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Pan T, Gallo ME, Donald KA, Webb K, Bath KG. Elevated risk for psychiatric outcomes in pediatric patients with Multisystem Inflammatory Syndrome (MIS-C): A review of neuroinflammatory and psychosocial stressors. Brain Behav Immun Health 2024; 38:100760. [PMID: 38586284 PMCID: PMC10992702 DOI: 10.1016/j.bbih.2024.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 02/19/2024] [Accepted: 03/17/2024] [Indexed: 04/09/2024] Open
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) is a secondary immune manifestation of COVID-19 involving multiple organ systems in the body, resulting in fever, skin rash, abdominal pain, nausea, shock, and cardiac dysfunction that often lead to hospitalization. Although many of these symptoms resolve following anti-inflammatory treatment, the long-term neurological and psychiatric sequelae of MIS-C are unknown. In this review, we will summarize two domains of the MIS-C disease course, 1) Neuroinflammation in the MIS-C brain and 2) Psychosocial disruptions resulting from stress and hospitalization. In both domains, we present existing clinical findings and hypothesize potential connections to psychiatric outcomes. This is the first review to conceptualize a holistic framework of psychiatric risk in MIS-C patients that includes neuroinflammatory and psychosocial risk factors. As cases of severe COVID-19 and MIS-C subside, it is important for clinicians to monitor outcomes in this vulnerable patient population.
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Affiliation(s)
- Tracy Pan
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI 029112, USA
- The Neuroscience Institute, University of Cape Town, South Africa
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Meghan E. Gallo
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI 029112, USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Irving Medical College, New York, NY, 10032, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, South Africa
| | - Kate Webb
- Division of Paediatric Rheumatology, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, 7700, South Africa
- Crick African Network, Francis Crick Institute, London, UK
| | - Kevin G. Bath
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Irving Medical College, New York, NY, 10032, USA
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Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care 2024; 36:137-144. [PMID: 38301123 DOI: 10.1080/09540121.2024.2308025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.
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Affiliation(s)
- Babalwa Zani
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
| | - Brian Luckett
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
| | - Tonya R Thurman
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
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Roumeliotis N, Carwana M, Trudeau O, Charland K, Zinszer K, Benigeri M, Diop M, Papenburg J, Ali S, Yaskina M, Wahi G, Forgeot d’Arc B, Côté S, Sadarangani M, Basta NE, Fontela PS, Gantt S, Klassen TP, Quach C, Doan Q. Mental Health Hospitalizations in Canadian Children, Adolescents, and Young Adults Over the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e2422833. [PMID: 38976264 PMCID: PMC11231797 DOI: 10.1001/jamanetworkopen.2024.22833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 05/17/2024] [Indexed: 07/09/2024] Open
Abstract
Importance The COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population. Objective To estimate the incidence of hospitalizations for mental health conditions, stratified by sex, region, and social determinants, in children and adolescents (hereinafter referred to as youths) and young adults comparing the prepandemic and pandemic-prevalent periods. Design, Setting, and Participants This Canadian population-based repeated ecological cross-sectional study used health administrative data, extending from April 1, 2016, to March 31, 2023. All youths and young adults from 6 to 20 years of age in each of the Canadian provinces and territories were included. Data were provided by the Canadian Institute for Health Information for all provinces except Quebec; the Institut National d'Excellence en Santé et en Services Sociaux provided aggregate data for Quebec. Exposures The COVID-19-prevalent period, defined as April 1, 2020, to March 31, 2023. Main Outcomes and Measures The main outcome measures were the prepandemic and COVID-19-prevalent incidence rates of hospitalizations for anxiety, mood disorders, eating disorders, schizophrenia or psychosis, personality disorders, substance-related disorders, and self-harm. Secondary measures included hospitalization differences by sex, age group, and deprivation as well as emergency department visits for the same mental health conditions. Results Among Canadian youths and young adults during the study period, there were 218 101 hospitalizations for mental health conditions (ages 6 to 11 years: 5.8%, 12 to 17 years: 66.9%, and 18 to 20 years: 27.3%; 66.0% female). The rate of mental health hospitalizations decreased from 51.6 to 47.9 per 10 000 person-years between the prepandemic and COVID-19-prevalent years. However, the pandemic was associated with a rise in hospitalizations for anxiety (incidence rate ratio [IRR], 1.11; 95% CI, 1.08-1.14), personality disorders (IRR, 1.21; 95% CI, 1.16-1.25), suicide and self-harm (IRR, 1.10; 95% CI, 1.07-1.13), and eating disorders (IRR, 1.66; 95% CI, 1.60-1.73) in females and for eating disorders (IRR, 1.47; 95% CI, 1.31-1.67) in males. In both sexes, there was a decrease in hospitalizations for mood disorders (IRR, 0.84; 95% CI, 0.83-0.86), substance-related disorders (IRR, 0.83; 95% CI, 0.81-0.86), and other mental health disorders (IRR, 0.78; 95% CI, 0.76-0.79). Conclusions and Relevance This cross-sectional study of Canadian youths and young adults found a rise in anxiety, personality disorders, and suicidality in females and a rise in eating disorders in both sexes in the COVID-19-prevalent period. These results suggest that in future pandemics, policymakers should support youths and young adults who are particularly vulnerable to deterioration in mental health conditions during public health restrictions, including eating disorders, anxiety, and suicidality.
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Affiliation(s)
- Nadia Roumeliotis
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Matthew Carwana
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Ofélie Trudeau
- Centre Hospitalier Universitaire Sainte-Justine Hospital Research Centre, Montreal, Quebec, Canada
| | - Katia Charland
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Kate Zinszer
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Mike Benigeri
- Institut National d’Excellence en Santé et en Services Sociaux, Montreal, Quebec, Canada
| | - Mamadou Diop
- Institut National d’Excellence en Santé et en Services Sociaux, Montreal, Quebec, Canada
| | - Jesse Papenburg
- Department of Pediatrics, Montreal Children’s Hospital, Montreal, Quebec, Canada
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Maryna Yaskina
- Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Gita Wahi
- McMaster Children’s Hospital, Hamilton, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
| | - Baudoin Forgeot d’Arc
- Department of Psychiatry, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Sylvana Côté
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Manish Sadarangani
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Patricia S. Fontela
- Department of Pediatrics, Montreal Children’s Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Soren Gantt
- Centre Hospitalier Universitaire Sainte-Justine Hospital Research Centre, Montreal, Quebec, Canada
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, Quebec, Canada
| | - Terry P. Klassen
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Caroline Quach
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, Quebec, Canada
| | - Quynh Doan
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
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Jency PJ, Dinesh RJ, Dhanalakshmi R, Srividya A, Azad PM, Kumar A. Effects of the COVID-19 Pandemic on the Lifestyle and Mental Health of Children in the Puducherry District: A Community-Based Cross-Sectional Study. Cureus 2024; 16:e63164. [PMID: 39070474 PMCID: PMC11272912 DOI: 10.7759/cureus.63164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has tremendously disrupted societal behaviors and norms. People had to cope with new situations, including restrictions on free movement, home confinement, and school closures, among others. With less scope for physical classes, online classes became rampantly common during and after the pandemic. A virtual learning platform cannot replace the societal learning and preparation of children that normally occurs in school settings. The pandemic had a multifaceted impact on children, disrupting their routine work, social life, and mental health. Such uncertain circumstances are bound to interfere with their emotional well-being, with long-term consequences. It is imperative to screen for the effects of the pandemic situation among children for timely action. METHODS A cross-sectional survey was carried out in both rural and urban areas of Puducherry, India, between February and April 2022, toward the fag end of the pandemic. Face-to-face interviews were conducted among caregivers of 621 children aged 6-17 years. Details such as sociodemographic, personal, and behavioral aspects of the child were collected. Emotional and behavioral difficulties during the pandemic were assessed using the parent (caregiver) version of the Strengths and Difficulties Questionnaire-25 (SDQ-25). Univariate analysis was performed using the chi-square test. Four different regression models were fitted to ascertain the factors influencing the overall difficulty score as well as the SDQ subscales, namely, the internalizing, externalizing, and prosocial scores. A P value of <0.05 was considered significant. RESULTS Overall, 101 (16.3%) children aged 6-17 years were likely to have emotional and behavioral difficulties according to the SDQ scores. Abnormal externalizing, internalizing, and prosocial scores were documented among 160 (25.8%), 258 (41.5%), and 285 (45.9%) children, respectively. Caregivers reported disruptions in their children's academic performance (426, 68.6%), sleeping patterns (269, 43.3%), and eating habits (256, 41.2%). The use of digital devices for noneducational purposes was reported among 97 (35.9%) children. Younger caregivers (18-45 years), children who used digital devices for >2 hours per day, children who experienced any death due to COVID-19 in their family, and caregivers who perceived that the psychological changes in their children were due to the pandemic were predictors of abnormal SDQ scores. Physical activity for more than two hours per day reduced the risk of emotional and behavioral difficulties in children by 60%. CONCLUSIONS This research underscores the potential ramifications of the pandemic on the mental well-being and lifestyle of children. Implementing initiatives that promote positive mental health and conducting preventive screening for vulnerable populations, such as children, are considered essential, anticipating the challenges posed by such unprecedented pandemic circumstances in the future.
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Affiliation(s)
- Priskilla Johnson Jency
- Department of Epidemiology and Operational Research, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, IND
| | - Raja Jeyapal Dinesh
- Department of Epidemiology and Operational Research, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, IND
| | - Rajendran Dhanalakshmi
- Department of Epidemiology and Operational Research, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, IND
| | - Adinarayanan Srividya
- Department of Biostatistics and Vector-Borne Diseases Modeling, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, IND
| | - Palappurath Maliyakkal Azad
- Department of Biostatistics and Vector-Borne Diseases Modeling, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, IND
| | - Ashwani Kumar
- Indian Council of Medical Research, Vector Control Research Centre, Puducherry, IND
- SIMATS, Saveetha University, Chennai, IND
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Frei-Landau R. Teachers as caregivers of grieving children in school in the post-COVID-19 era: using the self-determination theory to conceptualize teachers' needs when supporting grieving children's mental health. Front Pediatr 2024; 12:1320106. [PMID: 38873582 PMCID: PMC11169661 DOI: 10.3389/fped.2024.1320106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/16/2024] [Indexed: 06/15/2024] Open
Abstract
Background It has been estimated in recent studies that more than 1.5 million children worldwide lost a caregiver due to the COVID-19 pandemic. Childhood bereavement is associated with heightened risks of impaired academic and social performance, mental health issues, substance use disorders, and higher mortality rates. Yet children may receive insufficient support post-loss. Although the role of school psychologists in supporting grieving students has been examined, little is known about the role of teachers in this context. Specifically, knowledge about teachers' needs when supporting bereaved children is lacking. Objective The study's aim was to explore teachers' needs, drawing upon a well-established framework-self-determination theory (SDT)-which focuses on three human needs considered essential for optimal functioning: autonomy, competence, and relatedness. Methods Employing a qualitative approach, 36 teachers were interviewed about their needs when supporting grieving students. Interviews were transcribed and then analyzed using thematic content analysis. Results Analysis revealed three SDT-related needs: knowledge (theory- and practice-related), acknowledgment, and support (emotional and practical). Conclusions The findings enhance our theoretical understanding of childhood bereavement and may promote policy changes that ensure teachers' needs satisfaction. Its significance lies in the basic premise that supporting teachers' needs in the context of pediatric grief may eventually lead to their optimal ability to enact best practices for supporting grieving students' well-being.
