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Schonfeld DJ, Demaria T, Nasir A, Kumar S. Supporting the Grieving Child and Family: Clinical Report. Pediatrics 2024; 154:e2024067212. [PMID: 38881360 DOI: 10.1542/peds.2024-067212] [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: 04/25/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 06/18/2024] Open
Abstract
The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short- and long-term reactions. Pediatricians, within a patient-centered medical home, are in an excellent position to provide guidance to caregivers and to offer assistance and support to grieving children of all ages and their families. This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications. An understanding of guilt, shame, and other common reactions as well as an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss will help the pediatrician to address factors that may impair children's adjustment and to identify complicated mourning and situations when professional counseling is indicated. Advice on how to support children's participation in funerals and other memorial services and to anticipate and address grief triggers and anniversary reactions is provided so that pediatricians are in a better position to advise caregivers and to offer consultation to and collaborate with professionals in schools, early education and child care facilities, and other child congregate care sites. Pediatricians often enter their profession out of a profound desire to minimize the suffering of children and may find it personally challenging to bear witness to the distress of children who are acutely grieving. The importance of professional preparation and self-care is, therefore, emphasized, and resources are recommended.
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Affiliation(s)
- David J Schonfeld
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, California
- National Center for School Crisis and Bereavement at Children's Hospital Los Angeles, Los Angeles, California
| | - Thomas Demaria
- National Center for School Crisis and Bereavement at Children's Hospital Los Angeles, Los Angeles, California
| | - Arwa Nasir
- Department of Pediatrics, University of Nebraska, Omaha, Nebraska
| | - Sairam Kumar
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, California
- National Center for School Crisis and Bereavement at Children's Hospital Los Angeles, Los Angeles, California
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Schonfeld DJ, Demaria T. Mental Health Impact of Pandemics and Other Public Health Emergencies in Children. Pediatr Clin North Am 2024; 71:455-468. [PMID: 38754935 DOI: 10.1016/j.pcl.2024.01.015] [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: 05/18/2024]
Abstract
Pediatric health care providers can provide universal support to children and families to mitigate potential risk factors to adjustment while fostering protective factors to promote resiliency in children and families. They can educate caregivers about ways to enhance recovery of their children by modifying expectations and addressing the special emotional and social needs of their children. Most public health emergencies evolve through stages across an extended time period, often taxing the personal resources of health care providers. This underscores the need for pediatric health care providers to integrate self-care strategies in their personal and professional practice routines.
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Affiliation(s)
- David J Schonfeld
- Keck School of Medicine of the University of Southern California; National Center for School Crisis and Bereavement at Children's Hospital Los Angeles.
| | - Thomas Demaria
- National Center for School Crisis and Bereavement at Children's Hospital Los Angeles
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Durgut Şakrucu E, Demircioğlu H. The Related Role of Anxiety and Parental Resilience on the Aggressive Tendencies of Preschool Children during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2024; 11:661. [PMID: 38929240 PMCID: PMC11201574 DOI: 10.3390/children11060661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
In this study, we aimed to determine the related role of anxiety and parental resilience on the aggressive tendencies of preschool children during the COVID-19 pandemic. The study sample comprised a total of 293 parents with children aged 4-6 years. Relationships between Preschool Anxiety Scale, Aggression Orientation Scale, and Brief Resilience Scale total and subscale scores were evaluated using Pearson and Spearman correlation analysis. The results of this study show that there is a positive relationship between children's aggression tendencies and anxiety levels. We observed weak to moderate correlations between parents' resilience scores and the children's aggression and anxiety scores. Although linear regression analysis indicated no significant effect of parental resilience on children's aggressive tendencies, anxiety levels may be related. In addition, study results showed that the physical aggression tendencies of children differed according to their age and the number of children in the family, albeit at a low level. Further studies are needed to identify factors associated with aggression in preschool children.
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Affiliation(s)
| | - Haktan Demircioğlu
- Department of Child Development, Hacettepe University, 06800 Ankara, Türkiye;
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4
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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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Kapos FP, Vandeleur DM, Tham SW, Palermo TM, Groenewald CB. Comparing the prevalence of chronic pain in school-aged children in the United States from 2019 to 2020: a nationally representative study examining differences associated with the COVID-19 pandemic. Pain 2024; 165:233-242. [PMID: 37556380 PMCID: PMC10841312 DOI: 10.1097/j.pain.0000000000003020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/15/2023] [Indexed: 08/11/2023]
Abstract
ABSTRACT The coronavirus disease 19 (COVID-19) pandemic negatively affected children's health in the United States (US), with more severe disruption for marginalized groups. However, potential impact on pediatric chronic pain has not been assessed at the population level. This study aimed to (1) estimate differences in the US national prevalence of pediatric chronic pain during the first year of the COVID-19 pandemic (2020), relative to one year earlier (2019); (2) determine whether differences in prevalence varied across sociodemographic groups; and (3) explore changes in child, caregiver, and family factors associated with chronic pain prevalence. Using data of children 6 to 17 years from the National Survey of Children's Health 2019 and 2020 (n = 50,518), we compared weighted percentages of sample characteristics by year and conducted a series of directed-acyclic graph-informed survey-weighted Poisson regressions. The estimated national prevalence (95% CI) of pediatric chronic pain was 10.8% (9.9, 11.9%) in 2019, decreasing to 7.6% (6.9, 8.3%) in 2020. Contrary to hypotheses, the adjusted prevalence of chronic pain was 31% lower in 2020 than in 2019 (aPR = 0.69, 95% CI: 0.61, 0.79), adjusting for child age, sex, race or ethnicity, caregiver education, neighborhood park or playground, and census region. The 2019 to 2020 change in chronic pain prevalence was similar by age ( P = 0.34), sex ( P = 0.94), race or ethnicity ( P = 0.41), caregiver education ( P = 0.49), neighborhood park or playground ( P = 0.22), and census region ( P = 0.20). Exploratory analyses identified 3 potential contributors to the unexpected decrease in the national prevalence of pediatric chronic pain: lower prevalence of bullying, more frequent family meals, and higher family resilience.
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Affiliation(s)
- Flavia P. Kapos
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
| | - Daron M. Vandeleur
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - See Wan Tham
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Cornelius B. Groenewald
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
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Sward A, Zik J, McDonald AR, Niep L, Berkowitz S. A Developmentally Informed Approach to Address Mass Firearm Violence. Pediatr Clin North Am 2023; 70:1171-1182. [PMID: 37865438 DOI: 10.1016/j.pcl.2023.06.009] [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: 10/23/2023]
Abstract
Pediatric medical providers have an important role to play in response to mass gun violence events. Although mass gun violence events are rare, the rate of mass shootings is unfortunately increasing, and such events are shown to have significant and far-reaching psychological impact on children and adolescents. Recommendations from the behavioral health and pediatric fields are consolidated along with developmental considerations to support pediatric provider response in the aftermath of a mass gun violence event. Gun violence prevention strategies are also discussed.
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Affiliation(s)
- Ashley Sward
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA.
| | - Jodi Zik
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA; Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA
| | - Amber R McDonald
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA
| | - Laurel Niep
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA
| | - Steven Berkowitz
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA; Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 North Revere Court, Suite 4092, Aurora, CO 80045, USA
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Adu MK, Agyapong B, Agyapong VIO. Children's Psychological Reactions to Wildfires: a Review of Recent Literature. Curr Psychiatry Rep 2023; 25:603-616. [PMID: 37851204 DOI: 10.1007/s11920-023-01451-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE OF REVIEW This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires. The information gathered from this review will help health experts understand and address the mental health needs of children during wildfire disasters and may serve as a base for future studies to evaluate evidence-based public health responses to mitigate adverse outcomes. RECENT FINDINGS The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescent post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies). This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents' mental health, including children with disabilities in the communities that have experienced wildfire disasters.
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Affiliation(s)
- Medard K Adu
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada.
