scholarly journals The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ciara Conlon ◽  
Thérèse McDonnell ◽  
Michael Barrett ◽  
Fergal Cummins ◽  
Conor Deasy ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Emergency Departments ◽  
Children's Health ◽  
Children’S Health ◽  
Frontline Staff ◽  
Health And Wellbeing ◽  
Paediatric Emergency ◽  
Provision Of Care ◽  
The Impact

Abstract Background The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. Methods Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. Results The pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. Conclusions The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

scholarly journals The Impact of the COVID-19 Pandemic on Child Health and Well-Being: Are Children “Slipping through the Net”? A Qualitative Study of Frontline Emergency Care Staff

2021 ◽  
Author(s):  
Ciara Conlon ◽  
Thérèse McDonnell ◽  
Michael Barrett ◽  
Fergal Cummins ◽  
Conor Deasy ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Children's Health ◽  
Care Staff ◽  
Children’S Health ◽  
Frontline Staff ◽  
Health And Wellbeing ◽  
Paediatric Emergency ◽  
Health And Social Care ◽  
The Impact

Abstract BackgroundThe COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. MethodsFifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n=6), social workers (n=2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. ResultsThe pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care.Conclusions The spread of COVID-19 and subsequent polices to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

scholarly journals The impact of the low-income housing tax credit on children's health and wellbeing in Georgia

2018 ◽  
Vol 93 ◽  
pp. 390-396
Author(s):  
Katie A. Ports ◽  
Whitney L. Rostad ◽  
Feijun Luo ◽  
Michelle Putnam ◽  
Elizabeth Zurick
Keyword(s):  
Low Income ◽  
Children's Health ◽  
Children’S Health ◽  
Tax Credit ◽  
Health And Wellbeing ◽  
The Impact ◽  
Low Income Housing

scholarly journals The Impact of Children's Public Health Insurance Expansions on Educational Outcomes

2009 ◽  
Vol 12 (1) ◽  
Author(s):  
Phillip B Levine ◽  
Diane Schanzenbach
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Health Status ◽  
Educational Outcomes ◽  
Test Scores ◽  
Children's Health ◽  
Public Health Insurance ◽  
Children’S Health ◽  
Percentage Point Increase ◽  
The Impact

This paper examines the impact of public health insurance expansions through both Medicaid and SCHIP on children's educational outcomes, measured by 4th and 8th grade reading and math test scores, available from the National Assessment of Educational Progress (NAEP). We use a triple difference estimation strategy, taking advantage of the cross-state variation over time and across ages in children's health insurance eligibility. Using this approach, we find that test scores in reading, but not math, increased for those children affected at birth by increased health insurance eligibility. A 50 percentage point increase in eligibility is found to increase reading test scores by 0.09 standard deviations. We also examine whether the improvements in educational outcomes can be at least partially attributed to improvements in health status itself. First, we provide further evidence that increases in eligibility are linked to improvements in health status at birth. Second, we show that better health status at birth (measured by rates of low birth-weight and infant mortality), is linked to improved educational outcomes. Although the methods used to support this last finding do not completely eliminate potentially confounding factors, we believe it is strongly suggestive that improving children's health will improve their classroom performance.

scholarly journals Public health services: implementation of healthcare technologies

2020 ◽  
Vol 1 (1) ◽  
pp. 84-92
Author(s):  
Andrii Shipko ◽  
Serhii Shklyar ◽  
Oleksii Demikhov ◽  
Henryk Dzwigol
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Primary Prevention ◽  
Health Services ◽  
Health Management ◽  
Significant Risk ◽  
Children's Health ◽  
Children’S Health ◽  
Public Health Services ◽  
The Impact