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Giang C, Alvis L, Oosterhoff B, Kaplow JB. Protective Factors in the Context of Childhood Bereavement: Youth Gratitude, Future Orientation, and Purpose in Life. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241246919. [PMID: 38621174 DOI: 10.1177/00302228241246919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The objective of the study was to examine potential associations between positive youth development constructs (gratitude, future orientation, purpose in life) and psychological functioning (posttraumatic stress symptoms, depressive symptoms, maladaptive grief reactions) among bereaved youth and test whether these associations vary by age. A diverse sample of 197 clinic-referred bereaved youth (56.2% female; M = 12.36, SD = 3.18; 36.1% Hispanic, 23.7% White, 20.1% Black, 11.9% Multiracial, and 8.2% another race/ethnicity) completed self-report measures of psychological functioning and positive youth development constructs. Linear regression models indicated that gratitude and purpose were associated with lower posttraumatic stress and depressive symptoms among bereaved youth. Future orientation was associated with higher posttraumatic stress symptoms. Results were consistent across age. If replicated longitudinally, gratitude and purpose may be important protective factors against negative mental health outcomes in the aftermath of losing a loved one.
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Affiliation(s)
- Christopher Giang
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lauren Alvis
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
| | - Benjamin Oosterhoff
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
| | - Julie B Kaplow
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
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Houle B, Kabudula C, Mojola SA, Angotti N, Gómez-Olivé FX, Gareta D, Herbst K, Clark SJ, Menken J, Canudas-Romo V. Mortality variability and differentials by age and causes of death in rural South Africa, 1994-2018. BMJ Glob Health 2024; 9:e013539. [PMID: 38589045 PMCID: PMC11015189 DOI: 10.1136/bmjgh-2023-013539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/20/2023] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Understanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability. METHODS Using population surveillance data from the Agincourt Health and Socio-Demographic Surveillance System (AHDSS; 1994-2018) and Africa Health Research Institute (AHRI; 2000-2018) for 5-year periods, we calculated life expectancy from birth to age 85, mortality age distributions and variation, and life-years lost (LYL) decomposed into four cause-of-death groups. RESULTS The AIDS epidemic shifted the age-at-death distribution to younger ages and increased LYL. For AHDSS, between 1994-1998 and 1999-2003 LYL increased for females from 13.6 years (95% CI 12.7 to 14.4) to 22.1 (95% CI 21.2 to 23.0) and for males from 19.9 (95% CI 18.8 to 20.8) to 27.1 (95% CI 26.2 to 28.0). AHRI LYL in 2000-2003 was extremely high (females=40.7 years (95% CI 39.8 to 41.5), males=44.8 years (95% CI 44.1 to 45.5)). Subsequent widespread ART availability reduced LYL (2014-2018) for women (AHDSS=15.7 (95% CI 15.0 to 16.3); AHRI=22.4 (95% CI 21.7 to 23.1)) and men (AHDSS=21.2 (95% CI 20.5 to 22.0); AHRI=27.4 (95% CI 26.7 to 28.2)), primarily due to reduced HIV/AIDS/TB deaths in mid-life and other communicable disease deaths in children. External causes increased as a proportion of LYL for men (2014-2018: AHRI=25%, AHDSS=17%). The share of AHDSS LYL 2014-2018 due to non-communicable diseases exceeded pre-HIV levels: females=43%; males=40%. CONCLUSIONS Our findings highlight shifting burdens in cause-specific LYL and persistent mortality differentials in two populations experiencing complex epidemiological transitions. Results show high contributions of child deaths to LYL at the height of the AIDS epidemic. Reductions in LYL were primarily driven by lowered HIV/AIDS/TB and other communicable disease mortality during the ART periods. LYL differentials persist despite widespread ART availability, highlighting the contributions of other communicable diseases in children, HIV/AIDS/TB and external causes in mid-life and non-communicable diseases in older ages.
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Affiliation(s)
- Brian Houle
- School of Demography, The Australian National University, Acton, Australian Capital Territory, Australia
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - Chodziwadziwa Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanyu A Mojola
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology, School of Public and International Affairs, and Office of Population Research, Princeton University, Princeton, New Jersey, USA
| | - Nicole Angotti
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Sociology, American University, Washington, DC, USA
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Dickman Gareta
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Kobus Herbst
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- DSI-MRC South African Population Research Infrastructure Network, Durban, South Africa
| | - Samuel J Clark
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
| | - Jane Menken
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - Vladimir Canudas-Romo
- School of Demography, The Australian National University, Acton, Australian Capital Territory, Australia
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Marchal Torralbo A, Rodoreda Noguerola S, Perez Martín V, Bielsa Pascual J, Lizana Alcazo MT, Manresa Domínguez MJ, Vedia Urgell C. [Emotional well-being, perceptions and attitudes against COVID-19 on adolescents]. Semergen 2024; 50:102158. [PMID: 38157749 DOI: 10.1016/j.semerg.2023.102158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The worldwide pandemic of SARS-Cov2 has had a great impact on the lives of adolescents, affecting their health and well-being. There is little evidence of the emotional impact of the pandemic on adolescents. OBJECTIVE To explore the knowledge, perceptions, and attitudes of young people regarding COVID-19 and its impact on emotional well-being. METHOD A cross-sectional observational and descriptive study based on a survey of students aged 16-20 from five high schools in Barcelona metropolitan area. RESULTS The study was carried out on 291 surveys. Females made up 56.7% of the population. The average age was 16.9 years. A greater lack of knowledge about the transmission of the disease was detected. The most frequently used sources of information were social networks. In terms of emotional distress, the most important aspects were worry about getting sick (64%), family financial problems (46%), anxiety and irritability (27%), and apathy (26.5%). Gender differences were detected in terms of worries (women: 28.8%; men: 11.1%), sadness (women: 29.3%, men: 15.5%), and feelings of fear (women: 24.5%; men: 11%). 16.7% of the participants consulted a mental health professional, with this being more common in women (women: 23.8%; men: 7.4%). CONCLUSIONS COVID-19 has affected the emotional well-being of adolescents, especially the female population. It is necessary to implement emotional well-being strategies in early childhood to cope with possible stressful situations in daily life and avoid future mental health problems. There is a growing use of social media to combat social isolation. The results of the study hold the potential to strategies aimed at preempting forthcoming biopsychosocial distress.
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Affiliation(s)
- A Marchal Torralbo
- SAP Barcelonès Nord i Maresme, Institut Català de la Salut, Badalona, España; Referente Salud Comunitaria, Direcció d'Atenció Primària Metropolitana Nord, Institut català de la salut, Sabadell, España; Referente programa «Salut i escola», Institut Català de la Salut, Barcelona, España; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España.
| | - S Rodoreda Noguerola
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Adjunta a la direcció d'Atenció Primaria, Institut Català de la Salut, Barcelona, España; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), (2017 SGR 917), Barcelona, España
| | - V Perez Martín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; EAP Santa Rosa, Institut Català de la Salut, Santa Coloma de Gramenet, España
| | - J Bielsa Pascual
- Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), (2017 SGR 917), Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, IDIAPJordi Gol, Mataró, España
| | | | - M J Manresa Domínguez
- EAP Santa Rosa, Institut Català de la Salut, Santa Coloma de Gramenet, España; Departament d'Infermeria, Universitat Autònoma de Barcelona, Barcelona, España
| | - C Vedia Urgell
- SAP Barcelonès Nord i Maresme, Institut Català de la Salut, Badalona, España; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Lee N, Self-Brown SR, Bachman G, Howard AL, Gilbert LK, Hegle J, Perry EW, Saul J, Behl I, Massetti GM. Orphanhood vulnerabilities for violence and HIV by education, sex, and orphan type among 18-24-year-old youth: findings from the 2018 Lesotho violence against children and youth survey. PSYCHOL HEALTH MED 2024; 29:655-669. [PMID: 37434351 PMCID: PMC10782587 DOI: 10.1080/13548506.2023.2235280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/06/2023] [Indexed: 07/13/2023]
Abstract
HIV and violence among orphans are key measures of vulnerability in low-resource settings. Although Lesotho has the second highest HIV adult prevalence rate (21.1%) in the world, and the prevalence of orphanhood (44.2%) and violence exposure (67.0%) is high, little research exist on orphanhood vulnerabilities for violence and HIV in Lesotho. Using data from 4,408 youth (18-24 years old) from Lesotho's 2018 Violence Against Children and Youth survey, a nationally representative cross-sectional household survey, the study examined associations among orphan status, violence, and HIV and assessed how associations differed by education, sex, and orphan type, using logistic regression. Orphans had higher odds of violence (aOR, 1.21; 95% CI, 1.01-1.46) and HIV (aOR, 1.69; 95% CI, 1.24-2.29). Having primary education or less (aOR, 1.43; 95% CI, 1.02-2.02), male sex (aOR, 1.74; 95% CI, 1.27-2.36), and being a paternal orphan (aOR, 1.43; 95% CI, 1.14-1.80) were significant interaction terms for violence. Orphans who completed primary school or less (aOR, 1.61; 95% CI, 1.09-2.39), female (aOR, 3.08; 95% CI, 2.14-4.42) and double orphans (aOR, 2.54; 95% CI, 1.56-4.13) had higher odds of HIV. These relationships highlight the importance of comprehensive strategies to support education and family strengthening for orphans as core violence and HIV prevention efforts.
