GLUMNESS settles on a large part of the nation whenever the subject of comedy comes up now. The lockdown has led to a more frenetic search for entertainment, and the current state of humour hasn’t wanted for critics. This week, Royle Family star Ricky Tomlinson, 80, said it was dire, and listed several comedians, adding: “They should be done under the Trade Description Act.”

A state court ruled that Virginia must turn over growth data by school and classroom teacher, without redacting the teachers' names.

An Albanian man's heart is forever changed after suffering a heart attack and meeting Jesus in his recuperation.

UEFA is to introduce minimum medical requirements at UEFA competition matches from the start of next season, with guidelines drawn up by the UEFA Medical Committee.

Source: Retema - La Comisión Europea ha aprobado un conjunto de inversiones por valor de 222 millones de euros procedentes del presupuesto de la UE para facilitar la transición de Europa hacia un futuro más sostenible e hipocarbónico en el marco del programa LIFE de medio ambiente y acción por el clima. La financiación de la UE movilizará inversiones adicionales con las que se llegará a un total de 379 millones de euros destinados a 139 nuevos proyectos en 20 Estados miembros.

Adults born at very low birth weight (VLBW) (<1.5 kg) have higher blood pressure and higher fasting insulin levels than their peers born at term. However, they show no signs of endothelial dysfunction in childhood and in adolescence.

Adults born at a VLBW showed no endothelial dysfunction compared with term adults. They had, however, a thicker intima-media layer in relation to lumen size. More rapid growth during their first weeks of life was associated with better endothelial function. (Read the full article)

Preventive asthma medications (PAMs) are a primary management strategy to control asthma morbidity. Little is known about changes over time in prevalence of PAM use among children and adolescents in the United States.

Our analysis demonstrates an increase in use of PAMs among children and adolescents with current asthma in the United States from 1988–1994 to 2005–2008, but racial and ethnic disparities in use of PAMs persist. (Read the full article)

A delay in seeking medical care for children with significant injury often raises a concern about child abuse, but there are few data describing the range of responses children display after accidental fracture for providers to use in comparison.

This study presents the range of responses exhibited by children after accidental fractures and identifies factors associated with a delay in seeking medical care. No child was asymptomatic, although a minority did not manifest all expected responses after their injury. (Read the full article)

Pediatric weight gain is a critical aspect of the obesity epidemic. Chronic stress produces physiologic perturbations capable of altering brain mechanisms related to eating as well as those implicated in self-regulatory behaviors.

We show that early childhood risk exposures are associated with weight gain in adolescence, independent of childhood BMI. We also find that deficiencies in self-regulatory processes help explain the link between chronic stress and adiposity. (Read the full article)

The medical home is associated with beneficial outcomes in children with special health care needs and in the entire pediatric population. It is unknown if it benefits the majority of the pediatric population (ie, children without special health care needs).

This study is the first to demonstrate an association between the medical home and beneficial health care utilization, child health, and health-promoting behavior outcomes in children without special health care needs. (Read the full article)

Asthma is a common obstructive pulmonary disease experienced during pregnancy. Clinical guidelines recommend women with asthma maintain asthma medication use during pregnancy. Epidemiologic studies suggest an association between several types of defects and asthma or asthma medication use during pregnancy.

Data from a large, population-based, multicenter, case-control study was used. This provides the opportunity to study specific birth defects with minimal heterogeneity in case groups, as well as control for a variety of potential confounders. (Read the full article)

Studies in the Netherlands show that pubertal blockade at Tanner 2/3 prevents unwanted sex characteristics and improves psychological functioning. Endocrine Society guidelines (2009) recommend pubertal suppression for adolescents with gender identity disorder until approximately age 16.

This is the first study of a US cohort of children and adolescents with gender identity disorder. Patients were referred for medical treatment to a pediatric center that supports a multidisciplinary Gender Management Service. (Read the full article)

Tenfold medication error is a well-recognized risk of pharmacotherapy in pediatric practice but little evidence describes the circumstances of such errors.

This study identified 252 tenfold medication errors, 22 of which resulted in patient harm. We identified opioids and other high-risk medications to be associated with tenfold medication error and frequent, recurrent causes, mechanisms, and error enablers that suggest areas for future improvements. (Read the full article)

Complementary and alternative medicine (CAM) use for pediatric asthma is increasing. It is well known that effective asthma management depends on patient adherence to treatment. The authors of previous cross-sectional studies have linked CAM use with decreased adherence to conventional asthma treatment regimens.

