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Kaur K, Muralikrishnan J, Hussaindeen JR, Deori N, Gurnani B. Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned. Pediatric Health Med Ther 2023; 14:309-321. [PMID: 37849985 PMCID: PMC10578174 DOI: 10.2147/phmt.s395349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a "branch of medicine" suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.
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Affiliation(s)
- Kirandeep Kaur
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Janani Muralikrishnan
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India
| | | | - Nilutparna Deori
- Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Zhao G, Wang B, Li H, Ren H, Jiao Z. The relationship between depressive and anxious symptoms and school attendance among adolescents seeking psychological services in a public general hospital in China: a cross-sectional study. BMC Psychiatry 2023; 23:456. [PMID: 37344768 DOI: 10.1186/s12888-023-04813-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/23/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND School attendance problems (SAPs), whether absenteeism or dropout, are strongly associated with poor outcomes for adolescents. We examined multiple variables that influence SAPs to identify potential leverage points for improving school attendance. METHODS Self-reported SAPs and demographic information was collected from 392 adolescents in adolescents presenting to the general hospital for psychological services. PHQ-9 and GAD-7 were applied to assess the severity of depressive and anxious symptoms. We constructed logistic regression analysis and the Chi-Square Automatic Interaction Detection (CHAID) segmentation analysis via SPSS Decision Tree to identifying risk factors for the development of SAPs in adolescents. RESULTS SAPs were self-reported by 252 (64.3%) adolescents. The SAPs group and non-SAPs group showed a significant difference in age, PHQ9 total scores, GAD7 total scores, schools, siblings, residence, parental marital quality, general health, regular exercise, and regular diet. A post hoc comparison between the two groups showed that the frequency of SAPs was significantly higher in the moderately-severe and severe depressive groups compared with other three groups (none, mild, moderate). The frequency of SAPs in severe anxious groups was significantly different from the none-anxious group. According to the binary logistic regression analysis, the depressive severity, siblings, residence, marital quality of parents, general health, and regular diet were correlated with the SAPs among adolescents. The adjusted OR of SAPs according to moderately-severe depressive symptoms was 10.84 (95%CI: 1.967-59.742) and severe depressive symptoms was 6.659 (95%CI: 1.147-38.666). In the decision tree model, PHQ-9 severity was extracted as the first splitting variable, with regular exercise and residence as the second, and siblings as the third. The ROC curves for predicting SAPs showed a fair diagnostic accuracy of the model with AUCs of CHAID model (0.705,95%CI:0.652-0.759, P = 0.000) and logistic regression model (0.777,95%CI:0.729-0.824, P = 0.000). CONCLUSION Our study provides insights into the associations between depressive symptoms and poor school attendance and identifies a number of risk factors associated with SAPs. Effective intervention by mental health practitioners, more attention by policy makers, and further research in this area are urgently needed for adolescents.
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Affiliation(s)
- Guoqing Zhao
- Department of Psychology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Department of Psychology, Shandong Provincial Hospital, Shandong University, No. 324, Jingwu Weiqi Road, Huaiyin District, Jinan, 250021, Shandong, China
| | - Bin Wang
- Department of Psychology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Department of Psychology, Shandong Provincial Hospital, Shandong University, No. 324, Jingwu Weiqi Road, Huaiyin District, Jinan, 250021, Shandong, China
| | - Hui Li
- Department of Psychology, Qilu Hospital Of Shandong University Dezhou Hospital, Dezhou, 253014, Shandong, China
| | - Honghong Ren
- Department of Psychology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Department of Psychology, Shandong Provincial Hospital, Shandong University, No. 324, Jingwu Weiqi Road, Huaiyin District, Jinan, 250021, Shandong, China
| | - Zhian Jiao
- Department of Psychology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Department of Psychology, Shandong Provincial Hospital, Shandong University, No. 324, Jingwu Weiqi Road, Huaiyin District, Jinan, 250021, Shandong, China.
