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The COVID-19 pandemic has had an unprecedented impact on health care systems. At its height, governments worldwide implemented various public healdi measures to limit exposure to the virus and to [...], Background: In March 2020, Ontario instituted a lockdown to reduce spread of the SARS-CoV-2 virus. Schools, recreational facilities, and nonessential businesses were closed. Restrictions were eased through 3 distinct stages over a 6-month period (March to September 2020). We aimed to determine the impact of each stage of the COVID-19 public health lockdown on the epidemiology of operative pediatric orthopedic trauma. Methods: A retrospective cohort study was performed comparing emergency department (ED) visits for orthopedic injuries and operatively treated orthopedic injuries at a level 1 pediatric trauma centre during each lockdown stage of the pandemic with caseloads during the same date ranges in 2019 (prepandemic). Further analyses were based on patients&apos; demographic characteristics, injury severity, mechanism of injury, and anatomic location of injury. Results: Compared with the prepandemic period, ED visits decreased by 20% (1356 v. 1698, p < 0.001) and operative cases by 29% (262 v. 371, p < 0.001). There was a significant decrease in the number of operative cases per day in stage 1 of the lockdown (1.3 v. 2.0, p < 0.001) and in stage 2 (1.7 v. 3.0; P < 0.001), but there was no significant difference in stage 3 (2.4 v. 2.2, p = 0.35). A significant reduction in the number of playground injuries was seen in stage 1 (1 v. 62, p < 0.001) and stage 2 (6 v. 35, p < 0.001), and there was an increase in the number of self-propelled transit injuries (31 v. 10, p = 0.002) during stage 1. In stage 3, all patient demographic characteristics and all characteristics of operatively treated injuries resumed their prepandemic distributions. Conclusion: Provincial lockdown measures designed to limit the spread of SARS-CoV-2 significantly altered the volume and demographic characteristics of pediatric orthopedic injuries that required operative management. The findings from this study will serve to inform health system planning for future emergency lockdowns. Contexte : En mars 2020, l&apos;Ontario a décrété des mesures de confinement afin de réduire la propagation du virus SRAS-CoV-2. Les écoles, les installations récréatives, et les commerces non essentiels ont dû fermer. Les restrictions ont été par la suite progressivement assouplies en 3 phases distinctes sur une période de 6 mois (de mars à septembre 2020). Notre objectif était de déterminer les répercussions épidémiologiques de chaque phase du confinement imposé par les autorités de santé publique sur la chirurgie orthopédique pédiatrique et traumatologique. Méthodes : Nous avons réalisé une étude de cohorte rétrospective pour comparer le nombre de consultations aux services d&apos;urgence pour des blessures orthopédiques, traitées ou non en salle d&apos;opération, dans des centres de traumatologie pédiatrique de niveau 1 pendant chaque phase de confinement avec le nombre de consultations pendant les mêmes périodes de l&apos;année en 2019 (prépandémie). Nous avons effectué des analyses complémentaires en fonction des caractéristiques démographiques de la patientèle, ainsi que de la gravité, du mécanisme et de la localisation des blessures. Résultats : Comparativement à la période prépandémique, la fréquentation des services d&apos;urgence a diminué de 20% (1356 c. 1698, p < 0,001) et le nombre d&apos;interventions chirurgicales, de 29% (262 c. 371, p < 0,001). Nous avons constaté une baisse significative du nombre d&apos;interventions chirurgicales lors de la phase 1 du confinement (1,3 c. 2,0, p < 0,001), ainsi que lors de la phase 2 (1,7 c. 3,0, p < 0,001), mais aucune différence significative n&apos;a été observée lors de la phase 3 (2,4 c. 2,2, p = 0,35). Par ailleurs, nous avons constaté une baisse significative du nombre de blessures survenues sur des terrains de jeux durant la phase 1 (1 c. 62, p < 0,001) et la phase 2 (6 c. 35, p < 0,001), alors que le nombre de blessures occasionnées par des véhicules automoteurs a augmenté (31 c. 10, p = 0,002) lors de la phase 1. Enfin, lors de la phase 3, tous les paramètres démographiques de la patientèle et toutes les caractéristiques des blessures traitées en salle d&apos;opération sont revenus à leurs valeurs prépandémiques. Conclusion : Les mesures de confinement prises au niveau provincial pour limiter la propagation du virus SRAS-CoV-2 ont significativement modifié le volume et les caractéristiques démographiques des blessures orthopédiques pédiatriques nécessitant une prise en charge chirurgicale. Les résultats de cette étude serviront à améliorer la planification du système de santé en cas de nouveau confinement d&apos;urgence.