This longitudinal data set was unique, allowing us to focus on patients who initiated CAM and to follow subsequent asthma medication adherence. We found that CAM use was not associated with adherence, suggesting that patients may practice CAM alongside conventional therapies. (Read the full article)

Nonadherence to antiretroviral therapy among children and youth with HIV is a frequent problem that can result in treatment failure and disease progression for this population. Children and adolescents face different barriers to adherence than adults infected with HIV.

Few studies have examined specific barriers to adherence as reported by children with perinatally acquired HIV and their caregivers. This report examines the agreement between child and caregiver perceptions of adherence barriers and the factors associated with these barriers. (Read the full article)

Asthma disparities exist, with Latino children of Caribbean descent at risk for poor disease control. Controller medications reduce symptoms; however, medication adherence remains suboptimal. Identifying what factors predict poor medication adherence in at-risk groups could identify important treatment targets.

This study is the first to assess objective rates of medication use among children with asthma in Puerto Rico. Findings suggest that interventions incorporating family resources and addressing parental beliefs about medications may be of benefit across cultural groups. (Read the full article)

More than one-tenth pediatric patients use complementary and alternative medicines (CAM) for their medial conditions in the United States. Traditional Chinese medicine (TCM) is the most commonly used CAM in East Asia but large-scale epidemiologic studies are lacking.

In comparing TCM and non-TCM users among children in Taiwan, children’s age and parental TCM use were strongly associated with TCM use. Additionally, dyspepsia and allergic rhinitis were positively related to increasing TCM use. (Read the full article)

Numerous studies report disparate use of dental services among poor children. National estimates vary based on the data source, and little is known about how age, race, and health plan affect use of dental services among Medicaid-enrolled children.

Based on of Medicaid claims, dental services improved since 2002 but varied substantially by state, age, and type of insurance. Children entering school had the highest prevalence of care as did children in primary care case management and health maintenance organizations. (Read the full article)

Although observational studies have consistently reported an association between media use and child sleep problems, it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children.

This study demonstrates that a healthy media use intervention can improve child sleep outcomes and adds evidence that the relationship between media and sleep in preschool-aged children is indeed causal in nature. (Read the full article)

The higher the predischarge bilirubin percentile reading on the hour of life–specific nomogram, the higher becomes that infant's risk of developing significant hyperbilirubinemia. Neonates in the low-risk zones (≤75th percentile) have a low risk of developing hyperbilirubinemia.

Thirty-two percent of newborns readmitted for hyperbilirubinemia had low-risk zone predischarge bilirubin percentile values, predominantly in the intermediate low-risk zone (41st–75th percentile). The intermediate low-risk zone may not be as low risk as previously thought. (Read the full article)

Little is known about how communication during pediatric asthma visits is associated with child control medication adherence 1 month after the visit.

When providers asked for caregiver input into the asthma treatment plan during the visit, caregivers reported significantly higher child medication adherence to control medications 1 month later. (Read the full article)

Fever phobia is a ubiquitous problem throughout the world. As a result, fever is pharmacologically overtreated, and medical attention is frequently sought by worried parents.

Most Canadian parents fear their child’s fever, resulting in aggressive surveillance and treatment. Parents expect information about fever etiology and how to care for their ill child. Few parents expect antibiotics and satisfaction with care is high. (Read the full article)

Iatrogenic medical errors are an important medical care issue in the United States. Errors may be particularly important in children with chronic health conditions, especially as the prevalence of chronic conditions is increasing in children.

In a nationally representative sample, we found that pediatric inpatients with chronic conditions were at a significantly higher risk for medical errors than inpatient children without chronic conditions, controlling for severity of illness, length of stay, and other potential confounders. (Read the full article)

Social and environmental risks related to substandard housing contribute to adverse health outcomes. Partnerships between the health care and legal systems can help families address such risks and help clinicians understand the legal context of health.

A medical-legal partnership colocated in a pediatric primary care setting identified and treated a large cluster of poor quality, substandard housing. Housing improvements were possible because of strong collaboration between clinicians, attorneys, community partners, and families. (Read the full article)

Pediatric specialists are increasingly involved in prenatal care, particularly for congenital fetal conditions. Questions remain about pediatricians’ role in the management of maternal conditions that may affect postnatal health, and the attitudes of obstetric and pediatric specialists around such care.

Obstetric and pediatric specialists’ attitudes differ substantially regarding pediatricians’ role in providing consultation for maternal conditions that may affect a child’s health postnatally, and regarding whether court authorization may be appropriate when a woman refuses certain treatment recommendations. (Read the full article)

Newborn screening is often seen as a fait accompli, even in programs that ostensibly proceed on the basis of informed choice and parental consent.