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
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Zougheibe R, Dewan A, Norman R, Gudes O. Insights into parents' perceived worry before and during the COVID-19 pandemic in Australia: inequality and heterogeneity of influences. BMC Public Health 2023; 23:1944. [PMID: 37805455 PMCID: PMC10559437 DOI: 10.1186/s12889-023-16337-9] [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: 11/02/2022] [Accepted: 07/18/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Excessive worry is an invisible disruptive force that has adverse health outcomes and may advance to other forms of disorder, such as anxiety or depression. Addressing worry and its influences is challenging yet crucial for informing public health policy. METHODS We examined parents' worries, influences, and variability before and during COVID-19 pandemic and across geography. Parents (n = 340) and their primary school-aged children from five Australian states completed an anonymous online survey in mid-2020. After literature review, we conceptualised the influences and performed a series of regression analyses. RESULTS Worry levels and the variables contributing to parents' worry varied before to during the pandemic. The proportion of parents who were "very worried all the time" increased by 14.6% in the early days of the pandemic. During the pandemic, ethnic background modified parents' worry and parents' history of daily distress symptoms was a significant contributor (p < 0.05). Excessive exposure to news remained significant both before and during the pandemic. The primary predictor of parents' worry before COVID-19 was perceived neighbourhood safety, while the main predictor during COVID-19 was financial risk due to income change. Some variable such as neighbourhood safety and financial risk varied in their contribution to worry across geographical regions. The proportion of worried children was higher among distraught parents. CONCLUSION Parents' worry during the health pandemic was not triggered by the health risks factors but by the financial risk due to income change. The study depicts inequality in the impact of COVID-19 by ethnic background. Different policies and reported virus case numbers across states may have modified the behaviour of variables contributing to the geography of parents' worry. Exposure to stressors before the COVID-19 pandemic may have helped parents develop coping strategies during stressful events. Parents are encouraged to limit their exposure to stressful news. We advocate for parents-specific tailored policies and emphasise the need for access to appropriate mental health resources for those in need. Advancing research in geographical modelling for mental health may aid in devising much-needed location-targeted interventions and prioritising resources in future events.
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Affiliation(s)
- Roula Zougheibe
- School of Earth and Planetary Sciences, Curtin University, Kent Street, Perth, WA, 6102, Australia.
| | - Ashraf Dewan
- School of Earth and Planetary Sciences, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Ori Gudes
- School of Population Health, UNSW Medicine, New South Wales, Australia
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Devaskar SU, Cunningham CK, Steinhorn RH, Haq C, Spisso J, Dunne W, Gutierrez JR, Kivlahan C, Bholat M, Barakat S, de Leon Siantz ML, Romero S, Lefteris CT, Gaffney S, Deville J, Lerner C, Liu J, Kuelbs CL, Kukreja S, Golden C, Nelson Z, Elton K, Byington CL. Academic Health Centers and Humanitarian Crises: One Health System's Response to Unaccompanied Children at the Border. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:322-328. [PMID: 36512839 PMCID: PMC9944367 DOI: 10.1097/acm.0000000000005097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
University of California Health (UCH) provided a system-wide, rapid response to the humanitarian crisis of unaccompanied children crossing the southern U.S. border in the midst of the COVID-19 pandemic in 2021. In collaboration with multiple federal, state, and local agencies, UCH mobilized a multidisciplinary team to deliver acute general and specialty pediatric care to unaccompanied children at 2 Californian emergency intake sites (EISs). The response, which did not disrupt normal UCH operations, mobilized the capacities of the system and resulted in a safe and developmentally appropriate environment that supported the physical and mental health of migrant children during this traumatic period. The capacities of UCH's 6 academic health centers ensured access to trauma-informed medical care and culturally sensitive psychological and social support. Child life professionals provided access to exercise, play, and entertainment. Overall, 260 physicians, 42 residents and fellows, 4 nurse practitioners participated as treating clinicians and were supported by hundreds of staff across the 2 EISs. Over 5 months and across both EISs, a total of 4,911 children aged 3 to 17 years were cared for. A total of 782 children had COVID-19, most infected before arrival. Most children (3,931) were reunified with family or sponsors. Continuity of care after reunification or placement in a long-term shelter was enhanced by use of an electronic health record. The effort provided an educational experience for residents and fellows with instruction in immigrant health and trauma-informed care. The effort benefitted from UCH's recent experience of providing a system-wide response to the COVID-19 pandemic. Lessons learned are reported to encourage the alignment and integration of academic health centers' capacities with federal, state, and local plans to better prepare for and respond to the accelerating need to care for those in the wake of disasters and humanitarian crises.
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Affiliation(s)
- Sherin U. Devaskar
- S.U. Devaskar is distinguished professor of pediatrics, David Geffen School of Medicine at UCLA, executive chair, Department of Pediatrics, UCLA, physician-in-chief, UCLA Mattel Children’s Hospital, assistant vice chancellor of children’s health, UCLA Health, and executive director, UCLA Children’s Discovery and Innovation Institute, Los Angeles, California
| | - Coleen K. Cunningham
- C.K. Cunningham is pediatrician, UCI Health, Orange, chair, Department of Pediatrics, University of California, Irvine, School of Medicine, Irvine, and senior vice president and pediatrician-in-chief, Children’s Hospital of Orange County, Orange, California
| | - Robin H. Steinhorn
- R.H. Steinhorn is professor and vice dean for children’s clinical services, University of California San Diego, and president of children’s specialists of San Diego and senior vice president, Rady Children’s Specialists of San Diego, San Diego, California
| | - Cynthia Haq
- C. Haq is clinical professor and chair, Department of Family Medicine, UCI Medical Center, Orange, California
| | - Johnese Spisso
- J. Spisso is president, UCLA Health, chief executive officer, UCLA Hospital System, and associate vice chancellor, UCLA Health Sciences, Los Angeles, California
| | - William Dunne
- W. Dunne was administrative director of emergency preparedness, security, and safety services, UCLA Health, Los Angeles, California, at the time of writing. The author is currently director of emergency management, Penn State Health, Hershey, Pennsylvania
| | - Juan Raul Gutierrez
- J.R. Gutierrez is associate clinical professor, Department of Pediatrics, UCSF School of Medicine, co-director of pediatrics, UCSF Health and Human Rights Initiative and the Center of Excellence for Immigrant Child Health and Wellbeing, San Francisco, California
| | - Coleen Kivlahan
- C. Kivlahan is medical director, UCSF Human Rights Clinic, UCSF Health and Human Rights Initiative, San Francisco, California
| | - Michelle Bholat
- M. Bholat is professor and executive vice-chair, Department of Family Medicine, David Geffen School of Medicine at UCLA, and executive director and co-founder, International Medical Graduate Program, UCLA Health, Los Angeles, California
| | - Suzanne Barakat
- S. Barakat is assistant professor, Family Community Medicine, and executive director, UCSF Health and Human Rights Initiative, San Francisco, California
| | - Mary Lou de Leon Siantz
- M.L. de Leon Siantz is professor emeritus, Betty Irene Moore School of Nursing at UC Davis, and founding director, Center for the Advancement of Multicultural Perspectives on Science, Sacramento, California
| | - Stephanie Romero
- S. Romero is program manager, UCSF Health and Human Rights Initiative, San Francisco, California
| | - Chad T. Lefteris
- C.T. Lefteris is chief executive officer, UCI Health, Orange, California
| | - Samantha Gaffney
- S. Gaffney is manager in executive administration, UCLA Medical Center, Los Angeles, California
| | - Jaime Deville
- J. Deville is clinical professor of pediatrics, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, and UCLA Mattel Children’s Hospitaldirector, Care-4-Families Clinic, UCLA Health, Los Angeles, California
| | - Carlos Lerner
- C. Lerner is professor of clinical pediatrics and chair in pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Jasen Liu
- J. Liu is pediatrician, UCLA Health and UCLA Mattel Children’s Hospital, Los Angeles, California
| | - Cynthia L. Kuelbs
- C.L. Kuelbs is clinical professor of pediatrics, UC San Diego School of Medicinechief medical information officer, Rady Children’s Hospital, San Diego, California
| | - Sudeep Kukreja
- S. Kukreja is associate medical director and director of quality improvement, Neonatal Intensive Care Unit, Children’s Hospital of Orange County, medical director, Newborn Hearing Screening Program, Children’s Hospital of Orange County, and Mission Hospitalspecialist in neonatology, Children’s Hospital of Orange County, Orange, California
| | - Charles Golden
- C. Golden is pediatrician and executive medical director, Primary Care Network, Children’s Hospital of Orange County, Orange, California
| | - Zoanne Nelson
- Z. Nelson is associate vice president, Finance and Administration, University of California Health, Oakland, California
| | - Kristie Elton
- K. Elton is systemwide program manager for environment, health, and safety, UC Office of the President, Oakland, California
| | - Carrie L. Byington
- C.L. Byington is professor of pediatrics and pediatric infectious diseases, UCSF School of Medicine, San Francisco, and executive vice president, University of California Health, Oakland, California
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10
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Özcan M, Akça K, Aydoğdu F. The relationship between the COVID-19 pandemic and children's emotional and behavioral problems. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:87-94. [PMID: 36683560 DOI: 10.1111/jcap.12408] [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: 07/19/2022] [Revised: 01/01/2023] [Accepted: 01/12/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE This research was conducted to determine the relationship of the COVID-19 pandemic with the emotional and behavioral problems of children. METHOD In this study, carried out using the descriptive survey model, the Strengths and Difficulties Questionnaire was used with 205 mothers. RESULTS Significant differences were observed in the emotional and behavioral problems of children according to their mother's working status, having COVID-19 in the family, and being in contact. According to mothers' perceptions, the level of emotional and behavioral problems differed before and after the pandemic. CONCLUSIONS It can be concluded that the pandemic and related factors have an effect on children's emotional and behavioral problems.
