Relation between young children's anger and fathers' mental health during the covid-19 epidemic: Moderating role of gender and child number

The father-child interaction deserves attention during the COVID-19 epidemic. This study administrated the Child Anger Questionnaire and the SCL-90 Symptom Checklist to collect primary data from 1862 fathers of Chinese young children during the COVID-19 outbreak, examined the relation between young children's anger and their fathers' mental health, and verified whether the relation was moderated by the gender or the child number. The results demonstrated that the detection rate of anger among Chinese young children was 60.08%, the scores of SCL-90 factors of their fathers were significantly lower than the Chinese normal adult male norms and those of infant parents, and the anger of young children had a significant effect on their fathers' mental health. Gender and child number moderated this relation. It is of great significance to strengthen the attention to the anger of young children and the mental health of fathers during the period of public health emergencies, and to promote the harmonious interpersonal relationship between young children and their fathers. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Fetal impact of cystic fibrosis transmembrane conductance regulator modulator use during assisted and natural reproduction and partner pregnancy in men with cystic fibrosis

Background: Increasing availability of highly effective cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator therapy (HEMT) has improved the quality of life and long-term prognosis for many people with CF. Thus, more people with CF are considering parenthood. Almost all menwith CF (MwCF) are infertile because of congenital bilateral absence of the vas deferens (CBAVD). Based on CF animal models, CBAVD occurs early in gestation and is unlikely to be reversible using HEMT, but assisted reproductive techniques (ARTs) can enable MwCF to father children using the sperm in their testes. Animal reproductive models suggest no HEMT teratogenicity, and the amount of exposure of the fetus to HEMT via absorption of seminal fluid through the vaginal wall is predicted to be negligible, although to ensure no sperm exposure to HEMT, the life span of sperm would require MwCF to discontinue CFTR modulators for approximately 3 months before ART. Because abrupt discontinuation of CFTR modulators may result in health decline, MwCF and their providers must consider all potential risks. There are no published data in MwCF regarding use of HEMT during conception and partner pregnancy. Method(s): Beginning in August 2021, CF center staff in the United States, United Kingdom, and Australia completed a two-page anonymous questionnaire regarding MwCF who used CFTR modulators during ART (sperm retrieval and in vitro fertilization) or natural conception with subsequent partner pregnancy. Result(s): Providers have submitted 34 surveys for MwCF on CFTR modulators whose partner became pregnant after use of ART (n = 32) or natural conception (n = 2). The median age of the samplewas 32 (range 24- 43). Fifteen were homozygous for F508del, median percentage predicted forced expiratory volume in 1 second was 76% (range (22-111%), and median body mass index was 24 kg/m2 (range 18.5-32.1). Twenty-three were taking elexacaftor/tezacaftor/ivacaftor. The median time that MwCF were taking CFTR modulators before partner conception was 18 months (range 0-82). One newly diagnosed man initiated HEMT after sperm retrieval. Four MwCF stopped CFTR modulators before sperm retrieval, one of whom experienced pulmonary decline. None of the 19 MwCF whose condom use during pregnancy was known used condoms. Fetal complications in partners of MwCF included three first-trimester miscarriages, two* COVID, two breech presentation, two* vaginal bleeding, and one vasa previa. None of the complications were deemed definitively related to use of CFTR modulators. One MwCF experienced testicular infection after sperm retrieval#. Postpartum complications included three# infants with hypoxemia requiring neonatal intensive care unit stay, three maternal blood loss, one forceps delivery, and one caesarean section. No congenital anomalies were reported for any infant. (*/# overlap). Conclusion(s): Use of CFTR modulator therapy during partner conception and pregnancy in 34 MwCF has not resulted in higher-than-expected miscarriage rates or congenital anomalies. Providers should consider the risk to the health of MwCF combined with the lack of teratogenicity in animal reproductive models and limited safety data in the human fetus before discontinuing CFTR modulators before ART or natural partner conception. Survey collection is ongoing;results will be updated for presentationCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Challenges and Results of Haploidentical Stem Cell Transplantation for Adult Patients in Cuba

