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OBJECTIVE: To explore the experiences of a virtual group therapy programme for children with Osteogenesis Imperfecta (OI) who were unable to access face to face therapy due to a global pandemic. In a regional OI service up to 3 face to face 6-week therapy groups are offered for children during summer school holidays. Throughout the Covid-19 pandemic, OI children were at risk of deconditioning due to government restrictions in school attendance, exercise and socialisation. An alternative means of delivering therapy was required. METHOD(S): 30 families with school age children were invited to attend a virtual therapy group. Following initial interest from 21 children, 14 (age range 4-14 years) participated in a 5 week therapy group. Children were split into 3 age groups (4-7/8-12/13-14). Weekly 75 minute sessions comprised functional gross and fine motor activities. Educational elements with opportunities to explore thoughts and feelings were included. Each group were set a challenge to compete a virtual race from Bristol to Lands' End, recording their distance (walking, wheeling, cycling) throughout the week. Feedback was collected from participants and parents. RESULT(S): Feedback was received from 12/14 of attendees and parents and 4/7 who did not attend. Reasons for non-attendance included anxiety around video calls, other commitments and injuries. Of those that attended 100% (n=12) enjoyed the group and reported increased activity levels. Scavenger Hunt was cited as the favourite activity. 16.6% (n=2) children reported discussion on personal feelings uncomfortable. 16.6% (n=2) reported exercises were hard. 100% (n=9) of parents reported no significant difficulties with IT. Parent reported benefits included positive social interaction with other children with OI (66%, n=6), improving routine in preparation for school return (55%, n=5). Challenges for therapy team included identifying appropriate IT platform, choosing activities appropriate for various abilities and virtual instruction. Successes included time efficiency, full inclusion regardless of geographic location, increased activity levels of children with OI in preparation for school return. CONCLUSION(S): A safe, socially distanced method of delivering group therapy during a pandemic was achieved. Virtual therapy can be a useful adjunct, however this should not replace face to face therapy where possible.
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This study investigated the impact of COVID-19 related-anxiety on academics and absenteeism pre- and post-pandemic school years. The aim of this research was to investigate if anxiety impacted at-risk youths' (ethnically diverse high school students living in low-income areas) mental health during an important transitional stage of their lives following quarantine due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic. The sudden changes due to the COVID-19 pandemic, including pivoting to online learning, social distancing from peers, and a seemingly endless quarantine, increased students' uncertainties, and anxiety (Besser et al., 2020). This study further investigated gender differences in youths' anxiety response to COVID-19 as prior research indicates that females tend to be at higher risk for anxiety following trauma. This researcher recruited 99 high school students (grades 10-12) from a local, low-income suburban/rural high school with an ethnically diverse population. Findings indicated that COVID-19 related-anxiety impacted female students significantly more than male students upon returning to in-person learning (p = .05). In addition, COVID-19 related-anxiety had a positive correlation with State-Trait Anxiety scores. Results did not indicate significant changes due to COVID-19 related-anxiety on absenteeism, GPA or ELA grades upon returning to in-person learning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background Children's routines have been disturbed during the last 2 years due to national lockdowns with school closures. It is acknowledged that daily routine is important for a healthy bowel habit and we therefore had concerns that this may have a detrimental effect on children with constipation. Aim of Study To examine the effects of lockdown due to COVID19 on children's symptoms of constipation. Method Prospective data was obtained by questionnaires, which were handed to 50 children and parents attending a childhood constipation clinic in the normal way following the easing of lockdown. The questionnaires asked about symptoms that would normally be asked in the clinic appointments. Parents were asked if the child's symptoms had become worse, improved or stayed the same and asked respondents to give reasons for their answers. The questionnaires were then collated and common themes noted. Ethics approval was not required. Results 38% of parents reported improvement in symptoms 34% of parents reported deterioration in symptoms 28% of reported no change in symptoms. The reasons given for improvements in symptoms included an increase in the ability of parents to monitor children's fluid intake and toileting routines at home, easier access to toilets and less with holding behaviour, usually adopted to avoid using school toilets. These children were also reported as being generally more relaxed and happier to be at home. Of note in this group were reports that symptoms often deteriorated on returning to school. The reasons given for a deterioration in symptoms included a lack of physical activity, lack of routine in toileting and taking medication, and changes in diet. This group also commonly included reports of children and parents experiencing anxiety, isolation, anger and lack of motivation. The most common symptom to be reported as problematic was children either beginning to soil or their soiling becoming more frequent. Most who gave reasons in the group reporting no change did recognise some of the above observations and in some cases positive aspects such as easier access to toilets were counterbalanced by lack of exercise. Summary Many reasons for changes in symptoms of childhood constipation during the national lockdowns were reported. There was a balance, with almost equal numbers, reporting improvements and a worsening of symptoms. Others did not notice any change in their child's condition. Physical, behavioural and emotional reasons were cited as being responsible for changes in children's experience of constipation. Conclusion Lockdown due to COVID19 has had a varied effect on symptoms of constipation in children. The assumption that children's constipation would become worse has been challenged in that slightly more children improved during this time with some then deteriorating again when lockdown was eased. These results re-iterate the need to tailor approaches to treatments and care of children with constipation on an individual basis. It is also important to equally understand the anxieties of being in school for some but the effects of social isolation and uncertainty for others.