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Affiliation(s)
- NaeHyung Lee
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
- Copial Business Strategists LLC, Atlanta, GA, USA
- Office of Strategy and Innovation, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon R. Self-Brown
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Gretchen Bachman
- Office of Global HIV/AIDS, US Agency for International Development, Washington, DC, USA
| | - Ashleigh L. Howard
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Leah K. Gilbert
- Office of Safety, Security, and Asset Management, Office of the Chief Operating Officer, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth W. Perry
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Janet Saul
- Office of the Global AIDS Coordinator and Health Diplomacy, US Department of State, Washington, DC, USA
| | - India Behl
- School of Public and International Affairs, Princeton University, Princeton, NJ, USA
| | - Greta M. Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Blackburn J, Waring G, Turner M, Currell K, Caress AL. Exploring the Impact of Bereavement During the COVID-19 Pandemic on Children and Young People: A Scoping Review. Compr Child Adolesc Nurs 2024; 47:55-67. [PMID: 38127065 DOI: 10.1080/24694193.2023.2292503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
Experiencing bereavement as a child or young person (CYP) can have long-lasting effects. The societal and environmental burdens of the SARS-CoV-2 pandemic exacerbated the experience of loss and grief for many CYP, who were unable to access their usual the support networks. However, it is still unclear what is currently known and not known about the experiences of CYP bereaved during the SARS-CoV-2 pandemic. This review used the framework of Arksey and O'Malley and included five stages: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results. The methodological quality of the included studies was also assessed using the Critical Appraisal Skills Programme tool. The PRISMA framework was used for reporting the results. The electronic databases Medline, PsychINFO, CINAHL, and PubMed were searched for relevant articles. A total of three papers meeting the inclusion criteria were included in this review and two main themes identified: (1) support (which included sub-themes; social isolation and the impact on support; support from family and friends; wider support networks); (2) Emotional impact of bereavement during a pandemic. Access to support networks is crucial for CYP to understand and process their emotions relating to their bereavement experience. The pandemic meant that many usual support networks such as family and friends were inaccessible to CYP, who struggled to deal with their experience of grief during this time. Schools are a valuable support mechanism and can help CYP understand their emotions through open discussions about their bereavement. The limited empirical evidence currently available in this area of research demonstrates an important need to further understanding of the long-term impacts of dealing with pandemic-related loss in childhood.
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Affiliation(s)
- Joanna Blackburn
- Institute of Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Gill Waring
- Department of Nursing, School of Human and Health Sciences, Huddersfield, Huddersfield, UK
| | - Mary Turner
- Department of Nursing, School of Human and Health Sciences, Huddersfield, Huddersfield, UK
| | - Karen Currell
- Department of Nursing, School of Human and Health Sciences, Huddersfield, Huddersfield, UK
| | - Ann-Louise Caress
- Centre for Applied Research in Health, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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11
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Omotayo AO, Ogunniyi AI. COVID-19 induced shocks and its implications for human capital development. Int J Equity Health 2024; 23:30. [PMID: 38365738 PMCID: PMC10870588 DOI: 10.1186/s12939-024-02119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND COVID-19 has delivered an enormous shock to the global economy, triggering the deepest recession in eight decades, almost three times as deep as the 2009 global recession. Of all the nations in Africa, Nigeria remains one of the nations with a huge and significant impact on the human capital. METHODS Hence, here we employed the recent nationally representative data from Nigeria - the COVID-19 National Longitudinal Phone Survey 2020-World Bank Living Standards Measurement Study Integrated Agriculture Survey (LSMS-ISA), a harmonized dataset to explore how the COVID-19 induced shocks affected households' human capital development (using health and education outcomes). RESULTS The results indicate that the COVID-19 induced shocks impact on both health and education in Nigeria. Interestingly, access to social safety nets had a positive association with the health and education outcomes. The study concludes that households' access to social safety nets, particularly during the COVID-19 pandemic aids in the development of the nation's human capital. Therefore, effectively enhancing household's resilience and strengthening human capital development require positive and considerable innovation, maybe over a period of years. Hence, just an access to the national social safety nets programs or social programs may not be as effective as expected. Therefore, it may not be as successful as intended to just have access to national social safety net programs or social programs that contribute or transfer negligible amounts to the vulnerable recipients over short time frames.
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12
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Haller SP, Archer C, Jeong A, Jaffe A, Jones EL, Harrewijn A, Naim R, Linke JO, Stoddard J, Brotman MA. Changes in Internalizing Symptoms During the COVID-19 Pandemic in a Transdiagnostic Sample of Youth: Exploring Mediators and Predictors. Child Psychiatry Hum Dev 2024; 55:206-218. [PMID: 35794298 PMCID: PMC9816351 DOI: 10.1007/s10578-022-01382-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 01/11/2023]
Abstract
The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8-18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.
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Affiliation(s)
- Simone P Haller
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA.
| | - Camille Archer
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Annie Jeong
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Allison Jaffe
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Emily L Jones
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Anita Harrewijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Reut Naim
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Julia O Linke
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Joel Stoddard
- Department of Psychiatry & Neuroscience Program, Children's Hospital Colorado, Pediatric Mental Health Institute, University of Colorado, Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
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13
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Rothenberg WA, Skinner AT, Lansford JE, Bacchini D, Bornstein MH, Chang L, Deater-Deckard K, Giunta LD, Dodge KA, Gurdal S, Junla D, Liu Q, Long Q, Oburu P, Pastorelli C, Sorbring E, Steinberg L, Tirado LMU, Yotanyamaneewong S, Alampay LP, Al-Hassan SM. How adolescents' lives were disrupted over the course of the COVID-19 pandemic: A longitudinal investigation in 12 cultural groups in 9 nations from March 2020 to July 2022. Dev Psychopathol 2024:1-17. [PMID: 38273765 PMCID: PMC11272905 DOI: 10.1017/s0954579423001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
It is unclear how much adolescents' lives were disrupted throughout the COVID-19 pandemic or what risk factors predicted such disruption. To answer these questions, 1,080 adolescents in 9 nations were surveyed 5 times from March 2020 to July 2022. Rates of adolescent COVID-19 life disruption were stable and high. Adolescents who, compared to their peers, lived in nations with higher national COVID-19 death rates, lived in nations with less stringent COVID-19 mitigation strategies, had less confidence in their government's response to COVID-19, complied at higher rates with COVID-19 control measures, experienced the death of someone they knew due to COVID-19, or experienced more internalizing, externalizing, and smoking problems reported more life disruption due to COVID-19 during part or all of the pandemic. Additionally, when, compared to their typical levels of functioning, adolescents experienced spikes in national death rates, experienced less stringent COVID-19 mitigation measures, experienced less confidence in government response to the COVID-19 pandemic, complied at higher rates with COVID-19 control measures, experienced more internalizing problems, or smoked more at various periods during the pandemic, they also experienced more COVID-19 life disruption. Collectively, these findings provide new insights that policymakers can use to prevent the disruption of adolescents' lives in future pandemics.
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Affiliation(s)
- W. Andrew Rothenberg
- Duke University, Durham, NC, USA
- University of Miami Miller, School of Medicine, Miami, FL, USA
| | | | | | | | - Marc H. Bornstein
- NICHD, Bethesda, MD, USA
- UNICEF, New York, NY, USA
- Institute for Fiscal Studies, London, UK
| | | | - Kirby Deater-Deckard
- University of Massachusetts Amherst, Amherst, MA, USA
- Helsinki Collegium for Advanced Studies, Helsinki, Finland
| | | | | | | | | | - Qin Liu
- Chongqing Medical University, Chongqing, China
| | - Qian Long
- Duke Kunshan University, Kunshan, China
| | | | | | | | - Laurence Steinberg
- Temple University, Philadelphia, PA, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | | | - Suha M. Al-Hassan
- Abu Dhabi Early Childhood Authority, Abu Dhabi, United Arab Emirates
- Hashemite University, Zarqa, Jordan
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14
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Jones M, Jetelina KK. More to Offer Than Direct Clinical Benefit: FDA's Vaccine Licensure Process Ignores Population Health and Social Determinants of Disease. Am J Epidemiol 2024; 193:1-5. [PMID: 37527824 DOI: 10.1093/aje/kwad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/19/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
The current US Food and Drug Administration (FDA) licensure process underestimates the potential benefits of vaccines at both the individual and population levels by considering only direct clinical outcomes of vaccination. While all approved vaccines do protect the person who takes them from poor clinical outcomes for a specific infectious disease, many vaccines also have the potential to offer measurable, direct nonclinical benefits. For example, coronavirus disease 2019 (COVID-19) vaccinations for school-aged children may prevent school absenteeism. Also, by preventing infection or reducing its length and severity, some vaccines also protect-to some extent-the patient's immediate contacts from contracting the same disease. These nonclinical and population-level benefits are not considered as part of the FDA's current vaccine approval process, but they could be. We argue that the FDA's structured benefit-risk assessment framework, used for vaccine approvals, can and should consider both clinical and nonclinical benefits of vaccination when sufficient evidence exists to make an informed assessment. Including them could incentivize vaccine developers to measure additional vaccination effects, inform population health, and address health inequalities-including inequalities in the social determinants of health.
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15
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Closson K, Zharima C, Kuchena M, Dietrich JJ, Gadermann A, Zulu B, Ogilvie G, Beksinska M, Kaida A. " It's a 50/50 Thing You Know": Exploring the Multileveled Intersections of Gender and Power Within the Relationships of Young South African Men and Women. JOURNAL OF SEX RESEARCH 2024; 61:144-159. [PMID: 36260421 DOI: 10.1080/00224499.2022.2129561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Efforts to advance sexual health globally require greater understandings of youth intimate relationship dynamics. Among 38 South African youth (21 women/17 men aged 21-30 from Durban and Soweto) we conducted qualitative cognitive interviews to explore how gender and power intersect to shape intimate relationship dynamics (October 2019-March 2021). Participants discussed perceptions and relevance of each of 13 items comprising the Sexual Relationship Power (SRP) scale, a widely used measure of gender equity, and the influence of SRP on youth sexual health. Data analysis was guided by constructivist grounded theory. The findings were organized using the socio-ecological model, revealing how gender and power intersected at multiple levels to influence youth intimate relationships. Key influencing factors included individual-level gender attitudes, male partner expectations, and women's resistance to dominance; intimate relationship-level power dynamics, consent, and intimacy; family-level household configurations and parental monitoring of daughters; and societal-level traditional gender norms. At all levels, women discussed resisting power inequities through communication and rejection of inequitable relationships. While men also displayed resistance to inequitable power structures, most upheld traditional gender norms through institutional affiliation (e.g. church) and deep-rooted socialized beliefs and attitudes. Efforts to improve youth sexual health require multileveled approaches that address inequitable power dynamics.
