Ukrainian Children Research Articles

Initiatives to aid Ukraine arrivals

Local schemes have been launched to assist Ukrainian children and the youth workers who support them

Addressing vaccine inequities among Ukrainian refugees

Addressing vaccine inequities among Ukrainian refugees

Diseases of the endocrine system in children in Ukraine and specialized care to pediatric patients in 2021

The article provides information on the specialized medical care to children of various ages with endocrine pathology in Ukraine in the year 2021 and presents analysis of its dynamics over the past 8—10 years, based on the data of the official statistics of the Ministry of Health of Ukraine and Ukrainian databases of children with the rare (orphan) endocrine diseases. Information is provided on the provision of pediatric endocrinologists in various regions of Ukraine, the state of inpatient care by region, the indicators of neonatal screening for congenital hypothyroidism and congenital adrenal hyperplasia, and the incidence of endocrine pathology in children under 1 year of age.The article contains data on the dynamics of the prevalence of diabetes mellitus (DM) in children, its various types, malignant diseases of the endocrine glands, in particular thyroid cancer, a database of children with disorders of sexual differentiation (DSD), etc.It is noted that according to the register of children with DM in 2021, 11 193 patients under the age of 18 (15.0 per 10,000 child population) were registered, including 11 014 (14,74) children receiving insulin therapy (with DM type 1, other types of DM with the need for insulin treatment), 51 with DM type 2, 69 children with neonatal DM, of which the diagnosis was genetically confirmed in 40, and MODY was genetically confirmed in 59 children. The prevalence of DM among children aged 0—18 in 2021 increased by 46.2 % compared to 2012. The fastest growing prevalence and incidence of diabetes was among children under 6 years of age.Children with DSD undergo a detailed cytogenetic examination in the world’s leading genetic laboratories by specialists of the Department of Pediatric Endocrinology of the Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine. The database included 682 DSD patients, in particular with chromosomal DSD — 357 (52.3%, in particular 303 patients with Turner syndrome); 46, XY DSD — 119 patients (17.5%); 46,XX — 206 patients (30.2%) (of which 185 patients with DSD due to congenital adrenal hyperplasia).

Cascading Risks for Preventable Infectious Diseases in Children and Adolescents during the 2022 Invasion of Ukraine

Russia’s military incursion into Ukraine triggered the mass displacement of two-thirds of Ukrainian children and adolescents, creating a cascade of population health consequences and producing extraordinary challenges for monitoring and controlling preventable pediatric infectious diseases. From the onset of the war, infectious disease surveillance and healthcare systems were severely disrupted. Prior to the reestablishment of dependable infectious disease surveillance systems, and during the early months of the conflict, our international team of pediatricians, infectious disease specialists, and population health scientists assessed the health implications for child and adolescent populations. The invasion occurred just as the COVID-19 Omicron surge was peaking throughout Europe and Ukrainian children had not received COVID-19 vaccines. In addition, vaccine coverage for multiple vaccine-preventable diseases, most notably measles, was alarmingly low as Ukrainian children and adolescents were forced to migrate from their home communities, living precariously as internally displaced persons inside Ukraine or streaming into European border nations as refugees. The incursion created immediate impediments in accessing HIV treatment services, aimed at preventing serial transmission from HIV-positive persons to adolescent sexual or drug-injection partners and to prevent vertical transmission from HIV-positive pregnant women to their newborns. The war also led to new-onset, conflict-associated, preventable infectious diseases in children and adolescents. First, children and adolescents were at risk of wound infections from medical trauma sustained during bombardment and other acts of war. Second, young people were at risk of sexually transmitted infections resulting from sexual assault perpetrated by invading Russian military personnel on youth trapped in occupied territories or from sexual assault perpetrated on vulnerable youth attempting to migrate to safety. Given the cascading risks that Ukrainian children and adolescents faced in the early months of the war—and will likely continue to face—infectious disease specialists and pediatricians are using their international networks to assist refugee-receiving host nations to improve infectious disease screening and interventions.

