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Chest Compression Quality Over Time in Pediatric Resuscitations

Rapid initiation of effective chest compressions (CCs) for patients in cardiac arrest improves outcomes, yet even trained rescuers fail to provide consistently effective CCs. Pediatric data on CC quality and objective measures of CC work are limited.

CC quality deteriorates similarly in pediatric and adult models, and overall work done to compress the pediatric chest is similar to that in adults. Power output during CC performance is analogous to that generated during intense exercise such as running. (Read the full article)




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Time and Risk Preferences and the Use of Asthma Controller Medication

College students with asthma tend to have worse health outcomes than their peers without asthma. Consistent use of controller medication could improve outcomes for these students, but a predictive model of appropriate use of controller medication is needed.

This study adds risk tolerance and time preference to previously studied factors of nonadherence with control medication. These preferences have substantial impacts on use of controller medication and the potential success of asthma education programs. (Read the full article)




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Chlorhexidine Cleansing of the Umbilical Cord and Separation Time: A Cluster-Randomized Trial

Chlorhexidine cleansing of the cord can reduce mortality in high-risk settings. Time to separation may increase with topical applications of chlorhexidine; 1 previous community trial quantified this increase and did not measure whether caretakers perceived the delay.

Single and multiple cleansing of the umbilical cord increases time to separation by ~50%, or an average of 2 to 2.5 days. Caretakers were able to detect this difference and expressed dissatisfaction, while still accepting the intervention. (Read the full article)




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Genetic and Environmental Influences on Daytime and Nighttime Sleep Duration in Early Childhood

Sleep patterns of adult monozygotic twins are more similar than those of dizygotic twins, showing moderate heritability and little effects of environmental influences. There have been very few genetically informative studies of sleep in preschool children and results appear inconsistent.

From previous studies, we investigated daytime and nighttime continuous sleep duration longitudinally. This is the first time that the etiologies of daytime and nighttime continuous sleep duration trajectories were studied in early childhood. (Read the full article)




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Time Interval Between Concussions and Symptom Duration

Although concussion is increasingly being diagnosed in the pediatric population, little is known about what factors lead to prolonged postconcussive symptoms in children. In particular, the effect of previous history of concussion on recovery from a repeat injury is unclear.

Children with a history of previous concussion, particularly recent or multiple concussions, are at increased risk for prolonged symptoms after concussion. This suggests that repeat concussion, particularly within a vulnerable time window, may lead to longer duration of symptoms. (Read the full article)




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Late-Preterm Birth and Lifetime Socioeconomic Attainments: The Helsinki Birth Cohort Study

More than 70% of all preterm deliveries are late-preterm (34–36 weeks of gestation). Compared with those born at term, those born late-preterm have higher risk for medical and neurodevelopmental disabilities and suffer more often from mental and behavioral problems.

Late-preterm birth is associated with considerable lifetime socioeconomic disadvantages across the adult years. These disadvantages are not explained by childhood parental socioeconomic position. (Read the full article)




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Changes in Bedtime Schedules and Behavioral Difficulties in 7 Year Old Children

Links between clinically diagnosed sleep problems and adverse behavioral outcomes are well documented. However, in nonclinical populations, causal links between disrupted sleep and the development of behavioral difficulties are far from clear.

Seven-year-old children with nonregular bedtimes had more behavioral difficulties than children who had regular bedtimes. There were clear dose–response relationships, and the effects of not having regular bedtimes appeared to be reversible. (Read the full article)




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Catheter Dwell Time and CLABSIs in Neonates With PICCs: A Multicenter Cohort Study

Peripherally inserted central catheters (PICCs) are essential to deliver life-saving treatment to neonates. Longer PICC dwell times may increase the risk of central line–associated bloodstream infections (CLABSIs) in neonates, but previous studies have yielded inconsistent results, likely due to different study designs, analytic methods, and small sample sizes.

The risk of CLABSIs increases during the 2 weeks after PICC insertion and remains elevated for the catheter duration. These data support daily review of PICC necessity, optimization of catheter maintenance practices, and consideration of novel strategies to prevent CLABSIs. (Read the full article)




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Adiposity and Different Types of Screen Time

Screen time has risen to unprecedented levels among youth. Greater television time is known to be associated with gains in pediatric adiposity, but few studies have examined the longitudinal relations of other forms of screen-based media with weight gain.