Author(s): Aditya Chadda [1,1]; Priyanka Madaan [1,2]; Pawan Kumar [1]; Rajni Sharma [3]; Naveen Sankhyan [1] Introduction A spectrum of unusual presentations has been reported following traumatic brain injury (TBI) [...], Background: Kluver-Bucy syndrome (KBS), a symptom complex of hyperorality, dietary pattern changes, hypersexuality, memory disturbances, and visual agnosia, has been infrequently reported following traumatic brain injury (TBI) in children. Materials and Methods: We report a 5-year-old girl presenting with KBS following moderate traumatic brain injury. A literature search was conducted in July 2022 and extended till February 2023 on PubMed, Embase, and Web of Science electronic databases using search terms 'children' OR 'child' OR 'infant' OR 'pediatric' OR 'adolescent') AND 'Kluver-Bucy syndrome' AND 'trauma.' Original research studies, case reports, and case series of children ( Results: Of the 30 articles identified on screening, 12 studies were included and reviewed for phenotypic characterization. Including the index child, 33 children (21 boys) were identified with a median age at presentation of 14 years. Clinically, the commonly described findings were hyperorality (90.9%), placidity (87.9%), hypersexuality (69.7%), hypermetamorphosis (57.6%), dietary pattern changes (54.5%), visual agnosia (51.5%), and memory disturbances (45.5%). Neuroimaging abnormalities were reported in 24 children. Carbamazepine was somewhat useful in 4/5 children where it had been tried. Conclusions: KBS is rare in young children with TBI. A high degree of suspicion is required for the identification of this phenotype in young children. Symptoms are often transitory and carbamazepine may be useful. Keywords: Childhood traumatic brain injury, hyperorality, TBI, trauma

Author(s): Wen-Ching Tang [sup.1], Min-Pei Lin [sup.1], Jianing You [sup.2], Jo Yung-Wei Wu [sup.3], Kuan-Chu Chen [sup.1] Author Affiliations: (1) grid.412090.e, 0000 0001 2158 7670, Department of Educational Psychology and [...], The research investigated the prevalence of nonsuicidal self-injury (NSSI) during the COVID-19 outbreak and identified the psychosocial risk factors among junior high school students in Taiwan. Cross-sectional design was applied and 1,060 participants (Mage = 14.66, SD = 0.86 years) were recruited into the study. The prevalence of NSSI was found to be 40.9% (95% confidence interval, 37.9%-43.9%) during the COVID-19 outbreak. The results suggested that the self-injurers group were mostly female, and scored significantly higher in neuroticism, depression, impulsivity, alexithymia, virtual social support, dissatisfaction with academic performance, and lower in subjective wellbeing, self-esteem, actual social support, and family function than the non-injurers group. In addition, high neuroticism, low self-esteem, high virtual social support, high impulsivity, and high alexithymia were independently predictive in the logistic regression analysis. The principal results of this study suggested that NSSI was extremely prevalent among adolescents during the COVID-19 outbreak, and in particularly, personality and virtual environment risk factors and enhancing self-esteem should be the focus of NSSI preventive strategies when targeting this age population. Our results provide a reference towards designing NSSI prevention programs geared toward the high school population during the COVID-19 pandemic.

