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Summary Background The aim of this study was to evaluate different factors that may contribute to workload and job satisfaction among Austrian pediatricians. Methods We conducted an online survey with 16 questions and performed statistical analyses. Results Of 375 participating pediatricians, 61% were female, 39% male, 61% clinicians, 21% panel doctors and 12% private doctors. Overall, job satisfaction was moderate (6 ± 2.4 on a positive scale of 0–10). Higher working hours (p = 0.014) and higher patient numbers (p = 0.000) were significantly associated with lower job satisfaction. Lowest satisfaction was described for administrative or other nonmedical work. Lack of time for patient consultation was also correlated with poor satisfaction. Pediatricians older than 65 years reported the highest job satisfaction whereas pediatricians between 55 and 65 years and younger than 36 years showed the lowest scores. Although male pediatricians worked significantly more often more than 40 h per week than females (75% vs. 53%, p = 0.000), female pediatricians were less satisfied about the proportion of administrative (p = 0.015) and other nonmedical work (p = 0.014). Conclusion New working models considering less workload, particularly less nonmedical work and intensified collaboration between pediatric clinicians and practitioners are needed to allow more available time per patient, to increase job satisfaction and thus to raise attractivity for pediatric primary care.

Austria has had a long tradition of sleep and dream science since Sigmund Freund published his psychoanalytic theory of personality at the turn of the twentieth century. Sleep medicine today, however, is a multidisciplinary specialization and training in Austria lasts about 18 months. Exploring the impact of sleep on daily activity, Austrian scientists are especially interested in the role of sleep disorders as an independent risk factor for neurological, psychiatric, and vascular diseases and their therapeutic management.When the Austrian Sleep Research Association (ASRA) was founded in 1991, CPAP therapy for sleep apnea had already celebrated its 10th birthday and had become a standard therapy covered by all public health insurance. Quite in contrast, in the field of insomnia, cognitive behavioral therapy for insomnia (CBT-I) has been established in international therapy guidelines, but for sleep-disturbed patients, affordable rapid access to this therapeutic option is still a challenge in our country.Since 1998, the ASRA has been offering voluntary accreditation based on a quality check process to sleep centers. More recently, a sleep training plan was introduced to obtain a sleep physician diploma by the Austrian Medical Chamber.

AimsAn important barrier for a nationwide implementation of a daily physical activity (PA) intervention at primary schools is the lack of spatial and human resources. Therefore, the aim was to develop an innovative PA intervention that can be implemented, without additional spatial and human resource requirements. The effects of this intervention on anthropometrics and health-related fitness of primary school children were investigated.MethodsIn twelve primary schools, 24 classes were randomly allocated to an intervention and control group. In the intervention group, children received mix physical education lessons, cognitive content using movement, and additional opportunities for extracurricular physical activities (home exercises) over a 9-month period. In the control group, children received the usual physical education classes. At baseline (Sept 2021) and at follow-up immediately after the intervention (June 2022), body weight, height, waist circumference and fitness parameters (cardiorespiratory fitness, muscle strength, flexibility) were measured. Intervention effects were assessed using multilevel regression models, adjusted for gender, urban/rural school, sports club membership, and for baseline values of the outcome parameter. Interactions between intervention and being a member of a sports club were assessed.ResultsOf 485 invited children, 412 (85%) were included in the analyses; 228 in the intervention and 184 in the control group. Children were 9.7 (SD 0.5) years old at baseline. In the total intervention group, a reduction in waist-to-height ratio and increase in all fitness parameters were found compared to the control group. Interactions with being a member of a sports club were found, and intervention effects were more pronounced in the group of children who were not a member of a sports club.ConclusionsOur daily physical activity intervention for primary schools showed positive effects on important health related parameters, especially for children who were not in a sports club and had most of their PA at school. Wider implementation of this intervention in primary schools is warranted, which should be feasible, since we made sure that no extra resources are needed.Trial registrationDRKS00025515.