Among adolescents aged 9 to 19 years, television viewing was the type of screen time most consistently associated with gains in BMI. However, time with digital versatile discs/videos and video/computer games was also associated with gains in BMI among girls. (Read the full article)




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Comorbidity Clusters in Autism Spectrum Disorders: An Electronic Health Record Time-Series Analysis

Individuals with autism spectrum disorders have a higher comorbidity burden than the general pediatric population, including higher rates of seizures, psychiatric illness, and gastrointestinal disorders.

Comorbidities do not occur evenly. Our clustering analysis reveals subgroups characterized by seizure, psychiatric disorders, and complex multisystem disorders including auditory and gastrointestinal disorders. Correlations between seizure, psychiatric disorders, and gastrointestinal disorders are validated on a sample from a second hospital. (Read the full article)




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Timely Versus Delayed Early Childhood Vaccination and Seizures

Reasons for childhood immunization delay include parental intent and barriers such as transportation. To date there has been 1 study of the association of delayed vaccination and seizures, which found measles-mumps-rubella and measles-mumps-rubella-varicella vaccines are both associated with a higher rate of seizures if received after 15 months of age.

Our study found no association between the timing of vaccination and occurrence of seizures in the first year of life. By using different methods, our results support the observation that delaying vaccination with measles-containing vaccines past 15 months of age increases the incidence of postvaccination seizures. (Read the full article)




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Socioeconomic Status and Wait Times for Pediatric Surgery in Canada

Socioeconomic status (SES) often influences timeliness of health care delivery, even in publicly funded systems. Children need prompt surgical care for a variety of time-sensitive developmental conditions, and children of lower SES may be especially vulnerable to delays in surgery.

It is unknown whether a publicly funded system’s ability to provide timely pediatric surgical care is related to SES. In 39 327 consecutive surgical cases, we demonstrate that SES need not influence timeliness of surgical care in a publicly funded system. (Read the full article)




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Changes Over Time in Sex Assignment for Disorders of Sex Development

XY disorders of sex development have a diverse etiology and often present with atypical genitalia in the newborn period. Sex assignment in those cases in whom this is marked genital ambiguity is a rare, challenging situation that requires multidisciplinary input.

An international registry has shown temporal changes over the last 3 decades in the practice of sex assignment with a greater proportion of severely affected infants being raised as boys, raising the need for long-term monitoring of these children. (Read the full article)




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Etiologies for Seizures Around the Time of Vaccination

Childhood vaccinations mildly increase the risk of febrile seizures in the general pediatric population, during specific risk periods. However, vaccinations are common precipitants for (first) seizures in the genetically determined, fever-sensitive Dravet syndrome (formerly severe myoclonic epilepsy of infancy).

This study shows that in most children with epilepsy onset after vaccination, genetic or structural causes of epilepsy can be identified. This claim includes children with Dravet syndrome (~35%) but also children with benign epilepsy or preexistent encephalopathy. (Read the full article)




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Changes in Child Mortality Over Time Across the Wealth Gradient in Less-Developed Countries

In developed countries, child health disparities across wealth gradients are commonly widening; at the same time, child mortality in low- and middle-income countries is declining. Whether these declines are associated with widening or narrowing disparities is unknown.

A systematic analysis of the evidence on child mortality gradients by wealth in less-developed countries shows that mortality is declining fastest among the poorest in most countries, leading to declining disparities in this important indicator of child health. (Read the full article)




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Pediatric Germ Cell Tumors From 1987 to 2011: Incidence Rates, Time Trends, and Survival

Germ cell tumors in children are heterogeneous and rare neoplasms that occur in various locations, such as gonads, the central nervous system, and the pelvis. The incidence rate has been increasing in some countries.

Population-based analyses of germ cell tumors in children are rare. This population-based study describes the incidence rates, trends, and survival of germ cell tumors in German children from 1987 to 2011. (Read the full article)




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Etiology of Childhood Bacteremia and Timely Antibiotics Administration in the Emergency Department

Childhood bacteremia caused by vaccine-preventable organisms has substantially declined over the last decade. Recognition of bacteremia in children is difficult, and delayed administration of antibiotics is associated with poor outcomes. Adults with health care–associated Gram-negative bacteremia experience delays in receiving appropriate antibiotics.

