RESUMEN
During the spring of 2020, Nebraska's 983 public schools sat vacant, and Nebraska's 329,290 Pre-Kindergarten to Grade 12 students were learning in environments other than school. Educators were expected to pivot quickly from traditional classroom instruction to remote experiences. Understanding the effects of the pandemic on educators is necessary to effectively meet their needs and the needs of students. The purpose of this study was to identify and describe the experiences of Nebraska's urban and rural PreK-Grade 12 educators during the early stages of the COVID-19 pandemic. In surveys collected in July 2020, participants (i.e., superintendents, principals, and teachers) completed both fixed-response items and one open-ended question that assessed experiences during the initial pandemic-related school closings. The results indicate educators identified lack of family help and inability to engage students as a top concern about student academic progress. Educators reported dramatic increases in stress during school closures. Many reported coping only somewhat well or worse. Educators also reported personal challenges with remote instruction, including mental health issues and blurred work- and home-life boundaries. Significant differences were found between rural and urban educators, as well as between elementary and secondary educators. Direct quotes from participants vividly describe their lived experiences.
RESUMEN
BACKGROUND: Optimal inguinal hernia repair timing remains controversial. It remains unclear how COVID-19 related elective surgery cancellations impacted timing of inguinal hernia repair and whether any delays led to complications. This study aims to determine whether elective surgery cancellations are safe in pediatric inguinal hernia. METHODS: This multicenter retrospective cohort study at 14 children's hospitals included patients ≤18 years who underwent inguinal hernia repair between September 13, 2019, through September 13, 2020. Patients were categorized by whether their inguinal hernia repair occurred before or after their hospital's COVID-19 elective surgery cancellation date. Incarceration and emergency department encounters were compared between pre and postcancellation. RESULTS: Of 1,404 patients, 604 (43.0%) underwent inguinal hernia repair during the postcancellation period, 92 (6.6%) experienced incarceration, and 213 (15.2%) had an emergency department encounter. The postcancellation period was not associated with incarceration (odds ratio 1.54; 95% confidence interval 0.88-2.71; P = .13) or emergency department encounters (odds ratio 1.53; 95% confidence interval 0.94-2.48; P = .09) despite longer median times to inguinal hernia repair (precancellation 29 days [interquartile range 13-55 days] versus postcancellation 31 days [interquartile range 14-73 days], P = .01). Infants were more likely to have the emergency department be their index presentation in the postcancellation period (odds ratio 1.69; 95% confidence interval 1.24-2.31; P < .01). CONCLUSION: Overall, COVID-19 elective surgery cancellations do not appear to increase the likelihood of incarceration or emergency department encounters despite delays in inguinal hernia repair, suggesting that cancellations are safe in children with inguinal hernia. Assessment of elective surgery cancellation safety has important implications for health policy.