Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany : a natural experiment

The impact of COVID-19 on social life has been drastic and global. However, the different numbers of cases and different actions in different countries have been leading to various interesting yet unexplored effects on human behavior. In the present study, we compare the physical activity and recreational screen time of a representative sample of 1711 4- to 17-year-olds before and during the strictest time of the first COVID-19 lockdown in Germany. We found that sports activity declined whereas recreational screen time increased. However, a substantial increase in habitual physical activities leads to an overall increase in physical activity among children and adolescents in Germany. The effects differ in size but not in their direction between age groups and are stable for boys and girls. We conclude from this natural experiment that physical activity among children and adolescents is highly context-driven and mutual and does not act as a functional opposite to recreational screen time

Severe pediatric obesity:Diagnostic aspects

Severe pediatric obesity is a complex, chronic endocrine disease caused by genetic, environmental, behavioral, socioeconomic and cultural factors. In a minority of children with severe obesity, the obesity phenotype is caused by a singular underlying medical cause interfering with the function of the brain areas that regulate satiety and energy expenditure. Current guidelines define the following underlying medical causes: (1) genetic obesity disorders, (2) hypothalamic obesity, (3) endocrine obesity, and (4) medication-induced obesity. This thesis investigated several important diagnostic aspects of severe pediatric obesity. For example, the yield of the systematic diagnostic workup of Obesity Center CGG is described. A singular underlying medical cause was identified in 19% of patients, most of which (13%) were genetic obesity disorders (13% of patients). This shows that an extensive diagnostic approach is needed to identify the underlying medical causes. Furthermore, this thesis shows that the reported prevalence of a specific genetic obesity disorder, leptin receptor deficiency deficiency in Europe is only 2% of predicted prevalence, suggesting underreporting, underdiagnosis, early mortality, or a combination of these factors. This suggests that genetic screening should be performed in all cases with early-onset severe obesity and hyperphagia. This thesis also describes BMI trajectories of patients with genetic obesity and controls with obesity from a population-based cohort study. The presented BMI trajectories can thereby guide clinicians’ decision to perform genetic testing. Finally, a general discussion in the context of current literature is provided, including recommendations, future perspectives and implications

Year 2022: exploring COVID-19 pandemic in children.

COVID-19 pandemics is rapidly changing. In this article, we review progresses published in the Italian Journal of Pediatrics in 2022. More data on clinical pictures, prevention strategies and active management in children have been provided. The continued evolution of knowledge has driven transformations in the clinical approach to the disease and allowed key advancements in the care of children with COVID-19

Advances in pediatrics in 2023: choices in allergy, analgesia, cardiology, endocrinology, gastroenterology, genetics, global health, hematology, infectious diseases, neonatology, neurology, pulmonology

In the last year, there have been many remarkable articles published in the Italian Journal of Pediatrics. This review highlights papers that can be potentially helpful in healthcare practice among the most cited or accessed papers on the journal website. We have chosen key articles on allergy, analgesics, cardiology, endocrinology, gastroenterology, genetics, global health, infectious diseases, neonatology, neurology and pulmonology. Advances in understanding risk factors, mechanisms, diagnosis, treatment options and prevention of pediatric diseases have been discussed and in the context of the subsequent steps. We think that progresses achieved in 2023 will have a significant impact on the management of diseases in childhood

The Impact of COVID-19 on the Interrelation of Physical Activity, Screen Time and Health-Related Quality of Life in Children and Adolescents in Germany: Results of the Motorik-Modul Study

Reduced physical activity (PA) and prolonged screen time (ST) negatively influence health-related quality of life (HRQoL), a protective factor against illness and mortality. Studies addressing the relationship between PA, ST, and mental health in youth are scarce, especially in times with high mental health burdens like the COVID-19 pandemic. The purpose of this examination was to investigate whether PA, ST, and HRQoL before COVID-19 predict PA, ST, and HRQoL during the COVID-19 pandemic. Participants from the Motorik-Modul Study (MoMo; N = 1711; M$_{age}$ = 10.36 (SD = 4.04) years, female = 49.8%; healthy weight = 76.8%) self-reported their PA and ST as well as HRQoL both before and during COVID-19. Relationships of all variables, from before to during COVID-19, were investigated through a path prediction model. Results showed all variables during COVID-19 were predicted by the respective levels before COVID-19, independent of gender and age. Cross-lags revealed a negative influence of before COVID-19 ST on during COVID-19 PA. HRQoL before COVID-19 was positively associated with during COVID-19 PA in children younger than 10 years and females, but not in adolescents and boys. As age- and gender-independent negative influence of before COVID-19 ST on during COVID-19 PA has been detected, health policy may be advised to focus on a general reduction in ST instead of PA enhancement to ensure high PA levels

