Teaching Tolerance through Children's Own Voices: A Middle School Supplemental Health Text

This program plan and evaluation details a program centered on a pilot text and student and teacher assessment that will increase knowledge of children who live with disease and attend school on the middle school level. The text will be written on a 6th grade reading level with contributions from children age 7 to 17 years that have the diseases or conditions detailed in the text and who attend school.Master of Public Healt

A multicenter study of acute testicular torsion in the time of COVID-19

Background: Testicular torsion is a surgical emergency, and time to detorsion is imperative for testicular salvage. During the COVID-19 pandemic, patients may delay emergency care due to stay-at-home orders and concern of COVID-19 exposure. Objective: To assess whether emergency presentation for testicular torsion was delayed during the COVID-19 pandemic, and whether the rate of orchiectomy increased compared to a retrospective period. Study design: Patients were prospectively enrolled in a multicenter study from seven institutions in the United States and Canada. Inclusion criteria were patients two months to 18 years of age with acute testicular torsion from March through July 2020. The retrospective group included patients from January 2019 through February 2020. Statistical analysis was performed using Kruskal–Wallis tests, Chi-square tests, and logistic regression. Results: A total of 221 patients were included: 84 patients in the COVID-19 cohort and 137 in the retrospective cohort. Median times from symptom onset to emergency department presentation during COVID-19 compared to the retrospective period were 17.9 h (IQR 5.5–48.0) and 7.5 h (IQR 4.0–28.0) respectively (p = 0.04). In the COVID-19 cohort, 42% of patients underwent orchiectomy compared to 29% of pre-pandemic controls (p = 0.06). During COVID-19, 46% of patients endorsed delay in presentation compared to 33% in the retrospective group (p = 0.04). Discussion: We found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a higher proportion of patients reported delaying care. Strengths of the study include the number of included patients and the multicenter prospective design during the pandemic. Limitations include a retrospective pre-pandemic comparison group. Conclusions: In a large multicenter study we found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a significantly higher proportion of patients reported delaying care. Based on the findings of this study, more patient education is needed on the management of testicular torsion during a pandemic

A multicenter study of acute testicular torsion in the time of COVID-19

Background: Testicular torsion is a surgical emergency, and time to detorsion is imperative for testicular salvage. During the COVID-19 pandemic, patients may delay emergency care due to stay-at-home orders and concern of COVID-19 exposure. Objective: To assess whether emergency presentation for testicular torsion was delayed during the COVID-19 pandemic, and whether the rate of orchiectomy increased compared to a retrospective period. Study design: Patients were prospectively enrolled in a multicenter study from seven institutions in the United States and Canada. Inclusion criteria were patients two months to 18 years of age with acute testicular torsion from March through July 2020. The retrospective group included patients from January 2019 through February 2020. Statistical analysis was performed using Kruskal–Wallis tests, Chi-square tests, and logistic regression. Results: A total of 221 patients were included: 84 patients in the COVID-19 cohort and 137 in the retrospective cohort. Median times from symptom onset to emergency department presentation during COVID-19 compared to the retrospective period were 17.9 h (IQR 5.5–48.0) and 7.5 h (IQR 4.0–28.0) respectively (p = 0.04). In the COVID-19 cohort, 42% of patients underwent orchiectomy compared to 29% of pre-pandemic controls (p = 0.06). During COVID-19, 46% of patients endorsed delay in presentation compared to 33% in the retrospective group (p = 0.04). Discussion: We found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a higher proportion of patients reported delaying care. Strengths of the study include the number of included patients and the multicenter prospective design during the pandemic. Limitations include a retrospective pre-pandemic comparison group. Conclusions: In a large multicenter study we found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a significantly higher proportion of patients reported delaying care. Based on the findings of this study, more patient education is needed on the management of testicular torsion during a pandemic

Crowd-Patronage – Intermediaries, Geographies and Relationships in Patronage Networks

This article introduces a new mode of patronage of the arts: crowd-patronage. In so doing the article illustrates the plural roles of intermediaries in patronage networks which go beyond Bourdieuian cultural intermediaries to include regulatory and financial actors. A brief history of patronage is presented which outlines different modes and eras of patronage for the arts since the 12th century. Particular attention is paid to the geographies of patronage networks, the mobility of artists, the plurality of roles played by intermediaries and the relations between patrons and artists. These themes then structure the analysis of crowd-patronage through a case study of the patronage platform Patreon in the remainder of the paper. Crowd-patronage is distinctive because of the scale and geographical scope of patronage networks, its focus on funding practice rather than outputs, a shift in the power relationships between patron and artist, and processes of re-intermediation