BackgroundPrevious studies have shown that coronavirus disease 2019 (COVID-19) mitigation measures lead to reductions in health status and health-related fitness in children, whereas no data are currently available on the development of children after the removal of these mitigation measures. Therefore, we aimed to investigate the influence of different stringent measures, during and after COVID-19, on the longitudinal development of fitness and health status of primary school children.METHODSA longitudinal cohort study of 331 primary school children in Austria aged 7.7 ± 0.4 years at the start of the observation period was conducted. Before (Sept 2019), and during (June 2020, Sept 2020) and after (March 2021, June 2021, Sept 2021, and June 2022) the COVID-19 mitigation measures, fitness tests were carried out and anthropometric data of the children were collected. Age- and sex-specific standard deviation scores (SDSs) were calculated for seven individual fitness tests of the AUT FIT [1] test battery, body mass index, and waist-to-height ratio. In addition, children were classified into different fitness categories based on the AUT FIT summary score.ResultsAfter the implementation of COVID-19 mitigation measures, cardiorespiratory fitness and action speed decreased dramatically, and the number of children with overweight or obesity increased. At the last measurement after the COVID-19 mitigation measures (June 2022), significant improvements in cardiorespiratory fitness and weight status were observed. However, pre-COVID fitness levels were not achieved and BMI was still higher compared to Sept 2019.InterpretationOur study showed a trend reversal, in that the negative indirect effects of the COVID-19 measures on fitness and health parameters of children were followed by significant improvements in these parameters after the removal of those mitigation measures. At the end of the observation period, a positive trend in the development of fitness and health status was observed, although pre-COVID levels were not reached. Collaborative efforts are needed to reinforce the observed positive trend, and to continue to improve the level of fitness and health status of primary school children, and to mitigate the long-term negative health consequences of the COVID-19 pandemic.FundingAustrian Federal Ministry of Arts, Culture, Public Service and Sports (GZ2021-0.361.671).

ImportanceDifferent mitigation measures are mandated in schools worldwide to control the spread of SARS-CoV-2. The efficacy of most measures, however, has not been investigated thus far.ObjectiveTo investigate the usefulness of FFP-2 masks in classrooms to prevent the spread of SARS-CoV-2.DesignA retrospective comparative cohort study of infection rates (evaluated by PCR screening in school) in students wearing FFP-2 masks continuously and students in sports classes with limited face mask use.SettingA single-center evaluation comparing classes (middle school: age 10-16 years, 4-year high school: age 14-20 years) with a high sports focus (SF), with regular classes during the Delta and Omicron waves (September 2021–April 2022).ParticipantsIn total, 616 children/families were invited to participate in the comparative evaluation, and 614 (99.7%) followed this invitation by providing relevant information concerning their SARS-CoV-2 infection status. A total of 213 legal guardians (for children < 14 years) and 401 adolescents (≥14 years) reported SARS-CoV-2 infections during the 2021/22 school year.Main Outcomes and MeasuresA comparative analysis of cumulative SARS-CoV-2 infection rates in sports and non-sports classes (the 7-day classroom incidence of SARS-CoV-2 infections, and potential secondary infections among school classmates).ResultsCumulative SARS-CoV-2 infection rates were clearly higher in sports classes (with limited mask use) than in non-sports classes (continuous mask use). After the relaxation of the mitigation measures, students in non-sports classes, however, showed a clear “catch-up” of infections, leading to a higher incidence of infections during this phase. By the end of the observation period (April 30, 2022), only a small difference in cumulative SARS-CoV-2 infection rates (p=0.037, φ=0.09) was detected between classes with a sports focus and those without a sports focus.Conclusions and RelevanceWearing FFP2 face masks reduces the risk of SARS-CoV-2 infection if strict mitigation measures are applied. Following the relaxation of strict measures, previously “protected” students show a significant “catch-up” infection rate. Thus, continuous face mask use postpones rather than avoids SARS-CoV-2 infection in many cases. Therefore, the advantage of reduced transmission must be carefully balanced against the disadvantages associated with mask wearing throughout schools.

ZusammenfassungDiabetes ist eine der häufigsten chronischen Stoffwechselerkrankungen im Kindes- und Jugendalter. Die Zahl der Neuerkrankten hat in der letzten Dekade stark zugenommen.Typ-1-Diabetes ist mit > 90 % die häufigste Form des Diabetes im Kindes- und Jugendalter; deshalb bezieht sich das vorliegende Konzept auf Kinder und Jugendliche mit Typ-1-Diabetes. Seit 2016 gibt es in Österreich die ersten Rehabilitationszentren für Kinder und Jugendliche. Rehabilitation wird dann nötig, wenn sich Probleme mit dem Diabetes in der ambulanten Behandlung nicht lösen lassen oder auch wenn es wegen des Diabetes Schwierigkeiten mit Schule und Ausbildung gibt, und ist deshalb eine wichtiger Bestandteil in der Betreuung von Kindern und Jugendlichen mit Typ-1-Diabetes.Das vorliegende Konzept wurde von Mitgliedern der Arbeitsgruppe Pädiatrische Endokrinologie und Diabetologie Österreich (APEDÖ) in Zusammenarbeit mit den Vorständen der Rehabilitationskliniken und der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde (ÖGKJ) erstellt.Das Konzept beinhaltet Indikationen und Kontraindikationen für eine Diabetes Rehabilitation, geht auf die Ziele der Rehabilitation in den verschiedenen Altersgruppen (Kleinkinder, Schulkinder und Jugendliche) ein und gibt auch einen Überblick über die empfohlenen Anforderungen für das multidisziplinäre Rehabilitationsteam vor Ort.Das Rehabilitationskonzept der APEDÖ/ÖGKJ dient als Basiskonzept, die Rehabilitationspläne bleiben in der Verantwortung des jeweiligen Zentrums und sollen durch Austausch im Rahmen regelmäßiger Treffen zu einer Optimierung und Angleichung der Konzepte führen.

