Carbon savings potential of virtual care in obstructive sleep apnea and otitis media with effusion.

Objective: To determine the carbon savings potential of incorporating virtual care into surgical care pathways for pediatric patients with obstructive sleep apnea or otitis media with effusion. Methods: Pediatric patients with obstructive sleep apnea or otitis media with effusion were not enrolled, instead, a modeling cohort study design was used. This study utilized the British Columbia healthcare system and geography to model emissions. Care pathways were developed for pediatric patients with obstructive sleep apnea or otitis media with effusion requiring care at a tertiary pediatric center. Home addresses were located at the geographical center of the two most populated municipalities within each of the 10 most populated regional districts in 2020. Virtual visits replaced up to three clinically equivalent in-person visits. Emissions (kgCO2e) for transport and virtual visits were estimated. Population-weighted means and descriptive statistics were calculated. Results: Utilizing 1, 2, or 3 virtual visits in the obstructive sleep apnea care pathway yielded potential emissions savings of 19.9%, 39.9%, and 59.8% respectively. Integrating 1, 2, or 3 virtual visits into the otitis media with effusion care pathway produced potential emissions savings of 16.6%, 33.2%, and 49.7%, respectively. Integrating 3 virtual visits can save up to 2156.8 kgCO2e per patient. Conclusions: Appropriately conducting up to 50% of clinical encounters virtually for children with obstructive sleep apnea or otitis media with effusion reduced theoretical carbon emissions. For a single child, emission savings could reach over 2150 kgCO2e. Level of Evidence: Level 5.

Pneumonia during the first two years of life does not increase risk of respiratory infections in preschool children.

SUMMARY OBJECTIVES: To investigate the relationship between severe pneumonia during the first two years of life and subsequent respiratory infections in preschool children. METHODS: This was a cross-sectional study. We interviewed parents of children who were classified as exposed (n = 36) or non-exposed (n = 84), based on whether they were hospitalized with radiologically-confirmed pneumonia during the first two years of life. The main outcomes were physician-diagnosed respiratory infections (acute otitis media, pharyngitis, and pneumonia) and use of antibiotics during the last 2 and 12 months. RESULTS: There were no significant differences between two groups in terms of prevalence of acute otitis media, pharyngitis, pneumonia and use of antibiotics during the last 2 months (5.9 vs 6.2%, 14.3 vs 26.0%, 0.0 vs 1.2% and 36.7 vs 38.7% respectively; P > 0.05 for all comparisons) and during the last 12 months (20.6 vs 18.5%, 40.0 vs 45.5%, 2.8 vs 2.4% and 76.7 vs 77.3% respectively; P > 0.05 for all comparisons). CONCLUSIONS: Pneumonia severe enough to require hospitalization during the first two years of life does not increase the risk of respiratory infections in preschool children.

High prevalence of depression amongst mothers of children with asthma.

OBJECTIVE: To compare the prevalence of depression among mothers of children with asthma and mothers of children without asthma and to investigate the influence of severity and duration of childhood asthma on maternal depression. METHOD: A cross-sectional study including 80 mothers of children with asthma and 160 mothers of children without asthma who attended the pediatric outpatient clinics of a teaching hospital in Southern Brazil. The main outcome measure was the presence of depression in these mothers, measured by the Beck Depression Inventory. RESULTS: The prevalence of depression was higher among mothers of asthmatic children compared with mothers of non-asthmatic children (43.8% vs. 17.5%, p < 0.001), with an adjusted prevalence ratio of 2.74 (95% confidence interval [CI] 1.76-4.25). Mothers of children with persistent asthma had a higher prevalence of depression than mothers of children with intermittent asthma (62.8% vs. 21.6%, p < 0.001), with an adjusted prevalence ratio of 2.77 (95% CI: 1.46-5.27). No significant association was observed between duration of childhood asthma and maternal depression. CONCLUSION: Mothers of children with asthma have a higher prevalence of depression than mothers of children without asthma. The severity but not duration of childhood asthma is associated with maternal depression.