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1.
Journal of Korean Medical Science ; 37(17):e124, 2022.
Article in English | MEDLINE | ID: covidwho-1834341

ABSTRACT

BACKGROUND: The epidemiology of coronavirus disease 2019 (COVID-19) has changed continuously throughout the pandemic. METHODS: We analyzed changes in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to the age group in South Korea from February 2020 to December 2021. RESULTS: Since the COVID-19 pandemic, the incidence among adults aged >= 18 years was higher than all the other age groups in 2020;however, a shift toward younger ages occurred in June 2021. In addition, we found significant changes in epidemiology after the introduction of SARS-CoV-2 vaccines in adults aged >= 18 and children 12-17 years. Until recently, children were not regarded as the drive for the pandemic;however, children aged 5-11 and 0-4 years had the highest incidence among all the age groups. CONCLUSION: Therefore, policies for clinical support for an increase in COVID-19 cases among young children and age-specific preventive measures are needed.

2.
Euro Surveillance: Bulletin Europeen sur les Maladies Transmissibles = European Communicable Disease Bulletin ; 27(17), 2022.
Article in English | MEDLINE | ID: covidwho-1834262

ABSTRACT

IntroductionIn France, three complementary surveillance networks involving hospitals and paediatrician practices currently allow pertussis surveillance among infants (<1 year old) and children (1-12 years old). Data on incidences among adolescents (13-17 years old) and adults (>= 18 years) are scarce. In 2017, a sentinel surveillance system called Sentinelles network, was implemented among general practitioners (GPs). AimThe purpose of Sentinelles network is to assess pertussis incidence, monitor the cases' age distribution and evaluate the impact of the country's vaccination policy. We present the results from the first 4 years of this surveillance. Methods GPs of the French Sentinelles network reported weekly numbers of epidemiologically or laboratory-confirmed cases and their characteristics. Results A total of 132 cases were reported over 2017-2020. Estimated national incidence rates per 100,000 inhabitants were 17 (95% confidence interval (CI): 12-22) in 2017, 10 (95% CI: 6-14) in 2018, 15 (95% CI: 10-20) in 2019 and three (95% CI: 1-5) in 2020. The incidence rate was significantly lower in 2020 than in 2017-2019. Women were significantly more affected than men (83/132;63% of women, p = 0.004);66% (87/132) of cases were aged 15 years or over (median age: 31.5 years;range: 2 months-87 years). Among 37 vaccinated cases with data, 33 had received the recommended number of doses for their age. Conclusions These results concur with incidences reported in other European countries, and with studies showing that the incidences of several respiratory diseases decreased in 2020 during the COVID-19 pandemic. The results also suggest a shift of morbidity towards older age groups, and a rapid waning of immunity after vaccination, justifying to continue this surveillance.

3.
Anksioznost i simptomi depresije među decom i adolescentima u pandemiji COVID-19 - sistematski pregled. ; 79(4):389-399, 2022.
Article in English | Academic Search Complete | ID: covidwho-1834215