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Resumo Os movimentos de reassociação e de reagregação no retorno à presencialidade na escola, após um período de fechamento durante a pandemia de covid-19, são o foco deste estudo. Discutimos os achados de uma etnografia em uma escola pública de Porto Alegre, que teve como objetivo descrever e analisar os atores em ação na reorganização dos laços educativos nas aulas de Educação Física no retorno à presencialidade. O trabalho empírico permitiu organizar as descrições e análises em três trajetórias: 1) A busca por laços firmes; 2) Intencionalidades e estratégias sobre a 'prática'; e 3) Laços de confiança como estratégia e compromisso docente. Enquanto alguns laços visavam compensar possíveis déficits educativos apostando em dispositivos autoritários e punitivos em vista da compulsoriedade da dimensão "prática" e possibilitando pouco espaço para as emoções e a saúde mental, outros incidiram na construção de laços de confiança como estratégia educativa e como ação política necessária.
Abstract The reassociation and reaggregation movements in the return to school, after a period of closure during the COVID-19 pandemic, are the focus of this study. We discuss the findings of an ethnography in a public school in Porto Alegre, which aimed to describe and analyze the actors in action in the reorganization of educational bonds in Physical Education classes in the return to presence. We organized the descriptions and analyses in three trajectories: 1) The search for firm bonds; 2) Intentions and strategies about "practice"; and 3) Bonds of trust as a teaching strategy and commitment. While some bonds aimed to compensate for possible educational deficits by betting on authoritarian and punitive devices in view of the compulsory nature of the "practical" dimension and allowing little space for emotions and mental health, others focused on building bonds of trust as an educational strategy and as a necessary policy.
Resumen Los movimientos de reasociación y reagrupación en la vuelta a la actividad presencial en la escuela, tras el cierre durante la pandemia de Covid-19, son el foco de este estudio. Discutimos los hallazgos de una etnografía en una escuela pública de Porto Alegre, que tuvo como objetivo describir y analizar los actores en la reorganización de los vínculos educativos en las clases de Educación Física en la vuelta a la actividad presencial. El trabajo empírico permitió organizar las descripciones y análisis en tres trayectorias: 1) La búsqueda de vínculos firmes; 2) Intencionalidad y estrategias sobre la 'práctica'; y 3) Lazos de confianza como estrategia y compromiso docente. Mientras algunos vínculos buscaban compensar posibles déficits educativos apostando por dispositivos autoritarios y punitivos ante la obligatoriedad de la dimensión 'práctica' y dejando poco espacio para las emociones y la salud mental, otros se centraron en la construcción de lazos de confianza como estrategia educativa y como acción política necesaria.