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Affiliation(s)
- Meltem Özcan
- Health Services Vocational School, Erzincan Binali Yıldırım Üniversity, Erzincan, Turkey
| | - Kamile Akça
- Faculty of Health Sciences, Gaziantep Islam Science And Technology University, Gaziantep, Turkey
| | - Fatih Aydoğdu
- Health Services Vocational School, Erzincan Binali Yıldırım Üniversity, Erzincan, Turkey
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11
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Joseph MM, Mahajan P, Snow SK, Ku BC, Saidinejad M. Optimizing Pediatric Patient Safety in the Emergency Care Setting. Pediatrics 2022; 150:189658. [PMID: 36189487 DOI: 10.1542/peds.2022-059674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 02/25/2023] Open
Abstract
Patient safety is the foundation of high-quality health care and remains a critical priority for all clinicians caring for children. There are numerous aspects of pediatric care that increase the risk of patient harm, including but not limited to risk from medication errors attributable to weight-dependent dosing and need for appropriate equipment and training. Of note, the majority of children who are ill and injured are brought to community hospital emergency departments. It is, therefore, imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This technical report outlined the challenges and resources necessary to minimize pediatric medical errors and to provide safe medical care for children of all ages in emergency care settings.
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Affiliation(s)
- Madeline M Joseph
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, University of Florida Health Sciences Center-Jacksonville, Jacksonville, Florida
| | - Prashant Mahajan
- Departments of Pediatrics and Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Sally K Snow
- Independent Consultant in Pediatric Emergency and Trauma Nursing; Graham, Texas
| | - Brandon C Ku
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mohsen Saidinejad
- The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
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12
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Karbasi Z, Eslami P. Prevalence of post-traumatic stress disorder during the COVID-19 pandemic in children: a review and suggested solutions. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC9512982 DOI: 10.1186/s43045-022-00240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The outbreak of coronavirus began in China in December 2019. It became a pandemic and a public health emergency. There have been numerous reports related to post-traumatic stress disorder outbreaks in the COVID-19 crisis. After a natural disaster, children are at a higher risk for post-traumatic stress disorder. The current study is a review of the scientific literature on the effect of COVID-19 on the prevalence of symptoms of post-traumatic stress disorder in children. We searched PubMed, Web of Science, and Scopus databases until February 02, 2022. The search strategy was based on a combination of the following keywords “child,” “COVID-19,” and “post-traumatic stress disorder.” Results By searching the Web of Science, Scopus, and PubMed databases, 173 articles were retrieved. After reviewing the inclusion criteria and in terms of eligibility, 10 articles met the inclusion criteria out of the remaining 46 articles. Based on the findings, 80% of the articles were cross-sectional and 20% of them were longitudinal. The articles reviewed in this study reported an increase in the prevalence of post-traumatic stress disorder in children during or after the COVID-19 pandemic. Conclusions In summary, the findings of this review showed that restrictions and fears of COVID-19 had negative psychological effects on children. As well, one of the most important issues that arose at the time of the tragedy was that children were suffering from post-traumatic stress disorder. Given that post-traumatic stress disorder can be treated, it is essential to choose the appropriate therapeutic intervention approach in order to better deal with the negative effects in children.
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13
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Dass-Brailsford P, Thomley RSH, Jain D, Jarrett ES. The Mental Health Consequences of Hurricane Matthew on Haitian Children and Youth: An Exploratory Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:899-909. [PMID: 35958720 PMCID: PMC9360302 DOI: 10.1007/s40653-021-00413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 06/15/2023]
Abstract
Haiti has experienced many major natural disasters in the past decade that included Hurricane Matthew which led to mass damage to property, a depletion of basic resources, human fatalities and injuries, and mental health consequences that affected the poorest. The current study focused on the psychological effects of Hurricane Matthew on Haitian children and adolescents. Children display heightened depression, and PTSD symptoms in the aftermath of disasters (Hausman et al., Journal of Family Psychology 34:836-845, 2020), however, the researchers anticipated that children living in orphanages would display more severe mental health symptoms than those living with their families, because of their additional stressor of family loss. Using a convenience sample, quantitative data was collected using several instruments, in a survey format, that were individually administered to a sample of 77 adolescents. Participants had high depressive scores and reported multiple adverse events and limited access to basic needs. In comparing subgroups, we found children who were in orphanages reported significantly fewer adverse childhood experiences than those living with their families. This is likely because orphanages in Haiti consistently provide children with a safe and stable environment, buffering them against the traumatic effects of disasters. In contrast, children living with their families reported witnessing or experiencing interpersonal violence, neglect and abuse in addition to disaster-related stress. Before addressing the issues faced by disaster-affected children in Haiti, the systemic issues that maintain the socio-economic deprivation of so many citizens must be addressed. An important step is for policymakers to collaborate with mental health providers to develop community interventions that are low-cost and easily accessible. These interventions must consider and incorporate the social context and cultural patterns of help-seeking and treatment utilization in Haiti.
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Affiliation(s)
| | | | - Dipana Jain
- The Chicago School of Professional Psychology, Washington, DC USA
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14
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Nicholas DB, Mitchell W, Ciesielski J, Khan A, Lach L. A Qualitative Examination of the Impact of the COVID-19 Pandemic on Individuals with Neuro-developmental Disabilities and their Families. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:2202-2214. [PMID: 35855733 PMCID: PMC9281199 DOI: 10.1007/s10826-022-02336-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 05/26/2023]
Abstract
Individuals with neuro-developmental disabilities (NDD) have been profoundly affected by the COVID-19 pandemic. Based on focus groups with 24 service providers supporting this population, using an Interpretive Description approach, we examined perceived impacts of the pandemic on individuals with NDD and their families. The results highlight pandemic-related experiences which include: service reduction, the need for financial supports, relying on natural supports, and school-related challenges. Interruptions in services have resulted in intensified mental health issues for individuals with NDD and family caregivers, with particular concern for those with added social determinants of health-related barriers. Mitigating factors have also emerged, such as resilience and technology utilization to facilitate communication. Recommendations for resource flexibility and sufficiency as well as navigational support are offered.