ABSTRACT

Background/Aim. Children and adolescents are sensitive groups for the development of mental disorders during the crisis. The aim of this systematic review was to assess the impact of the COVID-19 pandemic on anxiety and depressive symptomatology in the population of children and adolescents. Methods. The investigation was based on a systematic review followed by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, including Ovid MEDLINE, Embase, Global Health, and APA Psyc Info databases, to identify relevant studies reporting anxiety and depressive symptoms among children and adolescents during the COVID-19 pandemic. A total of 27 articles were included. Results. Anxiety symptoms increased from 28.3% before the pandemic to 49.5% during confinement [General Anxiety Disorder (GAD)-7 = 11)] (McNemar test, p < 0.0001). More depressive symptomatology was found, as well as weight and sleep disturbances which are the characteristics of children and adolescents' mental health. Additionally, female teenagers were experiencing grater declines in mood disorders than male teenagers during the COVID-19 crisis. On the one hand, different positive correlations between anxiety and other variables, were found, such as clinical depressive symptoms and anxiety (3/14), smartphone and internet addiction (2/14), lower levels of family income (2/14), perceived threats (2/14), higher grades at school (2/14), and loneliness (1/14). On the other hand, positive correlations were reported between depression and children and adolescents that were socially disconnected (3/17). Finally, mothers with higher level of education and income were associated with higher level of happiness (2/17). Conclusion. COVID-19 has a strong impact on the mental health of children and adolescents regarding depression and anxiety symptoms. Prevention programs focused on coping strategies should be conducted in elementary schools, middle schools, and high schools. Mental health should become a priority matter for governments, and the current pandemic could be an opportunity to highlight the importance of mental well-being and to invest in the betterment of clinical trainings, treatments and mental health research. (English) [ FROM AUTHOR] Uvod/Cilj. Deca i adolescenti su osetljiva grupa za razvoj psihičkih poremećaja tokom krize. Cilj ovog sistematskog pregleda literature bio je da se proceni uticaj pandemije COVID-19 na razvoj simptoma anksioznosti i depresije u populaciji dece i omladine. Metode. Sistematski pregled literature je urađen pomoću PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protokola, uključujući Ovid MEDLINE, Embase, Global Health i APA Psyc Info baze podataka, u cilju identifikovanja relevantnih istraživanja o simptomima anskioznosti i depresije kod dece i adolescenata u toku pandemije COVID-19. Pregledano je 27 radova. Rezultati. Simptomi anksioznosti su se povećali sa 28,3% pre pandemije na 49,5% tokom „zatvaranja" usled pandemije [General Anxiety Disorder (GAD)-7 = 11)] (McNemar test p < 0,0001). Ustanovljen je i skok u simptomima depresije, kao i u telesnoj masi i poremećajima spavanju, koji karakterišu smetnje u mentalnom zdravlju dece i adolescenata. Poremećaj raspoloženja (pad) je bio veći kod tinejdžera ženskog, u odnosu na tinejdžere muškog pola. Pokazane su pozitivne korelacije između anksioznosti i drugih varijabli: kliničkih depresivnih simptoma i anksioznost (3/14), zavisnosti od pametnih telefona i interneta (2/14), nižeg porodičnog prihoda (2/14), percipirane opasnosti (2/14), viših razreda u školi (2/14), i usamljenosti (1/14). Pokazane su i pozitivne korelacije između depresije i socijalne isključenosti dece i adolescenata (3/17). Konačno, pokazana je povezanost između majki sa višim nivoima obrazovanja i prihoda i osećanja sreće (2/17). Zaključak. Pandemija COVID-19 ima snažan uticaj na mentalno zdravlje dece i adolescenata odnosno pojavu simptoma depresiije i anksioznosti. Zbog toga bi u osnovnim, srednjim i višim školama trebalo sprovoditi programe prevencije, sa fokusom na razvoj strategija prevladavanja. Mentalno zdravlje bi trebalo da postane prioritetna tema vlada zemalja, a trenutna pandemija mogućnost da se istakne važnost brige o mentalnom blagostanju i ulaganja u poboljšanje kliničkih treninga, tretmana i istraživanja u oblasti mentalnog zdravlja. (Bosnian) [ FROM AUTHOR] Copyright of Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia is the property of Military Medical Academy INI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

4.
Pediatrics ; 149(Suppl 5):01, 2022.
Article in English | MEDLINE | ID: covidwho-1833768

ABSTRACT

OBJECTIVES: To identify effective interventions that promote healthy screen time use and reduce sedentary behavior in school-age children and adolescents (SACA) in all settings, over the last 20 years. METHODS: Searches were conducted from 2000 until March 2021 using PubMed, Embase, Medline, PsycINFO, Ovid SP, The Cochrane Library, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, and the WHO regional databases, including Google Scholar and reference lists of relevant articles and reviews. Randomized-controlled trials and quasi-experimental studies assessing interventions to reduce sedentary behaviors and screen time in healthy SACA (aged 5-19.9 years) globally. Data were extracted by 2 reviewers and where possible, pooled with a random-effects model. RESULTS: The review included 51 studies, of which 23 were included in meta-analyses with 16 418 children and adolescents. Nondigital randomized-controlled trials reported a small, but significant reduction of TV-specific screen time (minutes per day) (mean difference, -12.46;95% confidence interval, -20.82 to -4.10;moderate quality of evidence) and sedentary behavior (minutes per day) (mean difference, -3.86;95% confidence interval, -6.30 to -1.41;participants = 8920;studies = 8;P = .002;moderate quality of evidence) as compared with control groups. For quasi-experimental studies, nondigital interventions may make little or no difference on screen time (minutes per day) or sedentary behavior (minutes per day), given the high uncertainty of evidence. Most studies were conducted in a high-income country. Generalizability of results to low- and middle- income countries remain limited. CONCLUSIONS: Public health policies and programs will be necessary to reduce excessive sedentary behavior and screen time, especially in the post-coronavirus disease 2019 reality.