This paper summarizes the arguments and counterarguments within the scientific discussion on the factors that influence public health service. The main purpose of this research is to determine the expected indicators of pathogenic and sanogenic effects on significant risk factors of pathology among children. For achieving the research goal, the authors substantiated the models of final results for the modification of risk factors. Investigation of antenatal and genealogical factors in healthy and ill children groups was performed using a specially compiled expert assessment card and parents’ interviews. The systemic population modeling methods were applied to develop and substantiate population health management models (early diagnosis and primary prevention). Evaluation of the expected effectiveness of the N-factor program of primary prevention was carried out on a set of genealogical and antenatal factors. Conducted logical analysis of the methodology of quantitative and qualitative determination of health and the gathered experience in that respect were taken into account in developing population models of preventive effects. This study provides the identified priority directions for realizing the regional and population programs to implement them further. The authors presented the example of calculating the expected effectiveness of children’s health management by eliminating the investigated factors. The authors determine the priority directions for realizing the regional and population programs pathology based on the influence on the various elements to improve the public health services system. An example of calculating the expected effectiveness of children’s health management by eliminating these factors is given. The obtained results could be used to further research the issues associated with a prospective assessment of the program’s effectiveness in reducing the impact of antenatal and genealogical factors on children’s health.

scholarly journals Investigating the impact of London’s Ultra Low Emission Zone on children’s health: Children’s Health in London and Luton (CHILL): Protocol for a prospective parallel cohort study

2021 ◽  
Author(s):  
Grainne Colligan ◽  
Ivelina Tsocheva ◽  
James Scales ◽  
Jasmine Chavda ◽  
Rosamund Dove ◽  
...  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Cohort Study ◽  
Air Quality ◽  
Respiratory Health ◽  
Children's Health ◽  
Children’S Health ◽  
List Type ◽  
Low Emission ◽  
The Impact

AbstractIntroductionAir pollution harms health across the life course. Children are at particular risk of adverse effects during development, which may impact on health in later life. Interventions that improve air quality are therefore urgently needed not only to improve public health now, but to prevent longer-term increased vulnerability to chronic disease. Low Emission Zones are a public health policy intervention aimed at reducing traffic-derived contributions to urban air pollution, but evidence that they deliver clear health benefits is lacking. We established a natural experiment design study (CHILL: Children’s Health in London and Luton) to evaluate the impacts of the introduction of London’s Ultra Low Emission Zone (ULEZ) on children’s health.Methods and analysisCHILL is a prospective two-arm parallel longitudinal cohort study of children aged 6-9 years, attending primary schools in Central London (the focus of the first phase of the ULEZ) and Luton (a comparator site). The primary goal of the study is to examine the impact of changes in annual air pollutant exposures as oxides of nitrogen, nitrogen dioxide, particulate matter less than 2.5microns and 10microns (NOx, NO2, PM2.5, PM10 respectively) across the two sites on lung growth, measured as forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), over four consecutive years. Secondary outcomes being investigated include a range of respiratory health indicators as well as inequality and health economic measures.Ethics and disseminationEthics approval has been given by Queen Mary University of London Research Ethics Committee (ref 2018/08). Dissemination will target audiences through a variety of channels, including research papers, conference and media presentations, web summaries and social media. CHILL is funded by National Institute for Health Research (NIHR) Public Health Research (Ref 16/139/09) with additional funding by Natural Environment Research Council, NIHR CLAHRC North Thames, NIHR ARC North Thames, and the Mayor of London. ClinicalTrials.gov: NCT04695093Strengths and limitations of this studyStrengthsCHILL uses a prospective parallel cohort design, allowing robust conclusions to be drawn on the impact of the ULEZ - a major city-wide air quality mitigation strategy - on air quality and children’s respiratory health.CHILL study cohorts include children from large and ethnically diverse populations living in urban areas characterised by poor air quality.LimitationsAttrition of study cohort population over time, although this has been accounted for in the original design of the study.Potential diminution of the ULEZ air pollution signal due to pre-compliance with ULEZ restrictions in the run up to the introduction of the scheme in Central London on the 8th April 2019, and minor impacts of other pollution mitigation measures.Added complexity of accounting for effects of COVID-19 and related lockdowns on traffic flows, air quality and children’s health.

scholarly journals 39 Physical and social distancing measures and child health behaviours during COVID-19: A cohort study