The Hermanos Ameijeiras Hospital (HAH) in Havana is the only center performing allogeneic hematopoietic stem cell transplantation (HSCT) in adult patients in Cuba. Because transplants from unrelated donors are not possible due to political restrictions and economic embargo, in 2016 HAH and University of Illinois at Chicago (UIC) started a collaboration to support the training of a physician, annual educational programs and exchange of guidelines and protocols to perform haploidentical transplants. The first haploidentical transplant was performed at HAH in 2016. Because of limited resources, disease risk stratification is based on morphologic assessment, as cytogenetic is tested on an irregular basis. Peripheral blood stem cells (PBSC) were infused based on total nucleated cell count (TNC) due to lack of reagents for flow cytometry. Posttransplant chimerism and CMV monitoring cannot be performed. Transplant activity was stopped in 2020 due to high expenses allocated for COVID19 pandemic in Cuba. From 2016 to 2020, 16 haploidentical HSCT in 15 patients (9 males/ 6 females) were completed at HAH. The median age of patients was 34 years (range:21-54). Diagnoses included: acute leukemia, n=12, myelodysplastic syndrome, n=1, Hodgkin disease, n=1, and severe aplastic anemia, n=1. At the time of transplant, 11 patients were in morphologic remission and 5 had active disease. Conditioning regimens utilized were myeloablative (Flu/Bu) in 10 cases and at reduced intensity (Flu/Cy/ TBI200 +/- ATG) in 6 cases, and GVHD prophylaxis was standard PTCy on D3 and 4, CsA and mycophenolate. The donors were mother (n=10), father (n=1), child (1), or sibling (n=3) and the median age was 48 years (range: 26-68). All patients received fresh stem cells from PBSC(n=13) or bone marrow (n=3). Median cell dose infused was 5.5x108 TNC/kg (range: 2.2-8). All patients but 1 engrafted and median time to neutrophil and platelet engraftment was 17 days (range:12-28) and 16 days (range:11-30), respectively. Acute graft-versus-host disease (GVHD) grade 2-3 occurred in 50% of patients and chronic GVHD in 2 out of 8 that were evaluable. Day 100 and 2-year overall survival rates were 73% and 40%, respectively. With a medium follow-up of 18.8 months (range: 0.3-64), 5 of 15 patients (30%) are alive and complete remission. Causes of death in the remaining 10 patients included relapse of original disease, n= 4;bacterial infection, n=2;brain hemorrhage, n=1;VOD, n=1;graft failure, n=1;and multi-organ failure, n=1. Despite significant difficulties, HAH implemented a haploidentical transplant program for adult patients in Cuba. Among future steps, improving access to molecular testing and using younger donors will be pursued to improve on the results. The partnership between HAH and UIC has been instrumental in building clinical and research capacity and continues to support HAH in its mission to provide care to patients in Cuba.(Figure Presented)Copyright © 2023 American Society for Transplantation and Cellular Therapy

Current tobacco use and SARS-CoV-2 infection in two Norwegian population-based cohorts.

BACKGROUND: Clear evidence of an increased risk for SARS-CoV-2 infection among smokers has not been established. We aimed to investigate associations between cigarette smoking or use of snus (snuff) and other nicotine-containing products and a positive SARS-CoV-2 test, taking test behavior into account. METHODS: Current tobacco use and testing behavior during the pandemic were recorded by adult participants from the Norwegian Mother, Father and Child Cohort Study and The Norwegian Influenza Pregnancy Cohort. SARS-CoV-2 infection status was obtained from The Norwegian Surveillance System for Communicable Diseases (MSIS) in May 2021 (n = 78,860) and antibody measurements (n = 5581). We used logistic regression models stratified by gender and adjusted for age, education, region, number of household members, and work situation. RESULTS: Snus use was more common among men (26%) than women (9%) and more prevalent than cigarette smoking. We found no clear associations between cigarette smoking or snus and a COVID-19 diagnosis among men. Associations among women were conflicting, indicating that cigarette smoke was negatively associated with a diagnosis (OR 0.51, 95% CI 0.35, 0.75), while no association was found for snus use (OR 1.07, 95% CI 0.86, 1.34). Compared with non-users of tobacco, both cigarette smokers and snus users had increased odds of being tested for SARS-CoV-2. CONCLUSIONS: Cigarette smoking, but not snus use, was negatively associated with SARS-CoV-2 infection in women. The lack of an association between snus use and SARS-CoV-2 infection in this population with prevalent snus use does not support the hypothesis of a protective effect of nicotine.