Living with congenital heart disease

Congenital heart defects, affecting 9.4 out of 1000 newborns, represent the most prevalent congenital diseases. Advances in medical and surgical interventions have significantly increased the survival rate, with over 90% of affected individuals now reaching adulthood. This study focuses on a cohort of patients who underwent surgical corrections in Rotterdam between 1968 and 1980, offering insights into their quality of life 40-53 years post-surgery, with a specific emphasis on psychosocial aspects. This research, focusing on the psychopathological aspects of adults with congenital heart disease, reveals a temporal decrease in psychopathology, though an increase in the last decade is noted. Gender differences were underlined in psychological well-being, with women experiencing more internalizing problems, while men exhibit fewer externalizing problems compared to their peers. Interestingly, adults with congenital heart disease do not demonstrate lower executive functions, but are more likely to have lower educational and occupational levels than the general population, especially in higher professions.Additionally, adults with congenital heart defects show reduced involvement in sports, irrespective of the severity of their condition. However, engagement in physical activity correlates with better psychological well-being. Moreover, they perceive their life expectancy similarly to, or even more positively than, their healthy peers. Furthermore, they show reluctance to engage in end-of-life discussions with physicians. Finally, this thesis highlights the favourable cardiological long-term prognosis for individuals with atrial septal defect, a relatively uncomplicated congenital heart defect.In summary, this thesis contributes robust data and valuable insights into the long-term development and evolving quality of life of adults with congenital heart diseases, from surgical intervention to adulthood.<br/

Description of sedentary lifestyle in patients with cardiovascular disease during the Covid-19 pandemic

A sedentary lifestyle is any type of activity that only expends a small amount of energy with an energy expenditure of not more than 1.5 METs when sitting or lying down. this has a very bad impact on health. These activities have a very bad impact on health. During the COVID-19 pandemic, people face many big challenges, one of which is social distancing in a sedentary lifestyle. The objective of this study is to describe changes in sedentary lifestyles among cardiovascular disease patients during the COVID-19 pandemic. The research design used was a literature review using 3 databases (Pubmed, Proquest, and Science Direct). The process of searching for articles using keywords and Boolean operators (AND, OR, or NOT) aims to define and expand the literature. The review found that the sedentary lifestyle increased up to 8 hours/day. In addition to what has been mentioned 4 other articles also mention an increase in sedentary lifestyle time and an increase in sitting time, this is in accordance with research conducted on the average daily duration of sedentary behaviour is 8.3 hours between Koreans and 7, 7 hours among American adults due to government regulations during the pandemic. All articles show that people who tend to be older and male have a higher risk of developing cardiovascular cases that lead to death during the COVID-19 pandemic. So it is necessary to expand the scope of information about the importance of physical activity so that all people with cardiovascular disease have high vigilance

Severe obesity in youth:health implications and treatment strategies

Childhood obesity is one of the most pressing health challenges. In recent years, the number of youth with obesity, especially those with severe obesity, is only increasing. This dissertation focused on youth with the most severe grade of obesity, as they suffer from tremendous physical and psychological consequences, and are often overlooked in clinical practice. The first part examined the consequences of the most severe grade of obesity in youth. This part also examined the effectiveness of the current cornerstone treatment, a multidisciplinary lifestyle intervention. For a subset of these adolescents, lifestyle interventions are insufficiently effective, and for this group additional treatment strategies are warranted. The second part of this thesis focused on optimizing treatment strategies for youth with severe obesity and explored the applicability of bariatric surgery

Health-related quality of life before and during the COVID-19 pandemic in Switzerland: a cross-sectional study.

INTRODUCTION The COVID-19 pandemic forced people to give up their daily routines and adjust to new circumstances. This might have affected health-related quality of life (HRQOL). We aimed to compare HRQOL during the first COVID-19 wave in 2020 to HRQOL before the pandemic and to identify determinants of HRQOL during the pandemic in Switzerland. METHODS We conducted a cross-sectional online survey during the pandemic (between May and July 2020; CoWELL sample; convenience sample). Before the pandemic (2015-2016), we had conducted a cross-sectional paper-based survey among a representative random sample of the Swiss general population (SGP sample). In both samples, we assessed physical and mental HRQOL (Short Form-36) and socio-demographic characteristics. In the CoWELL sample, we additionally assessed health- and COVID-19-related characteristics. Data were analysed using linear regressions. RESULTS The CoWELL sample included 1581 participants (76% women; mean age = 43 years, SD = 14 years) and the SGP sample 1209 participants (58% women, mean age = 49 years, SD = 15 years). Adjusted for sex, age, and education, the CoWELL sample reported higher physical HRQOL (PCS, +5.8 (95% CI: 5.1, 6.6), p < 0.001) and lower mental HRQOL (MCS, -6.9 (-7.8, -6.0), p < 0.001) than the SGP sample. In the CoWELL sample, especially persons with lower health literacy, who had no support network or who have had COVID-19, reported lower HRQOL. DISCUSSION Aspects unique to the COVID-19 pandemic affected HRQOL. Vulnerable persons such as those having had COVID-19, less support opportunities, and with lower health literacy are especially prone to impaired HRQOL during the COVID-19 pandemic

Changes in Physical Activity Patterns Due to the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population