5.
Health Affairs ; 41(5):680-688, 2022.
Article in English | MEDLINE | ID: covidwho-1833671

ABSTRACT

Temporary expansion of the Child Tax Credit (CTC) during the COVID-19 pandemic provided additional monthly income for US families, with no restrictions on use, from July through December 2021. This study examined food security and children's dietary intake after three months of expanded CTC payments. Parents completed online surveys before and after three months of CTC payments. Among parents participating in the expansion, food and beverage purchases were the most common use of expanded CTC funds (45.9 percent), particularly in households with very low food security (63.0 percent). From before to midway through the CTC expansion, very low food security decreased from 12.7 percent to 5.6 percent, and simultaneously, food security increased from 57.4 percent to 66.4 percent. The CTC expansion was also associated with decreases in children's consumption of added sugar, sugar-sweetened beverages, and sweetened fruit beverages. No changes were observed in children's intake of other dietary components. Our findings suggest that the expanded CTC payments may have helped lessen food insecurity and supported reductions in children's intake of added sugar in participating households.

6.
PLoS ONE [Electronic Resource] ; 17(3):e0266127, 2022.
Article in English | MEDLINE | ID: covidwho-1833646

ABSTRACT

BACKGROUND: City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households. METHODS: We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown. FINDINGS: Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22-96%);Q3 vs. Q1: 48% (17-89%);Q4 vs. Q1: 66% (30-211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7-76%). INTERPRETATION: By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.

7.
PLoS ONE [Electronic Resource] ; 17(3):e0265900, 2022.
Article in English | MEDLINE | ID: covidwho-1833642

ABSTRACT

In early pandemic waves, when vaccination against COVID-19 was not yet an option, distancing and reduced social contact were the most effective measures to slow down the pandemic. Changes in frequency and forms of social contact have reduced the spread of the COVID-19 virus and thus saved lives, yet there is increasing evidence for negative side effects such as mental health issues. In the present study, we investigate the development of loneliness and its predictors to examine the role of changes in social networks due to social distancing and other COVID-19-related life changes. A total of 737 participants (age range = 18-81 years) completed an online survey in three waves during the last quarter of 2020 at one-month intervals. Latent growth and multilevel modeling revealed that emotional loneliness increased over time, while social loneliness remained stable. Moreover, socially lonely individuals were likely to also develop emotional loneliness over time. Increased social distancing and sanitary measures were accompanied by decreased social interactions and loss of individuals considered SOS contacts and confidants. Changes in specific social network indicators were differentially associated with changes in emotional vs social loneliness: Loss of friends considered confidants was associated with increasing emotional loneliness, whereas loss of friends considered SOS contacts and reduced overall social interactions were related to increasing social loneliness. Lastly, individuals with more family-and-friend SOS contacts, more friends as confidants and an overall higher number of social interactions were more protected from feeling socially or emotionally lonely. Study findings enhance the understanding of underlying mechanisms differentially contributing to social and emotional loneliness and offer practical suggestions to reduce mental-health side effects of social distancing.

8.
BMJ Open ; 12(4):e056736, 2022.
Article in English | MEDLINE | ID: covidwho-1832453

ABSTRACT

OBJECTIVES: Children with experience of out-of-home care (OHC) are at an increased risk of adverse outcomes in later life, including poorer levels of psycho-social adjustment. Less is known about the intergenerational transmission of the trauma associated with OHC and psychosocial outcomes in mid-adulthood, particularly during a major health pandemic. DESIGN: To examine if there is evidence of intergenerational transmission of trauma associated with OHC in mid-adulthood, we used data from the 1970 British Cohort Study 2020 COVID-19 Survey. PARTICIPANTS: Cases were defined as cohort members (CMs) who had themselves experienced OHC (OHC1) and those whose mother reported to have been in OHC (OHC2). Among the 5320 CMs who participated in the second COVID-19 Survey, we have OHC information for n=4236. Our analytical samples range from n=2472 to 3864 depending on outcome: the largest sample comprised 105 (2.5%) CMs with direct OHC experience (OHC1), 93 (2.2%) CMs with a mother who had OHC experience (OHC2) and 3666 CMs with no OHC experience (OHC0). OUTCOME MEASURES: Self-reported outcomes at age 50 included indicators of depression, health and psychological well-being. Multivariate logistic regression models control for socioeconomic childhood background and current circumstances. RESULTS: Compared with the majority OHC0, the OHC1 group report higher levels of depression (OR 2.18 (95% CI 1.09 to 4.36) p<.05) and are at a greater risk of poor mental (OR 2.23 (95% CI 1.24 to 4.02) p<0.01) and general health (OR 3.32 (95% CI 1.65 to 6.67) p<0.001) during the pandemic. OHC2 was more than twice as likely to report poor mental health prepandemic (OR 2.52 (95% CI 1.37 to 4.64) p<0.01), but not during the pandemic. CONCLUSION: Children of care leaver mothers (OHC2) appear to be better adjusted than those who were themselves in care (OHC1), although compared with those without care experience (OHC0) both groups had an increased risk of poorer adult outcomes. However, the findings point to both continuity and discontinuity of disadvantage.