A qualitative life course perspective on covid-lockdowns and couples? division of unpaid labour

Covid-19 lockdowns in many countries were characterised by increases in unpaid labour (e.g. home-schooling), as well as changing working conditions (e.g. remote work). Consequently, a large body of research assesses changes in dual earner couples' gender division of unpaid labour. However, despite the increasingly detailed picture of households' division of labour before and after the onset of the pandemic, it remains unclear how dual earner parents themselves perceive their decision-making regarding labour divisions during lockdowns. Conse-quently, using data from 31 individual in-depth interviews in Belgium, this study adopts a biographical -interpretative method to assess variation in narratives regarding the household division of labour before and during lockdown. Results indicate five ideal type narratives which vary in the extent to which lockdown divisions of unpaid labour exhibit path-dependency or constitute new gender dynamics, but also regarding the balance between individual agency and societal factors as determinants of labour divisions. Taken together, narratives discussing new gender dynamics during lockdowns put forward sector-specific changes in working hours and remote work as external and exogenous determinants. However, most importantly, findings indicate that household decision-making regarding unpaid labour during lockdowns is mostly perceived as path-dependent on pre-covid decision-making (e.g. gender specialisation) in the context of structural (e.g. gendered leave schemes) and normative boundaries (e.g. gendered parenting norms). Such path-dependencies in the decision-making underlying quantitatively identifiable divisions of unpaid labour during lockdowns are likely to be neglected in the absence of a qualitative life course perspective.

Work-family Reconciliation among Quebec Mothers and Fathers during the Pandemic: Findings and Recommendations for Quebec

Research Framework: The health crisis resulted in difficult situations for many workers, but especially for parents, who had to reconcile their work and family activities while the children were at home. Objectives: The objective of this research is to compare the work-family reconciliation of Quebec fathers and mothers before and during the pandemic. Methodology: We use survey data collected from Quebec working parents in 2018, 2020 and 2021. Results: Our results lead to three observations: 1) the existence of gendered effects of the pandemic on Quebec workers 2) the role of employers in the reduction of work-family conflict, and 3) a certain ease reported in work-family reconciliation during a pandemic. Conclusions: The transition to telework has reduced time conflicts for many parents, and a larger proportion of them feel they have an easy work-family reconciliation in 2020 and 2021, than in 2018. Contribution: Our research makes it possible to formulate recommendations to improve the support offered to Quebec families in terms of work-family balance. © 2022 Centre - Urbanisation Culture Societe de l'INRS. All rights reserved.

Father's role and responsible ownership: The case of three family businesses in Indonesia

This study aims to see the importance of the father's role and the responsibility of ownership in three family companies in Indonesia. The family company's success cannot be separated from the father's role, responsible as the family company's owner. The study used a qualitative approach method. This study is based on interviews with three different family companies. Our findings present that those fathers who have prepared early and involve the second generation in the family business are more adaptable to business. An interesting finding is that it depends, however, on the interests of the next generation. For example, if the next generation prefers operations, this is not easy to reconcile with their father's desire to focus on marketing. In the twenty-first century, especially during the COVID-19 pandemic, entrepreneurship has changed. The family businessman's role is increasingly important amid market dynamics so that it affects globally. © 2022 by Emerald Publishing Limited. All rights reserved.

