A hard pill to swallow? Parental health shocks and children's mental health.

Based on comprehensive administrative health record data from Austria, this study examines how children's mental health responds to a severe parental health shock. To account for the endogeneity of a serious parental illness, our sample is restricted to children who experience the health shock of a parent at some point in time and we exploit the timing of shocks in a dynamic DID setting. We find a positive causal effect of parental health shocks on children's mental health care utilization. Affected children have higher medical attendance for the treatment of mental illnesses, consume more psychotropic drugs, and are more likely to be hospitalized with mental and behavioral disorders. A significant increase in the utilization of antidepressants, anxiolytics, and sedatives can be observed for older children, girls and children with a white-collar family background. Our findings have important policy implications for children's access to psychotherapies and mental health care after experiencing a traumatic household event.

Comparative characteristics of developing morphofunctional features of schoolchildren from different climatic and geographical regions.

OBJECTIVES: Adaptation processes in body of schoolchildren, along with study load and social factors, are determined by influence of climatic and geographical factors of residence region. This research has been undertaken to study the morphofunctional characteristics of schoolchildren at the age of 7-17 years. METHODS: The research involved 880 schoolchildren of both sexes in age from 7 to 17 years, studying in secondary school №22 in Pavlodar (Kazakhstan) and secondary school №7 in Kyzylorda (Kazakhstan). The Quetelet index of northern schoolchildren was within the norm but higher compared to southern peers. RESULTS: The Quetelet index was within the normal range for all schoolchildren, but higher among northerners. The indicator of the life index in the boys of the south was higher up to 10 years, then the adaptive possibilities of breathing decreased; in the girls in the north this indicator was higher in all periods, except for 8-9 years. The physical performance index (PWC170/kg) was higher in children from the southern region. CONCLUSIONS: This study revealed significant geographical differences in the morphofunctional development of children. The obtained data served allowed establishing the "Electronic map of schoolchildren's health" and indicated the need for systematic accounting of schoolchildren's health indicators for effective development of differentiated prevention programs.

Urgencias psiquiátricas en niños y adolescentes / Psychiatric Emergencies in Children and Adolescents

Introducción: Las urgencias psiquiátricas en la edad pediátrica constituyen un problema de salud pública. Objetivo: Describir las urgencias psiquiátricas y la conducta seguida, en el momento de su evaluación, en pacientes atendidos en consulta de urgencia. Métodos: Estudio observacional, descriptivo y transversal, en 340 pacientes examinados en el Hospital Pediátrico "Juan Manuel Márquez", de enero a abril de 2019. Se utilizó un instrumento validado en estudios anteriores y se realizó entrevista a pacientes y familiares. El procesamiento y análisis de los datos se realizó con el SPSS 21 y estadígrafos descriptivos. Para la comparación de frecuencias observadas y esperadas de una variable se empleó la prueba binomial, y la Ji-cuadrada, con una probabilidad de 0,5 por ciento. Resultados: El 53,8 por ciento de los pacientes declararon entre 15 y 19 años; 50,3 por ciento varones. El 61,2 por ciento presentaban antecedentes patológicos psiquiátricos y 40,3 por ciento procedía de medios familiares problemáticos. Entre los principales motivos de consulta destacaron la conducta suicida y el consumo de sustancias psicoactivas. El 25 por ciento de los pacientes requirió hospitalización, el resto se derivó a la atención ambulatoria. En más de 60 por ciento se utilizaron psicofármacos. Conclusiones: Predominaron en el estudio los adolescentes, masculinos, con antecedentes patológicos personales de enfermedad psiquiátrica, procedentes de medios familiares conflictivos, con diagnóstico de trastornos del comportamiento, conducta suicida, trastornos afectivos, psicosis y trastornos adictivos; entre estos últimos, se diagnosticó la patología dual. Solo la cuarta parte requirió hospitalización y en la mayoría se usaron psicofármacos (AU)