The study reports details of parental understanding, perceived ability to make an informed choice, and the availability of choice together with variables predictive of parental assessments of having made an informed choice. (Read the full article)

Children with medical complexity are high users of acute health care, but little is known about their service use across the continuum of care services and in the context of overall health care expenditures.

Although accounting for <1% of the child population, children with medical complexity use almost one-third of all pediatric health care expenditures and make multiple transitions across providers and health care settings. (Read the full article)

Medical imaging that uses ionizing radiation provides notable benefits in the clinical setting. Controversy regarding increased cancer risk, particularly in children, dictates that ordering practices and use of such medical imaging be evaluated to reduce unnecessary exposure to imaging-related radiation.

We evaluated the prevalence and characteristics of diagnostic imaging procedures in children. The proportion of higher radiation procedures is increasing, especially among children evaluated in the inpatient and emergency department settings and those with gastrointestinal and neurologic symptoms, and congenital anomalies. (Read the full article)

The medical home likely plays a positive role in outpatient health outcomes. Asthma is a common and frequent reason for pediatric hospitalization. It is unknown whether having a quality medical home can prevent readmission in children hospitalized for asthma exacerbations.

Poor access to a medical home was associated with increased readmission for asthma, whereas other measured aspects of medical home were not. Children with private insurance and good access to care had the lowest rates of readmission within a year. (Read the full article)

The prevalence of asthma and associated urgent medical visits vary dramatically across neighborhoods in New York City. Some, but not all, children with asthma wheeze when they exercise.

Exercise-induced wheeze was more common for asthmatic children living in neighborhoods with higher versus lower asthma prevalence. Because exercise-induced symptoms indicate a propensity for rapid-onset symptoms, this increased prevalence may contribute to the observed increase in urgent medical visits. (Read the full article)

Complementary and alternative medicine (CAM) use is common among children, especially those with chronic, recurrent, or incurable conditions. Concurrent use of CAM with conventional medications is of concern and needs to be assessed, especially in vulnerable patient populations.

CAM use is high among pediatric cardiology, gastroenterology, neurology, oncology, and respiratory patients, most of whom use CAM concurrently with conventional care. This study provides additional evidence to suggest the use of CAM be included in routine patient history taking. (Read the full article)

Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active management of bilateral AOM. However, severity of symptoms and otoscopic signs of bilateral and unilateral AOM have previously not been comprehensively studied.

Bilateral AOM seems to be clinically only a slightly more severe illness than unilateral AOM. When assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child’s symptoms together with otoscopic signs should also be acknowledged. (Read the full article)

Practice characteristics, such as practice size, have been associated with the readiness of adult primary care practices for medical home certification. Little is known about how ready primary care practices for children are for medical home certification.

Primary care practices for children attained only 38% of the infrastructure required for medical home certification. Smaller practice size was significantly associated with lower infrastructure scores. Medical home programs need effective approaches to support practices with limited resources. (Read the full article)

Children have been shown to imitate behaviors they see on screen.

Modifying what children watch can improve their observed behavior. (Read the full article)

Expectations are high that electronic health record–based clinical decision support and performance feedback will improve adherence to guidelines by delivering relevant and actionable information to clinicians. Few studies have evaluated these assertions or examined the combined effects of decision support and feedback.

Clinical decision support customized to a patient’s history and presentation and performance feedback are both effective for improving adherence to guidelines for otitis media. However, the combination of the 2 interventions is no better than either delivered alone. (Read the full article)

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)

Medications used to treat gastroesophageal reflux disease (GERD) are some of the most widely used medications in children younger than 1 year. There are strong indications that GERD is overdiagnosed and overtreated.

The factors that drive overtreatment of GERD are not well understood, but it has been proposed that the use of the GERD disease label could perpetuate use of medication. In this study we find evidence for this possibility. (Read the full article)

Rates of screen media use have risen in parallel with rates of obesity among young people. Identifying the specific characteristics of media use that are associated with obesity can help elucidate the explanatory processes and inform effective interventions.

This study examines the associations between BMI and characteristics of media use including the type of device, duration of use, and attention to the medium. The more that participants paid primary attention to television, the higher their BMI. (Read the full article)

Children are taking more medications than ever before. Medication errors in the hospital are common. Less is known about the medication errors that occur in children's homes, and there are no studies that examine the entire process.

We reviewed 963 medications in the homes of children with cancer at 3 sites. We found 3.6 errors with injury and 36 errors with potential for injury per 100 patients. Interventions should target common and dangerous errors at home. (Read the full article)

Medication ingestions are increasing among children despite a number of public health interventions. The majority of these poisonings are related to prescription as opposed to over-the-counter medications.