Kidney Limited Complement-Mediated Thrombotic Microangiopathy- a Challenging Case

Introduction: Complement-mediated thrombotic microangiopathy (CM-TMA) is a rare disease characterized by microangiopathic hemolytic anemia (MAHA), thrombocytopenia and organ injury. The absence of hemolysis and thrombocytopenia is rare. We present a case of kidney limited CM-TMA successfully treated with eculizumab. Method(s): A 36 year-old man with poorly controlled hypertension, obesity, CKD (baseline creatinine (sCr) 2,6mg/dL, albuminuria 150mg/g), hyperlipidemia, obstructive sleep apnea, hyperuricemia, SARS-CoV-2 infection 3 months earlier, and family history of CKD of unknown etiology (father started kidney replacement therapy (KRT) at young age) presented to the ER with high blood pressure and right hemiplegy. Head CT scan showed left thalamo-capsular hemorrhage. Oftalmologic exam was normal. Laboratory findings were: hemoglobin (Hb) 12.5g/dL, elevated white cell count (17.900/uL), platelet count 214.000/uL, sCr 4.3mg/dL, lactate dehydrogenase (LDH) 303U/L. Urine dipstick revealed protein+ and Hb++. Chest X-ray showed signs of pneumonia. The patient was admitted in ICU and mechanically ventilated. After 3 weeks, renal function recovered to its baseline (sCr 1.5mg/dL, no proteinuria) without KRT, and the patient was transferred to the medical ward. Several infectious complications prolonged hospital stay. After 3 months, a new mild SARS-CoV-2 infection was detected. At this time: Hb 9.9g/dL, platelets 220.000/uL, sCr 2.2mg/dL. Six days later the patient showed Hb 9.5 g/dL, without reticulocytosis, platelets 195.000/uL, sCr 6.3mg/dL, LDH 348U/L, normal haptoglobin, no schizocytes on blood smear. After 3 days, the patient was anuric and sCr increased to 10mg/dL, prompting KRT. Kidney ultrasound showed no abnormalities. Autoimmunity study was negative, normal C3/C4, no monoclonal gammopathy, and negative viral serologies. Kidney biopsy (KB) was performed as the etiology of AKI remained unclear. Light microscopy revealed thickned glomerular capillary walls with subendothelial expansion forming double contouring, arteriolar intimal expansion and fibrin thrombi occluding the vascular lumina. Scarse C3 deposition was observed in capillary walls. Since the morphological features were consistent with TMA, secondary causes were excluded and primary causes also investigated: ADAMTS13 activity, complement factor B and I were within normal range, slight decrease of factor H with normal anti factor H antibody. The molecular studies of complement genes were performed by NGS-based gene panel revealing a rare heterozygous missense mutation on gene CFB, c.1189G>A (p.Asp397Asn), described as a genetic risk factor of CM-TMA in the presence of a trigger. Result(s): Treatment with eculizumab was started and the patient showed signs of kidney recovery allowing KRT suspension 1 month later (sCr 5.53mg/dL). Of note, the patient never presented MAHA or thrombocytopenia. After 5 months, renal function improved to sCr 3.9mg/dL. Conclusion(s): We report a case of CM-TMA with isolated kidney injury without laboratory hallmarks of TMA. Patients usually require a secondary trigger for the disease to manifest, and in this case SARS-CoV-2 infection may have been the causative agent. A mutation in gene CFB may have predisposed the patient to the outcome. KB was crucial for diagnosis and prompted the treatment with eculizumab with partial recovery without the need for chronic KRT. No conflict of interestCopyright © 2023

Fathering in the Chilean context: Wellbeing and father involvement pre and post the COVID-19 pandemic

We examined father involvement in two groups of two-parent Chilean families with children aged from 2 to 7 years, one prior to the pandemic (N = 115) and the second during the pandemic (N = 103). We first presented a description of fathering in the Chilean context and then examined potential predictors of fathers' cognitive and affective involvement. Data showed that during the pandemic fathers reported significantly higher levels of depressive symptoms compared to before the pandemic. However, levels of cognitive and affective involvement did not vary across studies. Parental stress predicted cognitive and affective involvement in pre-pandemic fathers. Number of children and educational level were related only to cognitive involvement. The implications of these findings for intervention and future research are discussed. © 2022 Associação Portuguesa de Psicologia.

Feminized vaccine? Parents' attitudes toward HPV vaccination of adolescents in Poland: A representative study.

