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CMAJ. Canadian Medical Association Journal ; 64(5 Supplement 1):S59-S60, 2021.
Article in English | EMBASE | ID: covidwho-2065172

ABSTRACT

Background: Injured adolescents may go to pediatric (PTC) or adult (ATC) trauma centres. Although there appears to be little difference in mortality when adolescents are managed in PTCs versus ATCs, evidence suggests differences in clinical processes (e.g., computed tomographic scanning, operative intervention). Moreover, there is little information on nonclinical outcome variation. We aimed to examine differences in nonclinical outcomes of injured adolescents admitted to the lead PTC or ATC within a regional Canadian trauma system. Method(s): After injury-related hospital admission at the PTC or ATC, adolescents (15-17 yr, inclusive) and parents completed the following: the Quality of Trauma Acute Care Patient-Reported (or Parent- Reported) Experience Measure (QTAC-PREM), examining clinical care, information delivery, education and social supports, and opioid exposure;the Pediatric Quality of Life Inventory;and the Brief Symptom Inventory, a psychological distress measure. Data were collected on clinical outcomes and processes. Descriptive bivariate analyses compared outcomes by trauma centre type. Result(s): Twenty-six ATC and 32 PTC patients have been enrolled to date. Survey response rates were 69% (patients) and 75% (parents) at the PTC and 58% (patients) and 54% (parents) at the ATC. There was a similar age and sex distribution between the 2 centres. Injury severity was higher at the ATC, reflected by greater mean lengths of stay (PTC 2.3 d [standard deviation (SD) 2.1 d], ATC 13.3 d [SD 23.7 d]), and lower mean Glasgow Coma Scale scores (PTC 15.0, ATC 13.8) at the ATC. There were also 3 critical care admissions at the ATC and none at the PTC among recruited patients. No differences were observed in patient- or parent-reported clinical care and follow-up experiences. There was also no difference in patient- or parent-reported social and educational support, although subscales were limited by visitor restrictions because of the COVID-19 pandemic, and the majority of injuries occurring during summer months when students were out of school. Parents at the ATC reported fewer opportunities to stay with or near their child compared with those at the PTC (100% v. 69.2%). Parents reported better information provision at the PTC (mean 17.3 [SD 1.3] v. 13.9 [SD 5.2], out of 18 as measured by the QTAC-PREM). Patients and parents were more likely to report receiving opioid prescriptions on discharge at the ATC (55.6% v. 14.3%). There was no difference in quality of life or psychological distress between the PTC and ATC. Conclusion(s): Injured adolescents and their parents indicated similar clinical and follow-up experiences, although parents felt better informed at the PTC and reported better opportunities to stay near their child. Parents and patients reported higher opioid exposures at the ATC. Sharing of communication, accommodation and opioid prescribing practices may allow for improved experiences and reduced opioid exposures in injured adolescents presenting to ATCs. Multivariable analyses are necessary in the future to adjust for injury severity differences..

2.
Orthopaedic Journal of Sports Medicine ; 10(5 SUPPL 2), 2022.
Article in English | EMBASE | ID: covidwho-1916579

ABSTRACT

Background: Since April 2020, some high schools were closed to in-person teaching, and interscholastic and club sports were cancelled in an attempt to slow the spread of COVID- 19. While some US adolescents participated in sports since April 2020, other US adolescents did not participate in sports during this time. It is unknown what effect sport participation has had on the health of adolescents. Hypothesis/Purpose: To identify how sport participation during the COVID-19 pandemic impacted the health of adolescents. Methods: Adolescents across the US were recruited via social media to complete an online survey in the spring of 2021. Participants were asked to report their demographics (age, gender, race), whether they participated in school club or school sports since May 2020, type of school they attended (in-person, online, hybrid), and measures of mental health (MH), physical activity (PA) and quality of life (QoL). Assessments included the: General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. Assessment scores were compared for respondents who participated in sports (PAR) with those that did not participate in sports (NoPAR). Univariable comparisons between the groups were made via ttests or chi-square tests while means for continuous outcome measures were compared between the groups by ANOVA models that controlled for age, gender, race and the type of school attendance. Results: 4,693 adolescents (52% female, Age = 16.1+1.3 yrs., grades 9-12) from 38 states participated in the study with PAR = 4,286 (91%) and NoPAR = 407 (9%). NoPAR participants reported a higher prevalence of moderate to severe levels of anxiety (29.3% vs 21.3%, p<0.001) and depression (40.7% vs 19.8%, p<0.001). NoPAR participants reported lower (worse) PFABS scores (mean 13.2 [95%CI 12.4, 13.9] vs 21.2 [20.7, 21.6] p<0.001) and lower (worse) PedsQL total scores compared to the PAR group (77.9 [76.5, 79.3] vs. 83.2 [82.3, 84.1], p<0.001). Conclusions: Adolescents who did not play a sport during the COVID-19 pandemic reported significantly higher levels of anxiety and depression, as well as lower physical activity and quality of life scores compared to adolescents who did play a school or club sport. Participation in organized sports may offer an important opportunity to improve physical activity and mental health for adolescents during and after the COVID-19 pandemic.