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Despite being preventable, approximately 800,000 people die by suicide each year worldwide. Evidence suggests that suicide rates decrease during crises, but once the immediate threat passes, suicide rates are expected to increase. The COVID-19 pandemic likely affects risk and protective factors for suicide. Studies show mixed results regarding whether suicide behaviours have increased among adults during the pandemic. The results are however different for young people. An increase in suicidal behaviours has been identified in some countries among young people after lockdown period and when returning to schools. Data also suggests that there may have been a rise in deaths by suicide among those younger than 18 years in China, and during the first phase of lockdown in the United Kingdom. Studies have found significant decreases in hospital admissions for suicidal behaviours and visits to emergency departments both for adults and adolescents. Suicide can be prevented if evidence-based methods that exist are implemented in a systematic way.
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The coronavirus disease 2019 (COVID-19) pandemic has caused many problems in the health and education of children. For most children, the benefits of returning to school (im-proved access to education, fewer psychological problems, social interactions, economic aspects) outweigh the risks of COVID-19. The proper functioning of educational institutions is influenced by many factors depending on the type and capacity of the given school, the involvement of the management and the teaching staff, as well as the parents. Howev-er, the most important issue is to provide the authorities of educational institutions various possibilities of their functioning and available preventive measures, so that they can devel-op a management plan that will enable proper education and reduce the risk of COVID-19. The paper presents recommendations based on the latest recommendations of the World Health Organization (EHO), the United Nations Children's Fund (UNICEF), the Center for Disease Prevention and Control (CDC), the European Center for Disease Prevention and Control (ECDC), the European Agency for Safety and Health at Work (EU-OSHA) and scientific societies such as the American Academy of Paediatrics (AAP) and the European Academy of Pediatrics (EAP). The paper pays attention to the safe return of children to school, the organization of school work, and flu vaccinations. Another key issue discussed is the necessity of such political strategies of both central and local authorities, that will shape the well-being of our societies in the years to come, and that will make the world better for children, was also emphasized. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
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INTRODUCTION: ACL reconstruction is commonly performed in school-aged patients for whom missed time from school can have an impact on their education. Additionally, the COVID-19 pandemic has led to different ways of accessing school content. We sought to determine how many days of school school-aged patients should expect to miss following ACL reconstruction and how the availability of remote learning during the COVID-19 pandemic affected this. METHODS: We evaluated 53 ACL reconstruction patients in grades 7-12 undergoing surgery during the school year. Demographic, medical, and educational information were collected. Patients were placed into 1 of 2 cohorts: Group A (surgery before the COVID-19 pandemic) or Group B (surgery during the COVID-19 pandemic). We calculated days missed from school after surgery until return to either virtual or in-person school. RESULTS: Overall, patients returned to school after missing an average of 4.4 (SD, 3.0) days of school after ACL reconstruction surgery. Patients in Group A missed an average of 5.5 (SD, 2.9) school days, while patients in Group B missed an average of 2.3 (SD, 1.4) school days (p <.001). Eighty-nine percent of Group B patients first returned to school utilizing a virtual option. Among those returning virtually, these patients missed an average of 1.9 (SD, 0.9) school days. CONCLUSIONS: A virtual distance learning option results in fewer missed days of school post ACL reconstruction. When given this option, school-aged patients can expect to return to school within two days post-op. Otherwise, patients should expect to miss about one week of in-person schooling. In this regard, the COVID-19 pandemic has positively impacted educational opportunities for students post-surgery, and physicians should advocate for continuing virtual options for students receiving medical treatment.