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e28-e29
Author(s):  
Xuedi Li ◽  
Leigh Vanderloo ◽  
Jonathon Maguire ◽  
Charles Keown-Stoneman ◽  
Mary Aglipay ◽  
...  
Keyword(s):  
Public Health ◽  
Sleep Duration ◽  
Repeated Measures ◽  
Screen Time ◽  
Health Behaviours ◽  
Children's Health ◽  
Children’S Health ◽  
Healthy Children ◽  
Social Distancing ◽  
The Impact

Abstract Primary Subject area Public Health and Preventive Medicine Background Various studies have examined the general impact of the COVID-19 outbreak on children’s health behaviours. The impact of public health measures practised by children during COVID-19 is relatively unknown. Objectives The primary objective was to determine the association between physical and social distancing measures and children’s outdoor time, sleep duration, and screen time during COVID-19. Design/Methods A longitudinal study using repeated measures of exposures and outcomes was conducted in healthy children (0 to 10 years) between April 14 and July 15, 2020. Parents were asked to complete questionnaires about isolation, physical distancing practices, and children’s health behaviours. The primary exposure was the average number of days that children practised physical and social distancing measures per week. The three outcomes were children’s outdoor time, total screen time, and sleep duration during COVID-19. Linear mixed effects models were fitted using repeated measures of primary exposure and outcomes. Results This study included 554 observations from 265 children. Physical and social distancing measures were associated with shorter outdoor time (-17.2; 95% CI -22.07, -12.40; p < 0.001) and longer total screen time (11.3; 95% CI 3.88, 18.79; p = 0.003) during COVID-19. The association with outdoor time was stronger in younger children (< 5 years), and the associations with total screen time were stronger in females and in older children (≥ 5 years). Conclusion Physical and social distancing measures during COVID-19 have resulted in negative impacts on the health behaviours of Canadian children living in a large metropolitan area.

scholarly journals Lockdowns, lives and livelihoods: the impact of COVID-19 and public health responses to conflict affected populations - a remote qualitative study in Baidoa and Mogadishu, Somalia

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Dorien H. Braam ◽  
Sharath Srinivasan ◽  
Luke Church ◽  
Zakaria Sheikh ◽  
Freya L. Jephcott ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Narrative Analysis ◽  
Grey Literature ◽  
Age Groups ◽  
Research Approach ◽  
Structured Interviews ◽  
Or Education ◽  
Public Health Response ◽  
The Impact

Abstract Background Authorities in Somalia responded with drastic measures after the first confirmed COVID-19 case in mid-March 2020, closing borders, schools, limiting travel and prohibiting most group functions. However, the impact of the pandemic in Somalia thereafter remained unclear. This study employs a novel remote qualitative research method in a conflict-affected setting to look at how some of the most at-risk internally displaced and host populations were impacted by COVID-19, what determined their responses, and how this affected their health and socio-economic vulnerability. Methods We conducted a remote qualitative study, using Katikati, a 1-to-1 conversation management and analysis platform using short message service (SMS) developed by Lark Systems with Africa’s Voices Foundation (AVF), for semi-structured interviews over three months with participants in Mogadishu and Baidoa. We recruited a gender balanced cohort across age groups, and used an analytical framework on the social determinants of health for a narrative analysis on major themes discussed, triangulating data with existing peer-reviewed and grey literature. Results The remote research approach demonstrated efficacy in sustaining trusted and meaningful conversations for gathering qualitative data from hard-to-reach conflict-affected communities. The major themes discussed by the 35 participants included health, livelihoods and education. Two participants contracted the disease, while others reported family or community members affected by COVID-19. Almost all participants faced a loss of income and/or education, primarily as a result of the strict public health measures. Some of those who were heavily affected economically but did not directly experienced disease, denied the pandemic. Religion played an important role in participants’ beliefs in protection against and salvation from the disease. As lockdowns were lifted in August 2020, many believed the pandemic to be over. Conclusions While the official COVID-19 burden has remained relatively low in Somalia, the impact to people’s daily lives, income and livelihoods due to public health responses, has been significant. Participants describe those ‘secondary’ outcomes as the main impact of the pandemic, serving as a stark reminder of the need to broaden the public health response beyond disease prevention to include social and economic interventions to decrease people’s vulnerability to future shocks.

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