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The goal of the present study was to explore young children's attitudes and responses to different forms of social withdrawal by eliciting responses to hypothetical vignettes. Participants included 137 children (49 boys, 88 girls) in kindergarten and grade 1 classes (M age = 75.94 months, SD = 9.03) in Ottawa, Canada. Parents rated child characteristics, including shyness, unsociability and aggression. Children were also interviewed individually and presented with a series of hypothetical vignettes describing the behaviors of shy, unsociable, aggressive and socially competent children. In response to each vignette, children were asked a series of questions designed to assess their perceptions, attitudes and responses toward each child behavior. Results suggested that young children made surprisingly sophisticated distinctions between shyness and unsociability, demonstrating differences in terms of attributions of behavioral intent, liking and sympathetic responses. In addition, unsociable children evidenced a distinct pattern of responses to hypothetical peers. These findings add to the growing body of research distinguishing different forms of social withdrawal, and shed some light as to why unsociability in early childhood may not be so benign.

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov , NCT04384926 . Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include...

Despite growing research results indicating that shyness is a risk factor for psychosocial maladjustment in childhood, less is known about the conceptual mechanisms that may underlie these associations. The purpose of the current study was to explore links between self-reported shyness, coping strategies and social functioning in middle childhood. As well, we sought to examine the reliance on internalizing coping strategies as a potential mediator of the link between shyness and social functioning. Participants were 355 children aged 9 to 11 years who completed measures of shyness, loneliness, positive and negative affect, social anxiety, self-concept, well-being, and coping strategies. Results indicated that shyness was associated with greater internalizing difficulties and lower well-being. Moreover, internalizing coping was found to partially mediate the relation between shyness and certain indices of internalizing problems. These results suggest a conceptual pathway, where an over-reliance on internalizing coping may partially explain why shy children experience internalizing difficulties in middle childhood.

The purpose of the current study was to examine the role of organised sport participation as a moderator of the links between shyness and psychosocial maladjustment in childhood. Participants at Time 1 were 355 elementary schoolchildren (M age ϭ 10.1 years, SD ϭ 0.6); at Time 2, 1 year later, 201 children (56%) were retained. At both time points, children completed self-report assessments of their shyness and aggression, sport participation, and psychosocial adjustment. Parents also rated children's social skills. Overall, results indicated that sport participation was positively related to indices of positive adjustment (e.g., social skills, self-esteem). In contrast, shyness was associated with social skill deficiencies and internalizing problems. However, some evidence was also found to suggest that sport participation plays a unique protective role for shy children. Shy children who participated in sport over time reported a significant decrease in anxiety. Results are discussed in terms of the role of sport as a social context to enhance shy children's peer relations.