Bacteremia in children presenting to the emergency department is increasingly health care associated and resistant to empirical antibiotics. These infections are associated with increased length of stay. Rates of Gram-negative bacteremia have increased, and children with Gram-negative bacteremia experience delayed antibiotic administration. (Read the full article)




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Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture

Trainee success rates with infant lumbar puncture are poor. The model of just-in-time learning via simulation has produced clinical improvement for other medical skills such as cardiac compressions and central line dressing changes.

This is the first study to evaluate the impact of just-in-time-and-place simulation-based learning on success with infant lumbar puncture. The intervention improved clinical behaviors associated with success without making a significant impact on success with the procedure. (Read the full article)




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Parents' Daily Time With Their Children: A Workplace Intervention

Children’s time with parents is critical for healthy development. Lack of control over parents’ schedules and limited supervisor support for personal and family life can interfere with parents’ family time.

This is the first group randomized controlled field trial demonstrating effects of a workplace intervention, designed to increase schedule control and supervisor support, on working parents’ time with their children, as assessed by using longitudinal daily telephone interviews. (Read the full article)




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Care Coordination Over Time in Medical Homes for Children With Special Health Care Needs

Care coordination is a central part of the medical home model. Little is known about how care coordination is implemented in pediatrics and how it changes over time in primary care practices successfully adopting medical home principles.

In high-performing medical homes, care coordination evolved toward designing and carrying out routine activities and policies that aimed to forestall disruptions in care delivery. Investing in medical home teams, engaging electronic medical record systems, and improving workflow supported these changes. (Read the full article)




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Sedentary Time in Late Childhood and Cardiometabolic Risk in Adolescence

Evidence on the cardiometabolic consequences of sedentary behavior in youth is inconsistent and mostly relies on cross-sectional studies. Studies with objective measures of sedentary time have found limited evidence of cross-sectional associations with adiposity markers but no other outcomes.

Objectively assessed daily sedentary time was not prospectively associated with cardiometabolic outcomes. Moderate to vigorous physical activity was beneficially associated with body fat mass, insulin, high-density lipoprotein cholesterol, and clustered cardiometabolic score. (Read the full article)




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Physician and Nurse Nighttime Communication and Parents' Hospital Experience

Communication between parents and providers is an important driver of parent experience of care. The impact of nighttime communication, which has become increasingly relevant after changes in resident physician duty hours, on parent experience is unknown.

Parent communication with nighttime doctors and nurses, and parent perceptions of communication and teamwork between these providers, may be important drivers of parent experience. Efforts to improve nighttime communication, both with parents and between team members, may improve parent experience. (Read the full article)




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Fin24.com | MONEY CLINIC: Is it worth investing in a living annuity during the time of Covid-19?

A Fin24 reader heading into retirement seeks the opinion of an expert on investing during the uncertainty of Covid-19.




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Breathe: Caring for Students and Ourselves in the Time of Kavanaugh

So, how do we manage? What do we do when consistently engaging in the difficult discussion about rape culture is hard on our hearts, but helpful for our students?




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Promote Books with Free Online Multimedia Slideshow Tools

Just like grocery stores offer free food samples, technology companies, such as VoiceThread, offer free accounts for educators who want to try their products.




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Quality Content in Demand as Multimedia Use Expands

Digital curricula repositories are helping to fill the growing need for more and better multimedia content.




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$27 Million to Aid Early-Learning Multimedia Projects

U.S. Department of Education money will help public television develop projects promoting math and literacy for children ages 2 to 8.




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Multimedia Programs Reduce Summer Learning Loss

Summer programs that use multimedia may improve student literacy, numeracy, phonics skills, and math vocabulary, according to a study released by WestEd, a nonprofit education research organization. The report examines the Electric Company's Summer Learning Program, which is sponsored by the Sesame




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Multimedia Journalism Programs Emphasize Real-World Skills

Students are learning how to research and write scripts, hone interviewing techniques, and edit video footage, and some teenagers are even earning certifications in media technology.




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The World as Multimedia Village

Have you noticed that the Internet is changing the world into a




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Public Libraries Add Multimedia Learning to Digital Mission

Public libraries are moving deeper into digital learning, often in partnership with schools and other institutions, to help prepare students for the skills they'll need for college and careers.




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Education in Indian Country: An Education Week Multimedia Package

Education Week takes a close look at the obstacles and opportunities for American Indian children in finding success in school and beyond.




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Challenges Seen in Moving to Multimedia Textbooks

Most districts have the technology to support the basic digital textbooks of today, but not the interactive, multimedia-rich ones of the future.