Introduction: Psychiatric emergencies in pediatric age constitute a public health problem. Objective: To describe the psychiatric emergencies and the behavior followed, at the time of their evaluation, in patients attended in an emergency consultation. Methods: Observational, descriptive and cross-sectional study in 340 patients examined at Juan Manuel Márquez Pediatric Hospital, from January to April 2019. An instrument validated in previous studies was used and interviews were conducted with patients and relatives. Data processing and analysis was performed with SPSS 21 and descriptive statistics were used. For the comparison of observed and expected frequencies of a variable, the binomial test and the Chi-square, with a probability of 0.5 percent were used. Results: 53.8 percent of patients were between 15 and 19 years old, and 50.3 percent were male. 61.2 percent had a psychiatric pathological history and 40.3 percent came from problematic family environments. Among the main reasons for consultation were suicidal behaviour and the consumption of psychoactive substances. 25 pecent of patients required hospitalization, the rest were referred to outpatient care. Psychotropic drugs were used in more than 60 percent. Conclusions: In the study predominated adolescents, males, with a personal pathological history of psychiatric illness, from conflictive family environments, diagnosed with behavioral disorders, suicidal behavior, affective disorders, psychosis and addictive disorders; among the latter, dual pathology was diagnosed. Only a quarter required hospitalization and most used psychotropic drugs(AU)

Percepción del profesional de enfermería sobre los efectos del cambio climático en la salud infantil / The Nursing Professional's Perception of the Effects of Climate Change on the Health of Children

Introducción: El cambio climático cada vez afecta más a la salud de los niños porque presentan un crecimiento y desarrollo inmaduro. Enfermería cuida a este grupo poblacional en primer nivel de atención, donde puede realizar actividades de prevención y promoción de la salud ante esta amenaza ambiental. Objetivo: Describir la percepción del profesional de enfermería sobre los efectos del cambio climático en salud infantil. Métodos: Estudio cualitativo con abordaje exploratorio descriptivo realizado de mayo a junio del 2020, en el primer nivel de atención de la Red de Salud Lambayeque, Perú. La población la conformaron 97 enfermeras, el tamaño de la muestra fue de 12 obtenida por criterios de saturación y redundancia. Se utilizó la entrevista semiestructurada vía telefónica y el procesamiento de los datos fue con el análisis de contenido. Resultados: Se obtuvieron 4 categorías: a) Significado y causas del cambio climático que afectan la salud infantil, b) Identificación de enfermedades en los niños por el cambio climático, c) El actuar preventivo-promocional de la enfermera ante el cambio climático, d) Necesidad de aprender sobre el cambio climático y sus efectos en la salud infantil. Conclusión: Las enfermeras del estudio identificaron algunas causas y enfermedades relacionadas con el cambio climático, en su actuar preventivo se enfocan en la educación de enfermedades infectocontagiosas que afectan la salud infantil. Ante ello, existe la necesidad de incorporar la temática en los planes de estudio de las universidades, pues se encuentra catalogado como uno de los principales problemas de salud pública a nivel mundial(AU)

Introduction: Climate change increasingly affects the health of children, who become affected by immature growth and development. Nurses care for this population group at the first level of healthcare, where health prevention and promotion activities can be carried out in the face of this environmental threat. Objective: To describe the nursing professional's perception of the effects of climate change on the health of children. Methods: A qualitative study with a descriptive exploratory approach was conducted from May to June 2020 at the first level of healthcare of the Lambayeque health network in Peru. The population consisted of 97 nurses and the sample size was 12, obtained by saturation and redundancy criteria. A semistructured interview via telephone was used and the data were processed using content analysis. Results: Four categories were obtained: a) meaning and causes of climate change that affect the health of children, b) identification of children's diseases due to climate change, c) the nurse's preventive-promotional action in the face of climate change, and d) the need to learn about climate change and its effects on the health of children. Conclusion: The nurses in the study identified some causes and diseases related to climate change; in their preventive action, they focus on education about infectious-contagious diseases affecting the health of children. In view of this, there is a need to incorporate the topic into university curriculums, since it is considered as one of the main public health concerns worldwide(AU)

A Cost-Effectiveness Analysis of a Community Health Worker Led Asthma Education Program in South Texas.

