etiologies of eye pain, treatment recommendations, and the relationship between refractive errors and eye pain in the pediatric population before and during the COVID-19 pandemic. Methods : After IRB approval, we retrospectively reviewed the records of patients who visited our tertiary care institution between 2018 and 2021 with a chief complaint of eye pain, determined by the encounter's primary ICD-10 code. Patients who visited before 03/11/2020, when the WHO declared COVID-19 a pandemic, were classified as the pre-pandemic group (PPG), while patients who consulted after this date were classified as the during-pandemic group (DPG). Demographics, symptoms, refractive error, treatment, and schooling method were recorded as covariates and analyzed using a Chi-square and Fisher's exact test. Results : 38 patients were included in the study (21 PPG;17 DPG). The mean age was 10.1 ± 3.2 years, and the majority were African American (44.7%). Virtual school attendance for the PPG and DPG was 4.8% and 58.8%, respectively (P<0.05) (Table 1). There was a higher prevalence of reported blurry vision, headaches, eye redness, eye swelling, and rubbing among DPG patients (Table 1). Counseling on screen time minimization was more likely to be documented in the DPG (Table 2). A greater proportion of patients were prescribed new glasses in the DPG though there was no significant relationship between eye pain and refractive error or anisometropia in either group (P>0.05). Conclusions : The increased prevalence of CVS symptoms in the DPG suggests an association between virtual schooling and CVS in children. There is a role for ophthalmologists to improve rates of counseling for the prevention of eye pain-related symptomatology with digital device usage. Further studies will survey parents to assess their awareness of conservative treatments for eye pain such as artificial tears and decreased screen time.

Increase in Psychiatric Care Needs of Rural Children Postcovid-19

Background: Due to the COVID-19 pandemic children were deprived of in-person attendance at school and experienced social isolation. The impact of these social-distancing measures on pediatric mental health is only now being unraveled. We conducted a descriptive review of psychiatric diagnoses at a pediatric outpatient practice in a Southern Illinois rural community. We compared the trends of pediatric psychiatric diagnosis before and following the COVID pandemic. Methods: Pediatric Group LLC has multiple office locations in Rural Southern Illinois catering to about 10,000 pediatric patients staffed by pediatric providers and a clinical psychologist. The pediatric population has remained stable during the period. The care providers and practices have remained unchanged over the past four years. We did a retrospective review of electronic health records from January 2019 through June 2021. Using ICD10 diagnostic codes, we analyzed the top 100 diagnoses made at the pediatric practice. Diagnoses were broadly classified into psychiatric and non-psychiatric categories. Psychiatric illnesses included anxiety, attention deficit hypersensitivity disorder (ADHD), conduct disorders, mood disorders, sleep disorders, and other psychiatric illnesses such as post-traumatic stress disorder (PTSD). Descriptive comparisons were made between pre-COVID (2019) and post-COVID (2021) periods. Results: Compared to a baseline of 5044 encounters in 2019 (pre-COVID), attendance was 9% lower (4680) in 2020. Attendance dropped by 14% (2206) in the first half of 2020, increasing by 11% (2474) to reach preCOVID levels in the second half of 2020. The attendances continued to increase in the first half of 2021, reaching 43% higher (3614) numbers compared to pre-COVID levels. Compared to 2019 and 2020, an increase in all psychiatric diagnoses was seen in our offices in the year 2021. Further analysis of the year 2021 showed significant increases in Anxiety and Depressive disorders, Oppositional Defiant Disorder (ODD), Disruptive Mood Dysregulation disorder (DMDD), and Major Depressive disorders (MDD) that almost doubled the statistics from the pre-COVID period. Sleep disorders and Post Traumatic Distress Disorder (PTSD) visits increased by far more than 150 percent. (Table 1) Conclusion: A steady increase in pediatric psychiatric illness has been noted in the second half of 2020 and first half of 2021 following COVID pandemic. We observed an increase by over two times with almost all the psychiatric disorders in 2021. The overall increase in the incidence of various pediatric psychiatric illnesses is concerning. We believe that the absence of in-school attendance may have played a significant role.