Elbow fractures have a bimodal distribution, being more prevalent in the pediatric and elderly populations. (1) Among younger patients, elbow fractures represent approximately 20% of all fractures (2) and supracondylar [...], Background: The association between elbow fractures and outdoor playgrounds has always been anecdotal. We sought to determine the impact of closing outdoor playgrounds and other play areas during the COVID-19 lockdown on elbow fractures in a pediatric population. Methods: We conducted a retrospective cohort study of all elbow fractures from a single pediatric referral hospital between 2016 and 2020 for the months of April and May. The months chosen corresponded to the COVID-19 lockdown during which outdoor playgrounds were closed. Inclusion criteria were elbow fracture diagnosis based on radiography and age younger than 18 years. Fracture type, where the injury occurred and the mechanism of injury were recorded. Results: A total of 370 fractures were reported, with an average of 83 (95% confidence interval [CI] 83-84) per year for 2016-19 and only 36 recorded in 2020. The average annual number of fractures before 2020 was 17 (95% CI 16-17) for schools, and 33 (95% CI 31-34) for outdoor playgrounds, including 22 (95% CI 21-24) falls from playground structures. No fracture was reported in schools in 2020, and only 3 were reported from outdoor playgrounds (including 1 associated with falling from playground structures). Conclusion: We found an association between elbow fractures in a pediatric population and outdoor playground accessibility, but also with indoor public locations. Our findings emphasize the importance of safety measures in those facilities. Contexte: Le lien entre les fractures du coude et la fréquentation des terrains de jeux extérieurs a toujours été anecdotique. Nous avons voulu mesurer l&apos;impact de la fermeture des terrains de jeux extérieurs et autres aires de jeux durant le confinement dû à la COVID-19 sur les fractures du coude dans une population pédiatrique. Méthodes : Nous avons procédé à une étude de cohorte rétrospective regroupant tous les cas de fracture du coude dans 1 seul centre pédiatrique de référence entre 2016 et 2020 pour les mois d&apos;avril et de mai. Les mois choisis correspondent au confinement dû à la COVID-19 durant lesquels les terrains de jeux extérieurs étaient fermés. Les critères d&apos;inclusion étaient un diagnostic de fracture du coude, radiographie à l&apos;appui et un âge inférieur à 18 ans. On a également noté le type de fracture, le lieu de sa survenue et son mécanisme. Résultats: En tout, 370 fractures ont été signalées, à raison d&apos;une moyenne de 83 (intervalle de confiance [IC] de 95% 83-84) par année pour 2016-2019, et de seulement 36 en 2020. Le nombre annuel moyen de fractures avant 2020 était de 17 (IC de 95% 16-17) pour les écoles, et de 33 (IC de 95% 31-34) pour les terrains de jeux extérieurs, incluant 22 (IC de 95% 21-24) chutes des structures de terrains de jeu. Aucune fracture n&apos;a été signalée dans les écoles en 2020, et seulement 3 ont été signalées dans des terrains de jeux extérieurs (dont 1 associée à une chute d&apos;une structure de jeu). Conclusion : Nous avons établi un lien entre les fractures du coude dans une population pédiatrique et l&apos;accessibilité aux terrains de jeux extérieurs, mais aussi avec les aires de jeux intérieures publiques. Nos observations confirment l&apos;importance des mesures de sécurité dans ces lieux.

: Objective: To describe the characteristics of the New Zealand child injury prevention workforce and the organisations they represent. Methods: Representatives of organisations on the Safekids Aotearoa database were invited to complete an online survey. The standardised questionnaire asked for information about injury prevention focus and expertise, communication preferences and information access. Results: Of 196 respondents, the majority were female and identified as New Zealand European. For only a small proportion of respondents, child injury prevention is the main focus of their role. The key sources of child injury data and injury prevention information identified was Safekids Aotearoa, followed by the Ministry of Health. Respondents indicated that they would like to receive information on new research, training opportunities and upcoming events, and information from other organisations. Conclusions: Males and people of Pacific and Asian ethnicity are under?represented in the New Zealand child injury prevention workforce in New Zealand. The low engagement of the sector with M?ori authorities is of concern, given the inequities in rates of child injury that exist. Implications for public health: There is a need to conduct a wider and more regular audit of the child injury prevention sector to determine its composition and identify areas of concern., Unintentional child injury represents a considerable public health burden globally[sup.1] and in New Zealand.[sup.2] Injuries are the third?leading cause of death among children aged 0 to 14 years[sup.3] in New [...]