Status of orphan children in Ukraine in war

Purpose. The aim of our study is to study the historical experience of preventing homelessness and neglect of orphans, as well as the characteristics of legal norms that guarantee the protection of orphans in wartime. Method. The methodology includes a comprehensive analysis and generalization of theoretical and source material and further formulation of relevant conclusions and recommendations. The study used the principles of objectivity and systematicity, as well as general scientific, special legal and special historical methods of scientific knowledge: analysis, synthesis, comparative, functional-legal, system-historical. Results. The problem of orphans should be considered through the prism of the analysis of the historical experience of the emergence of such a phenomenon and the fight against it; causes of homelessness and neglect of orphans; the procedure for taking into care, adoption and upbringing of orphans; information policy of the state in the field of protection of orphans. Respect for the rights of the child is a fundamental task of the state and civil society. This problem is especially relevant in times of war, when the child is always the least protected. Statistics on the number of children orphaned by the war (since 2014), the number of children forcibly deported to Russia, the internal movement of orphans from areas where hostilities are taking place, indicate the urgency of the problem and the need to consolidate society to address this problems. Scientific novelty. The historical aspects of preventing child homelessness are analyzed, the causes of this phenomenon are determined; the changes that have taken place in the national legislation regarding the procedure of taking into care, adoption and upbringing of orphans are pointed out. Practical significance. The results of the study can be used in further historical and legal research, preparation of special courses.

Epidemiology and course features of acute kidney injury in Ukrainian children

Abstract. Epidemiological or clinical study on the pediatric population has not been conducted in Ukraine since the term acute kidney injury (AKI) was defined in the year 2004. Our study aimed to analyze the epidemiology, etiology, and features of the AKI in children over 20 years period.
 Materials and methods. The study included 242 children aged 6 months to 18 years with AKI who were observed during the years 2002-2020 in the reference center (until the year 2002: n=17; 2002-2012 years: n=105; 2013-2020 years: n=120).
 Results. The number of patients per 10.000 children ranged from 0.025 to 0.034 from 2013 to 2017, except for the year 2015 (0.008), but it began to decrease in 2018. Patients from the Kyiv region accounted for one-third of all episodes (34-29%), and the quotas of the Central Ukrainian region were also stable (6-5-4%). The quantity of Podolsky region tripled after the year 2012 (from 6 to 19%), and patients from the Black Sea region and Donetsk region appeared in the structure at that time (15-14% and 13-7%, respectively). The part of the Northwest region of Ukraine was reduced significantly (from 24 to 8%), as the Northeast region (from 12 to 5%) and Carpathian region (from 12 to 3%). Boys predominated among patients (145/59.9%), and the average age at disease onset was 4 years (from 3 months to 17 years and 11 months).
 The main AKI cause in children aged under the 12 months and 1-3 years old was hemolytic-uremic syndrome (with or without intestinal disorders), its quantity decreased in the age from 3 to 10 years (due to the increasing number of patients with hemolytic anemia) and in adolescents (due to glomerulonephritis and toxic factors). Complications such as multiple organ failure syndromes, sepsis, and congenital anomalies of the kidney and urinary tract aggravated the course of AKI.
 Conclusions. The relative proportion of AKI cases per year decreased in 2018-2019 compared to the 2013-2017 period with the largest part of disease detection in the central regions of Ukraine. Dominant etiological factors, age differences and complications of AKI in children were identified.

The educational opportunities of Ukrainian children at the time of the Russian invasion: perspectives from teachers

ABSTRACT The global Covid-19 pandemic has passed. This process required greater attention and care to the specifics of the organization of distance learning and the resolution of problems that arose for participants in the educational process. By late 2021 face-to-face teaching was returning but Russian aggression against Ukraine interrupted the comparatively carefree life of children and hindered access to kindergartens and schools which required a further focus on remote education. The paper outlines the peculiarities of the organization of distance learning under martial law in Ukraine and presents the problems of the organization of training during a time of conflict as well as the challenges presented by Internet platforms for the organization of the distance learning approaches recommended by the Ministry of Education of Ukraine. The aim of the research was theoretical analysis and generalization of literature on research problems, pedagogical observations, surveys, methods of mathematical statistics. The article provides one of the first analyses of the difficulties faced during this period of immense disruption based on empirical data and explains to what extent Ukrainian teachers under martial law have the possibility to organize distance teaching, what problems they face, what is the psychological state of children.

Paediatric refugees from Ukraine: guidance for health care providers.

