Well-designed public policy can promote health among children, 1-3 but there is reason to worry that pediatric health issues may get crowded out of policy discussions and debates. Politicians are incentivized to craft their health care policies around the interests of voting-age citizens, and politicians are unlikely to see children as important drivers of health care spending. 1,4 To assess the national political profile of pediatric health issues, we analyzed a database of Congressional candidate campaign websites.
Background The COVID-19 pandemic has posed profound challenges for pregnant patients and their families. Studies conducted early in the pandemic found that pregnant individuals reported increased mental health concerns in response to pandemic-related stress. Many obstetric practices changed their healthcare delivery models, further impacting the experiences of pregnant patients. We conducted a survey study to explore the ways in which COVID-19 impacted the lives of pregnant and newly postpartum people. Methods A mixed-methods survey was distributed to all patients ≥18 years old who were pregnant between January 1st, 2020 – April 28, 2021 in a large Midwest health system. Open-ended survey responses were analyzed for common themes using standard qualitative methodology. Results Among the 1182 survey respondents, 647 women provided an open-ended response. Of these, 77% were in the postpartum period. The majority of respondents identified as white, were partnered or married, and owned their own home. Respondents reported feeling greater uncertainty, social isolation, as though they had limited social and practical support, and negative mental health effects as a result of the pandemic. Many cited sudden or arbitrary changes to their medical care as a contributing factor. Though in the minority, some respondents also reported benefits from the changes to daily life, including perceived improvements to medical care, better work-life balance, and opportunities for new perspectives. Conclusions This large qualitative dataset provides insight into how healthcare policy and lifestyle changes impacted pregnant and postpartum people. Respondents expressed similar levels of uncertainty and mental health concerns compared to other cohorts but less overall positivity. Our findings suggest greater attention be given to the impact of pandemic-related stress on pregnant and postpartum women. As the pandemic continues, these data identify areas where investment in additional support may have the greatest impact.
Background/aimsTo report the incidence and clinical characteristics of paediatric keratitis diagnosed over a 10-year period in a well-defined population.DesignRetrospective, population-based study.MethodsSetting: multicentre. Population: patients (<19 years) diagnosed with keratitis as residents of Olmsted County from 1 January 2000, through 31 December 2009. Main outcome measures: calculated annual age-specific and gender-specific incidence rates, demographic information and initial and final visual acuity.ResultsA total of 294 diagnoses of keratitis occurred in 285 children during the 10-year period, yielding an incidence of 78.0 per 100 000 younger than 19 years (95% CI 69.0 to 87.1) or approximately 1 in 1282 children. The incidence increased throughout the 10-year study period (p<0.001). The mean age at diagnosis was 15.3 years (range, 0.2–18.9) and 172 (60.4%) were women. The observed forms included keratitis due to contact lens wear in 134 (45.6%), infectious keratitis in 72 (24.5%), keratitis not otherwise specified in 65 (22.1%) and keratitis sicca in 23 (7.8%). The visual acuity was reduced to ≤20/40 in 61 (21.4) of the 285 patients at the initial examination and in 24 (8.4%) at the final examination. Children with infectious keratitis had the poorest presenting vision and the best final vision, whereas the reverse was true for those with keratitis sicca.ConclusionsKeratitis, regardless of aetiology, was observed in approximately 1 in 1300 children by 19 years of age in this population-based cohort. Nearly half were related to contact lens wear and a decrease in vision to ≤ 20/40 occurred in 1 in 12 patients.
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