3.
Developmental Medicine and Child Neurology ; 64(SUPPL 3):62, 2022.
Article in English | EMBASE | ID: covidwho-1916120

ABSTRACT

Introduction: Annually an estimated 40,000 CYP in the UK sustain an ABI with many experiencing significant, life-long impairments that impact on physical and psychological development, health-related quality of life (HRQoL), educational achievement and social inclusion. Patients and methods: A quantitative cross-sectional survey was completed as part of a mixed methods study which aims to explore the longer term needs of CYP-ABI aged 5-18 and their families in one region of the UK. Participants were recruited using eligibility criteria through a regional specialist clinical service. Ethical approval was gained (REC-20/ EM/0258). The survey consisted of demographic questions and standardised outcome measures completed by the parent or CYP-Pediatric Quality of Life Inventory 4.0 (PedsQL), PedsQL-Family Impact Module (PedsQL-FIM), Child and Adolescent Scale of Participation (CASP), Parental Health Questionnaire-4 (PHQ-4). Additional free text questions were included to capture parent and CYP goals, impact of Covid-19 lockdowns and any other information they wished to share. Results: 44 families have completed the survey so far, a response rate of 26%. CYP PedsQL scores indicated 31% were at risk of impaired HRQoL and the CASP indicated 68% had severely impaired social participation. 48% of families had impaired family HRQoL (PedsQL-FIM) and 48% of parents screened positive for anxiety, depression or both (PHQ-4). Conclusion: These preliminary results indicate the long-term impact of an ABI on CYP and family HRQoL and CYP social participation. The context behind these scores will be explored more deeply in qualitative interviews during the next phase of the study.

4.
Open Access Macedonian Journal of Medical Sciences ; 10:1137-1142, 2022.
Article in English | EMBASE | ID: covidwho-1896946

ABSTRACT

BACKGROUND: Osteogenesis imperfecta (OI) is a common chronic illness with increasing prevalence. Coronavirus disease 2019 (COVID-19) and large society restriction policies in Indonesia cause problems and might affect the quality of life (QoL) of children with OI. AIM: The objective of the study was to evaluate determinant factors (such as number of hospital visits per year, calcium and/or Vitamin D consumption, fear and obstacles of visiting the hospital, and parent’s layoff) of OI children’s QoL pre and during the 1st year of the COVID-19 pandemic. METHODS: This was a cross-sectional study design conducted in the Pediatric Endocrinology Outpatient Clinic, Dr. Soetomo Hospital, Surabaya, Indonesia, during the 1st year of COVID-19 pandemic to assess the patient’s QoL. This study used a diagnostic group with questionnaires. The instrument included the Pediatric Quality of Life Inventory 4.0 Generic Score, a standardized interview questionnaire comprising questions on the participant characteristics and determinant factors pre and during the COVID-19 pandemic. Analysis of determinant factors pre and during the pandemic used McNemar. Correlation between determinant factors and QoL used linear regression for physical and emotional dimensions and logistic regression for social, school, and total score. RESULTS: Of the 22 children with OI, 19 had fear of visiting the hospital (p < 0.001), and 16 had obstacles to visiting the hospital (p < 0.01). Taking calcium and/or Vitamin D supplementation pre and during the COVID-19 pandemic affected school functioning (p = 0.015) and the total score (p = 0.027). CONCLUSION: The significant risk factors pre and during COVID-19 were fear of and obstacles to visiting the hospital. Supplementation of calcium and/or Vitamin D pre and during the COVID-19 pandemic significantly impacted school functioning and the total score.

5.
Pediatric Diabetes ; 22(SUPPL 30):45, 2021.
Article in English | EMBASE | ID: covidwho-1570987

ABSTRACT

Introduction: The alarming spread of the COVID-19 virus caused governments to impose imperative lockdowns and quarantines which negatively impacted vulnerable Type 1 diabetes children. Objectives: The study aim was to assess glycemic status and healthrelated quality of life (HRQoL) during the pandemic in a cohort of children with Type 1 diabetes (T1D) in Kuwait. Methods: Patients (aged 2-18) and their parents were recruited from the Childhood-Onset Diabetes electronic Registry (CODeR) and government hospitals. The Pediatric Quality of Life Inventory (PedsQL™) 3.0 Diabetes Module was used to evaluate disease specific total HRQoL through parent-proxy and self-reports. HbA1c results between February 24, 2020 and March 24, 2021 were collected from hospital records to assess glycemic status. Results: A total of 150 patients were included in the study (age 9.5 ±3.5 years, 51% males, diabetes duration 3.4±2.3 years). From the surveyed participants, 119 (84%) were on multiple daily injections, 26 (19%) had T1D family history and 132 (90%) were cared by both parents. Determined from 59 available results, mean HbA1c was 9.78%±1.61. Parent-proxy and patient HRQoL reports were similar in score (73.1±13.9 and 73.3±11.8). Patients reported lower QoL in the diabetes symptoms domain (p=0.04) and a higher QoL in the treatment barriers domain (p=0.002). Gender, nationality, and age did not affect HRQoL. Pump therapy and longer diabetes duration (>3 years) were associated with higher parent-proxy total HRQoL (p=0.01, p=0.03). Patients cared by both parents had slightly better glycemic status (9.6%±1.5 vs 10.9%±2.3) and better QoL scores in the diabetes symptoms domain (p=0.04). No statistical association was found between either HbA1c or COVID-19 history and total HRQoL. Conclusions: In this study, history of personal or family COVID-19 infection did not affect HRQoL. However, special support needs to be given to patients recently diagnosed with T1D, cared for by single parents, and treated with MDI to have a better HRQoL during the pandemic.

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