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Affiliation(s)
- Kalysha Closson
- School of Population and Public Health, University of British Columbia
| | - Campion Zharima
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand
- Centre for Health Policy, School of Public Health, University of the Witwatersrand
| | - Michelle Kuchena
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia
| | - Bongiwe Zulu
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand
| | - Gina Ogilvie
- School of Population and Public Health, University of British Columbia
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University
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16
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Abu-Ras W, Ashraf AbuLaban A, Talat AlQaisi S, AlQaisi MTH, Decker E. Orphans in Syria and Iraq Juggling Balls: Wars, COVID-19, and the NGO's financial crisis. Int J Qual Stud Health Well-being 2023; 18:2170010. [PMID: 36744740 PMCID: PMC9904298 DOI: 10.1080/17482631.2023.2170010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic's impact varies between and within nations, causing new forms of inequality. Refugee and orphan children in conflicted areas are more likely to suffer due to poverty, vulnerability, and limited access to essential services including reduction in donor funding. This qualitative study is the first to assess the effects of the COVID-19 pandemic and the financial crisis on Iraqi and Syrian orphaned children and their mothers. The Modified Grounded Theory was used for the preliminary analysis to expand the range of themes. This study has identified five major themes: financial crisis, low educational attainment, child labour, mental health issues, violence, and social problems. The impact of COVID-19 children and adolescents' mental health is of great concern. These multiple crises may significantly impact orphan children and adolescents' cognitive, mental health, and physical development. It is critical to address mental health issues during the current crisis and to plan for possible future pandemics and their intersecting outcomes. A Holistic approach requires providers to be aware of their clients' intersecting circumstances and needs using a range of lenses, including the person in the environment, family dynamics, culture, politics, and structural challenges. Offering food, medical supplies, and housing are considered basic needs.
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Affiliation(s)
- Wahiba Abu-Ras
- Adelphi School of Social Work, Garden City, NY, United States,CONTACT Wahiba Abu-Ras Adelphi School of Social Work, One South Avenue Garden City, Garden City, New York11530
| | | | | | | | - Eliza Decker
- MSW Candidate Adelphi School of Social Work, Garden City, NY, United States of America
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17
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Frei-Landau R. Who should support grieving children in school? Applying Winnicott's viewpoint to conceptualize the dyadic roles of teachers and school mental-health professionals in the context of pediatric grief. Front Psychiatry 2023; 14:1290967. [PMID: 38025458 PMCID: PMC10657861 DOI: 10.3389/fpsyt.2023.1290967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Rivi Frei-Landau
- The Loss, Crisis, and Resilience in a Multicultural Lens Research Lab, Faculty of Psychology, Achva Academic College, Shikmim, Israel
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18
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Tan E, Tang A, Debnath R, Humphreys KL, Zeanah CH, Nelson CA, Fox NA. Resting brain activity in early childhood predicts IQ at 18 years. Dev Cogn Neurosci 2023; 63:101287. [PMID: 37531865 PMCID: PMC10407667 DOI: 10.1016/j.dcn.2023.101287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
Resting brain activity has been widely used as an index of brain development in neuroscience and clinical research. However, it remains unclear whether early differences in resting brain activity have meaningful implications for predicting long-term cognitive outcomes. Using data from the Bucharest Early Intervention Project (Zeanah et al., 2003), we examined the impact of institutional rearing and the consequences of early foster care intervention on 18-year IQ. We found that higher resting theta electroencephalogram (EEG) power, reflecting atypical neurodevelopment, across three assessments from 22 to 42 months predicted lower full-scale IQ at 18 years, providing the first evidence that brain activity in early childhood predicts cognitive outcomes into adulthood. In addition, both institutional rearing and later (vs. earlier) foster care intervention predicted higher resting theta power in early childhood, which in turn predicted lower IQ at 18 years. These findings demonstrate that experientially-induced changes in brain activity early in life have profound impact on long-term cognitive development, highlighting the importance of early intervention for promoting healthy development among children living in disadvantaged environments.
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Affiliation(s)
- Enda Tan
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park 20740, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park 20740, USA.
| | - Alva Tang
- Department of Psychology, University of Texas at Dallas, Richardson 75080, USA.
| | - Ranjan Debnath
- Leibniz Institute for Neurobiology, Magdeburg 39118, Germany.
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville 37203, USA.
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University, New Orleans 70118, USA.
| | - Charles A Nelson
- Boston Children's Hospital of Harvard Medical School, Boston 02115, USA; Harvard Graduate School of Education, Harvard University, Cambridge 02138, USA.
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park 20740, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park 20740, USA.
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19
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Asravor RK. Uncovering the forgotten story of the impact of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome on economic growth in Ghana: A gender analysis. Int J Health Plann Manage 2023; 38:1495-1509. [PMID: 37353922 DOI: 10.1002/hpm.3675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/10/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023] Open
Abstract
Aside from being a health issue, Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) has an economic impact on Africa and Ghana in particular. Despite this, fewer empirical studies have examined the effect of the disease on economic growth from a gender point of view. This study aims to investigate the impact of the HIV/AIDS epidemic on economic growth in Ghana. The paper uses time series data spanning 1990-2018 to estimate the impact of HIV/AIDS from a gender perspective. The Cobb-Douglas aggregate function and the Granger Causality test were used to examine the determinant of growth and the direction of causality, respectively. The study's finding shows a unidirectional feedback causality running from HIV/AIDS to economic growth. Controlling for varieties of factors, the study found that HIV/AIDS has a negative significant impact on economic growth in both the short and long-run periods in Ghana. From the gender perspective, the impact of HIV/AIDS on growth was higher in the case of males when compared to females.
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20
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Mohajerin B, Lynn SJ, Cassiello-Robbins C. Unified Protocol vs Trauma-Focused Cognitive Behavioral Therapy Among Adolescents With PTSD. Behav Ther 2023; 54:823-838. [PMID: 37597960 PMCID: PMC10060014 DOI: 10.1016/j.beth.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/31/2023]
Abstract
Harmful consequences of COVID-19, such as prolonged quarantine, lack of social contact, and especially loss of parents or friends, can negatively impact children and adolescents' mental health in diverse ways, including engendering posttraumatic stress symptoms. Our study is the first to compare the transdiagnostic Unified Protocol for the Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich et al., 2009; Ehrenreich-May et al., 2017) with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in terms of outcomes related to PTSD symptoms (COVID-19-related vs. COVID-19 unrelated PTSD) and comorbid symptoms (i.e., anxiety, depression) and other measures (i.e., emotion regulation, self-injury, anger). Individuals diagnosed with PTSD were randomly assigned to the UP-A (n = 46) or TF-CBT group (n = 47), administered the SCID-5 and a battery of measures and followed up posttreatment and then after 3, 6, and 9 months. Ninety-three adolescents with PTSD were enrolled, 45% boys and 61% COVID-19-related PTSD. We adopted an intention-to-treat approach. At the initial post-intervention assessment, except for emotion regulation and unexpressed angry feelings, in which UP-A participants reported greater reductions, no significant differences in other variables were secured between the UP-A and TF-CBT. However, at follow-up assessments, the UP-A evidenced significantly better outcomes than TF-CBT. We found support for the UP-A compared with TF-CBT in treating adolescents with PTSD, regardless of COVID-19-related PTSD status, in maintaining treatment effectiveness over time.
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21
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Okegbe T, Williams J, Plourde KF, Oliver K, Ddamulira B, Caparrelli K. Impact of COVID-19 on HIV Adolescent Programming in 16 Countries With USAID-Supported PEPFAR Programs. J Acquir Immune Defic Syndr 2023; 93:261-271. [PMID: 36989134 PMCID: PMC10287048 DOI: 10.1097/qai.0000000000003201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/07/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has disrupted access to critical health services, resulting in diminished gains in HIV epidemic control. This review assesses the magnitude of the impact that the COVID-19 pandemic has had on HIV services for adolescents. METHODS PEPFAR Monitoring, Evaluation, and Reporting programmatic data were analyzed from across 16 USAID-supported adolescent care and treatment programs for fiscal year 2020 (FY20; October 2019-September 2020). Descriptive statistics were used to calculate absolute number and percent change between the pre-COVID-19 (Quarters 1-2; October 2019-March 2020) and COVID-19 periods (Quarters 3-4; April 2020-September 2020) for clinical cascade indicators. All analyses were conducted in Microsoft Excel. RESULTS The number of HIV tests conducted during COVID-19 decreased by 21.4% compared with pre-COVID-19, with a subsequent 28% decrease in adolescents identified living with HIV. The rate of proxy linkage to antiretroviral therapy increased between periods, from 86.9% to 90.4%. There was a 25.9% decrease in treatment initiations among adolescents during COVID-19. During FY20, viral load coverage rates for adolescents dropped from 81.6% in FY20Q1 to 76.5% in FY20Q4, whereas the rates of viral load suppression for adolescents increased from 76.1% in FY20Q1 to 80.5% in FY20Q4. CONCLUSION There was a substantial decrease in case-finding, treatment initiations, and viral load coverage rates for adolescents supported in USAID/PEPFAR programs during the COVID-19 pandemic. Additional health systems adaptations and strategies are required to ensure adolescents have continued access to HIV services during pandemic disruptions.
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Affiliation(s)
- Tishina Okegbe
- GHTASC, Credence Management Solutions LLC, Supporting the United States Agency for International Development (USAID), Office of HIV/AIDS, Washington, DC
| | - Jessica Williams
- United States Agency for International Development (USAID), Maputo, Mozambique
| | | | | | - Barbara Ddamulira
- United States Agency for International Development (USAID), Dar es Salaam, Tanzania; and
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22
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King LS, Guyon-Harris KL, Valadez EA, Radulescu A, Fox NA, Nelson CA, Zeanah CH, Humphreys KL. A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation. Am J Psychiatry 2023; 180:573-583. [PMID: 37211832 PMCID: PMC10751847 DOI: 10.1176/appi.ajp.20220672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The Bucharest Early Intervention Project is the first randomized controlled trial of foster care as an alternative to institutional care. The authors synthesized data from nearly 20 years of assessments of the trial to determine the overall intervention effect size across time points and developmental domains. The goal was to quantify the overall effect of the foster care intervention on children's outcomes and examine sources of variation in this effect, including domain, age, and sex assigned at birth. METHODS An intent-to-treat approach was used to examine the causal effects of the randomized controlled trial for 136 children residing in institutions in Bucharest, Romania (baseline age, 6-31 months) who were randomly assigned to either foster care (N=68) or care as usual (N=68). At ages 30, 42, and 54 months and 8, 12, and 16-18 years, children were assessed for IQ, physical growth, brain electrical activity (EEG), and symptoms of five types of psychopathology. RESULTS Participants provided 7,088 observations across follow-up waves. Children assigned to foster care had better cognitive and physical outcomes and less severe psychopathology than did those who received care as usual. The magnitude of these effect sizes remained stable across development. The foster care intervention most influenced IQ and disorders of attachment/social relatedness. CONCLUSIONS Young children benefit from placement in families after institutional care. The benefits of foster care for previously institutionalized children were remarkably stable across development.