9.
BMJ Open ; 12(5):e055716, 2022.
Article in English | PubMed | ID: covidwho-1832449

ABSTRACT

BACKGROUND: During adolescence, sleep and circadian timing shift later, contributing to restricted sleep duration and irregular sleep-wake patterns. The association of these developmental changes in sleep and circadian timing with cognitive functioning, and consequently academic outcomes, has not been examined prospectively. The role of ambient light exposure in these developmental changes is also not well understood. Here, we describe the protocol for the Circadian Light in Adolescence, Sleep and School (CLASS) Study that will use a longitudinal design to examine the associations of sleep-wake timing, circadian timing and light exposure with academic performance and sleepiness during a critical stage of development. We also describe protocol adaptations to enable remote data collection when required during the COVID-19 pandemic. METHODS: Approximately 220 healthy adolescents aged 12-13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires. DISCUSSION: The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents. ETHICS AND DISSEMINATION: Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media. STUDY DATES: Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023.

10.
Drug Metabolism & Disposition ; 50(5):576-590, 2022.
Article in English | MEDLINE | ID: covidwho-1832315

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3C-like protease inhibitor PF-07321332 (nirmatrelvir), in combination with ritonavir (Paxlovid), was recently granted emergency use authorization by multiple regulatory agencies for the treatment of coronavirus disease 2019 (COVID-19) in adults and pediatric patients. Disposition studies on nirmatrelvir in animals and in human reagents, which were used to support clinical studies, are described herein. Plasma clearance was moderate in rats (27.2 ml/min per kg) and monkeys (17.1 ml/min per kg), resulting in half-lives of 5.1 and 0.8 hours, respectively. The corresponding oral bioavailability was moderate in rats (34%-50%) and low in monkeys (8.5%), primarily due to oxidative metabolism along the gastrointestinal tract in this species. Nirmatrelvir demonstrated moderate plasma protein binding in rats, monkeys, and humans with mean unbound fractions ranging from 0.310 to 0.478. The metabolism of nirmatrelvir was qualitatively similar in liver microsomes and hepatocytes from rats, monkeys, and humans;prominent metabolites arose via cytochrome P450 (CYP450)-mediated oxidations on the P1 pyrrolidinone ring, P2 6,6-dimethyl-3-azabicyclo[3.1.0]hexane, and the tertiary-butyl group at the P3 position. Reaction phenotyping studies in human liver microsomes revealed that CYP3A4 was primarily responsible (fraction metabolized = 0.99) for the oxidative metabolism of nirmatrelvir. Minor clearance mechanisms involving renal and biliary excretion of unchanged nirmatrelvir were also noted in animals and in sandwich-cultured human hepatocytes. Nirmatrelvir was a reversible and time-dependent inhibitor as well as inducer of CYP3A activity in vitro. First-in-human pharmacokinetic studies have demonstrated a considerable boost in the oral systemic exposure of nirmatrelvir upon coadministration with the CYP3A4 inhibitor ritonavir, consistent with the predominant role of CYP3A4 in nirmatrelvir metabolism. SIGNIFICANCE STATEMENT: The manuscript describes the preclinical disposition, metabolism, and drug-drug interaction potential of PF-07321332 (nirmatrelvir), an orally active peptidomimetic-based inhibitor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3CL protease, which has been granted emergency use authorization by multiple regulatory agencies around the globe for the treatment of coronavirus disease 2019 (COVID-19) in COVID-19-positive adults and pediatric patients who are at high risk for progression to severe COVID-19, including hospitalization or death.

