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Children's and adolescents' lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017-2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85-1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93-1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57-1.02 and 0.26 (0.05-0.75)), whereas household and leisure accidents increased (1.33 (1.06-1.66) and 1.34 (1.06-1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38-1.16) and 2.09 (1.19-3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42-1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51-3.02)), but decreased in adolescent girls (0.56 (0.32-0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation.

BACKGROUND AND OBJECTIVES: The worldwide severe acute respiratory syndrome coronavirus 2 pandemic challenges adolescents' mental health. In this study, we aim to compare the number of pediatric ICU (PICU) admissions after suicide attempts during the first German lockdown and one year later during a second, prolonged lockdown with prepandemic years. METHODS: A retrospective multicenter study was conducted among 27 German PICUs. Cases < 18 years admitted to the PICU because of accidents or injuries between March 16 and May 31 of 2017 to 2021 were identified based on International Classification of Diseases, 10th Revision codes (German modification) and patient data entered into a database. This study is a subset analysis on suicide attempts in adolescents aged 12 to 17.9 years. The Federal Statistics Office was queried for data on fatal suicides, which were available only for 2020 in adolescents aged 10 to 17.9 years. RESULTS: Total admissions and suicide attempts declined during the first lockdown in 2020 (standardized morbidity ratio 0.74 (95% confidence interval; 0.58-0.92) and 0.69 (0.43-1.04), respectively) and increased in 2021 (standardized morbidity ratio 2.14 [1.86-2.45] and 2.84 [2.29-3.49], respectively). Fatal suicide rates remained stable between 2017 to 2019 and 2020 (1.57 vs 1.48 per 100 000 adolescent years) with monthly numbers showing no clear trend during the course of 2020. CONCLUSIONS: This study shows a strong increase in serious suicide attempts among adolescents during the course of the pandemic in Germany. More research is needed to understand the relation between pandemic prevention measures and suicidal ideation to help implement mental health support for adolescents.

An interview with Michael and Elizabeth Wendelin regarding their experiences as immigrants on the western plains. Recording is occasionally difficult to understand. 00:00:08 - Michael Wendelin on immigrating to the United States from Austria in 1881 00:02:20 - Near drowning of a female cousin 00:02:55 - Experience with Indigenous Americans in Nebraska 00:04:05 - Engleberg's butcher shop 00:05:27 - Wagon accident 00:06:49 - Move to Kansas 00:07:46 - Fourth of July celebration 00:08:26 - Life in a sod house in Herndon, KS 00:09:44 - The Chicken Hawk's nest 00:10:54 - Family size and memories of life on the homestead 00:16:23 - Memories of Buffalo Bill 00:17:12 - More memories of Indigenous Americans 00:18:40 - Travels 00:24:35 - Getting married 00:27:02 - More travels around the country 00:30:02 - Introduction to Elizabeth Wendelin interview 00:30:30 - Coming to the United States 00:31:24 - Travels 00:33:28 - Experiences with Indigenous Americans in Kansas 00:34:38 - Homelife 00:36:58 - Life in a sod house 00:38:14 - School experiences 00:39:45 - "Iron George" 00:40:40 - Available entertainment 00:41:30 - Fashion 00:43:30 - Early settlers of Herndon 00:44:30 - Churches 00:46:05 - Men's fashion 00:46:30 - More experiences with Indigenous Americans 00:47:30 - Weddings 00:49:28 - Births 00:50:07 - Deaths 00:52:09 - Christmas 00:52:39 - Other holidays 00:54:25 - Herndon Ox Roast 00:55:30 - Stores in Herndon 00:56:12 - Railroad coming to Herndon 00:58:58 - Music 00:59:30 - Floods

An interview with Charles F. Miller and John & Catherine Wolfram regarding their experiences as homesteaders on the Kansas plains. Second half of the recording is muffled. Interview with Charles F. Miller 00:00:48 - Coming to Kansas in 1886 00:02:58 - Graham County Kansas 00:04:37 - Schools in Graham County 00:07:28 - Literary Society 00:08:32 - Farming in Kansas 00:10:29 - Community events and church services 00:11:53 - Experiences as a school teacher 00:13:11 - Experiences as a County Surveyor 00:15:09 - Prairie fire of 1894 00:17:39 - Picnics and parties 00:19:00 - Teacher salaries 00:20:38 - Blizzards of 1886 and 1958 00:21:40 - Smallpox outbreak 00:23:38 - Interview with John and Catherine Wolfram 00:24:03 - Coming to Kansas in 1869 00:25:12 - Memories of Herndon, KS 00:26:30 - Life in a sod house 00:27:16 - Farming in western Kansas 00:28:49 - School experiences 00:32:03 - Churches 00:34:46 - Homelife 00:35:50 - Parties 00:37:40 - Types of entertainment 00:39:38 - Availability of stores 00:40:38 - 1902 Herndon Fire 00:42:08 - Transportation 00:47:26 - Celebrating Christmas