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Affiliation(s)
- David B. Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, 3-250, 10230 Jasper Avenue, Edmonton, Alberta T5J 4P6 Canada
| | - Wendy Mitchell
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, 3-250, 10230 Jasper Avenue, Edmonton, Alberta T5J 4P6 Canada
| | - Jill Ciesielski
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, 3-250, 10230 Jasper Avenue, Edmonton, Alberta T5J 4P6 Canada
| | - Arisha Khan
- Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal Quebec, H3A 2A7 Canada
| | - Lucyna Lach
- Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal Quebec, H3A 2A7 Canada
- School of Social Work, Faculty of Arts, McGill University, Suite 300, Wilson Hall, 3506 University Street, Montreal Quebec, H3A 2A7 Canada
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15
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Hosseinnejad M, Yazdi-Feyzabadi V, Hajebi A, Bahramnejad A, Baneshi R, Ershad Sarabi R, Okhovati M, Zahedi R, Saberi H, Zolala F. Prevalence of Posttraumatic Stress Disorder Following the Earthquake in Iran and Pakistan: A Systematic Review and Meta-Analysis. Disaster Med Public Health Prep 2022; 16:801-808. [PMID: 33779538 DOI: 10.1017/dmp.2020.411] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a common mental disorder following traumatic events. The present study was conducted to understand the prevalence of PTSD after the earthquake in Iran and Pakistan. The review includes all articles published from inception to March 2019. The pooled prevalence for overall PTSD was 55.6% (95% CI: 49.9-61.3). It was 60.2% (95% CI: 54.1-66.3) and 49.2% (95% CI: 39.4-59) for Iranian and Pakistani survivors, respectively. Women experienced higher incidence of PTSD than men. The variation of PTSD based on the clinical interview was lower than the self-report approach. The interval time between the earthquakes and the assessment showed that the prevalence of PTSD decreased over time. The prevalence of PTSD in Iran and Pakistan was higher than the global average, and the rate of the disorder in Iran was higher than in Pakistan. Sex, method of assessment, and time lag between the occurrence of disaster and assessment of PTSD affect the prevalence.
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Affiliation(s)
- Maryam Hosseinnejad
- Health in Disasters and Emergencies Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health, Faculty of Nursing and Midwifery and Health, Islamic Azad University, Kerman Branch, Kerman, Iran
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Bahramnejad
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Baneshi
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roghayeh Ershad Sarabi
- Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Okhovati
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Razieh Zahedi
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Saberi
- School of Management and Medical Informatics, Kerman University of Medical Sciences, KermanIran
| | - Farzaneh Zolala
- Social Determinants of Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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16
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Lin A, King MA, McCarthy DC, Eriksson CO, Newton CR, Cohen RS. Universal Level Designations for Hospitalized Pediatric Patients in Evacuation. Hosp Pediatr 2022; 12:333-336. [PMID: 35137099 DOI: 10.1542/hpeds.2021-006356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Children comprise approximately 22% of the population in the United States.1 In a widespread disaster such as a hurricane, pandemic, wildfire or major earthquake, children are at least proportionately affected to their share of the population, if not more so. They also have unique vulnerabilities including physical, mental, and developmental differences from adults, which make them more prone to adverse health effects of disasters.2-4 There are about 5000 pediatric critical care beds and 23 000 neonatal intensive care beds out of 900 000 total hospital beds in the United States.5 While no mechanism exists to consistently track pediatric acute care beds nationally (especially in real time), a previous study6 showed a 7% decline in pediatric medical-surgical beds between 2002 and 2011. This study also estimated there are about 30 000 acute care pediatric beds nationally. Finding appropriate hospital resources for the provision of care for pediatric disaster victims is an important concern for those charged with triaging patients in a major event.
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Affiliation(s)
- Anna Lin
- Department of Pediatrics, Division of Pediatric Hospital Medicine, Stanford University School of Medicine, Stanford, California
| | - Mary A King
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Washington, Seattle, Washington
| | - David C McCarthy
- Arizona Coordinator, Western Regional Alliance for Pediatric Emergency Management
| | - Carl O Eriksson
- Department of Pediatrics, Division of Critical Care, Oregon Health and Science University, Portland, Oregon
| | - Christopher R Newton
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Ronald S Cohen
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, California
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17
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Gabbe BJ, Veitch W, Mather A, Curtis K, Holland AJA, Gomez D, Civil I, Nathens A, Fitzgerald M, Martin K, Teague WJ, Joseph A. Review of the requirements for effective mass casualty preparedness for trauma systems. A disaster waiting to happen? Br J Anaesth 2021; 128:e158-e167. [PMID: 34863512 DOI: 10.1016/j.bja.2021.10.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 01/06/2023] Open
Abstract
Mass casualty incidents (MCIs) are diverse, unpredictable, and increasing in frequency, but preparation is possible and necessary. The nature of MCIs requires a trauma response but also requires effective and tested disaster preparedness planning. From an international perspective, the aims of this narrative review are to describe the key components necessary for optimisation of trauma system preparedness for MCIs, whether trauma systems and centres meet these components and areas for improvement of trauma system response. Many of the principles necessary for response to MCIs are embedded in trauma system design and trauma centre function. These include robust communication networks, established triage systems, and capacity to secure centres from threats to safety and quality of care. However, evidence from the current literature indicates the need to strengthen trauma system preparedness for MCIs through greater trauma leader representation at all levels of disaster preparedness planning, enhanced training of staff and simulated disaster training, expanded surge capacity planning, improved staff management and support during the MCI and in the post-disaster recovery phase, clear provision for the treatment of paediatric patients in disaster plans, and diversified and pre-agreed systems for essential supplies and services continuity. Mass casualty preparedness is a complex, iterative process that requires an integrated, multidisciplinary, and tiered approach. Through effective preparedness planning, trauma systems should be well-placed to deliver an optimal response when faced with MCIs.
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Affiliation(s)
- Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Health Data Research UK, Swansea University Medical School, Swansea, UK.
| | - William Veitch
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne Mather
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kate Curtis
- School of Medicine, University of Sydney, Sydney, Australia; Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - Andrew J A Holland
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney School of Medicine, Westmead, Australia
| | - David Gomez
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada
| | - Ian Civil
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Avery Nathens
- Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Mark Fitzgerald
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia; Trauma Service, The Alfred, Melbourne, Australia
| | - Kate Martin
- Department General Surgical Specialties, Royal Melbourne Hospital, Parkville, Australia
| | - Warwick J Teague
- Trauma Service, Royal Children's Hospital, Parkville, Australia; Surgical Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Anthony Joseph
- Royal North Shore Hospital Clinical School, School of Medicine, University of Sydney, St Leonards, Australia
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18
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John HB, Arumugam A, Priya M, Murugesan N, Rajendraprasad N, Rebekah G, Paul P, Chandna J, Lawn JE, Santhanam S. South Indian children's neurodevelopmental outcomes after Group B Streptococcus invasive disease: A case cohort study. Clin Infect Dis 2021; 74:S24-S34. [PMID: 34558605 PMCID: PMC8775645 DOI: 10.1093/cid/ciab792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background This study is part of a multicountry matched-cohort study designed to estimate the risk of long-term neurodevelopmental impairment (NDI) of children exposed to invasive group B Streptococcus (iGBS). The specific objective of this paper is to compare NDI across domains of iGBS survivors with a matched non iGBS group in our population. Methods Survivors of iGBS in a South Indian hospital were identified and recruited between January 2020 and April 2021. Cases were compared with age- and gender-matched non iGBS children. Participants were assessed using Bayley Scales of Infant and Toddler Development–3rd edition (BSID-III), Wechsler Preschool and Primary Scale of Intelligence–4th edition (WPPSI-IV), Wechsler Intelligence Scale for Children–5th edition (WISC-V), Child Behavior Checklist (CBCL), and Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), depending on age. Results Our cohort comprised 35 GBS-exposed and 65 matched non iGBS children, aged 1–14 years. The iGBS-exposed group had 17 (48.6%) children with impairment in ≥1 domain compared to 25 (38%) in the non iGBS group (unadjusted OR, 1.51; 95% CI, .65–3.46), 9 (26%) children with “multi-domain impairment” compared to 10 (15.4%) in the non iGBS group (unadjusted OR, 1.90; 95% CI, .69–5.24), and 1 (2.9%) child with moderate to severe impairment compared to 3 (4.6%) in the non iGBS group (unadjusted OR, .60; 95% CI, .06–6.07). In the iGBS group, more children had motor impairments compared with the non iGBS group (unadjusted OR, 10.7; 95% CI, 1.19–95.69; P = .034). Conclusions Children with iGBS seem at higher risk of developing motor impairments compared with a non iGBS group.