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Aims Background Child and young person (CYP) mental health is a public health priority with 75% of life long mental health problems starting before the age of 25.1 Prevalence of all mental health disorders among children aged 5-15 years is 11.2%.2 Aims * To highlight current in-patient numbers and pathway, from initial presentation to discharge. * Identify any changes that can be made to improve care foryoung people admitted with mental health presentations Methods Patients were identified from daily handover sheets from January 2019 to April 2021. Information on each patient was gathered using electronic patient record. Information gathered included: 1. Number of CAMHS inpatients broken down by age, gender and diagnosis. 2. Patient pathway including time spent waiting in A&E 3. Use of Registered mental health nurse (RMN) 4. Treatments provided on ward 5. Daily review by peadiatric and CAMHS team 6. Length of stay 7. Place of discharge Results 231 CYP admitted under CAMHS between January 2019 and April 2021. See figure 1. Of these admissions 86% were female. 27 patients accounted for a fifth of admissions. Average age at admission 14 years (8-16 years). IntentionalOverdose was the most common reason for admission. See figure 2. Due to changes in computer systems, complete information regarding patient stay was available for patients between April 2020 to April 2021. 72% of patients beached four hour ED wait of which 80% due to waiting for RMN to become available. 86% of patients required an RMN. 13% of patients were under section at some point during admission. Fifth of patients were discharged to tier 4 services. Average time from admission to discharge was 10 days. The longest admission was 264 days. 97% of patients had daily paediatric reviews and 80% of patients had a daily CAMHS reviews. 62% of patientsengaged in alternative therapy during their stay. Eg art therapy or youth support worker. Conclusion Admission rates dropped during the first COVID 19 lockdown and rates tend to be lower during summer months. There tends to be increased mental health admission following return to school in September. Eating disorder patients tend to have more prolonged inpatients stay due to waiting for Tier 4 bed availability. Lack of RMNs lead to prolonged wait time in ED prior to admission. A mental health awareness teaching week was delivered to the department to encourage the team to carry out HEADSSS assessment for all young people admitted and tailor services around the YP to help improve care of patients with mental health issues. (Figure Presented).
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Aims To review the glycaemic control of type 1 diabetic patients attending the paediatric and transition adolescent diabetes clinic within NHS Lanarkshire during the coronavirus pandemic. Methods A quantitative analysis of 348 patients attending the paediatric and transition adolescent diabetes clinics within NHS Lanarkshire was carried out. Data collected included age, sex, date of diagnosis and insulin delivery device. Comparing these measures to the Scottish Index of Multiple Deprivation (SIMD) of the patient. Patient data was anonymised within a single data collection sheet. Results 94% of patients across both clinics (n=298) attended a consultation during lockdown, before returning to school in August. Within the paediatric diabetes clinic, results from 199 patients were analysed. 30.65% (n=61) patients experienced a rise in their HbA1c over lockdown whilst 65.32% (n=130) of patients reduced their HbA1c. In this cohort, the mean HbA1c before lockdown compared to after lockdown was 3.77mmol/mol (95% CI 1.93, 5.61;P=0.000). 90 sets of patient data were analysed from the transition adolescent diabetes clinic. 27.78% (n=25) of patients had a rise in their HbA1c and whilst patients from this clinic gained tighter glycaemic control over lockdown. The mean HbA1c pre-lockdown compared to post-lockdown in this clinic reduced by 4.67mmol/mol (CI: +1.35, +7.99, P= 0.006). Patients residing in SIMD quintiles 3-5 had the greatest improvement in HbA1c over lockdown. Conclusion Glycaemic control of patients within the NHS Lanarkshire paediatric diabetes clinics improved over lockdown. There was a mean reduction in HbA1c over the lockdown period. Repeating this audit in a year would be beneficial to see how returning to school and further local lockdowns affected the glycaemic control of paediatric patients.
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Aims Post COVID-19 condition is defined by the WHO as a 'condition (which) occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis and generally have an impact on everyday functioning [1].' South Tees' Paediatric Post COVID-19 Assessment Clinic is one of fifteen tertiary paediatric clinics commissioned in England for the multidisciplinary assessment of children and young people (CYP) with suspected post COVID-19 condition. To assess patient data from clinic to identify any patterns of susceptibility and contextualise data in terms of the national picture. Methods Data was obtained from the referral form, clinic notes and service evaluation tool. Results In the period from July 2021 to February 2022, twelve CYP completed assessment. (See figure 1 for referral and assessment pathway). Of the assessed patients, eleven were of white and one of mixed ethnicity, seven were female and five male, three were between 6-11 years, six between 12-15 years and three between 16-18 years. Four were classified as being from a deprived location defined by living in a postcode that was classed as quintile 1 or 2 in the indices of multiple deprivation. Chronic fatigue and 'brain fog' were the two most common symptoms. However, symptoms like tinnitus (one child) and chronic chesty cough with wheeze (one child) were also noted. Four patients have still not managed full-time return to school. Two of these have attendance below 25%. Conclusion Though our experience was in line with national figures in terms of symptom profile, increased prevalence in females and teenagers [2], total number of referrals for assessment is significantly lower than expected. From the local area CYP population estimates [3] and most recent Office for National Statistics 'self-reported long COVID survey' results [2], we would have expected to see significantly higher numbers of patients with post COVID-19 condition (~150-250 patients under 16 years of age at the lowest estimate) but this is not the case. It is possible that symptoms reported in the survey are not severe enough to have significant impact on daily living warranting referral. The reduced referral numbers could also be due to reduced awareness (clinicians and community) or symptoms being attributed to other causes resulting in non-referral to appropriate services. Despite small numbers, one third of CYP seen in clinic continue to have multiple symptoms and have not been able to return to full-time education. This would have significant impact on long-term health and wellbeing of these CYP. There is an urgent need for research to find rehabilitation and therapeutic strategies for these CYP. 1. 'A clinical case definition of post COVID-19 condition by a Delphi consensus'. (2021) World Health Organization. 2. 'Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK'. (2022) Office for National Statistics. 3. 'Local population diversity'. (2018) Middlesbrough Council.