In 2023, the process of gradually introducing universal, free HPV vaccination into the vaccination program for children in Poland began. For this reason, the attitudes of parents of adolescents toward these vaccinations were examined in this study. The survey was conducted among 360 parents of children (girls and boys) aged 9-15. To achieve the best possible representativeness of the sample, parents were selected for the survey using a random-quota method. The survey was carried out using the CATI. The surveyed parents declared a high level of knowledge about HPV and awareness of HPV vaccination (74.2% of parents had heard of HPV, and 61.4% had heard of the HPV vaccine). The study showed a statistically significant relationship between parents' education and knowledge of HPV infection - the higher the parent's (mother or father) education, the higher the declared knowledge. Education was also a statistically significant factor influencing the declaration of vaccinating a child against HPV. In addition to parental education, the gender of the child was also a significant factor influencing willingness to vaccinate against HPV. Parents of boys were significantly more likely - than parents of girls - to declare that they would not vaccinate their sons against HPV. A significant factor influencing declarations to vaccinate against HPV was the child's vaccination against COVID-19. The study results indicate a strong correlation between parental education and parental knowledge and attitudes about HPV and the HPV vaccine.

Art Play with Daddy: Father-Child Play with Art Materials at Home.

Paternal involvement in household and childcare has increased over the past century, but global studies show that most mothers still remain responsible for a significantly higher proportion of total household care and childcare. Moreover, the COVID-19 pandemic has further negatively impacted mothers, who take on the majority of childcare responsibilities. However, scholars agree that a father's devotion to playing with the child fosters the child's cognitive, linguistic, and socio-emotional development. Acknowledging and approaching art as a dynamic and integrated play, this qualitative case study investigates five South Korean father-child dyads and their interactions while playing with art materials. The participants engaged in three thematic art sessions designed by the author. Data collection involved audio and video recordings of each session, surveys of adult participants, and photos of finished artworks. The study found that fathers' varied educational backgrounds and perceptions of their abilities to facilitate arts learning influenced their confidence in teaching the arts at home. Furthermore, having a theme and prompting questions assisted the fathers to facilitate more focused art play. The art play also provided the father-child dyads with arts learning opportunities, including learning and distinguishing colors and recognizing stereotypes associated with colors. Moreover, one-on-one interaction between the dyads helped them build a more intimate bond. This study presents specific examples of art activities and participants' responses, which might offer insights and educational implications for paternal involvement in child play and thematic art play at home.

Parent resolution of diagnosis and intervention fidelity in a parent-delivered intervention for pre-school children with autism: A mixed methods study

Background: There is growing interest in parent-delivered interventions (PDI) for children with autism. Treatment fidelity has been associated with child outcomes in PDI but little is known about what impacts fidelity. One factor not previously examined is parents' resolution to the autism diagnosis which involves adjusting expectations about the child and sensitively responding to their cues, strengths and needs. Relatively little is known about resolution in the context of autism but there is evidence of an association between resolution and parent wellbeing. Method: The study adopted a mixed methods approach to examine whether there is an association between PDI fidelity and parent resolution to diagnosis, and whether resolution is associated with parent wellbeing. Parents of 31 preschool children diagnosed with autism who attended up to 12 Parent-delivered Early Start Denver Model (P-ESDM) coaching sessions participated in the study. A thematic analysis of parent interviews was also undertaken to identify themes raised by resolved and unresolved parents in interviews. Results: There was no difference in overall mean fidelity scores between resolved and unresolved parents. Those classified as resolved had lower depression scores and parenting stress scores than parents classified as unresolved. The qualitative analysis revealed that parents' perceptions of their child's progress and their hopes for the future appeared to distinguish resolved and unresolved parents. Conclusions: Findings suggest that parent wellbeing and child progress may predict resolution which was not related to parent treatment fidelity in this study. Parent wellbeing and resolution status should be assessed at entry to PDI.

Web-Based Conversations Regarding Fathers Before and During the COVID-19 Pandemic: Qualitative Content Analysis.