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Affiliation(s)
- Hima B John
- Department of Neonatology, Christian Medical College, Vellore
| | - Asha Arumugam
- Department of Neonatology, Christian Medical College, Vellore
| | - Mohana Priya
- Department of Neonatology, Christian Medical College, Vellore
| | | | | | - Grace Rebekah
- Department of Biostatistics, Christian Medical College, Vellore
| | - Proma Paul
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaya Chandna
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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19
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Rider EA, Ansari E, Varrin PH, Sparrow J. Mental health and wellbeing of children and adolescents during the covid-19 pandemic. BMJ 2021; 374:n1730. [PMID: 34429302 DOI: 10.1136/bmj.n1730] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Elizabeth A Rider
- Department of Pediatrics, Harvard Medical School; and Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Eman Ansari
- Department of Pediatrics, Harvard Medical School; and Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | - Joshua Sparrow
- Department of Psychiatry, Harvard Medical School; and Brazelton Touchpoints Center, Division of Developmental Medicine, and Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
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20
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Setou N, Suzuki S, Matsuzuka T, Iwadate M, Maeda M, Namekata Y, Yoshida F, Oshima K, Ohira T, Yasumura S, Ohto H, Kamiya K, Yokoya S, Shimura H. Psychosocial support for the examinees and their families during the secondary confirmatory examination:Analyses of support records at first visit. Fukushima J Med Sci 2021; 67:53-63. [PMID: 34373400 PMCID: PMC8460285 DOI: 10.5387/fms.2021-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Purpose The Thyroid Ultrasound Examination (TUE) program is conducted as part of the Fukushima Health Management Survey. Following the established criteria, examinees are called in for a secondary confirmation examination, which may induce high anxiety related to a thyroid cancer for both the examinees and their families. Therefore, Fukushima Medical University created the Thyroid Support Team to reduce anxiety. The purpose of this study is to analyze the psychosocial support for examinees and their families through two types of records, and to clarify the current issues and determine future directions of support. Materials and methods We analyzed 223 records of support for the first visit of examinees who attended the secondary confirmatory examination, conducted at Fukushima Medical University from September 2018 to March 2019. Results During the first visit, frequent topics and questions brought up by the examinees and their families were about the “Thyroid Ultrasound Examination (TUE) program” and “Examination findings”. The Thyroid Support Team members assisted them by “Responding to questions”, “Confirming the doctor’s explanation” and “Providing information”. The percentage of people with high anxiety decreased in both examinees and their family members after the examination. The level of anxiety was lower among those who had already taken the secondary confirmatory examination. Family members’ anxiety was significantly higher than that of the examinees, and anxiety levels were highly correlated between examinees and their families. Conclusion The psychosocial support for examinees and their families was important in reducing their anxiety. Currently there are changes in social conditions and various opinions concerning the TUE. Thus, careful explanation and the need for decision-making supports for the examinees and their families increased. Also, we should take into account the aging of the examinees and expanding the available psychosocial support.
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Affiliation(s)
- Noriko Setou
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,School of Health Sciences, Asahi University
| | - Manabu Iwadate
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Thyroid and Endocrinology, School of Medicine, Fukushima Medical University
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University
| | - Yuko Namekata
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Fusae Yoshida
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Kayoko Oshima
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Susumu Yokoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Thyroid and Endocrine Center, Fukushima Global Medical Science Center, Fukushima Medical University
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Laboratory Medicine, School of Medicine, Fukushima Medical University
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21
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Garner A, Yogman M. Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health. Pediatrics 2021; 148:peds.2021-052582. [PMID: 34312296 DOI: 10.1542/peds.2021-052582] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
By focusing on the safe, stable, and nurturing relationships (SSNRs) that buffer adversity and build resilience, pediatric care is on the cusp of a paradigm shift that could reprioritize clinical activities, rewrite research agendas, and realign our collective advocacy. Driving this transformation are advances in developmental sciences as they inform a deeper understanding of how early life experiences, both nurturing and adverse, are biologically embedded and influence outcomes in health, education, and economic stability across the life span. This revised policy statement on childhood toxic stress acknowledges a spectrum of potential adversities and reaffirms the benefits of an ecobiodevelopmental model for understanding the childhood origins of adult-manifested disease and wellness. It also endorses a paradigm shift toward relational health because SSNRs not only buffer childhood adversity when it occurs but also promote the capacities needed to be resilient in the future. To translate this relational health framework into clinical practice, generative research, and public policy, the entire pediatric community needs to adopt a public health approach that builds relational health by partnering with families and communities. This public health approach to relational health needs to be integrated both vertically (by including primary, secondary, and tertiary preventions) and horizontally (by including public service sectors beyond health care). The American Academy of Pediatrics asserts that SSNRs are biological necessities for all children because they mitigate childhood toxic stress responses and proactively build resilience by fostering the adaptive skills needed to cope with future adversity in a healthy manner.
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Affiliation(s)
- Andrew Garner
- Partners in Pediatrics, Westlake, Ohio.,School of Medicine, Case Western Reserve University, Cleveland, Ohio
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22
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Ducy EM, Stough LM. Psychological effects of the 2017 California wildfires on children and youth with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103981. [PMID: 34020412 DOI: 10.1016/j.ridd.2021.103981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 03/18/2021] [Accepted: 04/23/2021] [Indexed: 06/12/2023]
Abstract
The psychological effects of disasters on children with disabilities are understudied, despite evidence towards increased risk for complications after other types of trauma exposure. This study investigated the experience of children and youth with disabilities exposed to the 2017 Northern California wildfires, with a particular focus on psychological reactions. In-depth interviews were conducted with parents of 14 children and youth with disabilities one year post-disaster. Thematic analysis was used to analyze the interviews. Parents described the wildfires as traumatic events for both themselves and their children. Children and youth exhibited stress, grief, and other emotional and behavioral reactions during evacuation, in the immediate aftermath, and one year post-disaster. Navigating disability-related needs, such as accessible housing, contributed to parent stress post-disaster. School and community-based mental health efforts are described, along with a call for increased attention to disaster-related reactions in children with developmental disabilities. Suggestions for improving preparedness and response efforts that better support children with disabilities and their families post-disaster are given.
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Affiliation(s)
- Elizabeth McAdams Ducy
- Sonoma State University, College of Education, Department of Educational Leadership and Special Education, 1801 E. Cotati Ave, Rohnert Park, CA, 94928, United States.
| | - Laura M Stough
- Texas A&M University, College of Education and Human Development, Department of Educational Psychology, 709 Harrington Office Building, College Station, TX, 77843, United States.
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23
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Bleile ACE, Koppenol-Gonzalez GV, Verreault K, Abeling K, Hofman E, Vriend W, Hasan A, Jordans MJD. Process evaluation of TeamUp: a movement-based psychosocial intervention for refugee children in the Netherlands. Int J Ment Health Syst 2021; 15:25. [PMID: 33741025 PMCID: PMC7977563 DOI: 10.1186/s13033-021-00450-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nearly 60,000 people applied for asylum in the Netherland in 2015, confronting the governmental structures and services with great administrative, logistical and service provision challenges. Refugee children's psychosocial needs and wellbeing are often overlooked, and post-migration support is of pivotal importance. METHODS An easy accessible movement-based psychosocial intervention, called TeamUp, was developed for children aged 6-17 living in refugee reception centres. A mixed-method process evaluation was conducted of (1) implementation process, assessing attendance (n = 2183 children, and n = 209 children); (2) implementation quality, using structured observations at two time points to evaluate facilitator's (2a) individual-level fidelity (n = 81 facilitators); (2b) team-level fidelity (n = 22 teams); (2c) facilitators' competencies (n = 81); (2d) trainee perceived self-efficacy pre-post training (n = 73); and (3) perceptions on implementation and outcomes, employing a survey (n = 99), focus group discussions and key informant interviews with children (n = 94), facilitators (n = 24) and reception centre staff (n = 10). RESULTS Attendance lists showed a mean of 8.5 children per session, and children attending 31.3% of sessions. Structured observations demonstrated 49.2% and 58.2% individual-level fidelity, 72.5% and 73.0% team-level fidelity, and 82.9% and 88.4% adequacy in competencies, each at T1 and T2 respectively. The main reported challenges included managing children's energy regulation (e.g. offering settling moments) and challenging behaviour. Training participation significantly improved perceived self-efficacy for trainees. The facilitator survey demonstrated on average, high satisfaction and self-efficacy, low experienced burden, and high perceived capacity-building support. Qualitatively, TeamUp was positively perceived by all stakeholders and was regarded as contributing to children's psychosocial outcomes. CONCLUSION (1) Attendance and group size were lower than expected. (2) The intervention's facilitator fidelity ranged from moderate to adequate-exhibiting a need for specific fidelity and capacity strengthening-while facilitator competencies were high. Trainee's perceived self-efficacy improved significantly following a 2-day training. (3) Facilitators expressed high levels of satisfaction, self-efficacy and support, and low burden. The intervention was positively perceived by all stakeholders and to have a positive impact on children's psychosocial learning and wellbeing.
