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This current article is drawn from a qualitative study investigating the motivations and uses of digital devices of Singapore parents with their toddlers and preschoolers (age range: 1-5-year-old children). The article focuses on three prominent empirical findings. First, parent participants tend to try using a digital device with children to gratify needs for children's learning, tension release, and bonding. Second, these parents' perceptions of the extent to which these needs are gratified and the risks when using digital devices influence their decision to use. Third, these interviewed parents observed that the appropriate use of digital devices, with their rich educational content, flexibility, and interactivity, were instrumental in providing further opportunities for learning and discovering the world of children. The article seeks to contribute to the international literature of early childhood learning by providing evidence on factors influencing parents' use of digital devices with their children and possible impacts of that use on children development.

Background Individuals who suffered a neurological adverse event after the Coronavirus disease (COVID-19) vaccine could hesitate and defer reimmunization. Aim We examine the risk of recurrence following reimmunization among patients who developed a neurological event after the first dose of the COVID-19 mRNA vaccine. Design Observational study. Methods Individuals who developed an adjudicated neurological adverse event (based on Brighton Collaboration criteria) within 6 weeks of the first dose of the COVID-19 vaccine requiring hospitalization were enrolled into a multicenter national registry in Singapore. Neurological recurrence, defined by the development of another neurological event within 6 weeks of the second vaccine dose, was reviewed. Clinical characteristics were compared between patients who chose to proceed or withhold further vaccination, and between those who received timely (3–6 weeks) or delayed (>6 weeks) reimmunization. Results From 235 patients (median age, 67 years; 63% men) who developed an adjudicated neurological event after their first dose of mRNA vaccine between 30 December 2020 and 20 April 2021, 181 (77%) chose to undergo reimmunization. Those who decided against reimmunization were older (median age, 74 vs. 66 years) and had greater physical disability following their primary neurological event (46% vs. 20%, P  < 0.001). Patients who suffered greater physical disability were three times more likely to delay their reimmunization (odds ratio 3.36, 95% confidence interval: 1.76–6.40). Neurological recurrence was observed in only four individuals (three with seizures and one with myasthenia gravis exacerbation). Conclusions A prior neurological event should not necessarily preclude reimmunization and the decision to proceed with reimmunization should consider the overwhelming benefits conferred by vaccination toward ending this pandemic. [ABSTRACT FROM AUTHOR]

Background Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) superspreading events suggest that aerosols play an important role in driving the coronavirus disease 2019 (COVID-19) pandemic. To better understand how airborne SARS-CoV-2 transmission occurs, we sought to determine viral loads within coarse (>5 μm) and fine (≤5 μm) respiratory aerosols produced when breathing, talking, and singing. Methods Using a G-II exhaled breath collector, we measured viral RNA in coarse and fine respiratory aerosols emitted by COVID-19 patients during 30 minutes of breathing, 15 minutes of talking, and 15 minutes of singing. Results Thirteen participants (59%) emitted detectable levels of SARS-CoV-2 RNA in respiratory aerosols, including 3 asymptomatic and 1 presymptomatic patient. Viral loads ranged from 63–5821 N gene copies per expiratory activity per participant, with high person-to-person variation. Patients earlier in illness were more likely to emit detectable RNA. Two participants, sampled on day 3 of illness, accounted for 52% of total viral load. Overall, 94% of SARS-CoV-2 RNA copies were emitted by talking and singing. Interestingly, 7 participants emitted more virus from talking than singing. Overall, fine aerosols constituted 85% of the viral load detected in our study. Virus cultures were negative. Conclusions Fine aerosols produced by talking and singing contain more SARS-CoV-2 copies than coarse aerosols and may play a significant role in SARS-CoV-2 transmission. Exposure to fine aerosols, especially indoors, should be mitigated. Isolating viable SARS-CoV-2 from respiratory aerosol samples remains challenging; whether this can be more easily accomplished for emerging SARS-CoV-2 variants is an urgent enquiry necessitating larger-scale studies. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel beta-coronavirus that causes a variety of symptoms in patients known as coronavirus disease (COVID-19). COVID-19 infection may cause complications involving the central nervous system (CNS), peripheral nervous system (PNS), muscles, or autonomic system (ANS). Compared with central and peripheral nervous system involvement in COVID-19 infection reports, the bibliography describing ANS manifestations is more limited. We report a patient with confirmed SARS-CoV-2, admitted to one of the tertiary hospitals in Singapore with small fiber neuropathy. Small fiber neuropathy as a neurological manifestation in COVID-19 infection is rare. Our case report adds to and supports this observation and also highlights how SFN in COVID-19 infection can be self-limited without requiring immunosuppressive treatment. [ABSTRACT FROM AUTHOR]

Young people experience high rates of mental health issues. However, many do not seek professional help. In order to encourage help-seeking behavior among young people, it is important to ensure that services are youth-friendly. This study aims to evaluate the Community Health Assessment Team (CHAT)'s mental health assessment service model using the World Health Organization (WHO) youth-friendly health service framework of accessibility, acceptability, and appropriateness (AAA), and to ascertain the extent to which the CHAT service model is youth-friendly. Three hundred young people aged 16–30 years, who had gone through CHAT mental health assessments, completed a 27-item questionnaire. Majority rated the items in the questionnaire favorably. Our results suggest that majority of the young people who accessed CHAT mental health assessment service found it to be youth-friendly. [ABSTRACT FROM AUTHOR]