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Purpose: To date studies of children with a kidney transplant and COVID-19 are limited. The Improving Renal Outcomes Collaborative (IROC) is a learning health network in the US comprised of 36 pediatric kidney transplant programs that provides infrastructure to efficiently conduct multicenter studies. Method(s): We collected COVID-19 testing, indications, and outcomes data. Data were linked to patient demographic and clinical data in the IROC registry. We previously reported the results of this effort from April 6-September 3, 2020 (era 1). Here we report data from September 4, 2020 - February 28, 2021 (era 2). We describe the differences in testing frequency and positive testing over the two eras. Result(s): In era 1, 22 centers submitted testing data;in era 2, 21 centers submitted testing data. There were 281 tests in 281 patients analyzed in era 1 and 648 tests for 465 patients in era 2. From era 1 to era 2, the proportion of positive tests increased from 24/281 (8.54%) to 109/465 (23%). Testing frequency and results from eras 1 and 2 are displayed in Figure 1. 133 patients tested positive for COVID-19 over both eras, and there was no difference in the symptoms at the time of testing between the two eras. The most common symptoms for both eras were fever (35%), cough (33%), rhinorrhea (23%), vomiting (14%), and diarrhea (14%). Over both eras, 41/133 (31%) that tested positive for COVID-19 had no symptoms at the time of testing. There were no differences in outcomes between the two eras. 117 patients (88%) had no transplant complications. 1 (0.8%) patient had T cell-mediated rejection, 3 (2%) had antibody-mediated rejection, 1 (0.8%) had mixed T cell- and antibodymediated rejection, 10 (7.5%) had acute kidney injury, 1 (0.8%) experienced graft failure, and 1 patient (0.8%) died from their COVID-19 infection. Conclusion(s): In this cohort, there was overall more testing and more positive COVID-19 tests in era 2. The dates of era 2 correspond with children returning to school and the Winter surge in cases in the US. Despite the increased number and proportion of positive patients, the clinical outcomes are consistent with reported outcomes for their non-immunosuppressed peers. Follow-up studies will be required to evaluate whether the availability of vaccines for adolescents and the rise of the delta variant as the predominant strain affect clinical outcomes. (Table Presented).
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Objective: To understand the emotion and sleep state of youths and adolescents who returned to school during the mild period of COVID-19. Methods: A total of 1621 subjects were investigated using the self-made information questionnaire, SAS, SDS and Pittsburgh Sleep Quality Index (PSQI). Nvivo12.0 and SPSS23.0 were used to analyze the data. Results: The subjects reported boredom, worry, nervousness. There were significant differences in sleep quality index in terms of gender, residence status, time of reading news of COVID-19, and time of communicating with parents (P<0.01). The sleep quality index (4.67±3.12) of college students was lower than the norm (5.8±2.4) (P<0.001), the SAS score (42.87±9.94) of teenagers was higher than the norm (29.78±10.07) (P<0.001), and the SDS score (47.64±11.34) of youths and teenagers was higher than the norm (33.46±8.55) (P<0.001). During this period, PSQI was significantly positively correlated with SAS score and SDS score, and effectively predicted SAS score and SDS score. Conclusion: During the stage of work and school resumption, the emotional state of youths and teenagers was still affected, but presented positive characteristics, with a variety of positive emotions. Compared with the general state, youths and teenagers showed higher depression and anxiety, but sleep quality of college students was better than that in the general state.