With the invasion of Ukraine by the Russian Army in February 2022, refugees, the majority of whom are women and children, started fleeing the war to neighbouring countries. Even before the current escalation, the conflict in the eastern part of Ukraine has led to the internal displacement of more than 200,000 children, and many others have experienced attacks, e.g. on schools. This inevitably leads to limitations in health care delivery. During transit, overcrowding, poor shelter and vulnerability may further put refugees at increased risk for infectious diseases. This consensus document aims to provide information and guidance regarding health issues that paediatricians and general practitioners may face when caring for Ukrainian children. Members of the Migrant Health Reference Group of Paediatrics Switzerland and the Paediatric Infectious Disease Group in Switzerland developed this recommendation between March and April 2022 in a modified Delphi process. A total of 50 recommendations were agreed on with a ≥80% consensus. These include the following topics: i) general aspects, including interpreter services, urgent health needs, personal history and general check-ups; ii) mental health, including how to search for signs of psychological distress without going into traumatic details; iii) vaccinations, including recommendations for evaluation and catch-up; iv) screening for tuberculosis, human immunodeficiency virus, and hepatitis B and C; and v) providing age-appropriate preventive and health service information. This document provides current evidence and guidance when caring for paediatric refugees from Ukraine. The recommendations focus on Switzerland but may well be used in other countries. These are based on current evidence and may need to be adapted to individual situations and once further evidence becomes available.

PEDAGOGICAL ACTIVITY "FIRST STATE THEATER FOR CHILDREN": ANALYSIS OF ARCHIVAL MATERIALS 1920-1927 YEARS

Pedagogical activity of “The First State Theatre for Children "Fairy-tale"”: analysis of archives materials 1920-1927. The process o f the creation and developing of the first theatre for children in Ukraine is revealed in the report. Pedagogical influence of the theatre on children revealed in 20-th years of the XX the century. The recovered facts determined key-directions of pedagogical work of the theatres in the following years.

The Ukrainian paediatric mental health system: challenges and opportunities from the Russo–Ukrainian war

On Feb 24, 2022, Russian military troops invaded Ukraine. As the war continues, millions of Ukrainian children and their families are desperate for safety and shelter. The adverse long-term consequences of war-related psychological trauma are well known,1 but little attention is paid to the mental health challenges during the active phases of wars.

The Ukrainian children emergency: How the Pediatric Oncology Unit of Turin supports cancer patients and their families who have escaped war.

Due to the war in Ukraine, many children have been killed and those who suffer from severe diseases, such as oncological pathologies, are facing serious challenges as their treatment is interrupted. The objective of this report is to describe one of the first Italian humanitarian expeditions launched to rescue children and their families to provide them with the best possible cancer care. The Pediatric Oncology Unit of Turin has welcomed 60 Ukrainians who are patients, caregivers and siblings. This report underlines the activities that have been implemented to offer this new type of patient the best possible care.

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees.

AimMillions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians.MethodsA systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review.ResultsIn 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication.ConclusionUkrainian children often have poor health and host countries need to be aware of their needs.

THE PRACTICE OF PSYCHOLOGICAL AND PEDAGOGICAL SUPPORT FOR CHILDREN OF FORCED MIGRANTS ABROAD (ON THE EXAMPLE OF POLAND)

The article highlights the problem of integration of Ukrainian children of forced migrants into the educational space of Poland during the Russian-Ukrainian war. The policy of assistance and psychological and pedagogical support for children of forced migrants in Poland is presented. The cultural and educational challenges faced by children in a foreign country were analyzed. The most important difficulties faced by Polish teachers during the period of adaptation of Ukrainian children are described. The level of children's adaptation to new living conditions after a year of their stay in Poland is outlined.It was found that in Poland during the Russian-Ukrainian war, Ukrainian children were given the opportunity to continue their education in educational institutions, learn the language for free, use social services (free medical care, financial social assistance for each child, financial social assistance for each immigrant, free residence in the country for 120 days, etc.), legal stay in the country.It was found that during the year of stay of Ukrainian children in Polish schools, most of them (about 90%) integrated into the new society, namely: the children learned the Polish language at the level of communication, established positive relations with the new environment, peers, capable of solving daily life problems within school, family, everyday life; take an active part in the social and cultural life of Polish society; have a satisfactory mental state and physical health; demonstrate adequacy in communication and intercultural relations; feel like whole and integrated individuals.About 10% of migrant children still have problems with language and integration. It is still difficult for these children to establish relationships with a new environment, peers, they have communication problems. This category of children includes children who have not attended school for a long time, but studied online in Ukrainian schools, who have problems with motivation to study, are still uncertain about their future, often such children are withdrawn, insecure, hostile to others, timid.
 Key words: forced migrants; adaptation problems; cultural and educational challenges; Polish educational policy; psychological and pedagogical support; integration of Ukrainian children; Russian-Ukrainian war.