Die Zahl von Teenagerschwangerschaften ist in Osterreich seit Jahren rucklaufig, die verbleibenden Falle erfordern jedoch eine enge Kooperation von Geburtshelfern, Neonatologen, Familien und sozialen Diensten. Bei optimaler Betreuung ist das Risiko fur neonatale Komplikationen nur gering erhoht. Bei inadaquater Schwangerschaftsbetreuung besteht jedoch ein erhohtes Risiko fur Fruhgeburtlichkeit, niedriges Geburtsgewicht und damit assoziierte Sekundarprobleme wie neonatales Atemnotsyndrom („infant respiratory distress syndrome“) und Gehirnblutung. Praventive Masnahmen wie Aufklarung uber Schwangerschaftsverhutung, regelmasige Schwangerschaftskontrollen und psychosoziale Betreuung stehen daher im Vordergrund.

Nach jahrelangem Bemuhen ist es im Jahr 2014 gelungen, Kinder- und Jugendlichenrehabilitation als gemeinsame Initiative der Sozialversicherungen und der Bundeslander osterreichweit vorzusehen. Nach einem 2‑stufigen EU-weiten Vergabeverfahren wurden 2017 und 2018 insgesamt 343 padiatrische Rehabilitationsbetten in insgesamt 11 Losen an die jeweiligen Bestbieter vergeben. Mittlerweile (Stand Dezember 2019) sind 306 dieser Versorgungseinheiten in Betrieb. Der Zugang zu Rehabilitationsaufenthalten wird niederschwellig gehalten und die Antragstellung ist osterreichweit einheitlich geregelt („single point of service“). Mangels entsprechender Vorerfahrung wird die Entwicklung einer entsprechenden Rehabilitationskultur noch ein wenig Zeit in Anspruch nehmen, bei weiterer Kooperation aller Beteiligten sollte dieses wichtige und bisher fehlende Versorgungssegment aber in naher Zukunft optimale Qualitat bieten konnen. Regelmasige Evaluierungen und ein Monitoring des Patienten- und Elternfeedbacks sollen dazu beitragen.

Background: The ramifications of COVID-19 restrictions might accelerate the already rising proportion of children with overweight or obesity. Objectives: To assess the association between COVID-19 restrictions and changes in body mass index (BMI) and the proportion of children with overweight or obesity. Methods: Cohort study with baseline measurements in September 2019 (prior to COVID-19 restrictions) and follow-up in June 2020, September 2020, and March 2021 at 12 primary schools in Austria. The height and weight of 738 children aged 7 to 10 years were measured and age- and sex-specific national and international standardized values were calculated. Changes over time were analysed by analysis of variance. Results: Mean BMI IOTF standard deviation scores (SDS) increased by 0.24 (95% CI, 0.21–0.28) between September 2019 and March 2021. The proportion of children with overweight or obesity increased from 20.7% to 26.2% during this period (p < 0.001) using national reference values—EQUI BMI AUT—comparable results were observed. Simultaneously, the height AUT SDS increased by 0.06 (95% CI, 0.05–0.08) with a larger increase in girls (+0.11; p < 0.001) than in boys (+0.03; p = 0.19). Conclusions: COVID-19 restrictions were associated with accelerated increases in mean BMI and the proportion of children with overweight or obesity. The increase in height SDS in girls calls for further investigations.

This study evaluates the performance of the antigen-based anterior nasal screening programme implemented in all Austrian schools to detect SARS-CoV-2 infections. We combined nationwide antigen-based screening data obtained in March 2021 from 5,370 schools (Grade 1–8) with an RT-qPCR-based prospective cohort study comprising a representative sample of 244 schools. Considering a range of assumptions, only a subset of infected individuals are detected with the programme (low to moderate sensitivity) and non-infected individuals mainly tested negative (very high specificity).