Distance learning, technological devices, lifestyle and behavior of children and their family during the COVID-19 lockdown in Lombardy: a survey

The effects of the COVID-19 pandemic on Italian primary school children's learning: A systematic review through a psycho-social lens

The COVID-19 pandemic drastically affected many areas and contexts of today's society, including school and family. Several studies focused on the worldwide effects of school closures on students' learning outcomes, context, and well-being. However, the data emerging from these studies are often inconsistent and fragmentary, highlighting the need of a comprehensive analysis of the phenomenon. This need is especially urgent for the countries with the most severe school closure, like Italy. This systematic review aims to collect the opinions of parents, teachers, and students on: other dimensions of Italian primary school students affected by school closures, beyond academic performance; hypothetical agreement between the opinions of parents, teachers, and students regarding the different effects of school closures on Italian primary school students; possible differences between the effects of school closures on Italian primary school students and the students in other countries. Our search was conducted using PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost. The results obtained from 34 articles revealed a strong concern on the part of all stakeholders involved in learning during the pandemic, with evident negative effects for Italian school students. The constraint on distance learning led to a drastic change in everyone's routine, and a negative emotional change on the part of young students. Parents and teachers generally considered distance learning to be ineffective for the education of their children and students; they encountered technical-practical difficulties in the use of electronic devices for participation in school activities; overall learning deficits on the part of students, especially in mathematics, as confirmed by INVALSI results were also found. The investigation reveals a condition of shared emotional and academic performance difficulty, and a further challenging circumstance for students previously at risk of marginalization. Further research in this field is paramount to identify new and adequate recovery strategies.

Relationship between Lifestyle Determinants and Perceived Mental and Physical Health in Italian Nursery and Primary School Teachers after the COVID-19 Lockdown

The COVID-19 lockdown and the consequent distance school learning made epochal changes in children's lifestyles; however, little is known about the lockdown effects on school teacher habits. The aim of this observational study is to examine differences in the lifestyle of nursery (NS) and primary (PS) school teachers after one of the COVID-19 lockdowns and investigate the relationship between perceived physical/mental health and demographics, weight status and lifestyle determinants, such as adherence to the Mediterranean Diet (MD) and physical activity level (PAL). A total sample of 265 participants (49.22 ± 6.95 years) filled out an online information questionnaire and standardized questionnaires to collect data on the Physical Component Summary (PCS), Mental Component Summary (MCS), PAL and MD-adherence. A t-test or ANOVA analysis was used to assess differences between quantitative variables: Mann-Whitney U or Kruskal-Wallis tests for qualitative variables. Spearman's correlations and multinomial logistic regression analyses were performed to identify categorical factors associated with classes of PCS and MCS. Teachers showed sufficient/high PAL, with a significantly higher level in the PS group (p < 0.05). This last showed a higher PCS score (p < 0.05). No differences between groups were found for MD-adherence, which was moderate/fair in both groups, and MCS, which was sufficient/good. Logistic regression showed that the only positive predictor of a high PCS was being physically active (OR 2.10, 95%CI 1.05-4.2, p < 0.05), while MCS was positively associated with normal weight status (OR 0.48, 95%CI 0.33-0.78, p = 0.020). This study highlights that PS teachers are more active than the NS group and perceive a higher physical health level. Mere predictors of physical and mental well-being are PA practice and being normal weight, respectively. This suggests that interventions to improve perceived health in this work category should be focused on the promotion of physical activity practice and on the maintenance of an optimal weight status.

The impact of the COVID-19 pandemic on children's occupations

Background

The COVID-19 pandemic changed the daily lives and limited everyday activities of children worldwide.

Objectives

To document the impact of the COVID-19 pandemic on children's occupations, the associated factors, and the impact on children's health, wellbeing, and development.

Methods

A narrative review was conducted by searching four databases (Scopus, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews).

Results

A total of 35 articles met the inclusion criteria. Out of the 34 articles, 23 were relevant to the impact of the COVID-19 pandemic on occupations related to leisure (n = 17), productivity (n = 11), and self-care (n = 9). Ten articles highlighted specific factors that had been linked to changes in occupational engagement and child behavior. Ten articles focused on the impact of occupational disruption during COVID-19 on health, wellbeing, and general development.

Conclusion

The COVID-19 pandemic seems to have had a negative impact on children's occupations, while the restrictions were still in effect. Further research is needed to establish reliable conclusions.

Emotions in Times of Pandemic Crisis among Italian Children: A Systematic Review

Several studies underlined the negative effects of forced social isolation on emotional processes in younger population. The current study aimed to review existing evidence of the pandemic's impact on the emotional regulation of Italian children aged 0-12 years in order to identify personal and contextual factors that may adversely impact their developmental process. Different electronic databases (Web of Science, APA PsycInfo, APA PsycArticles, MEDLINE, Psychology and Behavioral Sciences Collection, and Scopus) were used to identify peer-reviewed studies published in English and Italian. Thirteen studies were included in the review, covering a total of 18.843 children. All studies reported negative effects of the lockdown on a child's emotional processes. The most affected were children aged 3-5 years, those living in Northern Italy, and those with low socioeconomic status (SES) families. Alterations in emotional processes were associated with sleep disturbances, quality of family relationships, personality structures, the coping strategies used, and time spent with technological devices. Finally, two- (time × parenting) and three-way (time × parenting × environmental sensitivity) interactions resulted significantly in predicting a child's emotional regulation, respectively, in terms of externalizing and internalizing behaviors. This review remarks that children's emotional processes were negatively impacted during social lockdown, especially where acute social isolation interacted with a set of dispositional and situational risk factors.