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Affiliation(s)
- Lucy S. King
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
| | | | - Emilio A. Valadez
- University of Maryland, Department of Human Development and Quantitative Methodology, College Park, MD
| | | | - Nathan A. Fox
- University of Maryland, Department of Human Development and Quantitative Methodology, College Park, MD
| | - Charles A. Nelson
- Boston Children’s Hospital/Harvard Medical School, Boston, MA
- Harvard Graduate School of Education, Cambridge, MA
| | - Charles H. Zeanah
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
| | - Kathryn L. Humphreys
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
- Vanderbilt University, Department of Psychology and Human Development, Nashville, TN
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23
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Noppert GA, Duchowny KA, Stebbins R, Aiello AE, Dowd JB, Clarke P. Biological expressions of early life trauma in the immune system of older adults. PLoS One 2023; 18:e0286141. [PMID: 37343002 PMCID: PMC10284407 DOI: 10.1371/journal.pone.0286141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Poor immune function is associated with increased risk for a number of age-related diseases, however, little is known about the impact of early life trauma on immune function in late-life. METHODS Using nationally representative data from the Health and Retirement Study (n = 5,823), we examined the association between experiencing parental/caregiver death or separation before age 16 and four indicators of immune function in late-life: C-reactive Protein (CRP), Interleukin-6 (IL-6), soluble Tumor Necrosis Factor (sTNFR), and Immunoglobulin G (IgG) response to cytomegalovirus (CMV). We also examined racial/ethnic differences. FINDINGS Individuals that identified as racial/ethnic minorities were more likely to experience parental/caregiver loss and parental separation in early life compared to Non-Hispanic Whites, and had poorer immune function in late-life. We found consistent associations between experiencing parental/caregiver loss and separation and poor immune function measured by CMV IgG levels and IL-6 across all racial/ethnic subgroups. For example, among Non-Hispanic Blacks, those that experienced parental/caregiver death before age 16 had a 26% increase in CMV IgG antibodies in late-life (β = 1.26; 95% CI: 1.17, 1.34) compared to a 3% increase in CMV antibodies among Non-Hispanic Whites (β = 1.03; 95% CI: 0.99, 1.07) controlling for age, gender, and parental education. INTERPRETATION Our results suggest a durable association between experiencing early life trauma and immune health in late-life, and that structural forces may shape the ways in which these relationships unfold over the life course.
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Affiliation(s)
- Grace A. Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Kate A. Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Rebecca Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jennifer B. Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, United Kingdom
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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24
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Steventon Roberts KJ, Du Toit S, Mawoyo T, Tomlinson M, Cluver LD, Skeen S, Laurenzi CA, Sherr L. Protocol for the OCAY study: a cohort study of orphanhood and caregiver loss in the COVID-19 era to explore the impact on children and adolescents. BMJ Open 2023; 13:e071023. [PMID: 37263702 DOI: 10.1136/bmjopen-2022-071023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Globally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa. METHODS AND ANALYSIS Data will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12-18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision. ETHICS AND DISSEMINATION This study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.
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Affiliation(s)
- Kathryn J Steventon Roberts
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Institute for Global Health, University College London, London, UK
| | - Stefani Du Toit
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Tatenda Mawoyo
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
- School of Nursing & Midwifrey, Queens University, Belfast, UK
| | - Lucie D Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry & Mental Health, Univeristy of Cape Town, Cape Town, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
- Amsterdam Institute for Social Science Research, Faculty of Social & Behavioural Sciences, Univeristy of Amsterdam, Amsterdam, Netherlands
| | - Christina A Laurenzi
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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25
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Breen LJ, Greene D, Rees CS, Black A, Cawthorne M, Egan SJ. A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people. J Affect Disord 2023; 335:289-297. [PMID: 37196936 DOI: 10.1016/j.jad.2023.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Grief in young people is common and associated with symptoms of anxiety and depression, yet grief interventions for this age group are under-researched. METHOD We conducted a systematic review and meta-analysis to examine the efficacy of grief interventions in young people. The process was co-designed with young people and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PsycINFO, Medline, and Web of Science databases were searched in July 2021 (updated December 2022). RESULTS We extracted results from 28 studies of grief interventions with young people (14-24 years) that measured anxiety and/or depression (N = 2803 participants, 60 % girls/women). Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression. Meta-regression indicated that CBT for grief that included a higher degree of CBT strategies, was not trauma focused, had >10 sessions, offered on an individual basis, and did not involve parents, was associated with larger effect sizes for anxiety. Supportive therapy had a moderate effect for anxiety and a small-moderate effect for depression. Writing interventions were not effective for anxiety or depression. LIMITATIONS Studies are limited in number and there were few randomized controlled studies. CONCLUSIONS Findings indicate that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. CBT for grief should be offered as the first line treatment for grieving young people experiencing anxiety and depression. PROTOCOL REGISTRATION PROSPERO (registration number CRD42021264856).
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Affiliation(s)
- Lauren J Breen
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia.
| | - Danyelle Greene
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Clare S Rees
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Amy Black
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | | | - Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
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26
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Peng A, Simmons A, Amoako A, Tuite A, Fisman D. Relative pandemic severity in Canada and four peer nations during the SARS-CoV-2 pandemic. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2023; 49:197-205. [PMID: 38419909 PMCID: PMC10901147 DOI: 10.14745/ccdr.v49i05a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Background National responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been highly variable. We sought to explore the effectiveness of the Canadian pandemic response up to May 2022 relative to responses in four peer countries with similar political, economic and health systems, and with close historical and cultural ties to Canada. Methods We used reported age-specific mortality data to generate estimates of pandemic mortality standardized to the Canadian population. Age-specific case fatality, hospitalization, and intensive care admission probabilities for the Canadian province of Ontario were applied to estimated deaths, to calculate hospitalizations and intensive care admissions averted by the Canadian response. Health impacts were valued in both monetary terms, and in terms of lost quality-adjusted life years. Results We estimated that the Canadian pandemic response averted 94,492, 64,306 and 13,641 deaths relative to the responses of the United States, United Kingdom and France, respectively, and more than 480,000 hospitalizations relative to the United States. The United States pandemic response, if applied to Canada, would have resulted in more than $40 billion in economic losses due to healthcare expenditures and lost quality-adjusted life years. In contrast, an Australian pandemic response applied to Canada would have averted over 28,000 additional deaths and averted nearly $9 billion in costs. Conclusion Canada outperformed several peer countries that aimed for mitigation rather than elimination of SARS-CoV-2 in the first two years of the pandemic, with substantial numbers of lives saved and economic costs averted. However, a comparison with Australia demonstrated that an elimination focus would have saved Canada tens of thousands of lives as well as substantial economic costs.
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Affiliation(s)
- Amy Peng
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Alison Simmons
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Afia Amoako
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
- Public Health Agency of Canada, Ottawa, ON
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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27
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Coker TR, Cheng TL, Ybarra M. Addressing the Long-term Effects of the COVID-19 Pandemic on Children and Families: A Report From the National Academies of Sciences, Engineering, and Medicine. JAMA 2023; 329:1055-1056. [PMID: 36928897 DOI: 10.1001/jama.2023.4371] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This Viewpoint discusses a consensus report from the National Academies of Sciences, Engineering, and Medicine (NASEM) that reviews the impact of COVID-19 on the health and well-being of children and families and what needs to be done to attenuate longer-term negative effects.
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Affiliation(s)
- Tumaini R Coker
- Seattle Children's, University of Washington School of Medicine, Seattle
| | - Tina L Cheng
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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28
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Penna AL, de Aquino CM, Pinheiro MSN, do Nascimento RLF, Farias-Antúnez S, Araújo DABS, Mita C, Machado MMT, Castro MC. Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review. BMC Public Health 2023; 23:388. [PMID: 36823592 PMCID: PMC9950022 DOI: 10.1186/s12889-023-15003-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status. AIMS This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. METHODS Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. RESULTS The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. CONCLUSIONS Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.
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Affiliation(s)
- Ana Luiza Penna
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Camila Machado de Aquino
- grid.8395.70000 0001 2160 0329Department of Community Health, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Simone Farias-Antúnez
- grid.411237.20000 0001 2188 7235Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | | | - Carol Mita
- grid.38142.3c000000041936754XCountway Library, Harvard Medical School, Boston, USA
| | | | - Marcia C. Castro
- grid.38142.3c000000041936754XDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
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Hagquist C. Worry and Psychosomatic Problems Among Adolescents in Sweden in the Wake of the COVID-19 Pandemic: Unequal Patterns Among Sociodemographic Groups? J Adolesc Health 2023; 72:688-695. [PMID: 36781326 PMCID: PMC9918865 DOI: 10.1016/j.jadohealth.2022.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/02/2022] [Accepted: 12/15/2022] [Indexed: 02/13/2023]
Abstract
PURPOSE To analyze potential associations between sociodemographic factors and adolescents' worry about family finances and other types of worries during the COVID-19 pandemic and the potential associations between different worry themes and psychosomatic problems. METHODS From December 2020 to March 2021, 3,068 16-17 years old students in Sweden completed a questionnaire about the impact of the COVID-19 pandemic on their schooling and everyday life. From April to June 2020, 70% of these students also responded to questions about their psychosomatic health. Logistic regression was applied to analyze the associations between sociodemographic factors and different worry themes and estimate the association between worry and psychosomatic problems. RESULTS Across all 13 worry themes, girls reported worry to a higher degree than boys. In most of the cases, adolescents with a lower parental educational background or immigrant background reported more frequent worrying. This was most evident for worry about family finances. The differences between adolescents with a Swedish background and those with a foreign background were large except for worry about climate change. All worry themes were associated with the students' psychosomatic health. Those who often or always experienced worry were more likely to report psychosomatic problems. Worry about family finances showed the highest odds ratio and marginal effect. DISCUSSION Worry about family finances during the COVID-19 pandemic turns out to be a strong and socially structured stressor that may widen the health inequalities among young people. This underlines the need for preventive and promoting measures aimed at supporting socioeconomic disadvantaged groups.
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Affiliation(s)
- Curt Hagquist
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden.
