During the COVID-19 pandemic, numerous studies have shown the high prevalence of occupational stress (OS) of health workers, affecting the quality of health care provided. To date, there is no study regarding OS of emergency care pediatric nurses working in Greece. This study aimed to examine the pediatric nurses' OS working in tertiary public hospitals in Greece. In this cross-sectional study, a total of 104 pediatric nurses were recruited randomly from summer 2020 to summer 2021. The Expanded Nursing Stress Scale (ENSS), which consists of 59 items grouped into nine categories, was used to assess nurses OS. The overall OS mean score was 141.04 (SD = 33.48), indicating mild stress. Among nine categories, pediatric nurses were more stressed about patients and families (mean = 22.83, SD = 5.71), as well as death and dying (mean = 19.33, SD = 5.22), whereas they were less stressed about discrimination (mean = 4.21, SD = 4.09) and problems with peer support (mean = 12.11, SD = 4.58). Sex, age, and shifts did not correlate with OS. Borderline correlation was present between age and inadequate emotional preparation for less experienced nurses (p = 0.047), while higher educated pediatric nurses were more stressed because of workload than lower educated pediatric nurses (p = 0.044). Greek pediatric nurses suffered mild OS during the COVID-19 pandemic. There is a great need for further research and implementation of supportive sustainable programs aimed to the minimization of OS and the optimization of health care provided during and after the COVID-19 pandemic.

Objectives: This study aimed to synthesize evidence of the influence of multilevel social determinants of health (SDOHs) on asthma and allergic disease outcomes and healthcare utilization in children and adolescents, with a specific focus on how these determinants generate or widen health inequities, through a systematic review of the current literature and evidence. Methods: A literature search was performed in the PubMed, EBSCO, and Scopus databases. The search period for all databases was from 1 January 2020 to 15 January 2025. Studies published in English that evaluated the association between at least one SDOH, as a primary exposure or effect modifier, and asthma and/or allergic disease outcomes and healthcare utilization in children and adolescents aged ≤ 18 years were included. A narrative synthesis was conducted to systematically explore and compare findings across studies, grouped by SDOH domains and disease outcomes. The grouping of SDOH domains was based on the framework established by the Healthy People 2030 Initiative. The selected studies underwent a quality assessment. Results: After the eligibility assessment, 44 studies were included in this review. Regarding study design, twenty-one studies were cohort, followed by eighteen cross-sectional, three ecological, and two case-crossover studies. Disease outcomes covered incidence, severity/exacerbations, lung function, and healthcare use in asthma, and analogous measures also reported for atopic dermatitis, allergic rhinitis, and food allergy. The most frequently studied domain of SDOHs was Neighborhood and Built Environment (n = 26), followed by Economic Stability (n = 24), Social and Community Context (n = 21), Healthcare Access and Quality (n = 12), and Education Access and Stability (n = 10). The vast majority of studies (n = 31) found positive associations between the examined SDOH factors and asthma and/or allergic disease outcomes and healthcare utilization. The most frequently evaluated SDOH with positive associations were neighborhood and residential conditions (n = 10), discrimination (n = 8), parental education (n = 7), housing quality (n = 6), air pollution (n = 6), and household income (n = 5). Risk-of-bias appraisal showed that the evidence base was largely at low risk, with most cohort, cross-sectional, ecological and case-crossover studies rated good quality, and only a few cohort studies classified as fair because of limitations in exposure assessment and residual confounding control. Conclusions: These findings highlight the urgent need for coordinated interventions and policies addressing social, environmental, and economic factors to reduce health disparities and improve outcomes for vulnerable children, while stressing the importance of interventional studies to provide stronger evidence.

Purpose: The evaluation of the children’s quality of life has been established and applied to those suffering from chronic diseases concerning mainly the appreciation of the effectiveness of health care provision. The incidence of Type 1 diabetes has increased recently, posing a challenge to healthcare specialists, while it is considered to be a significant stress factor for the family. Methods: A review of epidemiological studies was conducted within the Medline and Cinahl databases. Following the application of the eligibility criteria, we identified 17 appropriate studies. Results: Youth with type 1 diabetes report remarkably similar quality of life to a nondiabetic youth population. Later age of onset of diabetes, good metabolic control, fewer hyperglycemic episodes, lower glycosylated hemoglobin (HbA1c) levels and intensified insulin therapy are associated with a better health-related quality of life (HRQOL). Educational intervention for adolescents with type 1 diabetes and family support could be a safeguard against possible deterioration in QoL and glycemic control over time. Conclusions: Chronic diseases affect not only the child’s life but also its families’. For this reason there is a need for well- educated and specialized nurses to support and lead the families to the effective management of the disease.