National System for Neonatal Transfer and Distribution of Ukrainian Children Requiring Hospitalization During the State of War in Ukraine

National System for Neonatal Transfer and Distribution of Ukrainian Children Requiring Hospitalization During the State of War in Ukraine

Polymorphic Variants of Interleukin-13 R130Q and Interleukin-4 T589C in Children with and without Cow's Milk Allergy.

Cow’s milk allergy (CMA) is one of the most frequent types of food allergy. The aim of the study was to investigate whether IL-13 R130Q and IL-4 T589C polymorphisms are associated with the risk of CMA in young Ukrainian children. A total of 120 children (age range: 1–3 years) participated in the study and were divided into two groups: CMA (n = 60) and healthy controls (CNT, n = 60). The CMA group had two subgroups: specific oral tolerance induction (SOTI, n = 30) and milk elimination diet (MED, n = 30). The CNT group had two subgroups: positive family history of allergy (+FHA, n = 24) and negative family history of allergy (−FHA, n = 36). In the CMA group, molecular genetic testing of CC, CT, and TT genotypes of single nucleotide IL-4 T589C gene polymorphisms showed significantly higher rates of the CC genotype compared to healthy controls (92.2% vs. 58.8%; p < 0.01). In the CMA group, molecular genetic testing of GG, GA, and AA genotypes of single nucleotide IL-13 R130Q gene polymorphisms showed significantly higher rates of GA and AA polymorphic locus genotypes compared to healthy controls (43.5% vs. 22.4%, p < 0.05 and 8.7% vs. 0%, p < 0.05, respectively). In future studies, the genotypic and allelic distribution of these polymorphic variants will be determined in children with CMA and healthy children.

Rotaviruses and Noroviruses as Etiological Agents of Acute Intestinal Diseases of Ukrainian Children.

(1) Background: Rotavirus and norovirus infections are the primary viral causes of childhood diarrhea. In Ukraine, the diarrhea-linked infant mortality rate is low, but the number of children infected is quite high. This study examined the rates of rotavirus and norovirus infections throughout Ukraine. (2) Methods: Fecal samples for children admitted to hospitals in six Ukrainian cities (Kyiv, Lviv, Sumy, Odesa, Kharkiv, and Uman) were tested for the presence of rotavirus and norovirus. (3) Results: The overall rate of hospitalized children suffering from diarrhea with confirmed presence of rotavirus or norovirus in fecal samples was significant (20.67% and 27.94%, respectively). Samples obtained from children from Lviv had significantly higher rates of the viruses, and Kyiv and Uman had significantly lower rotavirus or norovirus detection levels than expected. (4) Conclusion: Childhood diarrhea impacts Ukraine significantly. The economic and societal effects of the failure to address this public health issue are indicated by the hospitalization rate of children with preventable illnesses. The geographical disparities in Ukraine for child hospitalizations caused by rotavirus and norovirus infections could result from environmental (sanitary factors or water purity issues) or social factors. Further research is needed to completely characterize infant viral infections in Ukraine.