BACKGROUND: Studies of new and expecting parents largely focus on the mother, leaving a gap in knowledge about fathers. OBJECTIVE: This study aimed to understand web-based conversations regarding new and expecting fathers on social media and to explore whether the COVID-19 pandemic has changed the web-based conversation. METHODS: A social media analysis was conducted. Brandwatch (Cision) captured social posts related to new and expecting fathers between February 1, 2019, and February 12, 2021. Overall, 2 periods were studied: 1 year before and 1 year during the pandemic. SAS Text Miner analyzed the data and produced 47% (9/19) of the topics in the first period and 53% (10/19) of the topics in the second period. The 19 topics were organized into 6 broad themes. RESULTS: Overall, 26% (5/19) of the topics obtained during each period were the same, showing consistency in conversation. In total, 6 broad themes were created: fatherhood thoughts, fatherhood celebrations, advice seeking, fatherhood announcements, external parties targeting fathers, and miscellaneous. CONCLUSIONS: Fathers use social media to make announcements, celebrate fatherhood, seek advice, and interact with other fathers. Others used social media to advertise baby products and promote baby-related resources for fathers. Overall, the arrival of the COVID-19 pandemic appeared to have little impact on the excitement and resiliency of new fathers as they transition to parenthood. Altogether, these findings provide insight and guidance on the ways in which public health professionals can rapidly gather information about special populations-such as new and expecting fathers via the web-to monitor their beliefs, attitudes, emotional reactions, and unique lived experiences in context (ie, throughout a global pandemic).

Determining Screen Time of Children Between 3-9 Years During COVID-19 Pandemic And Investigation of Factors Related To Screen Time

Objective: The first COVID-19 case in Turkey was detected on March 11, 2020, and measures were taken to prevent the epidemic's progression. As the schools were closed and curfew was imposed on children with periodically updated bans, children had to spend more time at home during the day. In the study, we aimed to determine how the COVID-19 pandemic has influenced the screen time of children aged 3-9 in Turkey and examine the factors affecting screen time. Material(s) and Method(s): This descriptive cross-sectional study was conducted between May 3, 2020, and May 30, 2020. Throughout Turkey, mothers or fathers with at least one child between the ages of 3 and 9 were invited to the online survey via social media, telephone message groups, or e-mail. The parents who voluntarily answered the online questionnaire constituted the study participants. Result(s): A total of 9483 parents with children between the ages of 3 and 9 participated in the study. It was determined that 82.9% of the children participating in the study had increased screen time compared to the pre-pandemic period. The mean increase in screen time was 151+/-96 minutes/day. The increase was more than one hour per day in 74.9% of the participants (n=5122). The average daily screen time of the children participating in the study on the dates specified during the pandemic period was 193+/-124, the average time spent for online education was 67+/-62 minutes/day, and for leisure activities with the screen was 133+/-121 minutes/day. Screen time was significantly higher in children whose parent did not have a plan for child's screen use (OR: 3.085, 95% CI, 2.723 to 3.494, p<.001) or children who did not use the screen under parental control (OR: 1.533, 95% CI, 1.352 to 1.73, p<.001). Conclusion(s): During the pandemic, daily screen time increased in a significant number of children, and the time they spent in front of the screen was relatively high. The purpose and duration of screen use varied between preschoolers and school children. Parental attitudes and behaviors were related to children's screen time during the pandemic period. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

Alone (together): becoming a parent in the pandemic

This paper draws on the author's own experience of becoming a parent during the Covid-19 pandemic as a starting point from which to explore, and consider, how the experience of new parenthood was profoundly affected by the unusual and challenging circumstances created by the pandemic. Using a psychoanalytic lens, the author considers the legacy effects of Covid-19 restrictions and the atmosphere of heightened anxiety and danger, on the families who welcomed their first child in 2020 or 2021. The paper brings into focus the simultaneous experience of increased isolation and the withdrawal of support that would ordinarily be offered to new parents, along with the increased opportunities for closeness and early bonding this might bring, and considers how these factors might interrelate. It considers the changes to fatherhood that the pandemic created, and examines the benefits as well as pitfalls of the unusual circumstances brought about by successive lockdowns in the UK. The paper also explores the role that child psychotherapy has, as a profession, to examine and understand this experience for new parents and children born in the pandemic. Copyright © 2023 Association of Child Psychotherapists.