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Affiliation(s)
| | | | | | | | - Elin Hofman
- War Child Holland, Amsterdam, The Netherlands
| | | | - Adnan Hasan
- War Child Holland, Amsterdam, The Netherlands
| | - Mark J D Jordans
- War Child Holland, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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Petrocchi S, Levante A, Bianco F, Castelli I, Lecciso F. Maternal Distress/Coping and Children's Adaptive Behaviors During the COVID-19 Lockdown: Mediation Through Children's Emotional Experience. Front Public Health 2020; 8:587833. [PMID: 33330330 PMCID: PMC7711130 DOI: 10.3389/fpubh.2020.587833] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/19/2020] [Indexed: 01/09/2023] Open
Abstract
The present study focused on the psychological impact that the lockdown due to coronavirus disease-19 (COVID-19) had on families in Italy. During the COVID-19 pandemic, the Italian government imposed a strict lockdown for all citizens. People were forced to stay at home, and the length of the lockdown was uncertain. Previous studies analyzed the impact of social distance measures on individuals' mental health, whereas few studies have examined the interplay between the adults' functioning, as parents, during this period and the association with the child's adjustment. The present study tested if maternal distress/coping predicts children's behaviors during the COVID-19 lockdown, hypothesizing a mediation effect via children's emotional experience. Participants were 144 mothers (M age = 39.3, 25-52, SD = 5.6) with children aged 5-10 years (M age = 7.54, SD = 1.6, 82 boys); mothers answered to an online survey. Results indicated that mothers with higher exposure to COVID-19 showed higher levels of distress and higher display of coping attitudes, even if in the structural equation modeling model, the COVID-19 exposure was not a predictor of mothers' distress. Compared with mothers with good coping skills, mothers with higher stress levels were more likely to attribute negative emotions to their children at the expense of their positive emotions. Moreover, children's emotions acted as mediators between maternal distress/coping and children's adaptive/maladaptive behaviors. In conclusion, it is important to support parents during pandemic emergence, by providing them with adequate information to manage the relationship with their children, to reduce their level of distress and to enhance their coping abilities.
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Affiliation(s)
- Serena Petrocchi
- Institute of Communication and Health, Università della Svizzera Italiana, Lugano, Switzerland
- Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
| | - Annalisa Levante
- Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
| | - Federica Bianco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Ilaria Castelli
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Flavia Lecciso
- Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
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Schonfeld DJ, Melzer-Lange M, Hashikawa AN, Gorski PA. Participation of Children and Adolescents in Live Crisis Drills and Exercises. Pediatrics 2020; 146:peds.2020-015503. [PMID: 32839245 DOI: 10.1542/peds.2020-015503] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children and adolescents should be included in exercises and drills to the extent that their involvement advances readiness to meet their unique needs in the event of a crisis and/or furthers their own preparedness or resiliency. However, there is also a need to be cautious about the potential psychological risks and other unintended consequences of directly involving children in live exercises and drills. These risks and consequences are especially a concern when children are deceived and led to believe there is an actual attack and not a drill and/or for high-intensity active shooter drills. High-intensity active shooter drills may involve the use of real weapons, gunfire or blanks, theatrical makeup to give a realistic image of blood or gunshot wounds, predatory and aggressive acting by the individual posing to be the shooter, or other means to simulate an actual attack, even when participants are aware that it is a drill. This policy statement outlines some of the considerations regarding the prevalent practice of live active shooter drills in schools, including the recommendations to eliminate children's involvement in high-intensity drills and exercises (with the possible exception of adolescent volunteers), prohibit deception in drills and exercises, and ensure appropriate accommodations during drills and exercises based on children's unique vulnerabilities.
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Affiliation(s)
- David J Schonfeld
- National Center for School Crisis and Bereavement, Children's Hospital Los Angeles and Department of Clinical Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California;
| | - Marlene Melzer-Lange
- Division of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin
| | - Andrew N Hashikawa
- Departments of Emergency Medicine and Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Peter A Gorski
- Departments of Pediatrics and Humanities, Health, and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; and.,Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
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26
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Fung A, Ricci MF. Rethinking 'essential' and 'nonessential': the developmental paediatrician's COVID-19 response. Paediatr Child Health 2020; 25:265-267. [PMID: 32754000 PMCID: PMC7337771 DOI: 10.1093/pch/pxaa077] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/26/2020] [Indexed: 11/13/2022] Open
Abstract
While terms such as 'essential' and 'nonessential' used amidst the COVID-19 pandemic may serve a practical purpose, they also pose a risk of obstructing our view of the harmful indirect health consequences of this crisis. SARS-CoV-2 cases and deaths in children are minimal compared to adults, but the pandemic impacts other 'essential' aspects of children's health including child development and the associated areas of paediatric behaviour, mental health, and maltreatment. Alongside the management of severe SARS-CoV-2 cases in emergency rooms and intensive care units, continuing to care for children with developmental disabilities must also be concurrently championed as 'essential' during this crisis. The potentially devastating lifelong effects of the pandemic and isolation on an already vulnerable population demand that action be taken now. Video conferences and phone calls are 'essential' instruments we can use to continue to provide quality care for our patients.
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Affiliation(s)
- Alastair Fung
- Winnipeg Children’s Hospital, Pediatrics and Child Health, Winnipeg, Manitoba
| | - M Florencia Ricci
- Child Development Clinic, Neonatal Follow-up Clinic, Winnipeg, Manitoba
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27
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Abstract
OBJECTIVES The American Academy of Pediatrics (AAP) calls for the inclusion of office-based pediatricians in disaster preparedness and response efforts. However, there is little research about disaster preparedness and response on the part of pediatric practices. This study describes the readiness of pediatric practices to respond to disaster and delineates factors associated with increased preparedness. METHODS An AAP survey was distributed to members to assess the state of pediatric offices in readiness for disaster. Potential predictor variables used in chi-square analysis included community setting, primary employment setting, area of practice, and previous disaster experience. RESULTS Three-quarters (74%) of respondents reported some degree of disaster preparedness (measured by 6 indicators including written plans and maintaining stocks of supplies), and approximately half (54%) reported response experience (measured by 3 indicators, including volunteering to serve in disaster areas). Respondents who reported disaster preparation efforts were more likely to have signed up for disaster response efforts, and vice versa. CONCLUSIONS These results contribute information about the state of pediatric physician offices and can aid in developing strategies for augmenting the inclusion of office-based pediatricians in community preparedness and response efforts.