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CTA Goes Multimedia

The California Teachers Association continues its assault on NCLB. To supplement its Web ads, it has turned to YouTube and radio ads. The YouTube video tears at heartstrings and predicts that NCLB will lead to the end of public education as we know it. The radio ad includes standard union criticism




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Multimedia Tool: Teaching the Presidential Campaign

The Newseum in Washington has just launched Decision 2012: Exploring Elections and the Media, an online resource for teaching about the presidential campaign and election.




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Tech Talk: Multimedia Transformation

Participate in a chat about how multimedia tools are transforming teaching and learning in core academic subjects.




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Multimedia in the Classroom




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Multimedia

Video, audio, photo galleries and infographics on education news and issues from preschool through the 12th grade.




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Fin24.com | OPINION | Time to recover like a millennial

For companies to survive and even thrive beyond the coronavirus pandemic, they’re going to have think more like the millennial generation, says Dr Anushka Bogdanov.




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The International Criminal Tribunal for Rwanda: Time for Pragmatism




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Refugees and Displaced Persons in Burundi – Defusing the Land Time-Bomb




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Time for a New Approach to Disarm the FDLR




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Time to pull out UN troops in Congo? Not so fast

With a fledgling democratic government and a formal peace process finally in place in the Democratic Republic of Congo (DRC), the country will celebrate its 50th year of independence next month.




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Is It Time for the American Approach to Assessment to Change?

The U.S. tests its students more than most nations, but is the deluge of data providing the information schools need?




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Evaluation of the efficacy of antibiotic combinations against multidrug-resistant Pseudomonas aeruginosa in automated time-lapse microscopy and static time-kill experiments [Clinical Therapeutics]

Objectives: Antibiotic combination therapy is used for severe infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Yet, data of which combinations are most effective is lacking. This study aimed to evaluate the in vitro efficacy of polymyxin B in combination with 13 other antibiotics against four clinical strains of MDR Pseudomonas aeruginosa.

Methods: We evaluated the interactions of polymyxin B in combination with amikacin, aztreonam, cefepime, chloramphenicol, ciprofloxacin, fosfomycin, meropenem, minocycline, rifampicin, temocillin, thiamphenicol or trimethoprim by automated time-lapse microscopy using predefined cut-off values indicating inhibition of growth (≤106 CFU/mL) at 24 h. Promising combinations were subsequently evaluated in static time-kill experiments.

Results: All strains were intermediate or resistant to polymyxin B, anti-pseudomonal β-lactams, ciprofloxacin and amikacin. Genes encoding β-lactamases (e.g., blaPAO and blaOXA-50) and mutations associated with permeability and efflux were detected in all strains. In the time-lapse microscopy experiments, positive interactions were found with 39 of 52 antibiotic combination/bacterial strain setups. Enhanced activity was found against all four strains with polymyxin B used in combination with aztreonam, cefepime, fosfomycin, minocycline, thiamphenicol and trimethoprim. Time kill experiments showed additive or synergistic activity with 27 of the 39 tested polymyxin B combinations, most frequently with aztreonam, cefepime, and meropenem.

Conclusion: Positive interactions were frequently found with the tested combinations, also against strains that harboured several resistance mechanisms to the single drugs and with antibiotics that are normally not active against P. aeruginosa. Further study is needed to explore the clinical utility of these combinations.




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Fin24.com | JSE wrap | Surge as global sentiment remains optimistic

Local stocks advanced for a second consecutive session on Thursday as global markets remained resurgent.




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Investing time, not wasting it

For Roberto Ramirez, serving God in missions has been one step of faith after another.




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Maintaining community connections, one game at a time

Penn State Greater Allegheny student Katarina Shields wanted to help her fellow students seek creative ways to stay connected, make new friends and reduce stress during the remote learning period. The junior IST major developed “Virtual Game Night," a place to game for students attending all Penn State campuses, through the local gamer app Discord. The first event will be held April 18.




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Best of Ricardinho: the all-time Futsal EURO top scorer

Seven goals in Ljubljana made Portugal winger Ricardinho the all-time top UEFA Futsal EURO finals top scorer: we look at the numbers and the skills behind the man that lifted the trophy, 'O Mágico',




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Investing time, not wasting it

For Roberto Ramirez, serving God in missions has been one step of faith after another.