Rising rates of poisonings in children are strongly correlated with rising use of hypoglycemics, antihyperlipidemics, β-blockers, and opioids among adults. These events are associated with considerable health care utilization, both in terms of emergency department visits and hospital admissions. (Read the full article)

Atherosclerotic cardiovascular diseases are rooted in childhood. Vascular intima-media thickness (IMT) and elasticity are early surrogate markers of atherosclerosis. In adults, cardiorespiratory fitness is associated with enhanced arterial elasticity and decreased IMT.

Fitness was favorably associated with aortic IMT and elasticity in adolescents. The association was independent of several cardiometabolic risk factors. In fit adolescents, the increase in IMT during the preceding 6 years was smaller compared with low-fit peers. (Read the full article)

Child maltreatment is a serious and prevalent public health problem in the United States. Responsible for substantial morbidity and mortality, maltreatment affects children's physical and mental health.

Although many health impacts of child maltreatment have been documented, no claims-based study has quantified the impact of maltreatment on health service utilization and costs. This study presents systematic claims-based estimates of maltreatment impacts on utilization and costs for the Medicaid population. (Read the full article)

Cross-sectional estimates suggest that one-third of children are enrolled in Medicaid or other public insurance programs. The percentage of children enrolled in Medicaid at any point during childhood, and which children use Medicaid as a longer-term insurance source, is unknown.

Over a 5-year period, 41% of children were enrolled in Medicaid at some point. Of those children, 51.5% were enrolled during all 5 years. Children with sociodemographic risk factors are more often enrolled for longer periods of childhood. (Read the full article)

Previous studies have shown that nonmedical exemptions (NMEs) to immunization cluster geographically and contribute to outbreaks of vaccine-preventable diseases such as pertussis. The 2010 pertussis resurgence in California has been widely attributed to waning immunity from acellular pertussis vaccines.

This study provides evidence of spatial and temporal clustering of NMEs and clustering of pertussis cases and suggests that geographic areas with high NME rates were also associated with high rates of pertussis in California in 2010. (Read the full article)

Studies of psychotropic use in very young US children in the last decade have been limited by the regions, insurance types, or medication classes examined. There is a paucity of recent, nationally representative investigations of US preschool psychotropic use.

In a national sample of 2 to 5 year olds, the likelihood of psychotropic prescription peaked in the mid-2000s, then stabilized in the late 2000s. Increased psychotropic use in boys, white children, and those lacking private health insurance was documented. (Read the full article)

Use of complementary and alternative medicine (CAM) is increasingly common among American youth; however, information on use of CAM among youth with recurrent headache (HA) is limited.

Youth across a range of chronic conditions experience HA. These youth are more likely to use CAM. Use and expenditures for conventional medical care, and increased difficulties in activity and functioning are greater for youth with HA who use CAM. (Read the full article)

Psychotropic use is common and increasing in children with mental disorders but little is known about the long-term patterns of psychotropic use and polypharmacy among commercially insured children with autism spectrum disorders.

Among 33 565 children with autism spectrum disorders, 64% used psychotropic medications and 35% had evidence of polypharmacy. Older children and those who had seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression had increased risk of psychotropic use and polypharmacy. (Read the full article)

Unintentional overdose and emergency department visits secondary to nonmedical use of prescription drugs are on the rise with peak age of onset in midadolescence for these risk behaviors. Also, risk behaviors, such as substance use and violence, tend to cluster.

Approximately 1 in 10 adolescents or young adults using the emergency department endorse nonmedical prescription opioid or sedative use in the past year. Rates of current opioid or sedative prescriptions are low among this group. (Read the full article)

In 2007, manufacturers voluntarily withdrew over-the-counter (OTC) infant cough and cold medications (CCMs) from the US market. A year later, manufacturers announced OTC CCM labeling would be revised to warn against OTC CCM use by children aged <4 years.

Among children aged <2 and 2 to 3 years, emergency department visits for CCM adverse events declined nationally after the withdrawal and labeling revision announcement relative to all adverse drug event visits. Unsupervised ingestions caused most CCM adverse events after each intervention. (Read the full article)

Children with autism spectrum disorders (ASD) or attention-deficit/hyperactivity disorder (ADHD) are at increased risk for sleep disturbances and excessive media use. However, the relationship between media use and sleep in children with ASD or ADHD has not been studied.

In-room access to screen-based media and video game hours were associated with less sleep among boys with ASD. The relationships between media use and sleep were much more pronounced among boys with ASD than among boys with ADHD or typical development. (Read the full article)