Physicians’ perspectives on adverse drug reactions in pediatric routine care: a survey

Background Children and adolescents are at particular risk for adverse drug reactions (ADRs). We investigated physicians’ perceptions on ADRs in pediatric routine care. Methods In this exploratory study from April to November 2020, we invited physicians treating pediatric patients across Germany to complete an online questionnaire consisting mainly of closed questions. Results Completion rate was 98% (127/129). Of all participants, 23% (29/127) stated they were not able to estimate how many of their pediatric patients experienced ADRs during drug therapy. The remaining physicians estimated that 7.5% (median; Q25/Q75 3%/20%) of their pediatric patients were affected by ADRs. Regarding counseling on ADRs, 61% (77/127) stated they do not ask regularly the extent to which parents want to be informed. In total, 26% (33/127) stated they avoid counseling on ADRs concerning commonly used approved therapies, whereas only 4% (5/127) did so concerning off-label use (P < 0.001). Altogether, 16% (20/127) stated they rather prescribe new medicines as they hope for better effectiveness; 72% (91/127) said they are cautious about doing so owing to yet unknown ADRs. Of all respondents, 46% (58/127) stated they do not report ADRs to the authorities. Concerning the black triangle symbol, a European pharmacovigilance measure, 11% (14/127) stated they knew it and 6% (7/127) stated they reported any suspected ADR for drugs with that symbol. Conclusions Physicians’ perspectives on ADRs were ambivalent: ADRs influenced their parent counseling and drug prescribing; yet, they struggled to estimate the impact of ADRs on their patients and were not aware of specific pharmacovigilance measures.

BELAJAR TATAP MUKA MASA PANDEMI COVID-19 PADA SEKOLAH DASAR DI KECAMATAN SEMARANG BARAT

The SARS-CoV-2 virus that causes a worldwide pandemic has changed the learning system to online since early 2020. However, the Ministerial Decree 4 states that schools may hold face-to-face learning in 2021. The purpose of the study was to determine the preparation of elementary schools to carry out face-to-face learning. This type of research is descriptive with a population of 45 elementary schools in the district of West Semarang. The results of the study provide an overview of toilets (100%), hand washing facilities (100%), disinfection (100%), access to health services (87%), application of social distancing (10%), checking body temperature (56%), use of PPE (100%), human resources (80%), parent counseling (100%), monitoring (68%). So, it can be concluded that elementary schools are ready to learn face-to-face with an average score of 85.8%.

A Pilot Study Examining the Effect of Acceptance and Commitment Therapy as Parent Counseling

There is some scientific evidence to support the applicability and preliminary effects of ACT as a parent intervention but more research is needed. In this pilot research, Acceptance and Commitment Therapy (ACT) is provided as a parent counseling therapy in order to increase psychological flexibility which in turn helps parents to choose attuned parenting behavior, invest in a helpful parent-child relationship, deal with feelings of incompetence, and cope with their own psychopathology. ACT parent counseling is developed for parents of children (3–18 years old) with psychiatric problems. The mean age of the parents (n = 101) was 47.1 years (range = 30–66). A repeated measures design was used including pretreatment, posttreatment, and 6-month follow-up measurements. The main outcomes were ACT measures (psychological flexibility, parental psychological inflexibility, and cognitive fusion). Secondary outcomes included parenting behavior, the quality of the parent-child interaction, parental competence, parental psychopathology, and the satisfaction with the treatment program. This is the first study we know of that showed statistically significant improvements on parental psychological flexibility, parenting behavior (except behavioral control), parent-child relations, parental competence, and parental internalizing psychopathology directly after treatment. At 6-month follow-up, significantly less conflicts, more parental competence, and less parental psychopathology was found. However, the improvements were not clinically significant, as calculated with the RCI. No control group was used in this uncontrolled pilot study but preliminary findings indicate that ACT parent counseling can help parents to increase psychological flexibility in order to choose more flexible and effective parenting behavior.

PROBLEMS OF TEACHERS’ INTERACTION WITH PRESCHOOLERS AND THEIR PARENTS IN THE CONDITIONS OF MODERN EDUCATIONAL CHALLENGES COVID-19

The article analyzes the new realities of preschool education in the context of the Covid-19 pandemic; The problems of interaction of teachers with preschoolers and their parents during distance education are singled out, namely among the technological difficulties we first single out the availability of computer equipment, high-speed Internet, the ability to repair any equipment damage during the epidemic. Pedagogical problems include the shortage of staff with universal training, ie those who have modern pedagogical and information technologies and are psychologically ready to work with preschoolers and their parents in the new educational and cognitive network environment. Administrative problems include compiling lists for group training sessions, parent counseling, communication with families and children whose e-mail address has changed. Priority online platforms and tools for working with parents and preschoolers have been identified. The authors also present the positive aspects of distance education for teachers, namely the possibility of free education on various educational platforms; the results of a survey of educators and future bachelors on the problems of distance education of preschoolers in a pandemic. The results of the survey showed that not all the benefits of distance education were realized in the conditions of the epidemic in relation to preschool institutions. For example, due to the workload of adults (both teachers and parents), the network environment, such features as flexibility (education at a convenient time and place), large audience, efficiency, manufacturability (use of new advances in information technology), social equality and, as a consequence, quality were not typical. The most important problem - distance education has shown the inability to provide education and social support for children from poor families (e.g., nutrition)

Perinatal and long-term outcome (up to 24 months) with isolated ventriculomegaly

A retrospective assessment of the pregnancy outcome, ultrasound data, childbirth outcome and neurological postnatal follow-up was carried out for 62 cases of isolated enlargements of the occipital horns of the lateral ventricles revealed prenatally. It was found that the incidence of unfavourable perinatal outcomes in newborns with isolated pre-ventriculomegaly (3.8 %) and borderline ventriculomegaly (10 %) revealed in the antenatal period (10 %) did not exceed that one in newborns with normal width of the occipital horns of the lateral ventricles (7.9 %). There were no unfavourable outcomes at the age up to 24 months in these groups. Unfavourable perinatal outcomes (neurological disorders, chromosomal abnormalities and pathology revealed postnatally by MRI) occurred in 66.6 % of cases with “apparently” isolated moderate ventriculomegaly and long-term unfavourable outcomes were observed in half of the cases. If isolated moderate ventriculomegaly are revealed, invasive prenatal diagnosis, MRI and parent counseling about the neurological risks in the postnatal period are necessary.