This current article is drawn from a qualitative study investigating the motivations and uses of digital devices of Singapore parents with their toddlers and preschoolers (age range: 1–5-year-old children). The article focuses on three prominent empirical findings. First, parent participants tend to try using a digital device with children to gratify needs for children's learning, tension release, and bonding. Second, these parents' perceptions of the extent to which these needs are gratified and the risks when using digital devices influence their decision to use. Third, these interviewed parents observed that the appropriate use of digital devices, with their rich educational content, flexibility, and interactivity, were instrumental in providing further opportunities for learning and discovering the world of children. The article seeks to contribute to the international literature of early childhood learning by providing evidence on factors influencing parents' use of digital devices with their children and possible impacts of that use on children development. [ABSTRACT FROM AUTHOR]

We describe the spectrum of acute neurological disorders among hospitalized patients who recently had COVID-19 mRNA vaccination. We performed a prospective study at 7 acute hospitals in Singapore. Hospitalized patients who were referred for neurological complaints and had COVID-19 mRNA vaccines, BNT162b2 and mRNA-1273, in the last 6 weeks were classified into central nervous system (CNS) syndromes, cerebrovascular disorders, peripheral nervous system (PNS) disorders, autonomic nervous system (ANS) disorders and immunization stress-related responses (ISRR). From 30 December 2020 to 20 April 2021, 1,398,074 persons (median age 59 years, 54.5% males) received COVID-19 mRNA vaccine (86.7% BNT162b2, 13.3% mRNA-1273); 915,344(65.5%) completed 2 doses. Four hundred and fifty-seven(0.03%) patients were referred for neurological complaints [median age 67(20–97) years, 281(61.5%) males; 95.8% received BNT162b2 and 4.2% mRNA-1273], classified into 73(16.0%) CNS syndromes, 286(62.6%) cerebrovascular disorders, 59(12.9%) PNS disorders, 0 ANS disorders and 39(8.5%) ISRRs. Eleven of 27 patients with cranial mononeuropathy had Bell's palsy. Of 33 patients with seizures, only 4 were unprovoked and occurred within 2 weeks of vaccination. All strokes occurred among individuals with pre-existing cardiovascular risk factors. We recorded 2 cases of cerebral venous thrombosis; none were vaccine-induced thrombotic thrombocytopenia. Five had mild flares of immune-mediated diseases. Our observational study does not establish causality of the described disorders to vaccines. Though limited by the lack of baseline incidence data of several conditions, we observed no obvious signal of serious neurological morbidity associated with mRNA vaccination. The benefits of COVID-19 vaccination outweigh concerns over neurological adverse events. • Of 1,398,074 vaccinated persons, 457 patients developed neurological disorders. • The spectrum includes epilepsy, encephalopathy, stroke, Bell's palsy and GBS. • No conclusive evidence of causal link between mRNA vaccines and these disorders. • The benefits of COVID-19 vaccination outweigh the risks of COVID-19 infection. [ABSTRACT FROM AUTHOR]

To describe the spectrum of COVID-19 neurology in Singapore. We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 onset. Neurological diagnoses and relationship to COVID-19 was made by consensus guided by contemporaneous literature, refined using recent case definitions. 47,572 patients (median age 34 years, 98% males) were diagnosed with COVID-19 in Singapore between 19 March to 19 July 2020. We identified 90 patients (median age 38, 98.9% males) with neurological disorders; 39 with varying certainty of relationship to COVID-19 categorised as: i) Central nervous system syndromes-4 acute disseminated encephalomyelitis (ADEM) and encephalitis, ii) Cerebrovascular disorders-19 acute ischaemic stroke and transient ischaemic attack (AIS/TIA), 4 cerebral venous thrombosis (CVT), 2 intracerebral haemorrhage, iii) Peripheral nervous system-7 mono/polyneuropathies, and a novel group, iv) Autonomic nervous system-4 limited dysautonomic syndromes. Fifty-one other patients had pre/co-existent neurological conditions unrelated to COVID-19. Encephalitis/ADEM is delayed, occurring in critical COVID-19, while CVT and dysautonomia occurred relatively early, and largely in mild infections. AIS/TIA was variable in onset, occurring in patients with differing COVID-19 severity; remarkably 63.2% were asymptomatic. CVT was more frequent than expected and occurred in mild/asymptomatic patients. There were no neurological complications in all 81 paediatric COVID-19 cases. COVID-19 neurology has a wide spectrum of dysimmune-thrombotic disorders. We encountered relatively few neurological complications, probably because our outbreak involved largely young men with mild/asymptomatic COVID-19. It is also widely perceived that the pandemic did not unduly affect the Singapore healthcare system. Unlabelled Image • Out of 47,572 COVID-19 patients, we identified 39 with neurological disorders. • 'CNS syndrome' is delayed, occurring in critically ill COVID-19 patients. • Dysautonomia occurred relatively early and largely in mild infections. • 63.2% of AIS/TIA patients had asymptomatic COVID-19. • We recorded 4 cerebral venous thromboses, in mild/asymptomatic COVID-19. [ABSTRACT FROM AUTHOR]