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BACKGROUND: This study investigated the impact of coronavirus disease 2019 pandemic school closures on the mental health of school students with chronic diseases. METHODS: Questionnaires were distributed to students from 4th-9th grade diagnosed with chronic diseases at Osaka Medical College Hospital and their parents or caregivers. Questionnaires from 286 families were returned by mail after the schools reopened. The students were divided into the "psychosomatic disorder" group (group P, n = 42), the "developmental disorder" group (group D, n = 89), and the "other disease" group (group O, n = 155). Using students' self-reports on the Questionnaire for Triage and Assessment with 30 items, we assessed the proportion of students with a high risk of psychosomatic disorder in three groups. We investigated how the students requiring the support of somatic symptom (SS) felt about school during school closure. Further, using parents' and caregivers' answers, SS scores were calculated before and during school closure and after school reopening. RESULTS: The proportion of students with a high risk of developing psychosomatic disorder increased in all groups. For the students in Group P, the response "I did not want to think about school" indicated an increase in SS scores, and for the students in Group O, "I wanted to get back to school soon" indicated a decrease. Furthermore, especially in Group P students, SS scores decreased transiently during school closure and increased after school reopening. CONCLUSIONS: The impact of school closure on mental health differed depending on students' diagnoses and feelings about school during school closures.
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COVID-19/epidemiology , Mental Health/statistics & numerical data , Schools , COVID-19/prevention & control , Child , Chronic Disease , Developmental Disabilities/epidemiology , Humans , Japan/epidemiology , Pandemics , Psychophysiologic Disorders/epidemiology , Risk Factors , Surveys and QuestionnairesABSTRACT
Introduction: The COVID-19 pandemic significantly disrupted the daily lives of children and adolescents. This study aimed to characterize sleep and mood during COVID in youth with asthma and/or eczema at two times: shortly after the lifting of stay at home orders (Summer 2020 [T1]) and after youth returned to school (Winter 2021 [T2]). Methods: Pediatric PROMIS measures (Sleep Disturbances, Sleep- Related Impairment, Anxiety, Depressive Symptoms) and the Pediatric Sleep Practices Questionnaire were administered through REDCap. Parents of younger children (YC, 5-7 years, n=16) completed proxy measures for their children, while older children (OC, 8-12 years, n=16) and adolescents (ADOL, 13-17 years, n=17) completed self-report measures. Results: For YC, mean Sleep Disturbances T-scores significantly decreased between T1 and T2 (62.0 vs. 56.4, p=.02), with no significant changes in the other variables. For OC, there were no significant changes in mean T-scores for any of the outcomes. For ADOL, there was a significant increase in Sleep-Related Impairment between T1 and T2 (52.0 vs. 57.7, p=.003), as well as a significant increase in Depressive Symptoms (48.2 vs. 52.5, p=.04). At T1, technology use prior to bedtime was more common in ADOL (YC=37.5%, OC=37.5%, ADOL=88.2%). At T2, technology use was also more common in ADOL (YC=50.0%, OC=37.5%, ADOL=64.7%), with an increase in YC technology use and a decrease in ADOL technology use observed. Parental presence while falling asleep was greatest in YC at both time points, with no noted changes in any group across time (T1: YC=56.3%, OC=18.8%, ADOL=17.6%;T2: YC=50.0%, OC=25.0%, ADOL=11.8%). Conclusion: This study was limited by a small sample size, but provides some insights into the sleep and mood of children and adolescents with allergic disease during the first year of the COVID-19 pandemic. Although YC had fewer sleep disturbances at T2, there was an increase in technology use prior to bedtime. For ADOL, some of the changes in sleep, technology use, and depressive symptoms were likely due to the return to school at T2. Finally, it was notable that multiple OC and ADOL required parental presence to fall asleep. Additional research is needed to understand how the ongoing pandemic is impacting children and adolescents.