11.
Journal of General Virology ; 103(4), 2022.
Article in English | MEDLINE | ID: covidwho-1831590

ABSTRACT

Encephalitis is most often caused by a variety of infectious agents identified through diagnostic tests utilizing cerebrospinal fluid. We investigated the clinical characteristics and potential aetiological agents of unexplained encephalitis through metagenomic sequencing of residual clinical samples from multiple tissue types and independent clinical review. Forty-three specimens were collected from 18 encephalitis cases with no cause identified by the Australian Childhood Encephalitis study. Samples were subjected to total RNA sequencing ('metatranscriptomics') to determine the presence and abundance of potential pathogens, and to describe the possible aetiologies of unexplained encephalitis. Using this protocol, we identified five RNA and two DNA viruses associated with human infection from both non-sterile and sterile sites, which were confirmed by PCR. These comprised two human rhinoviruses, two human seasonal coronaviruses, two polyomaviruses and one picobirnavirus. Human rhinovirus and seasonal coronaviruses may be responsible for five of the encephalitis cases. Immune-mediated encephalitis was considered likely in six cases and metatranscriptomics did not identify a possible pathogen in these cases. The aetiology remained unknown in nine cases. Our study emphasizes the importance of respiratory viruses in the aetiology of unexplained child encephalitis and suggests that non-central-nervous-system sampling in encephalitis clinical guidelines and protocols could improve the diagnostic yield.

12.
Health Equity ; 6(1):338-344, 2022.
Article in English | ProQuest Central | ID: covidwho-1830943

ABSTRACT

The COVID-19 pandemic has highlighted structural inequities that are barriers to thriving for children in neighborhoods with concentrated disadvantage. Health systems are increasingly addressing health-related social needs. The “Pittsburgh Study” is a longitudinal, community-partnered study focused on child and adolescent thriving and racial equity. This initiative will elucidate critical influences on childhood health and thriving, evaluate developmentally appropriate interventions to improve outcomes from birth to high school, and establish a child health data hub. Integration of community members into scientific inquiry, rapid data-to-action cycles, and workforce development are strategies health systems may consider to enhance child health equity.

13.
Journal of Human Rights ; 21(2):227-244, 2022.
Article in English | Academic Search Complete | ID: covidwho-1830751

ABSTRACT

Although international and domestic laws prohibit child marriage, millions of girls are married every year worldwide, a trend only aggravated by the COVID-19 pandemic. Since the turn of the century, the global advocacy movement to end child marriage has gained momentum by standardizing its framing, using testimonies and symbols to generate empathy and mobilize solidarity, and engaging with policymakers to end the practice. In this article, I draw on newspaper articles, advocacy reports, and interviews with activists in the United States and Latin America to identify the reasons behind its success. I also discuss several challenges activists are grappling with as the movement evolves, including intra-network dynamics regarding the centrality of sexuality and the forms child marriage adopts around the world. [ FROM AUTHOR] Copyright of Journal of Human Rights is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

14.
Lancet ; 399(10337):1761-1763, 2022.
Article in English | ProQuest Central | ID: covidwho-1829703

ABSTRACT

Child survival has improved because of combined efforts in these areas;but the scale and scope of the global threats to child health and wellbeing, including conflicts, climate crises, and other humanitarian emergencies, all compounded by COVID-19, now put decades of progress at grave risk. 5 and set out a bold vision for a broader focus on child and adolescent health, wellbeing, and social development, expanding on the impressive gains made in young child survival over the past few decades.6 The Commission urged policy makers to take a long-term view of child wellbeing, considering evidence that shows early investments in children's health, education, and development have lifelong, intergenerational, and economic benefits for children and societies.7,8 The Commission recommended that investments should not be restricted to health and education alone, but spread across sectors—in universal health coverage, good nutrition and food security, safe and affordable housing, protected environments with clean water and air, and safe places to play—since all sectors contribute to child wellbeing. Even before the pandemic, progress towards the 2030 targets in the Sustainable Development Goals (SDGs) to save the lives of women and children was already behind by about 20%, with millions of children and women unable to access life-saving services.10 Continuing global crises are placing child health and wellbeing at grave risk.