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Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC, Wright J, Adirim T, Agus MS, Callahan J, Gross T, Lane N, Lee L, Mazor S, Mahajan P, Timm N, Goodloe J, Brown K, Abell B, Alson R, Bachista K, Bowman L, Boynton H, Brown SA, Chang A, Copeland D, De Lorenzo R, Douglas D, Fowler R, Gallagher J, Gilliam S, Guyette F, Holland D, Jarvis J, Kalan C, Keeperman J, Kupas D, Lairet J, Levy M, Lyon K, Manifold C, McCabe-Kline K, Mell H, Miller B, Millin M, Rosen B, Ross J, Ryan K, Sanko S, Schlesinger S, Sheppard C, Sibold H, Smith S, Spigner M, Stracuzzi V, Tanski C, Tennyson J, White C, Wilcocks D, Yee A, Young T, Foresman-Capuzzi J, Johnson R, Martin H, Milici J, Brandt C, Nelson N, Lyng J, Watson S, Remick K, Dietrich A, Bates K, Flake F, Flores G. Pediatric Readiness in Emergency Medical Services Systems. Ann Emerg Med 2020; 75:e1-e6. [DOI: 10.1016/j.annemergmed.2019.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/28/2022]
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Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC. Pediatric Readiness in Emergency Medical Services Systems. Pediatrics 2020; 145:peds.2019-3307. [PMID: 31857380 DOI: 10.1542/peds.2019-3307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This is a joint policy statement from the American Academy of Pediatrics, American College of Emergency Physicians, Emergency Nurses Association, National Association of Emergency Medical Services Physicians, and National Association of Emergency Medical Technicians on pediatric readiness in emergency medical services systems.
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Affiliation(s)
- Brian Moore
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Manish I Shah
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Sylvia Owusu-Ansah
- Division of Emergency Medical Services, Department of Pediatrics and Emergency Department, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Toni Gross
- Department of Emergency Medicine, Children's HospitalNew Orleans and Louisiana State University Health New Orleans, New Orleans, Louisiana
| | - Kathleen Brown
- Departments of Pediatrics and Emergency Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.,Division of Emergency Medicine, Children's National Medical Center, Washington, District of Columbia
| | - Marianne Gausche-Hill
- Departments of Emergency Medicine and Pediatrics, David Geffen School of Medicine, University of California, Los Angeles and Harbor-University of California, Los Angeles Medical Center, Los Angeles, California
| | - Katherine Remick
- San Marcos Hays County Emergency Medical Services, San Marcos, Texas.,Austin-Travis County Emergency Medical Services System, Austin, Texas.,Department of Pediatrics, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Kathleen Adelgais
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado
| | - John Lyng
- Level I Adult Trauma Center and Level II Pediatric Trauma Center, North Memorial Health Hospital, Minneapolis, Minnesota
| | - Lara Rappaport
- Department of Pediatric Emergency Medicine and Urgent Care Center, Denver Health Medical Center, Denver, Colorado
| | - Sally Snow
- Pediatric Emergency and Trauma Nursing, Fort Worth, Texas
| | - Cynthia Wright-Johnson
- Emergency Medical Services for Children, Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland; and
| | - Julie C Leonard
- Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital and College of Medicine, The Ohio State University, Columbus, Ohio
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30
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Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC. Pediatric Readiness in Emergency Medical Services Systems. PREHOSP EMERG CARE 2019; 24:175-179. [DOI: 10.1080/10903127.2019.1685614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Abstract
Currently, throughout the world, there are nearly 40 million children displaced by natural or man-made disasters. The special needs of children in disasters are often unrecognized, yet children comprise half of disaster victims. The purpose of this review is to provide information on (1) demographics related to children and disasters, both domestic and international; (2) risks for children who experience disasters; (3) programs that help children in disasters; and (4) training programs on the special needs of children in disasters. Children who are displaced by disasters are at risk of acute and long-term medical problems. Disaster experiences can also lead to acute and long-term psychological problems. Ultimately, these have worldwide negative implications for human society, including education, health care, security, and economic and political aspects of daily life. There is a compelling need for more services to help the children who have experienced disasters and for education to train more relief workers about the special needs of children in disasters.
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32
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Salt RJ, Sickora C, Page TL, Martinez ML, Cantu AG, Schwab KW, Lee M. "We didn't forget" Utilizing a Community-Nurse Partnership to Promote Health in Rockport, Texas after Hurricane Harvey. Public Health Nurs 2019; 37:113-120. [PMID: 31713275 DOI: 10.1111/phn.12684] [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: 05/08/2019] [Revised: 09/22/2019] [Accepted: 10/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND On August 25th 2017 Harvey, a category 4 hurricane, made landfall on the south coast of Texas with heavy winds and rain that severely damaged the seaside town of Rockport. The challenge facing healthcare providers following a natural disaster is timely assessments of community need and available resources. One week later, faculty at the University of Texas Health Science Center San Antonio, School of Nursing (SON) completed a community assessment and developed valuable partnerships. AIMS Eighteen days after the initial assessment, faculty had secured support from The Children's Health Fund and operationalized strategies to provide disaster relief and experiential learning opportunities for the SON Population Focused Health undergraduate students. MATERIALS & METHODS The community-as-partner model served as the framework to apply the nursing process to a community in crisis. As the focus shifted to recovery, the team prioritized the need to address long-term consequences for children after a natural disaster. RESULTS Two educational sessions were designed using an interactive and instructional approach to discuss parental strategies to assess and support children as they navigated through loss after Harvey. DISCUSSION This community-nurse partnership has endured, and the SON faculty and students continue to travel to Rockport to promote health and provide education to the community.
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Affiliation(s)
- Rebekah J Salt
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Cindy Sickora
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Tracey L Page
- St. David's School of Nursing, Texas State University, Round Rock, TX, USA
| | - Martha L Martinez
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Adelita G Cantu
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Karen W Schwab
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Moonju Lee
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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Abstract
Children are affected by all types of disasters disproportionately compared with adults. Despite this, planning and readiness to care for children in disasters is suboptimal locally, nationally, and internationally. These planning gaps increase the likelihood that a disaster will have a greater negative impact on children when compared with adults. New voluntary regional coalitions have been developed to fill this gap. Some are pediatric focused or have pediatrics well integrated into the greater coalition. This article discusses key points of pediatric disaster planning, specific vulnerabilities, and the care of children in general and in specific disaster situations.
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Affiliation(s)
- Mitchell Hamele
- Department of Pediatrics-Critical Care, Tripler Army Medical Center, Honolulu, HI 96859, USA.
| | - Ramon E Gist
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 49, Brooklyn, NY 11203, USA
| | - Niranjan Kissoon
- Department of Pediatrics and Emergency Medicine, BC Children's Hospital, Sunny Hill Health Centre for Children, UBC, Child and Family Research Institute, B245 - 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada
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Pediatric disaster preparedness: identifying challenges and opportunities for emergency department planning. Curr Opin Pediatr 2019; 31:306-311. [PMID: 31090569 DOI: 10.1097/mop.0000000000000750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To review the current literature on best practices for pediatric disaster preparedness in an emergency department (ED). RECENT FINDINGS Children have unique anatomical, physiologic, immunologic, and psychosocial needs that impact their vulnerability to and resilience in a disaster, yet they have been historically underrepresented in disaster planning at local and national levels. Lessons learned from recent disaster events, disaster research, and disaster experts provide guidance on pediatric disaster preparedness for ED. SUMMARY All EDs should include children in their disaster plans and exercises. ED staff should be knowledgeable about their role in institutional disaster operations and familiar with standard disaster management principles.
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35
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Affiliation(s)
- David J Schonfeld
- USC National Center for School Crisis and Bereavement, Los Angeles, California
- University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
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36
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[Neonatal transport for disasters]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:305-311. [PMID: 31014419 PMCID: PMC7389216 DOI: 10.7499/j.issn.1008-8830.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
Neonates are vulnerable to greater damage in disasters and thus have special needs for equipment and medical staff. It is necessary to establish a regional neonatal transport network, in order to provide a platform for effective information communication and resource sharing. Neonatal care centers for critically ill neonates at all levels need to develop a disaster response plan for neonatal transport, and master this plan. In case of disasters, neonatal transport should be directed at the government level, in order to arrange emergency transport resources in a unified, reasonable and efficient way. Meanwhile, the psychological needs of family members and rescue staff should be taken into account.
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37
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Duan XD, Li JJ, Shi Y. [Interpretation of the disaster response plans in the pediatric intensive care unit]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:312-316. [PMID: 31014420 PMCID: PMC7389230 DOI: 10.7499/j.issn.1008-8830.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
In April 2018, the Group of Pediatric Disasters, Pediatric Society, Chinese Medical Association and Pediatric Committee, Medical Association of Chinese People's Liberation Army issued the disaster response plans in the pediatric intensive care unit (PICU). This article outlines the development of the plans and the implementation of PICU disaster rescue, along with ethical issues in the context of disasters and psychological reconstruction after a disaster.
