RESUMEN
This joint statement by the European Society for Emergency Paediatrics and European Academy of Paediatrics aims to highlight recommendations for dealing with refugee children and young people fleeing the Ukrainian war when presenting to emergency departments (EDs) across Europe. Children and young people might present, sometimes unaccompanied, with either ongoing complex health needs or illnesses, mental health issues, and injuries related to the war itself and the flight from it. Obstacles to providing urgent and emergency care include lack of clinical guidelines, language barriers, and lack of insight in previous medical history. Children with complex health needs are at high risk for complications and their continued access to specialist healthcare should be prioritized in resettlements programs. Ukraine has one of the lowest vaccination coverages in the Europe, and outbreaks of cholera, measles, diphtheria, poliomyelitis, and COVID-19 should be anticipated. In Ukraine, rates of multidrug resistant tuberculosis are high, making screening for this important. Urgent and emergency care facilities should also prepare for dealing with children with war-related injuries and mental health issues. Ukrainian refugee children and young people should be included in local educational systems and social activities at the earliest opportunity.
RESUMEN
INTRODUCTION: Studies linked obesity with a large number of medical conditions including decreased cognitive functioning. The relation between BMI and cognition was proven in adults, but in adolescents the results are conflicting. Further, limited data are available on the impact of weight loss on cognition. This study analyzed the impact of a 30-week lasting weight loss program on cognition and determined the impact of changes in body composition and self-perceived fatigue on changes in cognition. METHODS: Sixty-two obese adolescents were evaluated at baseline and after 30 weeks. Stroop test (ST; selective attention), Continuous Performance Test (CPT; sustained attention) and Ray Auditory verbal learning test (RAVLT; short-term memory) were assessed. Additionally, body composition parameters and fatigue (MFI-20) were evaluated. RESULTS: Improved reaction times were found for ST and CPT after the intervention, but were independent for reductions in BMI, fat mass, fat%, and fatigue. Short memory also improved with decreased fatigue as an influencing parameter. Accuracy of ST and CPT showed no significant changes. CONCLUSION: A 30-week lasting inpatient weight loss program improved selective attention, sustained attention, and short-term memory. Changes in body composition did not explain the improvements in cognitive functioning. Decreased fatigue resulted in improved aspects of cognition.