15.
Lancet ; 399(10337):1759-1761, 2022.
Article in English | ProQuest Central | ID: covidwho-1829702

ABSTRACT

A major agenda to reduce premature mortality remains unfinished, with 8·6 million deaths globally among children and adolescents (aged 0–20 years), including stillbirths, in 2019.2 Analysis of long-term birth cohorts shows the detrimental effects of early-life deprivation and toxic stress on health, nutrition, and cognitive development of children, often extending across generations.3 Despite ample evidence supporting evidence-based interventions,4 implementation across health, education, and social systems is poor.5 Although the SDGs were painstakingly crafted and shaped into a global strategy with strong benefit–cost ratios for investing in women and children,6 corresponding implementation has been disappointing and disjointed, lacking political commitment and resources. The UN Secretary General abandoned his patronage of the Every Woman Every Child initiative, the much touted efforts by WHO on the Universal Health Coverage framework hardly mention children,7 and resources at UNICEF for core child health and development programmes have stagnated.8 At the half-way mark of the SDG period, most countries and global programmes remain in the mode of targeting specific diseases and age bands in childhood, rather than the age continuum and integration of child and adolescent periods.9–11 Many countries are only beginning to localise the SDGs and develop granular national goals,12 and few have a comprehensive child and adolescent health strategy. Over three decades since the historic meeting in New York that laid out the importance of human capital,26 we call for a global summit for children that covers the entire period of preconception, pregnancy, childhood, and adolescence (age <20 years), and is responsive to their current and future needs.

16.
The Lancet ; 399(10337):1810-1829, 2022.
Article in English | ProQuest Central | ID: covidwho-1829701

ABSTRACT

Summary Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5–9 years) and the transition from childhood to adolescence (10–19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.

17.
Radiologia ; 64(2):119-127, 2022.
Article in English | MEDLINE | ID: covidwho-1829489

ABSTRACT

BACKGROUND: The coronavirus 2019 (COVID-19) epidemic spread throughout the world from the beginning of 2020, increasing healthcare professionals' workloads and levels of physical and emotional stress. AIMS: To determine the prevalence of burnout syndrome in Spanish radiologists during the COVID-19 pandemic and the factors associated with the development of this syndrome, and to compare these findings with those obtained before the pandemic. METHODS: This observation study took place between April 2020 and August 2020 (during the pandemic) through an online survey. A total of 150 responses were obtained. Demographic and work-related information was compiled. Burnout syndrome was measured with the Maslach Burnout Inventory Human Services Survey (MBI-HSS). The prevalence and characteristics of burnout syndrome obtained in this survey were compared with those of the same survey done in 2019. We performed a statistical analysis to identify possible risk factors and protective factors associated with this syndrome and to determine the homogeneity of the two samples. RESULTS: The prevalence of burnout syndrome increased during the COVID-19 pandemic (49.3% vs. 33.6%, p=0.002). No risk factors or protective factors that were valid both before and after the pandemic were identified. No correlations were identified between sociodemographic or work-related characteristics and burnout syndrome. CONCLUSION: This study demonstrates that burnout syndrome increased significantly in radiologists during the COVID-19 pandemic, affecting nearly half of all those who responded to the survey. These results underline the need to assess support for professional wellbeing of radiologists in Spain. No correlations were identified between burnout and gender, age, number of calls, years in the job, annual income, teaching, marital status, number of children, or type of contract.

20.
Infant Ment Health J ; 2022.
Article in English | PubMed | ID: covidwho-1826006

ABSTRACT

Relational experiences during infancy and early childhood are key drivers for building health, social emotional development, and learning capacities, each vital for wellbeing. The U.S. child health sectors share a commitment to universal health promotion, prevention and early intervention, and a growing enthusiasm for the research-affirmed primacy of caregiver-child interactions during the critical first 1000 days of life. Given our nation's growing children's mental health crisis, racial justice awakening and the need to reimagine equitable supports for young families post-COVID19, the child health sectors seek new tools and clinical approaches that blend science-to-practice innovations with co-developed activities that are meaningful to families. This special section brings together papers about a journey of co-discovery between researchers, clinicians, and parents during the development and refinement of new video- and interview-based dyadic relational screening and monitoring tools. The collection of papers addresses a range of topics including early relational health (ERH), development and validation of the Early Relational Health Screen, its application within research and clinical settings, and thoughtful discussions from multiple perspectives. Informed by the diversity informed tenets, this journey highlights not only science-informed approaches, but also co-development with families of equitable approaches to understanding and serving children and their caregivers.

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