Purpose: This paper examines the cost-effectiveness of an asthma-related education program. Materials and Methods: Using a pre and post approach, the paper calculates first changes in cost due to variations in outcome (from baseline to follow-up). We also estimate cost-effectiveness ratios for each of the eight outcomes (numbers of asthma attacks, hospital, and ER visits, and physical and emotional health, and activity levels of both children and family members). Results: The intervention saved the household around $36 per day. Cost-effectiveness ratios ranged between less than $2.2 for children and family members' physical and emotional health, and activity levels to between $4.1 and $82.8 for asthma attacks and hospital visits. Cost-benefit results showed minimal benefit due to conservative estimates. We could not quantify the economic value of physical and emotional health improvement seen based on the measures. Conclusion: Cost savings and ratios suggest that such a program could reduce health disparities due to improved knowledge, decreasing exposure to asthma triggers, enhancing health outcomes, and improving the quality of life of the children with asthma and their whole family.

Acceptability and feasibility of a messenger-based psychological chat counselling service for children and young adults ("krisenchat"): A cross-sectional study.

BACKGROUND: Adolescence represents a vulnerable period to experience personal crises or mental health problems. However, many concerns stay unnoticed due to the hesitance of young people to seek help and the unavailability and inaccessibility of appropriate help services. Contemporary interventions have been developed incorporating with target group specific needs and preferred modes of communication. krisenchat (German for "crisis chat") is a German low-threshold chat-based psychosocial crisis counselling service that is available around-the-clock. Despite the growing number of online support services, there is a dearth of research regarding the acceptability, usability, and feasibility. METHODS: The present cross-sectional study analyzed retrospective anonymous data on sociodemographic variables, utilization behavior, and user satisfaction of all krisenchat users between May 2020 and July 2021. Predictors of user satisfaction were identified using exploratory multiple regression analysis. Subgroup analyses were conducted using chi-square-tests to identify differences in user satisfaction. RESULTS: Data of N = 6962 users was included in the analysis. More than 50% of those reported not having contacted the professional health care system before. The mean user of krisenchat was 17 years old (M = 16.6, SD = 3.5), female (female: 83.4%, male: 14.7%, diverse: 1.8%), and first approached the service at 4 PM (M = 4:03 PM, SD = 5:44 h). More than 60% of the users contacted the service between 4 PM and 12 AM, 10% even between 12 AM and 8 AM. The most frequent chat topics were concerns regarding psychiatric symptoms (60.1%), psychosocial (34.0%) or emotional distress (30.2%). The majority of the users (64.7%) reported high levels of satisfaction and 88.3% a high likelihood (60% or more) of recommending krisenchat to others. Also, the results indicate that the number of messages and their respective length differed between users and counsellors, with users writing several, but shorter messages and counsellors replying with fewer, but longer messages. CONCLUSION: The results of the present study imply a high acceptability and feasibility of krisenchat. Overall, there is a high need for a 24/7 messenger-based chat counselling service in crises for children and young adults. Currently, there is no other online service for youth that is available after 7 PM or at weekends, which indicates the great importance of krisenchat and its function to bridge a current gap in the mental health care system. A need for further research emerges e.g., for subgroup differences regarding utilization patterns and also for further insights regarding help-seeking behavior via social media in youth. STUDY REGISTRATION: DRKS00026671.

Recommendations for school-going students post CoVid-19 in Bangladesh.

The CoVid-19 pandemic caused by SARS-CoV-2 has taken more lives than any other pandemic so far, with non-pharmacological interventions such as lockdown, school closures, and travel bans, especially social distance, abounding around the world. With limited resources, these interventions pose the ultimate challenge to the education system in developing countries like Bangladesh, especially in providing uninterrupted education for all children in rural areas, where a significant number of students are enrolled in this area. However, the initiative to close schools for an extended period has affected children physically, emotionally, socially, and in various ways. Noteworthy, it demands to reopen to protect the future of children. Schools have reopened in many countries around the world. It is of interest to document recommendations for school-going students post CoVid-19 in Bangladesh using evidence-based data, information, and knowledge. We document such data in the context of Bangladesh to take such policy initiatives.