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Introduction: Low-intensity aerobic training has demonstrated to be beneficial in patients with Duchenne muscular dystrophy (DMD). Aerobic exercise counteracts physical deterioration. Daily exercise (walking to and back from school, playing in the park, etc) is supposed to have a big influence on the muscular state of the patient, but its importance has never been studied before. 6MWT is a primary endpoint for DMD and a strong predictor of decline in ambulation. In Spain, because of the COVID situation, the Spanish population was confined to their home on 14th March 2020. Children could start to go for a walk from April 26th, but they didn't go back to school until September 2020. Patients and methods: DMD children visited in Hospital Sant Joan de Deu with: (1) Previous basal 6MWT (6MWT pre): June 2019;(2) 6MWT pre-confinement (6MWT basal): December 2019;(3) 6MWT post-confinement (6MWT post): June 2020. We analyzed the meters' difference between 6MWT pre and 6 MWT basal, compared with the meter's difference between 6 MWT basal and 6MWT post. Results: 28 DMD children: age: 6-17 years. Meters' difference between 6MWT pre-6MWT basal: average- 1.08, standard deviation 45.97, minimum-157, median 8.50, maximum 93. Meters' Difference between 6MWT basal-6MWT post: average- 34.62, standard deviation 48.26, minimum-124, median- 28.50, maximum 106. The differences are statistically significant (p = 0.006 Wilcoxon test). Conclusion: DMD children presented a bigger deterioration in the 6MWT after confinement. These results support the importance of avoiding a sedentary lifestyle to preserve ambulation and slow down the disease.
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Background The Covid-19 pandemic and the implemented sanitary measures signifi-cantly impact adolescents in several essential areas of their lives. Young people with a migration background are a vulnerable population facing additional challenges compared to others of the same age, and little is known about their experience during this pandemic. The aim of the study is the describe their perspective. Methods Adolescents were recruited at the pediatric outpatient clinic at the Uni-versity Hospital of Lausanne, in the French part of Switzerland. Thirteen interviews were conducted from November 2020 to January 2021. Inclu-sion criteria were: age between 14 and 19 years old, having lived in Swit-zerland for less than 10 years, and being fluent in French or English.A the-matic content analysis was performed to extract themes and topics. We compared our results with other studies among adolescents. Results Thirteen adolescents (9 females and 4 males) from 4 countries partici-pated in the study, with a median age of 16 years. Three of them were living in migrant reception centers. They had been living in Switzerland for an average of 2.3 years. They encountered difficulties in understanding COVID-19 related infor-mation shared with them, whether it was about the virus or related to the lockdown. Sanitary measures were extremely well respected. Remote learning was described as stressful due to a lack of access to computers or other hardware, lack of understanding of homework, or limited space in the housing. For those living in migrant reception centers, sharing com-mon areas and proximity with other people was very difficult. Adolescents were generally used to spending a lot of time with their families. Some youths were very isolate and did not notice any difference in their social lives during the lockdown. For example, communication using social net-works with their friends abroad continued as usual. Several revealed dif-ficulties in returning to school, notably challenges in learning French or finding an apprenticeship position. Conclusions Migrant adolescents share similar experiences to youth of the same age but present greater challenges in some areas like the understanding of information, or difficulties in their education and social life. In the event of further lockdown, special attention must be paid to this population to ensure their proper development and integration. A global follow up of this young population during and after the pandemic is needed.
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Introduction: The COVID-19 pandemic forced most Kansas schools to adopt remote or hybrid learning in 2020-2021. Wichita Collegiate School proceeded with an in-person teaching model. The purpose of this study was to determine if in-person learning can be done safely during the COVID-19 pandemic prior to vaccine use. Methods: Wichita Collegiate is a private school located in Sedgwick County, Kansas. The study population included 671 students (grades 1 - 12) and 130 staff. The procedures implemented during the school year (August 19, 2020 - May 21, 2021) included: mandatory face coverings, six feet physical distancing, and daily temperature checks. A registered nurse performed contact tracing and executed quarantine requirements per the U.S. Centers for Disease Control and Prevention guidelines. Results: Over the study period, 487 students and staff were tested for COVID-19 and 18.5% (n = 90) were positive. Overall, students and staff rate of COVID-19 infection was lower than the expected rate when compared to the surrounding community of Sedgwick County. Thorough contract tracing of positive cases revealed that 2.2% (n = 2) individuals were likely exposed to COVID-19 at school. Conclusions: This study suggested that transmission of COVID-19 was infrequent in a school setting with in-person attendance, even before widespread vaccine availability. By following public health guidelines and utilizing contact tracing, it was possible to limit the spread of COVID-19 during in-person learning. This has immediate implications for how schools safely returned to in-person learning in the post-vaccine era.
