Taking emic and etic to the family level: interlinking parents' and children's COVID-19 views and experiences in Germany.

BACKGROUND: COVID-19 impacted families globally, restricting movement, and changing daily routines and family dynamics. In order to explore and contrast children's and parents' experiences and perceptions of life during COVID-19, we used Pike's distinction of emic (an insider's view) and etic (an outsider's view) and adapted the concept to the family level to differentiate between children's and parents' own perspectives (emic) and their view of other family members (etic). METHODS: Our qualitative study is based on face-to-face in-depth individual interviews with parents (n = 13) and their children (n = 16) and included migrant families as a hitherto underrepresented group in COVID-19 research in Germany. Interviews were recorded, transcribed in NVivo and quality-checked. We employed thematic analysis to explore similarities and differences in perceptions and experiences of children and parents at the family level and across the entire data set. RESULTS: We identified the following major themes in parents' and children's experiences: managing role and relationship changes within the nuclear family, coping with social expectations and demands, and re-evaluations of life's priorities. Parents' etic views on children showed strong overlap with children's emic view in terms of physical movement restrictions, experiencing good and tense family times, and internalizing rules. For issues such as experiencing stigma, divorce or language acquisition, parents' views were not reflected in children's accounts. Children's testing experience, by contrast, was more nuanced than parents' perceptions of it. Children's etic views of parents, a perspective rarely found in qualitative research with children, overlapped with mothers' experiences of role strain. CONCLUSIONS: The consideration of parents' and children's emic and etic perspectives provided deeper insights into family members' experiences, navigation, and views of COVID-19 measures. Applying the emic/etic distinction to the family context enriches the sociology of childhood studies and enables a more nuanced understanding of diverging experiences within families and should thus be further explored within and beyond epidemics in order to guide future pandemic measures.

In vivo monitoring of urea cycle activity with (13)C-acetate as a tracer of ureagenesis.

BACKGROUND: The hepatic urea cycle is the main metabolic pathway for detoxification of ammonia. Inborn errors of urea cycle function present with severe hyperammonemia and a high case fatality rate. Long-term prognosis depends on the residual activity of the defective enzyme. A reliable method to estimate urea cycle activity in-vivo does not exist yet. The aim of this study was to evaluate a practical method to quantify (13)C-urea production as a marker for urea cycle function in healthy subjects, patients with confirmed urea cycle defect (UCD) and asymptomatic carriers of UCD mutations. METHODS: (13)C-labeled sodium acetate was applied orally in a single dose to 47 subjects (10 healthy subjects, 28 symptomatic patients, 9 asymptomatic carriers). RESULTS: The oral (13)C-ureagenesis assay is a safe method. While healthy subjects and asymptomatic carriers did not differ with regards to kinetic variables for urea cycle flux, symptomatic patients had lower (13)C-plasma urea levels. Although the (13)C-ureagenesis assay revealed no significant differences between individual urea cycle enzyme defects, it reflected the heterogeneity between different clinical subgroups, including male neonatal onset ornithine carbamoyltransferase deficiency. Applying the (13)C-urea area under the curve can differentiate between severe from more mildly affected neonates. Late onset patients differ significantly from neonates, carriers and healthy subjects. CONCLUSION: This study evaluated the oral (13)C-ureagenesis assay as a sensitive in-vivo measure for ureagenesis capacity. The assay has the potential to become a reliable tool to differentiate UCD patient subgroups, follow changes in ureagenesis capacity and could be helpful in monitoring novel therapies of UCD.

Child health prioritisation in national adaptation policies on climate change: a policy document analysis across 160 countries.

Integration of child-specific adaptation measures into health policies is imperative given children's heightened susceptibility to the health impacts of climate change. Using a document analysis method, we examined 160 national adaptation policies for inclusion of child-relevant measures and identified 19 child health-related adaptation domains. 44 (28%) of 160 countries' policies that were analysed failed to include any domains, 49 (31%) included at least one child-related domain, 62 (39%) included between two and six domains, and five (3%) included at least seven domains. Predominant domains among child-specific adaptation measures included education and awareness raising, followed by community engagement and nutrition. No country addressed children's direct needs in the domain of mental health. National adaptation policies tend towards overly simple conceptualisations of children across four major lenses: age, social role, gender, and agency. Limited inclusion of child-specific measures in national adaptation policies suggests insufficient recognition of and action on children's susceptibility to climate change effects.

"I couldn't see my friends; the internet was bad, and I hardly went out" - insights into children's and adolescents' experiences of COVID-19 in Germany.

PURPOSE: We explored children's experiences of COVID-19 in terms of proximity and distance to significant others. METHODS: Our qualitative study with children in Germany (6-15 years of age) explored their views and experiences of COVID-19 times via drawings and face-to-face semi-structured interviews (n = 13). We analysed data thematically and used the socio-ecological model as the theoretical underpinning. Case studies contextualized how children dealt with the COVID-19 precautions. RESULTS: Salient motives in children's drawings were school scenarios showing distance-keeping and mask-wearing as an expression of interpersonal distance; in the home-schooling context, loneliness was highlighted. Drawings also illustrated the impact of COVID-19 in terms of separation, illness and death. A dynamic perception of proximity and distance emerged from drawings and interviews. COVID-19 barred children from spending "real" time together with close friends. Bridging physical distance virtually was easier for adolescents than for children. CONCLUSION: To bolster children's mental and social resilience in future epidemics, participants' plea for maintaining social and physical interactions with significant others and for keeping schools open should be heeded by policy-makers. Our study also highlights the benefits of conducting direct research with children and using non-verbal methods of data collection.