[Art therapy in treatment, rehabilitation, micro- and macrosocial adaptation of children with autism spectrum disorders by means of a special rehabilitation and adaptation program "Art therapy (drama therapy): 'Because You are Needed ' for children with general disorders of psychological development and other mental disorders"].

For the first time, the effectiveness of art therapy (drama therapy) in children with mental disorders has been studied on substantial clinical data. Psychotherapeutic work involved certain form of drama therapy that included patients watching Moscow theaters performances and then discussing them with family and in group therapy sessions with psychologists. Researchers have developed drama therapy methods for children with mental disorders, determined indications and contraindications for this treatment. The study shows effects of art therapy on the child adaptation to the conditions of the micro-social environment, particularly on his family adaptation, formation of harmonious, supportive, rehabilitative family relations. It is noted that art therapy influences adolescent's adaptation to the conditions of the macrosocial environment, particularly his adaptation in a peer group, behavior in various situations and formation of normal behavioral patterns in different environmental conditions.

Two-year development of children conceived by IVM: a prospective controlled single-blinded study.

STUDY QUESTION: Is there a difference in mental development of children conceived by IVM in comparison to IVF or ICSI, independently, at the age of 2 years? SUMMARY ANSWER: No differences could be found in mental development of IVM children compared to IVF and IVM children compared to ICSI as well. WHAT IS KNOWN ALREADY: Only few retrospective or non-controlled studies addressed the health of IVM children and did not show a negative impact of the IVM procedure. STUDY DESIGN, SIZE, DURATION: Prospective controlled single-blinded study including 63 pregnancies (21 per IVM, IVF and ICSI groups) with 70 children expected. Examinations of 62 embryos at first trimester screening, of 57 fetuses at 21st week of pregnancy, of 60 children at birth and of 37 children at their second birthday were performed during the study period from January 2009 until October 2016. Bayley score at the age of 2 was the primary outcome parameter. Data of 40 children after spontaneous conception from a previous prospective unrelated study were further used as control at 2 years examination and compared to the pooled ART group (IVM, IVF and ICSI). PARTICIPANTS/MATERIALS, SETTING, METHODS: Twenty-one IVM pregnancies achieved in the study period were included. For each of them, the following IVF- and ICSI pregnancies were recruited as controls. Ultrasound examinations during pregnancy, examinations of newborns and of children around their second birthday were done by blinded prenatal specialists, pediatricians and neuropediatricians, respectively. MAIN RESULTS AND THE ROLE OF CHANCE: Children conceived after IVM did not show differences during embryonic development, at birth nor in their neuropediatric development at the age of 2 compared to their counterparts after IVF and after ICSI (Bayley score 91.3 ± 21.0 for IVM, 96.8 ± 13.2 for IVF and 103.9 ± 13.1 for ICSI) and of the pooled ART group compared to children after spontaneous conception (96.6 ± 16.4 ART and 103.2 ± 9.4 spontaneous conception). When analyzing singleton pregnancies only, again no differences during pregnancy, at birth and at their 2-year evaluation were detected between IVM versus IVF and IVM versus ICSI. LIMITATIONS, REASONS FOR CAUTION: Due to the small sample size data must be interpreted with caution. To allow a confirmative answer that there are no health risks for children conceived by IVM, large multicenter cohort or registry-based studies are urgently needed. WIDER IMPLICATIONS OF THE FINDINGS: The study adds further information to previous uncontrolled or retrospective studies, which were unable to detect risks for the health of IVM children. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by the 'Deutsche Forschungsgemeinschaft' (DFG): STR 387/4-1. G.R. receives royalties from Pearson Assessment Germany (editor fee for Bayley-III). The other authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: Not applicable.

Initial healthcare to pediatric population under the radiation events. / MEDYChNA DOPOMOGA DYTIaChOMU NASELENNIu PRY RADIATsIY̆NYKh PODIIaKh NA PERShYKh ETAPAKh.