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30
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Fortuna LR, Brown IC, Lewis Woods GG, Porche MV. The Impact of COVID-19 on Anxiety Disorders in Youth. Child Adolesc Psychiatr Clin N Am 2023; 32:531-542. [PMCID: PMC9894765 DOI: 10.1016/j.chc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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31
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Fäldt A, Nejat S, Edvinsson Sollander S, Durbeej N, Holmgren A. Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic. Eur J Public Health 2023; 33:127-131. [PMID: 36479865 PMCID: PMC9898009 DOI: 10.1093/eurpub/ckac181] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had wide effects on child health globally. Increased prevalence of childhood obesity has been observed by a number of countries during the pandemic. The absence of a formal societal lockdown during the pandemic, made Sweden stand out compared to other countries. This study aims to examine changes in BMI among preschool children in Sweden before and during COVID-19 pandemic. METHODS Retrospective population-based cross-sectional study, with longitudinal follow-up for a portion of the children. The study included 25 049 children from three Swedish regions, with growth measures at 3- (n = 16 237), 4- (n = 14 437) and 5-years of age (n = 11 711). Care Need Index was used as a socioeconomic parameter at health centre level. RESULTS There was an increase in BMI in children aged three (P = 0.028) and four (P<0.001) during the COVID-19 pandemic. Obesity in 3-year-old girls increased from 2.8% to 3.9%. Four-year-olds increased in obesity, and overweight (girls) and the prevalence of underweight decreased in boys. No change in BMI was observed in 5-year-olds. Children in areas of low socioeconomic status had higher risk of obesity. CONCLUSIONS Overweight and obesity increased among 3- and 4-year-old children in Sweden, findings that were accentuated in children attending child health centres in areas with lower socioeconomic status. The COVID-19 pandemic is likely to have affected health behaviours negatively in Swedish preschool children. Our results expose the need for extended efforts directed to prevent childhood obesity, especially targeting lower socioeconomic areas.
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Affiliation(s)
- Anna Fäldt
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden
| | - Sahar Nejat
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden.,Paediatric Public Health Unit, Sachs Children's Hospital, Stockholm, Sweden
| | - Sofia Edvinsson Sollander
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden.,Department of Pediatrics, Östersund Hospital, Östersund, Sweden.,Public Health Unit, Östersund Hospital, Östersund, Sweden
| | - Natalie Durbeej
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden
| | - Anton Holmgren
- GP-GRC, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Halland Hospital, Halmstad, Sweden.,Department of Research and Development, Region Halland, Halmstad, Sweden
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32
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Tuberculosis in the time of COVID-19: The successful results of treatment in Peru. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:138-139. [PMID: 36759054 PMCID: PMC9903147 DOI: 10.1016/j.eimce.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 02/10/2023]
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33
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[Tuberculosis in the time of COVID-19: The successful results of treatment in Peru]. Enferm Infecc Microbiol Clin 2023; 41:138-139. [PMID: 35637875 PMCID: PMC9132789 DOI: 10.1016/j.eimc.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Indexed: 02/07/2023]
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McKune SL, Acosta D, Fujii Y, Joyce-Beaulieu D, Sayeed MA, Cato E, Flaherty KE, Creasy-Marrazzo A, Pu R, Kariyawasam S, Arukha A, Cummings DAT, Long MT, Maurelli AT, Nelson EJ. The infected and the affected: A longitudinal study of the impact of the COVID-19 pandemic on schoolchildren in Florida. Front Public Health 2023; 11:1003923. [PMID: 36969651 PMCID: PMC10030597 DOI: 10.3389/fpubh.2023.1003923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/16/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives To identify risk factors associated with symptoms of anxiety, depression, and obsessive-compulsive disorder (OCD) among children during the 1st year of the COVID-19 pandemic. Methods A longitudinal study with three cross-sectional timepoints [April 2020 (n = 273), October 2020 (n = 180), and April 2021 (n = 116)] was conducted at a K-12 public school in Florida. Infection and sero-positivity for SARS-CoV-2 was determined by molecular and serologic approaches. Adjusted odds ratios using mixed effect logistic regression models for symptom-derived indicators of anxiety, depression, and OCD in children in April 2021 are presented; past infection and seropositivity were included in the models. Results The prevalence of anxiety, depression, or OCD moved from 47.1, to 57.2, to 42.2% across the three timepoints during the study. By endline of the study, in April 2021, non-white children were at higher risk for depression and OCD. Risk for anxiety, depression, and OCD was associated with students who lost a family member due to COVID-19 and who were identified as at-risk in previous timepoints. Rates of SARS-CoV-2 infection and seropositivity were low and not statistically associated with assessed outcomes. Conclusions In situations like the COVID-19 pandemic, targeted mental health interventions and screenings are needed in children and adolescents, especially among minority children.
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Affiliation(s)
- Sarah L. McKune
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- *Correspondence: Sarah L. McKune
| | - Daniel Acosta
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
| | - Yui Fujii
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
| | - Diana Joyce-Beaulieu
- Department of Special Education, School Psychology, and Early Childhood Studies, College of Education, University of Florida, Gainesville, FL, United States
| | - Md Abu Sayeed
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Emilee Cato
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Katelyn E. Flaherty
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
| | - Ashton Creasy-Marrazzo
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Ruiyu Pu
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Subhashinie Kariyawasam
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Anantha Arukha
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Derek A. T. Cummings
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Maureen T. Long
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Anthony T. Maurelli
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Eric J. Nelson
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, United States
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
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Skeen S, Marlow M, du Toit S, Melendez-Torres GJ, Mudekunye L, Mapalala E, Ngoma K, Ntanda BM, Maketha M, Grieve C, Hartmann L, Gordon S, Tomlinson M. Using WhatsApp support groups to promote responsive caregiving, caregiver mental health and child development in the COVID-19 era: A randomised controlled trial of a fully digital parenting intervention. Digit Health 2023; 9:20552076231203893. [PMID: 37928327 PMCID: PMC10624105 DOI: 10.1177/20552076231203893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/08/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Digital interventions hold important potential for supporting parents when face-to-face interventions are unavailable. We assessed the feasibility and effectiveness of a digital parenting intervention in Zambia and Tanzania. Methods Using a randomised controlled trial, we evaluated the Sharing Stories digital parenting intervention for caregivers of children aged 9-32 months with access to a smartphone in their household. Caregivers were stratified based on child age and randomly assigned to the intervention or waitlist control arm. The intervention was delivered via facilitated WhatsApp groups over 6 weeks to promote caregiver wellbeing and responsive caregiving through shared reading activities. Primary outcomes were caregiver-reported responsive caregiving, child language and socio-emotional development. Secondary outcomes were caregiver mental health and parental stress. Masked assessors conducted assessments at baseline and immediate follow-up. Results Between October 2020 and March 2021, we randomly assigned 494 caregiver-child dyads to the intervention (n = 248) or waitlist control (n = 246) arm. Caregivers in the intervention group reported more responsive caregiving (OR = 2.55, 95% CI: 1.15-5.66, p = 0.02), time reading or looking at books (β = 0.45, p = 0.04) and telling stories (β = 0.72, p = 0.002). Intervention caregivers reported significantly lower symptoms of depression (β = -0.64, p = 0.05) and anxiety (β = -0.65, p = 0.02). Child development and parental stress did not differ significantly between groups. Conclusions Digital parenting interventions using WhatsApp can effectively promote responsive caregiving and caregiver mental health in low-resource settings, with great potential for scalability. Trial registration ISRCTN database, ISRCTN77689525.
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Affiliation(s)
- Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Marguerite Marlow
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Stefani du Toit
- Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
| | - GJ Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
| | - Lynette Mudekunye
- Regional Psychosocial Support Initiative (REPSSI) Regional, Randburg, South Africa
| | - Edwick Mapalala
- Regional Psychosocial Support Initiative (REPSSI), Dar es Salaam, Tanzania
| | - Kelvin Ngoma
- Regional Psychosocial Support Initiative (REPSSI), Lusaka, Zambia
| | | | - Moroesi Maketha
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Caitlin Grieve
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Laura Hartmann
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Sarah Gordon
- Department of Global Health, Centre for Evidence-Based Health Care, Stellenbosch University, Tygerberg, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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36
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Nearchou F. Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022:1-12. [PMID: 36590446 PMCID: PMC9795111 DOI: 10.1007/s40653-022-00511-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.
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Affiliation(s)
- Finiki Nearchou
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin, Dublin 4 Ireland
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37
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Treglia D, Cutuli JJ, Arasteh K, Bridgeland J. Parental and Other Caregiver Loss Due to COVID-19 in the United States: Prevalence by Race, State, Relationship, and Child Age. J Community Health 2022; 48:390-397. [PMID: 36515763 PMCID: PMC9749637 DOI: 10.1007/s10900-022-01160-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 12/15/2022]
Abstract
The more than one million COVID-19 deaths in the United States include parents, grandparents, and other caregivers for children. These losses can disrupt the social, emotional, and economic well-being of children, their families, and their communities, and understanding the number and characteristics of affected children is a critical step in responding. We estimate the number of children who lost a parent or other co-residing caregiver to COVID-19 in the U.S. and identify racial, ethnic, and geographic disparities by aligning COVID-19 death counts through mid-May 2022 with household information from a representative sample of individuals. We estimate that 216,617 children lost a co-residing caregiver to COVID-19; 77,283 lost a parent and more than 17,000 children lost the only caregiver with whom they lived. Non-White children were more than twice as likely as White children to experience caregiver loss, and children under 14 years old experienced 70% of caregiver loss. These losses are a salient threat to the functioning of families and the communities in which COVID-19 deaths are concentrated, compounding additional challenges to physical and mental health and economic stability disproportionately imposed by the pandemic on historically disadvantaged populations. Policymakers and systems should take steps to ensure access to appropriate supports.
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Affiliation(s)
- Dan Treglia
- University of Pennsylvania, 3814 Walnut St, Philadelphia, PA, 19104, USA.
| | - J J Cutuli
- Nemours Children's Health, Wilmington, DE, USA
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38
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Laurenzi CA, Mamutse S, Marlow M, Mawoyo T, Stansert Katzen L, Carvajal-Velez L, Lai J, Luitel N, Servili C, Sinha M, Skeen S. Critical life course interventions for children and adolescents to promote mental health. Glob Ment Health (Camb) 2022; 10:e4. [PMID: 36843881 PMCID: PMC9947636 DOI: 10.1017/gmh.2022.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/08/2022] [Accepted: 10/31/2022] [Indexed: 12/13/2022] Open
Abstract
Childhood and adolescence are key developmental periods in the life course for addressing mental health, and there is ample evidence to support significant, increased investment in mental health promotion for this group. However, there are gaps in evidence to inform how best to implement mental health promotion interventions at scale. In this review, we examined psychosocial interventions implemented with children (aged 5–10 years) and adolescents (aged 10–19 years), drawing on evidence from WHO guidelines. Most psychosocial interventions promoting mental health have been implemented in school settings, with some in family and community settings, by a range of delivery personnel. Mental health promotion interventions for younger ages have prioritised key social and emotional skills development, including self-regulation and coping; for older ages, additional skills include problem-solving and interpersonal skills. Overall, fewer interventions have been implemented in low- and middle-income countries. We identify cross-cutting areas affecting child and adolescent mental health promotion: understanding the problem scope; understanding which components work; understanding how and for whom interventions work in practice; and ensuring supportive infrastructure and political will. Additional evidence, including from participatory approaches, is required to tailor mental health promotive interventions to diverse groups’ needs and support healthy life course trajectories for children and adolescents everywhere.
