SARS-CoV-2 in Pediatric Inpatient Care: Management, Clinical Presentation and Utilization of Healthcare Capacity

This study scrutinizes management and clinical presentation of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in pediatric inpatient care and evaluates the utilization of pediatric healthcare capacity during the pandemic. Within this retrospective cohort study, we systematically reviewed data of all 16,785 pediatric patients (<18 years admitted to our clinical center between January 2018 and June 2021). Data on SARS-CoV-2 test numbers, hospital admissions and clinical characteristics of infected patients were collected. Since January 2020, a total of 2513 SARS-CoV-2 tests were performed. In total, 36 patients had a positive test result. In total, 25 out of 36 SARS-CoV-2 positive children showed at least mild clinical symptoms while 11 were asymptomatic. Most common clinical symptoms were fever (60%), cough (60%) and rhinitis (20%). In parallel with the rising slope of SARS-CoV-2 in spring and fall 2020, we observed a slight decrease in the number of patients admitted to the pediatric department while the median duration of hospital treatment and intensive care occupancy remained unchanged. This study underlines that SARS-CoV-2 infected children most frequently exhibit an asymptomatic or mild clinical course. Noteworthy, the number of hospital admissions went down during the pandemic. The health and economic consequences need to be discussed within health care society and politics

Political Skill Moderates the Success of Psychopaths at the Workplace

On one hand, psychopaths tend to be callous, emotionally deficient, aggressive, self promoting, impulsive, and pursuant of unmitigated agency regardless of the extent to which it comes at the expense of others. On the other hand, by all accounts, psychopaths tend to be charming, seductive, self-confident, composed, risk-seeking, and adept at impression management (Babiak & Hare, 2006; Paulhus & Williams, 2002). Therefore, the purpose of this study was to reconcile these contrasting positions by examining whether (non-violent) psychopaths truly can be “successful” in the workplace. Drawing on socioanalytic theory (Hogan, 1983), we hypothesized that psychopaths in possession of political skill would be better able to package, conceal, and/or restrain their desires to get ahead in such a way as to be perceived as less counterproductive and more adaptive. Results provided support for these hypotheses. Implications for theory, practice, and future research are provided in light of a number of notable strengths and limitations

Schulkarrieren von Kindern mit angeborenen Herzfehlern

Abstract English Objectives: We analysed the upbringing and school careers of children, adolescents and young adults diagnosed with a congenital heart disease (CHD) in Germany. Method: A cross-sectional study was conducted using an online survey. The recruitment of study participants was carried out via the database of the German National Register for Congenital Heart Disease (NRCHD). Patients born between 1992 and 2011 were enrolled in the study. We compared our results to the general population with census data from the German Federal Statistics Office. Results: 3,605 people participated in the survey and out of these, 2,901 (80.5%) completed the questionnaire. Detailed information regarding the underlying CHD diagnosis as well as clinical data from medical records was available for 2,609 (72.4%) patients. The overwhelming majority of patients were enrolled at a normal elementary school (83.4%). Patients were predominantly enrolled at the age of six or younger (74.6%) which is similar to the general population (64%). 83.0% of patients with a mild, 74.3% of patients with a moderate and 68.2% of patients with a severe CHD were enrolled at the age of six or younger. 45.7% of the graduated study participants had acquired the qualifications to study at university (“Abitur”). School careers varied significantly among the different CHD severity subgroups. When analysing all graduated participants 57.3% of mild, 47.3% of moderate and 35.1% of severe CHD patients attained the general university admission qualifications. CHD patients frequently suffered from psychological or behavioural disorders (33.3%) and often had to repeat a school year (11.2%). The highest incidence of psychiatric disorders was reported in patients with severe CHDs. These patients most often had to repeat a school year. Conclusions: In our study, the majority of participating CHD patients had a standard school career. These initial results are of great importance to affected families and treating physicians as they can alleviate parents’ fears by showing that a normal school career is possible for patients diagnosed with a CHD. Nevertheless, school form and age at enrolment and the final school degree attained varied depending on the severity of the underlying CHD. Patients were more likely to be diagnosed with a psychological disorder and/or forced to repeat a class if their CHD was more severe. Therefore, better systems are required to identify at-risk patients to enable early interventional therapy.Abstrakt Deutsch Ziele: Wir analysierten die schulische Entwicklung von Kindern, Jugendlichen und jungen Erwachsenen mit der Diagnose eines angeborenen Herzfehlers (AHF) in Deutschland. Methoden: Mittels einer Online-Befragung wurde eine Querschnittsstudie durchgeführt. Die Studienteilnehmer wurden über die Datenbank des Nationalen Registers für angeborene Herzfehler (NRAHF) rekrutiert. Zwischen 1992 und 2011 geborene Patienten wurden in die Studie eingeschlossen. Wir verglichen unsere Ergebnisse mit der Allgemeinbevölkerung mit Hilfe von Daten des Statistischen Bundesamtes. Ergebnisse: 3.605 Personen nahmen an der Studie teil, von denen 2.901 (80,5%) die Umfrage vollständig ausfüllten. Ausführliche Informationen über den zugrundeliegenden AHF sowie klinische Daten aus Krankenhausakten lagen für 2.609 (72,4%) Patienten vor. Die Mehrheit der Patienten besuchte eine normale Grundschule (83,4%). Die Patienten wurden überwiegend im Alter von 6 Jahren oder jünger (74,6%) eingeschult, in einem vergleichbaren Alter zur Allgemeinbevölkerung (64%). 83% der Kinder mit leichtem, 74,3% mit moderatem und 68,2% mit schwerem AHF wurden im Alter von 6 Jahren oder jünger eingeschult. 45,7% der Schulabsolventen beendeten ihre Schullaufbahn mit dem Erwerb des Abiturs. Schullaufbahnen variierten zwischen den verschiedenen AHF-Untergruppen. In der Auswertung aller graduierten Teilnehmer erreichten 57,3% der Patienten mit einem leichten, 47,3% mit moderatem, und 35,1% mit schwerem AHF das Abitur. Patienten mit AHF litten vermehrt an psychischen Störungen (33,3%) und mussten häufig das Schuljahr wiederholen (11,2%). Hierbei traten psychische Störungen mit der höchsten Inzidenz bei Patienten mit einem schweren angeborenen Herzfehler auf. Diese Patientengruppe mussten am häufigsten ein Schuljahr wiederholen. Schlussfolgerung: In unserer Studie hatte die Mehrheit der teilnehmenden Patienten mit einem AHF eine normale Schulkarriere. Diese Ergebnisse sind für betroffene Familien und Ärzte von großer Bedeutung, da sie die Ängste der Eltern lindern können, indem sie zeigen, dass eine normale Schulkarriere auch mit der Diagnose eines angeborenen Herzfehlers möglich ist. Dennoch unterschieden sich das Alter und die Schulform bei der Einschulung sowie der erreichte Schulabschluss je nach Schweregrad des zugrundeliegenden angeborenen Herzfehlers. Patienten mit schweren AHF wurden häufiger mit einer psychischen Störung diagnostiziert und mussten häufiger eine Schulklasse wiederholen. Daher sind bessere Früherkennungssysteme erforderlich, um Risikopatienten zu identifizieren, die eine frühzeitige Intervention und Unterstützung benötigen