TRANSFORMATION OF MENTAL TRAUMA IN CHILDREN USING THE HIBUKI - THERAPY METHOD

The article analyzes the concept of "mental trauma" as a life event that affects significant aspects of a person's existence and leads to deep psychological experiences. It is emphasized that a child of preschool age is not able to transform the psychotrauma received as a result of a stress reaction on his own, so in most cases it leads to severe mental breakdowns. Various scientific approaches to understanding mental trauma were analyzed and the sufficient complexity and multifacetedness of this psychological phenomenon, the lack of a single approach to its understanding, was noted. It is noted that the use of toys in the transformation of mental trauma of an individual contributes to the establishment of emotional contact, the removal of emotional tension, the expansion of the worldview of the surrounding world, and the prevention of maladaptive behavior. The toy encourages the child to play, and the psychologist uses the therapeutic effect of the game to help the child transform psychological and social difficulties that hinder personal and emotional development. The article examines the problem of transformation of mental trauma in children, resulting from natural disasters and hostilities in their country, with the help of Hibuki-therapy. The essence and role of Hibuki- therapy as a method of toy therapy in working with children who have experienced severe emotional stress are described. The process of formation of the therapeutic model of Hibuki-therapy is studied. It is emphasized that the author's model is based on the principle according to which children who actively resist experienced stressful situations can transform their fears and better adapt to life after any mental trauma. The proposed method encourages the child to focus on the toy dog's feelings and needs, as well as on the child's role as caregiver, thereby offering a distraction from their own fears and anxieties. Taking care of a soft toy, a child can dispel his fears and worries. It is important that the child begins to feel like a competent caregiver, and not a restless person who needs help. Today, Hibuki is an important tool that helps Ukrainian children cope with the trauma of war. The children's parents are also involved in this process, and they receive instructions on how to care for Hibuki.

Abdominal pain in children with intraabdominal purulent diseases and acute complications of type I diabetes mellitus: a non-systematic review

Annotation. The prevalence of type I diabetes mellitus (T1DM) among children in Ukraine reached 9105 patients in 2018 and continues to rise. Differential diagnosis of abdominal pain in ketoacidosis and intraabdominal purulent diseases is an important factor contributing to prompt and appropriate management of such patients. We analyzed the prevalence of T1DM in different age groups and specific features of abdominal pain related to its complications and concomitant intraabdominal purulent diseases in childhood in this article. Scientific research for the period from 2008 to 2021 was carried out according to the primary search strategy “type I diabetes mellitus” (T1DM, pediatric, children, prevalence), “ketoacidosis” (ketoacidosis, diabetic ketoacidosis, children), “abdominal pain” (acute abdominal pain, children), “acute appendicitis” (acute appendicitis, pediatric, children) and the combination of AND/OR in the scientometric databases MEDLINE (PubMed), Scopus, Web of Science. The leading role in the pathogenesis of pain belongs to electrolyte imbalance (acidosis) arising from the accumulation of intermediate products of fat oxidation. Abdominal pain in intraabdominal purulent diseases includes visceral, somatic parietal, and irradiating elements. The coincidence of onset peaks of intraabdominal purulent diseases, accompanied by acute abdominal pain and T1DM in this population requires the development of a standardized algorithm for the differential diagnosis of these pathologies.

Using the project method as a means of developing the creative potential of primary school children in Ukraine

ABSTRACT This article analyses the features of innovative curriculum design and the associated research activities of primary school students in Ukraine. It is emphasised that the priority is the formation of ‘meta-subject results’ in junior high school students, which can be seen as universal learning activities that will ensure, to a large extent, the success of learning at the next levels of education. Our research has shown the undeniable effectiveness of innovative curriculum design allied to pupil research activities based on project work when compared with traditional methodological approaches to learning. We argue that the increasing demand to develop key competencies in education gives a heightened need for these pedagogical approaches. Moreover, the introduction of project work allows the teacher to form a pedagogical situation in which the student formulates a goal and achieves it whilst developing the key skills that will underpin their wider education.

Formation of multicultural competence of preschool children

The peculiarities of the development of the modern globalized world indicate the need to address the field of culture as an important principle of raising children from preschool age. The purpose of the article is to analyze the formation of the foundations of multicultural competence of preschool children in Ukraine. The objectives of the study are: to investigate the features of the theoretical perception of multiculturalism in the modern Ukrainian pedagogical system, to interpret empirical material on the attitude to multiculturalism among the surveyed parents and preschool children. The research is based on the use of theoretical research methods, including analysis, synthesis, induction and deduction, concretization, comparison, abstraction. Also, the study was formed as a result of using a statistical method, which consisted of qualitative analysis of experimental data. The results show that the multicultural development environment is an integrated category, which includes various areas of activity of the preschooler, so it is important to provide special conditions, a stable psychological atmosphere. The work on the basis of empirical material summarizes the favorable attitude of preschool children to foreigners and the desire of parents to deepen this program. According to our author's definition, multicultural education should be understood as the process of assimilation by preschoolers of values and experiences of other ethnic groups in the region where they live, with special emphasis on the study of their cultural achievements and national characteristics.