The objective of this paper is to analyze the data from scientific literature and available recommendations for health professionals on healthcare providing to pediatric population in the events associated with risk of radiation exposure. Over the past sixty years there were several large scale radiological events with a large number of chil dren affected, namely the atomic bombing of Hiroshima and Nagasaki, accident at the Chornobyl nuclear power plant, contact to 137Cs radiation source unutilized at the hospital shutdown in Brazil etc. Further research has crys tallized injuries and health disorders in the survived children in all cases being much more significant vs. other pop ulations. Analysis of circumstances and features of a number of emergency situations or incidents in the nuclear industry for several decades has shown a high probability of radioactive materials release into the environment. The danger of terrorism with the use of ionizing radiation sources resulting in a considered inevitable hazard to the chil dren is estimated as serious in recent years and deserves an especial mention here.

Redes e ação intersetorial: a experiência de um Centro de Atenção Psicossocial Infanto-juvenil domunicípio do Rio de Janeiro / Networking and intersectoral action: Children and youth experience a Psychosocial Care Center in the city of Rio de Janeiro

O estudo busca identificar as estratégias adotadas, práticas e desafios cotidianos nas relações interinstitucionais estabelecidas por um Centro de Atenção Psicossocial Infanto-Juvenil na construção do trabalho de articulação de rede e implementação de ações intersetoriais no cotidiano do serviço. Visando dar sustentação teórico-conceitual ao estudo, são utilizados os marcos legais que sob o qual se baseia o processo de implantação da Política de Saúde Mental Infanto-Juvenil no país e os referenciais teórico-conceituais vinculados a Teoria da Produção Social, a Teoria do Agir Comunicativo e Atos de Fala e a Teoria das Conversações. A sustentação empírica deste estudo se deu através da aplicação de entrevistas com profissionais de um Centro de Atenção Psicossocial Infanto-Juvenil situado no Município do Rio de Janeiro e dos serviços da rede, e de observações realizadas nas reuniões de trabalho realizadas entre estes serviços. Destaca-se como objetivos das entrevistas e das observações a identificação das ações desenvolvidas no cotidiano pelos profissionais do serviço voltadas a articulação de redes e para o desenvolvimento de ações intersetoriais, a apreensão das concepções que embasam as ações destes profissionais e de profissionais de serviços que mantêm articulação permanente com o CAPSi e a identificação dos desafios enfrentados no trabalho de articulação de redes e desenvolvimento de ações extramuros. Adota-se uma abordagem qualitativa e uitiliza-se a aplicação de entrevistas semiestruturadas e observação participante como técnicas de coleta de dados...

The study seeks to identify the strategies adopted, practices and everydaychallenges in interinstitutional relationships established by a Children and YouthPsychosocial Care Center in building the network of articulation and implementation ofintersectoral actions work in the service environment.Aiming to study the theoretical and conceptual support, legal framework thatunder which the process of implementation of the Mental Health Policy Children andYouth in the country and the theoretical and conceptual framework related to Theory ofSocial Production, the theory is based are used Communicative Action and Speech Actsand the Theory of Conversations.Empirical support of this study occurred through the application of interviewswith a Child and Youth Psychosocial Care Center located in the city of Rio de Janeiroand of network services, and observations made in the working meetings between theseservices. Stands out as goals from interviews and observations to identify the actionsdeveloped by professionals in daily service oriented articulation of networks and thedevelopment of intersectoral actions to grasp the concepts that underlie the actions ofthese professionals and professional services maintain ongoing liaison with the CAPSiand identifying challenges facing the articulation work of networking and developingextramural actions. Adopts a qualitative approach and uitiliza to application of semistructuredinterviews and participant observation as data collection techniques. Amongthe results we highlight the indispensability of intersectoral work in providing assistancein the professionals' view CAPSi and professionals that comprise the network of localservice, the network work as a work in permanent construction, as CAPSi triggercommunication between services, the need for improving communication betweeninstitutions and conceptual diversity on the network design as a challenge to thecoordination of actions and the interaction between services...