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Affiliation(s)
- Christina A. Laurenzi
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Sihle Mamutse
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Marguerite Marlow
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Tatenda Mawoyo
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Linnea Stansert Katzen
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Liliana Carvajal-Velez
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, NY, USA
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Joanna Lai
- Programme Group, Health Section, UNICEF, New York, NY, USA
| | - Nagendra Luitel
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
- Amsterdam Institute for Social Science Research, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
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39
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Guida F, Kidman R, Ferlay J, Schüz J, Soerjomataram I, Kithaka B, Ginsburg O, Mailhot Vega RB, Galukande M, Parham G, Vaccarella S, Canfell K, Ilbawi AM, Anderson BO, Bray F, Dos-Santos-Silva I, McCormack V. Global and regional estimates of orphans attributed to maternal cancer mortality in 2020. Nat Med 2022; 28:2563-2572. [PMID: 36404355 PMCID: PMC9676732 DOI: 10.1038/s41591-022-02109-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/25/2022] [Indexed: 11/21/2022]
Abstract
Despite women being disproportionally affected by cancer deaths at young ages, there are no global estimates of the resulting maternal orphans, who experience health and education disadvantages throughout their lives. We estimated the number of children who became maternal orphans in 2020 due to their mother dying from cancer in that year, for 185 countries worldwide and by cause of cancer-related death. Female cancer deaths-by country, cancer type and age (derived from GLOBOCAN estimates)-were multiplied by each woman's estimated number of children under the age of 18 years at the time of her death (fertility data were derived from United Nations World Population Prospects for birth cohort), accounting for child mortality and parity-cancer risk associations. Globally, there were 1,047,000 such orphans. Over half of these were orphans due to maternal deaths from breast (258,000, 25%), cervix (210,000, 20%) and upper-gastrointestinal cancers (136,000, 13%), and most occurred in Asia (48%: India 15%, China 10%, rest of Asia 23%) and Africa (35%). Globally, there were 40 new maternal orphans due to cancer per 100,000 children, with a declining trend with a higher Human Development Index (range: 121 in Malawi to 15 in Malta). An estimated 7 million children were prevalent maternal orphans due to cancer in mid-2020. Accelerating the implementation of the World Health Organization's cervical and breast cancer initiatives has the potential to avert not only millions of preventable female cancer deaths but also the associated, often-overlooked, intergenerational consequences of these deaths.
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Affiliation(s)
- Florence Guida
- International Agency for Research on Cancer, Lyon, France.
| | - Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine, Stony Brook University (State University of New York), Stony Brook, NY, USA
| | - Jacques Ferlay
- International Agency for Research on Cancer, Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Ophira Ginsburg
- Centre for Global Health, US National Cancer Institute, Rockville, MD, USA
| | | | | | - Groesbeck Parham
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Andre M Ilbawi
- Global Breast Cancer Initiative, Department of Non-communicable Diseases, World Health Organization (WHO), Geneva, Switzerland
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, Department of Non-communicable Diseases, World Health Organization (WHO), Geneva, Switzerland
| | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Wray A, Pickwell-Smith B, Greenley S, Pask S, Bamidele O, Wright B, Murtagh F, Boland JW. Parental death: a systematic review of support experiences and needs of children and parent survivors. BMJ Support Palliat Care 2022:bmjspcare-2022-003793. [PMID: 36384696 DOI: 10.1136/spcare-2022-003793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bereaved people need a supportive response from those around them. Knowing children's and surviving parents' needs following parental death is the first step to ensuring a supportive response. However, no systematic review has reported on this phenomenon. AIM To systematically identify and synthesise qualitative literature exploring support experiences of parentally bereaved children and surviving parents. METHODS Systematic review with thematic synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE, Embase, PsycINFO, CINAHL and the British Nursing Database were searched for relevant papers to September 2021. Included studies were appraised for quality and thematically synthesised using Thomas and Harden's thematic synthesis framework. RESULTS Fifteen qualitative studies from nine countries were included. There were four analytical themes from the children's perspectives (1) Openness of communication with children about death and dying, (2) Children's challenges of managing change, (3) Navigating emotions, and (4) Children's acceptability, access and engagement with support. There were three analytical themes from the parents' perspectives: (1) Adjusting as a parent, (2) Supporting their children, and (3) Parent's acceptability, access and engagement with support. CONCLUSIONS Following a parental death, open and honest communication and involvement in what is happening within the family will help children cope. Both children and parents suppress emotions and avoid conversations to protect each other and those around them. A taboo around death exists and constrains the support some families receive. Childhood bereavement is a public health issue, with a need for professionals and communities to better understand and respond to the needs of bereaved families.CRD42020166179.
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Affiliation(s)
- Alexandra Wray
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Benjamin Pickwell-Smith
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull, Kingston upon Hull, UK
| | - Sarah Greenley
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull, Kingston upon Hull, UK
| | - Sophie Pask
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Olufikayo Bamidele
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull, Kingston upon Hull, UK
| | - Barry Wright
- Child Orientated Mental Health Innovation Collaborative, Hull York Medical School, York, UK
| | - Fliss Murtagh
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Jason W Boland
- Senior Clinical Lecturer and Honorary Consultant in Palliative Medicine, Hull York Medical School, Hull, UK
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41
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Demombynes G, de Walque D, Gubbins P, Urdinola P, Veillard J. Are COVID-19 age-mortality curves for 2020 flatter in developing countries? Evidence from a cross-sectional observational study of population-level official death counts and excess deaths estimates. BMJ Open 2022; 12:e061589. [PMID: 36351719 PMCID: PMC9659715 DOI: 10.1136/bmjopen-2022-061589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Previous studies have found a pattern of flatter COVID-19 age-mortality curves among low-income and middle-income countries (LMICs) using only official COVID-19 death counts. This study examines this question by comparing the age gradient of COVID-19 mortality in a broad set of countries using both official COVID-19 death counts and excess mortality estimates for 2020. DESIGN This observational study uses official COVID-19 death counts for 76 countries and excess death estimates for 42 countries. A standardised population analysis was conducted to assess the extent to which variation across countries in the age distribution of COVID-19 deaths was driven by variation in the population age distribution. SETTING AND PRIMARY OUTCOMES Officially reported COVID-19 deaths and excess deaths for 2020 for all countries where such data were available in the COVerAGE database and the short-term mortality fluctuations harmonised data series, respectively. RESULTS A higher share of pandemic-related deaths in 2020 occurred at younger ages in middle-income countries compared with high-income countries. People under age 65 years constituted on average (1) 10% of official deaths and 11 % of excess deaths in high-income countries, (2) 34% of official deaths and 33% of excess deaths in upper-middle-income countries, and (3) 54% of official deaths in LMICs. These contrasting profiles are due only in part to differences in population age structure. CONCLUSIONS These findings are driven by some combination of variation in age patterns of infection rates and infection fatality rates. They indicate that COVID-19 is not just a danger to older people in developing countries, where a large share of victims are people of working age, who are caregivers and breadwinners for their families.
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Affiliation(s)
| | - Damien de Walque
- Development Research Group, World Bank, Washington, District of Columbia, USA
| | - Paul Gubbins
- Human Development Global Practice, World Bank, Santiago, Chile
| | - Piedad Urdinola
- School of Economics, Universidad Nacional de Colombia - Sede Bogotá, Bogota, Bogota, Colombia
| | - Jeremy Veillard
- Human Development Global Practice, World Bank Group, Bogota, Colombia
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Dorn F, Lange B, Braml M, Gstrein D, Nyirenda JLZ, Vanella P, Winter J, Fuest C, Krause G. The challenge of estimating the direct and indirect effects of COVID-19 interventions - Toward an integrated economic and epidemiological approach. ECONOMICS AND HUMAN BIOLOGY 2022; 49:101198. [PMID: 36630757 PMCID: PMC9642024 DOI: 10.1016/j.ehb.2022.101198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 10/26/2022] [Accepted: 11/06/2022] [Indexed: 05/06/2023]
Abstract
Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.
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Affiliation(s)
- Florian Dorn
- ifo Institute - Leibniz Institute for Economic Research, Munich, Germany; Department of Economics, University of Munich (LMU), Germany; CESifo Munich, Germany.
| | - Berit Lange
- Epidemiology Department, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany; Hannover Medical School (MHH), Germany; German Center for Infection Research (DZIF), Braunschweig, Germany
| | - Martin Braml
- ifo Institute - Leibniz Institute for Economic Research, Munich, Germany; World Trade Organization, Economic Research and Statistics Division, Geneva, Switzerland
| | - David Gstrein
- ifo Institute - Leibniz Institute for Economic Research, Munich, Germany; Department of Economics, University of Munich (LMU), Germany
| | - John L Z Nyirenda
- Epidemiology Department, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany; University Hospital Freiburg, University of Freiburg, Germany
| | - Patrizio Vanella
- Epidemiology Department, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany; Hannover Medical School (MHH), Germany; Department of Health Reporting & Biometrics, aQua-Institut, Göttingen, Germany
| | - Joachim Winter
- Department of Economics, University of Munich (LMU), Germany; CESifo Munich, Germany
| | - Clemens Fuest
- ifo Institute - Leibniz Institute for Economic Research, Munich, Germany; Department of Economics, University of Munich (LMU), Germany; CESifo Munich, Germany
| | - Gérard Krause
- Epidemiology Department, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany; Hannover Medical School (MHH), Germany; German Center for Infection Research (DZIF), Braunschweig, Germany
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43
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Zima BT, Edgcomb JB, Rodean J, Cochran SD, Harle CA, Pathak J, Tseng CH, Bussing R. Use of Acute Mental Health Care in U.S. Children's Hospitals Before and After Statewide COVID-19 School Closure Orders. Psychiatr Serv 2022; 73:1202-1209. [PMID: 35611510 PMCID: PMC9633407 DOI: 10.1176/appi.ps.202100582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19–related school closure orders. METHODS This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3–17 years in 44 U.S. children’s hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals. RESULTS Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for >50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p<0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively. CONCLUSIONS Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children’s hospitals after COVID-19–related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care.
