Younger and Rural Children are More Likely to be Hospitalized for SARS-CoV-2 Infections.

Purpose: To identify characteristics of SARS-CoV-2 infection that are associated with hospitalization in children initially evaluated in a Pediatric Emergency Department (ED). Methods: We identified cases of SARS-CoV-2 positive patients seen in the Arkansas Children's Hospital (ACH) ED or hospitalized between May 27, 2020, and April 28, 2022 using ICD-10 codes within the Pediatric Hospital Information System (PHIS) Database. We compared infection waves for differences in patient characteristics, and used logistic regressions to examine which characteristics led to a higher chance of hospitalization. Findings: We included 681 pre-Delta cases, 673 Delta cases, and 970 Omicron cases. Almost 17% of patients were admitted to the hospital. Compared to Omicron infected children, pre-Delta and Delta infected children were twice as likely to be hospitalized (OR=2.2 and 2.0, respectively; p<0.0001). Infants less than 1 year of age were >3 times as likely to be hospitalized than children ages 5-14 years regardless of wave (OR=3.42; 95%CI=2.36-4.94). Rural children were almost 3 times as likely than urban children to be hospitalized across all waves (OR=2.73; 95%CI=1.97-3.78). Finally, those with a complex condition had nearly a 15-fold increase in odds of admission (OR=14.6; 95%CI=10.6-20.0). Conclusions: Children diagnosed during the pre-Delta or Delta waves were more likely to be hospitalized than those diagnosed during the Omicron wave. Younger and rural patients were more likely to be hospitalized regardless of wave. We suspect lower vaccination rates and larger distances from medical care influenced higher hospitalization rates.

The moderation effect of identity exploration and basic psychological needs satisfaction on flourishing of Chinese rural children.

Most studies equate children's mental health to a state of flourishing, which is a positive feeling and functions in their lives. Identity exploration and the satisfaction of three basic psychological needs are universal and crucial indicators of children's flourishing. First, according to identity crisis theory, children in the pre-adolescence period begin to explore their own identities, a process which significantly affects their development and flourishing. Meanwhile, self-determination theory points out that the basic psychological needs, namely the needs for autonomy, competence, and relatedness, are essential for children's development and flourishing in the worldwide. Accordingly, this study examined how identity exploration affects the flourishing of rural children in China, one kind of collectivism cultural contexts, with the interaction effect of identity exploration and basic psychological needs satisfaction. To understand the interaction effect of identity exploration and basic psychological needs satisfaction on rural children's flourishing, we form a theoretical framework combining identity crisis theory and self-determination theory. Both these two theories emphasize the importance of self in facilitating mental health and the development of functioning. Specifically, identity crisis theory focuses on intrapsychic process, while self-determination theory stresses the influence of the surrounding environment on the individual, which provides a solid foundation for integrating these two theories to explore rural children's flourishing in China. Accordingly, this study collected 520 left-behind children and 475 other rural children in Liaoning Province in Mainland of China, and used regression analysis to measure the associations among variables. This study found that identity exploration and basic psychological needs satisfaction positively affect rural children's flourishing respectively, while their interaction effects negatively affect on their flourishing.

The moderation effect of identity exploration and basic psychological needs satisfaction on flourishing of Chinese rural children

Abstract Most studies equate children's mental health to a state of flourishing, which is a positive feeling and functions in their lives. Identity exploration and the satisfaction of three basic psychological needs are universal and crucial indicators of children's flourishing. First, according to identity crisis theory, children in the pre-adolescence period begin to explore their own identities, a process which significantly affects their development and flourishing. Meanwhile, self-determination theory points out that the basic psychological needs, namely the needs for autonomy, competence, and relatedness, are essential for children's development and flourishing in the worldwide. Accordingly, this study examined how identity exploration affects the flourishing of rural children in China, one kind of collectivism cultural contexts, with the interaction effect of identity exploration and basic psychological needs satisfaction. To understand the interaction effect of identity exploration and basic psychological needs satisfaction on rural children's flourishing, we form a theoretical framework combining identity crisis theory and self-determination theory. Both these two theories emphasize the importance of self in facilitating mental health and the development of functioning. Specifically, identity crisis theory focuses on intrapsychic process, while self-determination theory stresses the influence of the surrounding environment on the individual, which provides a solid foundation for integrating these two theories to explore rural children's flourishing in China. Accordingly, this study collected 520 left-behind children and 475 other rural children in Liaoning Province in Mainland of China, and used regression analysis to measure the associations among variables. This study found that identity exploration and basic psychological needs satisfaction positively affect rural children's flourishing respectively, while their interaction effects negatively affect on their flourishing.

Marginalization and fluorosis its relationship with dental caries in rural children in Mexico: A cross-sectional study.

OBJECTIVE: Examine the association between marginalization and fluorosis with caries experience in Mexican rural children aged 8-12, in Oaxaca, Mexico. METHODS: Cross-sectional study of 283 rural schoolchildren selected from two locations with high and medium levels of marginalization where the water fluoride concentration ranged from 2.0 to 2.5 ppm/F. Caries was evaluated using the DMFT index and dental fluorosis with the Thylstrup-Fejerskov Index (TFI). Socioeconomic data were collected from participants' parents, with data on the children's characteristics collected from them via a questionnaire. RESULTS: The prevalence of caries was 72.4% (DMFT ≥1) in the permanent dentition. The prevalence of fluorosis was 98.0% (TFI ≥4=71.4%). 54.8% of the children brushed their teeth two or more times daily. In logistic regression children living in high levels of marginalization were more likely to present caries (OR=2.11, 95% CI 1.13 - 3.93) than children living in medium levels. Children with severe fluorosis (TFI ≥4) (OR=1.93, 95% CI 1.06 - 3.53) were more likely have caries than those with TFI ⟨3. CONCLUSION: Rural children with a high level of marginalization and fluorosis (TFI ≥4) were more likely to present caries. Poor oral hygiene and low dental service levels were found in both marginalized areas. Populations with medium/high marginalization are more susceptible to caries.

Cognitive deficits and ALA-D-inhibition in children exposed to multiple metals.

Children are especially vulnerable to adverse effects of multiple metals exposure. The aim of this study was to assess some metals concentrations such as lead (Pb), arsenic (As), chromium (Cr), manganese (Mn) and iron (Fe) in whole blood, serum, hair and drinking water samples using inductively coupled plasma-mass spectrometry (ICP-MS) in rural and urban children. In addition, evaluate the adverse effects of multiple metals exposure on cognitive function and δ-aminolevulinate dehydratase (ALA-D) activity. The cognitive ability assessment was performed by the Raven's Colored Progressive Matrices (RCPM) test. The ALA-D activity and ALA-D reactivation index (ALA-RE) activity with DTT and ZnCl2 also were determined. Forty-six rural children and 23 urban children were enrolled in this study. Rural children showed percentile IQ scores in the RCPM test significantly decreased in relation to urban children. According to multiple linear regression analysis, the Mn and Fe in hair may account for the cognitive deficits of children. Manganese and Fe in hair also were positively correlated with Mn and Fe in drinking water, respectively. These results suggest that drinking water is possibly a source of metals exposure in children. ALA-D activity was decreased and ALA-RE with DTT and ZnCl2 was increased in rural children in comparison to urban children. Moreover, ALA-D inhibition was correlated with Cr blood levels and ALA-RE/DDT and ALA-RE/ZnCl2 were correlated with levels of Cr and Hg in blood. Thus, our results indicated some adverse effects of children's exposure to multiple metals, such as cognitive deficits and ALA-D inhibition, mainly associated to Mn, Fe, Cr and Hg.