Home spirometry and virtual visits in children with cystic fibrosis – the child’s perspective

Objectives: Children with cystic fibrosis (CF) in Sweden are routinely monitored at the hospital more often than the recommended CF guidelines. The COVID-19 pandemic has challenged the healthcare system and the use of digital tools and virtual visits has rapidly increased. The aim of this study was to investigate how children experienced home spirometry (HS) and virtual visits. Methods: A prospective multicentre study including children aged 5–17 years from all 4 Swedish CF centres were conducted between May 2020 to November 2021. All participants received a home spirometer AirNext (NuvoAir,Stockholm, Sweden). Physical visits could be converted to virtual visits during the study and the children were instructed to perform HS prior to both virtual and a physical visits. An anonymous survey was conducted at the end of the study. Results: A total of 60 children with CF were included in the study. During the mean (range) study period of 6.8 (3.1–11.5) months, they completed on average 2.3 (1–4) virtual visits and 3.0 (2–4) physical visits. The survey was completed by 55 (92%) participating children with a mean age of 11.5 (5– 17) years. The virtual visitswere rated just as high as the physical meetings. No child felt more stressed with the opportunity to perform HS;on the contrary, some children (22%) felt less stressed with this possibility. After the introduction of HS, almost all children (98%) responded that they felt calmer or as before the introduction of HS. Half of the children responded that they nowunderstand their CF-disease better than before. Virtual visits reduced the burden of travel time to the hospital and shortened the mean time away from school up to 3.0 (1.3–4.0) days over a year. Conclusion: Home spirometry increased the understanding of the CF lung disease and did not cause more stress in children with CF. Virtual visits were very appreciated and provide a possibility to decrease school absenteeism due to fewer physical visits at the hospital.

Absenteeism and COVID-19: A mixed-methods case study of a New England school district with one-to-one device distribution

This mixed-methods case study aimed to explore absenteeism and attendance expectations in Caufield, a pseudonym for a New England school district that facilitated an overnight one-to-one technology distribution in response to COVID-19. The sample consisted of one middle school in a four-school district in Connecticut. This research study sought to understand attendance expectations and the access and use of technology in response to COVID-19. In addition, the study explored limitations to online learning due to the absenteeism of teachers and students. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

An examination of the impact of distance learning on course failures and GPAs of sophomore students in a suburban high school

The COVID-19 pandemic caused schools nationwide to open the 2019-2020 school year with educational options for students and parents. Distance learning has become increasingly popular with the ability to learn anytime and anywhere. Traditional learning provides face-to-face instruction with the ability for collaboration among students. This quantitative study compared the impact of virtual or face-to-face instruction on students' progress towards high school graduation. Specifically, this study investigated the effect the two instructional models had on course failures, grade point average, and attendance. Lastly, this study investigated the influence a tiered two intervention, Extended School Day, had on students identified as Off-Track students who had earned less than the required credits and had a grade point average below 2.0. Unpaired, two-tailed t-tests were used to determine the instructional model's impact on course failures, absenteeism, and grade point average. Archival data from a suburban high school from the 2019- 2020 school year was analyzed. The results showed that distance education students accumulated less course failures and better grade point averages for semester one. The results shifted towards traditional learning for semester two, and a Fisher Exact test was used to calculate the effect Extended School Day had on Off-Track students. The results demonstrated this two-tiered intervention benefitted those who attended by decreasing course failures thus increasing grade point average. These results suggested that distance education provided a better learning environment for students during the beginning of the 2019-2020 school year. However, traditional education impacted students more positively during the second semester. Therefore, distance education may be a good option during times of emergency, but it cannot be the only option for all students. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Remote Education/Homeschooling During the COVID-19 Pandemic, School Attendance Problems, and School Return-Teachers' Experiences and Reflections

According to Norway's Educational Act (2-1), all children and youths from age 6 to 16 have a right and an obligation to attend free and inclusive education, and most of them attend public schools. Attending school is important for students' social and academic development and learning;however, some children do not attend school caused by a myriad of possible reasons. Interventions for students with school attendance problems (SAPs) must be individually adopted for each student based on a careful assessment of the difficulties and strengths of individuals and in the student's environment. Homeschooling might be one intervention for students with SAPs;however, researchers and stakeholders do not agree that this is an optimal intervention. Schools that were closed from the middle of March 2020 due to the COVID-19 pandemic provided an opportunity to investigate remote education more closely. An explorative study was conducted that analyzed 248 teachers' in-depth perspectives on how to use and integrate experiences from the period of remote education for students with SAPs when schools reopen. Moreover, teachers' perspectives on whether school return would be harder or easier for SAP students following remote education were investigated. The teachers' experiences might be useful when planning school return for students who have been absent for prolonged periods.