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Leung J, Quinn C, Carlyle M, Ellem R, Tisdale C, Davidson L, White MJ, Kavanagh DJ, Hides L. Retrospective Self-Reports of How Adolescent Substance Use Changed with the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013680. [PMID: 36294257 PMCID: PMC9602900 DOI: 10.3390/ijerph192013680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 06/01/2023]
Abstract
The final year of high school is a challenging phase of adolescents' lives and substance use can play an important role. We examined changes in the frequency and quantity of alcohol and cannabis use, and demographic correlates among Grade 12 students of 2020. Students (N = 844) from nine schools retrospectively self-reported changes in substance use after the easing of COVID-19 lockdowns (back to school), compared to before the pandemic. Changes in use were examined with age, gender, Aboriginal or Torres Islander, parental and family characteristics, and truancy. Thirty-one percent of students reported that they used alcohol less frequently, and 24% reported that they used it more frequently compared to pre-COVID-19. Most students (46%) reported that they used cannabis less, while a subset reported using more frequently (22%). A history of truancy was associated with an increased frequency (OR = 2.13 [1.18-3.83]) of cannabis use. A substantial minority of adolescents used more alcohol and cannabis after the initial COVID-19 lockdown period. Students in their final year who reported increased use may benefit from increased support to manage their substance use.
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Affiliation(s)
- Janni Leung
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Catherine Quinn
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Molly Carlyle
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Rhiannon Ellem
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Calvert Tisdale
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Lily Davidson
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Melanie J. White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, QLD 4000, Australia
| | - David J. Kavanagh
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, QLD 4000, Australia
| | - Leanne Hides
- Lives Lived Well Group (LLW), School of Psychology, The University of Queensland, St. Lucia, QLD 4072, Australia
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, St. Lucia, QLD 4072, Australia
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Dror C, Hertz-Palmor N, Yadan-Barzilai Y, Saker T, Kritchmann-Lupo M, Bloch Y. Increase in Referrals of Children and Adolescents to the Psychiatric Emergency Room Is Evident Only in the Second Year of the COVID-19 Pandemic-Evaluating 9156 Visits from 2010 through 2021 in a Single Psychiatric Emergency Room. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158924. [PMID: 35897293 PMCID: PMC9332552 DOI: 10.3390/ijerph19158924] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
Introduction: The COVID-19 pandemic affected the wellbeing of children and adolescents. The psychiatric emergency room (ER) is the hub of psychiatric emergencies and reflects clinically significant mental problems. Previous studies compared 2019 and 2020 and observed a decline in ER referrals. The current study focused on the continuous trend of referrals from 2010 to the end of 2021. Method: In our observational retrospective study, we procured data from 9156 child and adolescent referrals to our psychiatric ER. The comparison was made based on similar months of each year. Results: There was a significant positive trend in monthly referrals between 2010 and 2021, representing a similar increase in referrals per month in comparison to that month in the preceding year (unstandardized β = 4.21, 95% CI = 3.44 to 4.98, p < 0.0001). Between March 2020 and February 2021 (monthly visits = 72.5 + 16.6 [median = 79.5], annual referrals = 870), we observed no additive effect beyond this general trend after controlling for population growth. Conversely, between March and December 2021 (monthly referrals = 106.1 + 31.8 [median = 105.5], overall referrals = 1061) we observed a significant additive effect beyond the projected incline, as predicted by previous years (β = 21.61, 95% CI = 12.12 to 31.06, p < 0.0001). Conclusions: The first year of the COVID-19 pandemic was no different from the continuous decade long rise of referrals to the children and adolescents’ psychiatric ER. Conversely, the second year showed an additional incline beyond the general trend. The complexity in this rising need demands the awareness of clinicians and policy makers alike.
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Affiliation(s)
- Chen Dror
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (C.D.); (N.H.-P.)
| | - Nimrod Hertz-Palmor
- The Child and Adolescent Psychiatry Division, Sheba Medical Center, Edmund and Lily Safra’s Children Hospital, Ramat Gan 52621, Israel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (C.D.); (N.H.-P.)
| | - Yael Yadan-Barzilai
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
| | - Talia Saker
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Maya Kritchmann-Lupo
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuval Bloch
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel; (Y.Y.-B.); (T.S.); (M.K.-L.); (Y.B.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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