Children from historically disadvantaged groups (racial minorities, lower socioeconomic status [SES]) may be particularly susceptible to mental health consequences during the COVID-19 pandemic. We examined the impact of the pandemic, including mental health symptoms and COVID-19-related fears and behaviors, in a sample of majority Black American (72%) children ( n =64, ages 7–10, 24 female) from an urban area with high infection rates. Children completed a mental health screening form prior to the pandemic (October 2019) and at two time points during the pandemic (May, August 2020). We examined the impact of SES on mental health changes over time, COVID-19 fears and behaviors, and perceived impact of the pandemic. We also tested whether baseline mental health predicted the impact of COVID-19. Children's fears of illness increased over time, and these effects were independent of race and SES. However, lower SES children reported more fears about social distancing during the pandemic as compared to higher SES children. Lower SES children also reported more internalizing symptoms at baseline, which decreased in this group following stay-at-home orders. Results highlight the need to reduce the risk of persistent fear and mitigate the mental health consequences among vulnerable pediatric populations during and after the pandemic.

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BackgroundThere is little consensus on the management of dog bite victims. Few studies have examined long-term patient outcomes. This study was designed to evaluate two outcomes: infection and unfavorable scar formation.MethodsA retrospective study of dog bite cases from January 2013 to May 2016 was conducted at our level I pediatric trauma center. Forty-five patients were identified who received definitive repair and had long-term follow-up for reasons other than rabies vaccination. Variables recorded were wound characteristics including presence of tissue loss, location in the hospital of the wound repair procedure, personnel performing the repair, postrepair infection, and a binary assessment of unfavorable scar formation.ResultsUnfavorable scarring was not significantly related to either repair location or personnel. Rate of infection was not significantly related to repair location. However, infection rate was significantly related to personnel performing the repair (p=0.002), with 8 of 11 (73%) infections after repair by emergency physicians compared with surgeons.DiscussionThe presence of infection was significantly related to bedside repair by emergency physicians. The data are suggestive of differences in wound preparation and repair technique between emergency department and surgical personnel. Standardizing technique could reduce infectious complications and long-term morbidity associated with repairing dog bites and other contaminated wounds. A robust and practical classification system for dog bite wounds would be helpful in stratifying these wounds for research comparison and healthcare triage.Level of evidenceThe level of evidence for this retrospective study is level III.

This exploratory study examined the impact of Heroes Circle, a martial arts-based curriculum on stress, emotional, and behavioral problems in elementary school children. While students completed classroom surveys at baseline, post-curriculum surveys were collected from teachers, students, and parents/guardians 2 and 5 months after COVID-19-related school shutdowns. Satisfaction with the curriculum was high among those who received the intervention. Children reported increased mindfulness and decreased stress over the school year. Most children (77%) were still using the program's techniques and reporting benefits 5 months later, including lower internalizing symptoms and COVID-19-related fears. These patterns were not observed at the control school.