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Affiliation(s)
- Xu-Dong Duan
- Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China.
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38
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Altman RL, Santucci KA, Anderson MR, McDonnell WM, Fanaroff JM, Bondi SA, Narang SK, Oken RL, Rusher JW, Scibilia JP, Scott SM, Sigman LJ. Understanding Liability Risks and Protections for Pediatric Providers During Disasters. Pediatrics 2019; 143:peds.2018-3893. [PMID: 30804075 DOI: 10.1542/peds.2018-3893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although most health care providers will go through their careers without experiencing a major disaster in their local communities, if one does occur, it can be life and career altering. The American Academy of Pediatrics has been in the forefront of providing education and advocacy on the critical importance of disaster preparedness. From experiences over the past decade, new evidence and analysis have broadened our understanding that the concept of preparedness is also applicable to addressing the unique professional liability risks that can occur when caring for patients and families during a disaster. Concepts explored in this technical report will help to inform pediatric health care providers, advocates, and policy makers about the complexities of how providers are currently protected, with a focus on areas of unappreciated liability. The timeliness of this technical report is emphasized by the fact that during the time of its development (ie, late summer and early fall of 2017), the United States went through an extraordinary period of multiple, successive, and overlapping disasters within a concentrated period of time of both natural and man-made causes. In a companion policy statement (www.pediatrics.org/cgi/doi/10.1542/peds.2018-3892), recommendations are offered on how individuals, institutions, and governments can work together to strengthen the system of liability protections during disasters so that appropriate and timely care can be delivered with minimal fear of legal reprisal or confusion.
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Affiliation(s)
- Robin L. Altman
- Department of Pediatrics, New York Medical College of Touro University and Maria Fareri Children's Hospital of Westchester Medical Center Health Network, Valhalla, New York
| | - Karen A. Santucci
- Department of Pediatrics, School of Medicine, Yale University and Children’s Emergency Department, Yale-New Haven Hospital, New Haven, Connecticut
| | | | - William M. McDonnell
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
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Huebner CR, Kimball-Eayrs CA, Burnett MW, Cunningham BK, Faux BM, Foster CW, Judd CA, Lemmon KM, Mondzelewski LM, Weisse ME, Wolf LJ, Wong D, Yogman M, Baum R, Gambon TB, Lavin A, Mattson G, Montiel-Esparza R, Nasir A, Wissow LS. Health and Mental Health Needs of Children in US Military Families. Pediatrics 2019; 143:peds.2018-3258. [PMID: 30584059 DOI: 10.1542/peds.2018-3258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children in US military families share common experiences and unique challenges, including parental deployment and frequent relocation. Although some of the stressors of military life have been associated with higher rates of mental health disorders and increased health care use among family members, there are various factors and interventions that have been found to promote resilience. Military children often live on or near military installations, where they may attend Department of Defense-sponsored child care programs and schools and receive medical care through military treatment facilities. However, many families live in remote communities without access to these services. Because of this wide geographic distribution, military children are cared for in both military and civilian medical practices. This clinical report provides a background to military culture and offers practical guidance to assist civilian and military pediatricians caring for military children.
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Affiliation(s)
| | | | | | - Mark W. Burnett
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | | | - Brian M. Faux
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | | | | | - Keith M. Lemmon
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | | | - Martin E. Weisse
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Lauren J. Wolf
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - David Wong
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Michael Yogman
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Rebecca Baum
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Thresia B. Gambon
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Arthur Lavin
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | - Gerri Mattson
- Department of Pediatrics, Naval Medical Center, San Diego, California
| | | | - Arwa Nasir
- Department of Pediatrics, Naval Medical Center, San Diego, California
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Shi Y. [Disaster response plans in the neonatal intensive care unit]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:1033-1037. [PMID: 29046196 PMCID: PMC7389272 DOI: 10.7499/j.issn.1008-8830.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
Newborns in the neonatal intensive care unit (NICU) are highly vulnerable in disasters due to their need for specialized and highly technical support. It is strongly encouraged to prepare for the most likely disaster scenarios for the NICU. During a disaster, neonatal care providers should maintain situational awareness for decision-making, including available equipment, medication, and staffing. Neonatal care providers also should consider the ethical issues and the psychosocial needs of the families and neonatal care staff.
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Affiliation(s)
- Yuan Shi
- Group of Pediatric Disaster, Pediatric Society, Chinese Medical Association; Pediatrics Committee, Medical Association of Chinese People's Liberation Army
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Dziuban EJ, Peacock G, Frogel M. A Child's Health Is the Public's Health: Progress and Gaps in Addressing Pediatric Needs in Public Health Emergencies. Am J Public Health 2017; 107:S134-S137. [PMID: 28892439 DOI: 10.2105/ajph.2017.303950] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children's needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved.
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Affiliation(s)
- Eric J Dziuban
- Eric J. Dziuban and Georgina Peacock are with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Michael Frogel is with the National Pediatric Disaster Coalition, and is also with Maimonides Infant and Children's Hospital, Brooklyn, NY
| | - Georgina Peacock
- Eric J. Dziuban and Georgina Peacock are with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Michael Frogel is with the National Pediatric Disaster Coalition, and is also with Maimonides Infant and Children's Hospital, Brooklyn, NY
| | - Michael Frogel
- Eric J. Dziuban and Georgina Peacock are with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Michael Frogel is with the National Pediatric Disaster Coalition, and is also with Maimonides Infant and Children's Hospital, Brooklyn, NY
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Barfield WD, Krug SE, Watterberg KL, Aucott SW, Benitz WE, Eichenwald EC, Goldsmith JP, Hand IL, Poindexter BB, Puopolo KM, Stewart DL, Krug SE, Chung S, Fagbuyi DB, Fisher MC, Needle SM, Schonfeld DJ. Disaster Preparedness in Neonatal Intensive Care Units. Pediatrics 2017; 139:peds.2017-0507. [PMID: 28557770 DOI: 10.1542/peds.2017-0507] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Disasters disproportionally affect vulnerable, technology-dependent people, including preterm and critically ill newborn infants. It is important for health care providers to be aware of and prepared for the potential consequences of disasters for the NICU. Neonatal intensive care personnel can provide specialized expertise for their hospital, community, and regional emergency preparedness plans and can help develop institutional surge capacity for mass critical care, including equipment, medications, personnel, and facility resources.
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Affiliation(s)
| | - Steven E. Krug
- Northwestern University Feinberg School of Medicine, Evanston, Illinois; and
- Department of Pediatric Emergency Medicine, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois
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Abstract
The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short- and long-term reactions. Pediatricians, within a patient-centered medical home, are in an excellent position to provide anticipatory guidance to caregivers and to offer assistance and support to children and families who are grieving. This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications and to address any misinformation, misinterpretations, or misconceptions. An understanding of guilt, shame, and other common reactions, as well an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss, will help the pediatrician to address factors that may impair grieving and children's adjustment and to identify complicated mourning and situations when professional counseling is indicated. Advice on how to support children's participation in funerals and other memorial services and to anticipate and address grief triggers and anniversary reactions is provided so that pediatricians are in a better position to advise caregivers and to offer consultation to schools, early education and child care facilities, and other child congregate care sites. Pediatricians often enter their profession out of a profound desire to minimize the suffering of children and may find it personally challenging when they find themselves in situations in which they are asked to bear witness to the distress of children who are acutely grieving. The importance of professional preparation and self-care is therefore emphasized, and resources are recommended.
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Abstract
Infants, children, adolescents, and young adults have unique physical, mental, behavioral, developmental, communication, therapeutic, and social needs that must be addressed and met in all aspects of disaster preparedness, response, and recovery. Pediatricians, including primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, have key roles to play in preparing and treating families in cases of disasters. Pediatricians should attend to the continuity of practice operations to provide services in time of need and stay abreast of disaster and public health developments to be active participants in community planning efforts. Federal, state, tribal, local, and regional institutions and agencies that serve children should collaborate with pediatricians to ensure the health and well-being of children in disasters.
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