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This paper considers the role of school closures in the spread of the SARS-CoV-2 virus. To isolate the impact of the closures from other containment measures and identify a causal effect, we exploit variation in the start and end dates of the summer and fall school holidays across the 16 federal states in Germany using a difference-in-differences design with staggered adoption. We show that neither the summer closures nor the closures in the fall had a significant containing effect on the spread of SARS-CoV-2 among children or a spill-over effect on older generations. There is also no evidence that the return to school at full capacity after the summer holidays increased infections among children or adults. Instead, we find that the number of children infected increased during the last weeks of the summer holiday and decreased in the first weeks after schools reopened, a pattern we attribute to travel returnees.
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The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted all aspects of healthcare including solid organ transplantation. In this review, we discuss the specific impact of COVID-19 on the pediatric solid organ transplant population including access to grafts for pediatric transplant candidates as well as COVID-19 disease manifestations in pediatric transplant recipients. We address the current knowledge of prevention and management of COVID-19 in pediatric transplant recipients and provide additional information regarding social distancing, infection prevention and return to school.
Subject(s)
COVID-19 , Organ Transplantation , Child , Humans , Pandemics/prevention & control , SARS-CoV-2 , Transplant RecipientsABSTRACT
Objectives: The objective of the School Transition After Traumatic Brain Injury (STATBI) project is to rigorously evaluate the impact of BrainSTEPS, a formal return-to-school (RTS) program, on academic, social, and health outcomes for students in grades K-12 who have experienced TBI of any severity, compared to students who have no formal RTS programming. In 2020, the study shifted to examine the effects of COVID-related educational changes on students who experienced a TBI prior to the pandemic. Methods: STATBI uses a mixed method, cohort-controlled research design. The IRB-approved protocol includes electronic survey administration and virtual interviews with parents and children. The data included in this presentation is crosssectional, although the full STATBI protocol is longitudinal. Measures include standardized assessments of executive function, participation, social, and cognitive abilities, in addition to semi-structured interviews with parents, students, teachers, and BrainSTEPS team members. Between 11/2020 and 1/ 2021, 250 families were invited to participate in this portion of the study. Results: Of the 46 families that completed majority of the protocol, the average student age was 14.2 years (SD = 3.3). The sample included students with mild (n = 19), moderate (n = 12), and severe (n = 13) TBI. The average age at injury was 11.8 years (SD = 4.3) and average time since injury was 2.7 years (SD = 2.1). A total of 44 families completed the COVID questionnaire with 6.8% (n = 3) reporting that their students had been diagnosed with COVID, though none required hospitalization. Students with COVID missed 5 or more days of school. 13.6% (n = 6) of families reported a household family member having a diagnosis of COVID. Most families reported that their students were attending school in either a hybrid model (40.9%, n = 18) or fully remote (45.5%, n = 20). Families reported the following areas of accommodation were needed: physical accommodations (25%, n = 11), learning/thinking (36.4%, n = 16), and behavioral/social (22.7%, n = 10). Additional interview data regarding COVID, barriers and facilitators of COVID-related school changes for children with TBI, and performance across all measures in the protocol are currently being analyzed and will be available by the time of presentation. Conclusions: The STATBI project is unique in its focus on RTS for youth with TBI, and this data is particularly pertinent as it highlights the impact of COVID-related school changes on students who experienced a TBI prior to the beginning of the pandemic. Our sample included many students who reported having mild injuries but who continued to have academic needs that warranted a referral to the BrainSTEPS program. Majority of the enrolled participants were engaged in school via hybrid or remote options with a consistent minority requiring academic supports. Implications of COVID-related school changes on students with TBI based on data collected during the first - unique and challenging - year of a longitudinal study will be discussed.