Children’s and adolescents’ conceptualisations of depression

While there is extensive research on adult conceptualisations of mental illness, as well as on children’s understanding of physical health and illness, research on children’s conceptualisations of mental illness is limited. The primary aim of this thesis is to provide a detailed account of children’s and adolescents’ conceptualisations of depression. In the first study, individual semi-structured interviews with primary school pupils (N=105) from two age groups (mean ages: 8.9 and 11.8 years) were conducted, with the use of depression and control vignettes, to elicit children’s depression concepts, help-seeking intentions and desired social distance. Children’s depression conceptualisations were organised according to the common-sense model of illness representations (CSM). Quantitative content analysis was performed to allow for descriptive analysis; in turn, inferential statistics were used to examine age, gender and self-reported direct and indirect experience differences. Children differentiated between depression and control vignettes, however did not spontaneously label depression or recognised the mental health nature of difficulties. Children provided a wide variety of possible causes that reflected common risk factors for depression, primarily referring to interpersonal factors. Children considered negative consequences of untreated depression, and identified that depressed characters need help. They suggested numerous sources of help, which were mainly informal. Children considered depression to be curable and would seek help primarily from parents if depressed. Older children showed more sophisticated conceptualisations of depression. No substantial gender or experience differences were found. Subsequently, a single session school-based mental health literacy intervention on adolescent depression, adapted from an intervention created by NHS mental health professionals, was developed, using the mental health literacy and CSM frameworks. The second study consists of a pilot evaluation of the intervention, using a controlled before and after design, to examine the effect of the intervention on young people’s depression literacy, help-seeking and help-providing intentions as well as social distance. Young people’s depression literacy was measured by the Adolescent Concepts of Depression Questionnaire (ACDQ), developed for the purposes of this study. Exploratory factor analysis was conducted to indicate the factor structure of the ACDQ, which was in turn used to examine participants’ baseline depression literacy and the effect of age, gender, current depressive symptomatology and direct/ indirect experience with depression and other mental illness (Study 2a). In turn, the effectiveness of the intervention is presented (Study 2b). 339 adolescents (mean age: 13.4 years, 168 female) were allocated to either the intervention (N=171) or a control group (N=168), and completed the ACDQ one week before and following the intervention. Mixed results were found for gender, depressive symptoms and experience differences. Mixed ANOVA was conducted between time and group; the results show that the intervention was effective in informing young people’s depression literacy (ACDQ total score), and specifically in young people’s knowledge of treatment options for depression (treatment subscale), perceived curability of depression (curability subscale), symptom recognition, help-seeking and help-providing intentions. No significant improvements were found for social distance, perceived helpfulness of sources of help, and two of the ACDQ subscales. The contribution of this thesis lies upon the detailed examination of children and adolescent depression conceptualisations, adding to the limited evidence base, especially in children’s mental health literacy. The pilot evaluation of the intervention is promising, and upon re-evaluation could be standardised and implemented in Scottish schools. Implications for clinical practice and mental health literacy are also discussed

A survey and panel discussion of the effects of the COVID-19 pandemic on paediatric urological productivity, guideline adherence and provider stress

Introduction The COVID-19 pandemic has led to an unprecedented need to re-organise and re-align priorities for all surgical specialties. Despite the current declining numbers globally, the direct effects of the pandemic on institutional practices and on personal stress and coping mechanisms remains unknown. The aims of this study were to assess the effect of the pandemic on daily scheduling and work balances, its effects on stress, and to determine compliance with guidelines and to assess whether quarantining has led to other areas of increased productivity. Methods A trans-Atlantic convenience sample of paediatric urologists was created in which panellists (Zoom) discussed the direct effects of the COVID-19 pandemic on individual units, as well as creating a questionnaire using a mini-Delphi method to provide current semi-quantitative data regarding practice, and adherence levels to recently published risk stratification guidelines. They also filled out a Perceived Stress Scale (PSS) questionnaire to assess contemporary pandemic stress levels. Results There was an 86% response rate from paediatric urologists. The majority of respondents reported near complete disruption to planned operations (70%), and trainee education (70%). They were also worried about the effects of altered home-lives on productivity (<= 90%), as well as a lack of personal protective equipment (57%). The baseline stress rate was measured at a very high level (PSS) during the pandemic. Adherence to recent operative guidelines for urgent cases was 100%. Conclusion This study represents a panel discussion of a number of practical implications for paediatric urologists, and is one of the few papers to assess more pragmatic effects and combines opinions from both sides of the Atlantic. The impact of the pandemic has been very significant for paediatric urologists and includes a decrease in the number of patients seen and operated on, decreased salary, increased self-reported stress levels, substantially increased telemedicine usage, increased free time for various activities, and good compliance with guidelines and hospital management decisions

Pneumococcal infection of respiratory cells exposed to welding fumes; Role of oxidative stress and HIF-1 alpha

Colt Foundation: CF/05/12