Persistence of Lockdown Consequences on Children: A Cross-sectional Comparative Study

Lockdown during the COVID-19 pandemic had a significant psychological impact on children and adolescents. This study compared lockdown effects on children aged 1-10 years in 2020 and 2021. Two structured questionnaires were administered to 3392 parents in 2020, and 3203 in 2021. Outcomes considered for the data analysis included sleep changes, episodes of irritability, attention disturbances, distance learning and number of siblings. For data analysis, children were divided into two groups: pre-scholar (1-5 years old) and older ones. The lockdown was associated with a significant increase in sleep disturbances in 2020 and persisted after a year. The high prevalence of mood changes persisted unchanged in children under the age of 10 in 2020 and in 2021. Even if strengthened family ties seemed to mitigate the negative impact of lockdowns in 2020, this effect appeared absent or at least reduced in 2021. Irritability and rage in children were perceived to have increased in 2021 compared to 2020. A significant reduction in digital device use was observed in 2021 compared to 2020. Overall, the most harmful consequences of the lockdown in 2020 were still observed in 2021. Further studies are needed to analyze possible psychological effects that the generation who experienced the pandemic during early childhood may have, particularly in their future adolescence, in order to identify possible intervention practices to support families.

The year 2021 in COVID-19 pandemic in children

In this article, the developments in the field of COVID-19 pandemic published in the Italian Journal of Pediatrics in 2021 are reflected. We describe progresses in SARS-CoV-2 transmission route, clinical presentation, diagnosis, treatment, and access to health care facilities in children. They led to substantial changes in the clinical approach.

Caregivers' Intention to Vaccinate Their Children Under 12 Years of Age Against COVID-19: A Cross-Sectional Multi-Center Study in Milan, Italy

The impact of Coronavirus disease 2019 (COVID-19) on the pediatric population is increasingly recognized. A widespread vaccination in childhood would provide benefits for children and might help ending the pandemic by enhancing community protection. Following recent approval by the European Medicines Agency (EMA) of Comirnaty (Pfizer-BioNTech) for children aged 5-11 years, we aimed to investigate caregivers' intention to vaccinate their children <12 years of age against COVID-19. A structured questionnaire was administered to caregivers of children aged <12 years visiting the Emergency Department or the outpatient clinics in three major hospitals of Milan, Italy, from 20 September to 17 October 2021. A total of 612 caregivers were invited to participate and 604 accepted (response rate >98%). Three questionnaires were excluded due to compiling errors and 601 were included in the analysis. A total of 311 (51.7%) caregivers stated they would have their child vaccinated, 138 (23%) would refuse to vaccinate their child and 152 (25.3%) were unsure. The intention to vaccinate the child was higher in caregivers vaccinated against COVID-19, in those with a bachelor's degree or higher level of education, and in those with friends/acquaintances who became ill or died due to COVID-19. This study shows that increasing efforts are necessary to provide evidence-based tailored information to caregivers and to promote vaccination in this pediatric age group.

Caregivers' Attitudes Toward COVID-19 Vaccination in Children and Adolescents With a History of SARS-CoV-2 Infection

Background

Limited data are available on the attitudes of caregivers toward COVID-19 vaccination in children and adolescents with a history of SARS-CoV-2 infection or Long Covid symptoms. The aim of this study was to investigate the vaccine hesitancy among caregivers of children and adolescents with a documented history of SARS-CoV-2 infection and to explore the possible associations between COVID-19 manifestations and the acceptance of the vaccine.

Methods

Caregivers of children or adolescents with a microbiologically confirmed diagnosis of SARS-CoV-2 infection evaluated in two University Hospitals were interviewed.

Results

We were able to contact 132 caregivers and 9 declined to participate. 68 caregivers (56%) were in favor of COVID-19 vaccination for their child. In the multiple logistic regression, child's age (OR 1.17, 95%CI 1.06-1.28) and hospitalization due to COVID-19 (OR 3.25, 95%CI 1.06-9.95) were positively associated with being in favor of COVID-19 vaccination. On the contrary, the occurrence of child's Long Covid was associated with a higher likelihood of being against the vaccination (OR 0.28, 95%CI 0.10-0.80).

Conclusions

This preliminary study shows that only about half of the interviewed parents of children and adolescents with a previous SARS-CoV-2 infection are willing to vaccinate them to prevent a repeated COVID-19 infection. These findings might help healthcare workers to provide tailored information to caregivers of children with a previous SARS-CoV-2 infection.