Health-related quality of life and metabolic control in children and young patients with type 1 diabetes and in their parents before and after the COVID-19 lockdown

Introduction: Italy was the first EU country to be affected by COVID-19 outbreak. The sudden change in everyday life was challenging for children and young people (CYP) who rely heavily on peer connections for emotional and social support. Concerns for consequences in CYP with type 1 diabetes (T1D) rose. Objective(s): To compare the diabetes-specific health-related quality of life (D-HRQOL) of CYP with T1D and their parents and the glycemic control before and after COVID-19-related lockdown. Method(s): The Pediatric Quality of Life InventoryTM 3.0 Diabetes Module (PedsQLTM 3.0 DM) was used to evaluate the D-HRQOL. Patients who filled the D-HRQOL before lockdown (December 2019-February 2020;T0) were recruited in the study and filled the same survey immediately after the lockdown was stopped (June 2020;T1) during a routine outpatient or telemedicine visit. Data on diabetic ketoacidosis (DKA), severe hypoglycemic events, insulin therapy [dose and delivery method (MDI/CSII)], glucose monitoring method (SBGM/isCGM/rtCGM), glycosylate hemoglobin (HbA1c), physical activity (h/week), and SARS-CoV-2 infection were also collected. Continuous and categorical data are reported as median and percentage, respectively. Result(s): Sixty-two CYP (males 48.4%;age: 12.6 [5.25-17.8] years;T1D duration 4.23 [0.45- 16.4] years;MDI 71%;rtCGM 52%, SBGM 29%, and isCGM 19%;telemedicine visit 56.5%) with T1D and their parents (60 mothers, 10 fathers) were enrolled. Patients' and fathers' scales scores did not significantly change from T0 to T1. Mothers' 'Diabetes symptoms' scale score increased (67.0 vs. 70.4;p=0.007). According to visit type (outpatient vs. telemedicine), glucose monitoring (SBGM vs. isCGM vs. rtCGM), and insulin therapy (MDI vs. CSII), D-HRQOL data were longitudinally comparable and no differences was found between groups. During lockdown no DKA, severe hypoglycemic events, and SARS-CoV-2 were recorded in patients. Despite the significant decrease of exercise from T0 to T1 (3.25 vs. 0.50 h/week;p<0.0001), glycemic control (HbA1c 58.5 vs. 57.9 mmol/mol) and total daily insulin dose (0.86 vs. 0.82 IU/kg/day) were unchanged. At T1, the lower the HbA1c, the better patients' 'Diabetes symptoms' (R=-0.41, p<0.001), 'Worry' (R=-0.27, p=0.032) scales, and total scores (R=-0.33, p=0.009). Similar results were found in parents. Conclusion(s): During COVID-19 pandemic-related lockdown the D-HRQOL did not change in CYP with T1D and their parents. During visits we stressed the importance to keep a balanced nutritional program, according to new time spent on exercise, making diabetes managements easier and allowing the maintenance of good glycemic control without acute complications.

Growth hormone deficiency and SHOX variants present in 2 siblings short for the family target

P1 was referred with short stature aged 2.4 yrs (HtSDS -2.1). Mother's height 165cm (+0.5 SD), father's 185cm (+1.55 SD). Growth hormone (GH) deficiency was diagnosed following two GH stimulation tests (peak GH 6.8 ng/ml at 3.2 yrs, 5.17 ng/ml at 3.7 yrs) IGF1 4.6 nmol/L (1.7-27.6) at 2.5 yrs. Pituitary MRI was normal. GH treatment was started at 5 years at HtSD -2.2. Once P1 demonstrated catchup growth (up one centile in 7 months), P1's older sister P2 was referred for investigation of short stature (HtSDS -1.5). She was not dysmorphic but her mother noted antenatal scans had short foetal femur lengths on the 5th centile. Birth weight was on the 10th centile at 2.65kg at 38 weeks gestation. Short stature was present from age 3 with height tracking along the 2nd centile. Her GH was 7.17 ng/ml at time 0 on a growth hormone stimulation test, IGF1 25.9 nmol/L (3.1 - 51.9). This was performed during the COVID pandemic and could not be repeated. It was felt that GH deficiency was unlikely so a skeletal survey was requested. This showed mild Madelung deformity and short 4th/5th metacarpals. Subsequent SHOX analysis revealed that she was heterozygous for 2 SHOX dosage abnormalities in cis. The first was a deletion located between 133 kb and 163 kb downstream of the SHOX gene. The second was a duplication that included the final exons of the SHOX gene (exons4-6a). Family testing revealed the same SHOX variants in P1's father, who was the smallest in class in early childhood and had grown late into adulthood, reaching a tall final height at aged 21. Mother and P1 did not have these SHOX variants. P1 has demonstrated excellent catch-up growth on GH treatment, HtSDS +0.4. IGF1 36.5 nmol/L (2.7-45.5) at 7.3 years. P2 has been on GH treatment for over a year, latest HtSDS - 1. Conclusion(s): Both siblings were short for the family target. Following a diagnosis of GH deficiency in one sibling, the investigative pathway for the other was assumed. Routine karyotype was performed after GH stimulation test with SHOX analysis requested after the skeletal survey report. The siblings' father has the same SHOX variants as P2 and is tall. Biological effects of SHOX deletion appears to be variable in this family and is present in P2 radiologically. The duplication is of uncertain significance.