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Affiliation(s)
- Bonnie T Zima
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Juliet Beni Edgcomb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jonathan Rodean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Susan D Cochran
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Christopher A Harle
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jyotishman Pathak
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Chi-Hong Tseng
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Regina Bussing
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
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Grzejszczak J, Gabryelska A, Gmitrowicz A, Kotlicka-Antczak M, Strzelecki D. Are Children Harmed by Being Locked up at Home? The Impact of Isolation during the COVID-19 Pandemic on the Phenomenon of Domestic Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13958. [PMID: 36360840 PMCID: PMC9657348 DOI: 10.3390/ijerph192113958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population's mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agnieszka Gmitrowicz
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
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45
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Rice T. Children Who Lose a Parent in the COVID-19 Era: Considerations on Grief and Mourning. PSYCHOANALYTIC STUDY OF THE CHILD 2022. [DOI: 10.1080/00797308.2022.2120336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Denckla CA, Averkamp NM, Slopen N, Espinosa Dice AL, Williams D, Shear MK, Koenen KC. Social Determinants Associated With Exposure to Childhood Parental Bereavement and Subsequent Risk for Psychiatric Disorders. JAMA Netw Open 2022; 5:e2239616. [PMID: 36315141 PMCID: PMC9623444 DOI: 10.1001/jamanetworkopen.2022.39616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
IMPORTANCE Prevalence of childhood parental death varies by race and ethnicity and socioeconomic status, yet whether similar variation persists in the association with lifetime psychiatric disorder is unknown. OBJECTIVE To assess whether race and ethnicity and parental educational attainment are associated with the risk of death of a parent; to determine whether the risk for lifetime psychiatric disorder associated with death of a parent was moderated by race and ethnicity and highest parental educational attainment; and to examine a potential intersection of race and ethnicity with parental educational attainment in the risk of lifetime psychiatric disorder associated with death of a parent. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the National Comorbidity Study: Adolescent Supplement (NCS-A), 2001 to 2004. Participants included youth aged 13 to 18 years, restricted to Black, Hispanic, and White youth due to power limitations. Data were analyzed from February 26, 2021, to April 21, 2022. EXPOSURE Death of a parent during childhood. MAIN OUTCOMES AND MEASURES The primary study outcome was any lifetime Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) psychiatric disorder, assess via assessed via structured clinical interviews. RESULTS Among 9501 youth (mean [SD] age, 15.2 [1.5] years; 50.9% female), including 511 youth who had experienced parental death and 8990 youth who had not, the cumulative hazard of parental death by age 18 years was approximately doubled for Hispanic (10.1%; 95% CI, 6.9%-14.7%) and Black (14.0%; 95% CI, 10.6%-18.4%) youth compared with White youth (6.0%; 95% CI, 4.7%-7.8%). Similar patterns were noted by parental educational attainment: the cumulative hazard of parental death for youth of parents with less educational attainment was nearly double (10.1%; 95% CI, 8.1%-12.6%) compared with youth of parents with more education (6.6%; 95% CI, 5.2%-8.4%). Death of a parent was positively and significantly associated with risk of any lifetime psychiatric disorder (aOR, 1.34; 95% CI, 1.03-1.75) compared with youth who had not experienced death of a parent. However, this association was not moderated by race and ethnicity (aOR, 1.05; 95% CI, 0.58-1.92) or parental educational attainment (aOR, 1.19; 95%, 0.70-2.04), although power analyses suggest that larger sample sizes are needed. CONCLUSIONS AND RELEVANCE In this cross-sectional study, Black and Hispanic youth experienced elevated parental death compared with White youth, yet the risk for any lifetime psychiatric disorder after parental death was not significantly moderated by race and ethnicity or parental education. Both individual- and population-level interventions may be needed to address the increased risk of psychiatric disorders, although additional studies with larger sample sizes are needed.
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Affiliation(s)
- Christy A Denckla
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Natalie M Averkamp
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | | | - David Williams
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
- Department of Sociology, Harvard University Faculty of Arts and Sciences, Cambridge, Massachusetts
| | | | - Karestan C Koenen
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
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Rousseau C, Quach C, Dubé È, Vanier-Clément A, Santavicca T, Monnais-Rousselots L. Vaccination of children in marginalized neighbourhoods: Equity and diversity challenges with COVID-19 vaccination campaigns. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2022; 48:420-423. [PMID: 38125395 PMCID: PMC10730105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has exacerbated social inequities along ethnic, racial and socio-economic lines, with significant harmful consequences for children. Building on the lessons learned from community-based initiatives, this commentary proposes a reflection around equity, diversity, and inclusion challenges embedded in child vaccination campaigns during an emergency context. We argue that building equitable and inclusive practices around marginalized communities' child vaccination is a multifaceted challenge. Beyond good intentions-wanting to protect children-the risks and benefits associated with highlighting diversity in each intervention need to be carefully considered, especially when it comes to a contested/polarizing procedure such as vaccination with a novel type of vaccine. Often, a one-size-fits-all approach negates and perpetuates structural inequities. In other cases, highlighting diversity and inequities may inadvertently increase stigma and discrimination, and further harm or infantilize targeted communities. By providing multiple perspectives, a transdisciplinary approach can support decision-making in a crisis context.
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Affiliation(s)
| | | | - Ève Dubé
- Institut national de santé publique du Québec, Montréal, QC
| | | | - Tara Santavicca
- CIUSSS-Centre-Ouest-de-l’ile-de-Montréal - CoVivre, Montréal, QC
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48
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Deshpande SJ, Velonjara J, Lujan S, Petroni G, Wang J, Patel KV, Boyle LN, Bell MJ, Vavilala MS. Provider perceptions of severe pediatric traumatic brain injury care priorities across hospitals in South America before and during the COVID-19 pandemic. PLoS One 2022; 17:e0275255. [PMID: 36174092 PMCID: PMC9522258 DOI: 10.1371/journal.pone.0275255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background
To understand provider perceptions of the COVID-19 pandemic on priorities of severe pediatric traumatic brain injury (TBI) care across hospitals in South America.
Methods
Site principal investigators (PIs) from 17 hospitals in South America enrolled in the PEGASUS-Argentina randomized controlled trial completed questionnaires regarding order of tasks performed in the care of a typical pediatric patient with severe TBI before (2019) and during (2021) the COVID-19 pandemic. Acute care processes were examined by quintiles to identify early, mid, and late actions and were categorized and compared. Associations of hospital volume and subspecialty resource availability with prioritization of key process actions were examined.
Finding
Site PIs from 15 and 16 hospitals completed the surveys in 2019 and 2021, respectively, including 14 who completed both. Action category order was stable between 2019 and 2021 and were ranked in priorities as: initial encounter, primary survey, interventions and invasive monitors, diagnostics, medications, staff communication, then disposition (in 2019) or nutrition (in 2021). There was variation in specific action order between hospitals at both timepoints, with only a few initial encounter and disposition actions limited to a single quintile. There was no reported association between hospital volume or subspecialty resource availability with prioritization of key process actions.
Interpretation
Despite novel healthcare challenges presented by the COVID-19 pandemic, providers in South America perceived maintaining standard severe pediatric TBI care consistent with BTF guidelines. There was large variability in specific action order between individual hospitals reported.
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Affiliation(s)
- Shyam J. Deshpande
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States of America
- Department of Pediatrics, University of Washington, Seattle, WA, United States of America
- Harborview Injury Prevention & Research Center, Seattle, WA, United States of America
| | - Julia Velonjara
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States of America
- Harborview Injury Prevention & Research Center, Seattle, WA, United States of America
- * E-mail:
| | - Silvia Lujan
- Centro de Informática e Investigación Clínica, Rosario, Argentina
| | - Gustavo Petroni
- Centro de Informática e Investigación Clínica, Rosario, Argentina
| | - Jin Wang
- Department of Pediatrics, University of Washington, Seattle, WA, United States of America
- Harborview Injury Prevention & Research Center, Seattle, WA, United States of America
| | - Kushang V. Patel
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States of America
- Harborview Injury Prevention & Research Center, Seattle, WA, United States of America
| | - Linda Ng Boyle
- Department of Industrial and System Engineering, University of Washington, Seattle, WA, United States of America
| | - Michael J. Bell
- Children’s National Hospital Critical Care Medicine, Washington, DC, United States of America
| | - Monica S. Vavilala
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States of America
- Department of Pediatrics, University of Washington, Seattle, WA, United States of America
- Harborview Injury Prevention & Research Center, Seattle, WA, United States of America
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49
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Foster care leads to sustained cognitive gains following severe early deprivation. Proc Natl Acad Sci U S A 2022; 119:e2119318119. [PMID: 36095188 PMCID: PMC9499516 DOI: 10.1073/pnas.2119318119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study examined longitudinal data from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care following exposure to severe psychosocial deprivation. We report data from 135 participants assessed in early adulthood (age 18 y). We find that 16 y after randomization occurred, those who had been randomized to high-quality foster care had significantly higher IQ scores (9 points, 0.6 SD) than those randomized to care as usual. Mediation analyses provide evidence that the causal effect of the intervention on cognitive ability in early adulthood could be explained, in part, by higher-quality caregiving and attachment security. These findings indicate that early investment in family care as an alternative to institutional care leads to sustained gains in cognitive ability. Fostering caregiving relationships is a likely mechanism of the intervention. In addition, exploratory analyses indicate that stable placements throughout childhood are associated with the greatest long-term gains in cognitive ability. Whether early interventions for infants and young children lead to lasting change has significant implications for decisions to invest in programs aimed at improving children's developmental outcomes.
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Chu DT, Thi HV, Al-Tawfiq JA, Memish ZA. Children orphaned by COVID-19: A grim picture and the need of urgent actions. Travel Med Infect Dis 2022; 50:102446. [PMID: 36064076 PMCID: PMC9439863 DOI: 10.1016/j.tmaid.2022.102446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 had caused as a global pandemic and resulted in enormous burdens. In addition, faced with the proliferation of SARS-CoV 2 variant strains, this pandemic is continuing unremitting. The world seemed to focus primarily on middle-aged and elderly deaths, however the interest of the impact of COVID-19 on children is limited. Scientists have estimated that orphanhood and caregiver death related to COVID-19 had increased twice in the last six months compared with the first 14 months of the pandemic. Orphans face directly the health consequences.
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Affiliation(s)
- Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Viet Nam; Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hue Vu Thi
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Viet Nam
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ziad A Memish
- Director Research and Innovation Centre, King Saud Medical City, Ministry of Health and College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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