Survey to Investigate Adherence to Growth Hormone Treatment in Children: The Impact of COVID-19 Pandemic

Introduction: Treatment adherence is crucial for the success of Growth Hormone (GH) therapy. Non-adherence rates have varied over a wide range from 5% to 80% in the literature. Several factors may have an impact on treatment adherence. Besides, with the COVID-19 pandemic that affected the whole world, there were problems with the hospital admission and routine controls of the patients who used GH treatment. Objective(s): The survey's primary objective is to investigate adherence to treatment in patients with GH. The survey will also investigate potential problems in GH treatment during the pandemic. Material(s) and Method(s): The survey was sent to pediatric endocrinologists. Patient data, diagnosis, history of pituitary surgery, current GH doses, duration of GH therapy, who administers the therapy (mother and father, patient), duration of missed doses, reasons for missed doses as well as problems associated with GH therapy, and missed dose data in the recent year (after the onset of the pandemic) and causes were asked. The treatment adherence category was determined based on missed dose rates over the past month (0 to 5%, full adherence;5.1 to 10% moderate adherence;>10% non-adherence). Result(s): 427 cases from thirteen centers were evaluated. The median age of diagnosis of the cases (56.2% male) was 8.5 (0.13-16) years. GH treatment indications were isolated GH deficiency (61.4%), multiple pituitary hormone deficiency (14%), Turner syndrome (7.5%), idiopathic GH deficiency (7.5%), and SGA (2.8%), and other (6.8%). GH therapy was administered by 70% parents and 30% patients. Mean daily dose was 32.3 mcg/kg, the annual growth rate was 7.52+/-2.7 cm. GH adherence rate was good (70.3%), moderate (14.7%), and poor (15%), respectively. The reasons for non-adherence were mainly due to forgetting, being tired, inability to access medication, and pen problems. It was noteworthy that the COVID-19 pandemic had a negative effect on adherence in 22%. The problem with an appointment, taking the medication, and anxiety about going to the hospital were the main reasons. There was no difference between genders in the adherence rate. Non-adherence to GH treatment decreased statistically when the patient administered the treatment, increased age, the duration of the treatment, and COVID-19 pandemia. A non-statistical decrease was found in the annual growth rate as the skip rate increased. Conclusion(s): During the COVID-19 pandemic, poor adherence was found to be 15%, and the duration of hormone use and advanced age are important factors. The pandemic period negatively affected compliance.

Paternal Mental Health and Parenting in the COVID-19 Pandemic Era

The COVID-19 pandemic has negatively affected the family economy by threatening job security, which has been acting as a source of stress for fathers. Social distancing has increased father-child interaction time and the burden of parenting. The parenting stress levels of fathers increased, and mental health problems such as depression and anxiety were induced. This was reported to be more serious in vulnerable groups, according to the race or socioeconomic status of the fathers. Fathers' mental health problems in the context of COVID-19 affect father-child relationships and children's adjustment in the long term. Healthcare professionals must develop community-based intervention programs to screen fathers' risk factors and educate them on mental health issues, while considering the changing roles and mental health of fathers during the pandemic. Before another epidemic breaks out. Copyright © 2022 The Author(s). Published by IMR Press.