A program to support pediatric primary care providers in mental health care using point-of-care, telephone-based advice from specialists has been available since 2005 in Massachusetts. Other US states are implementing similar models. Little is known about how providers use this service.

There is wide variability in adoption and use of this program. Patterns are associated with panel size, enrollment timing, and assignment to the program team at the pilot site. Findings will help new programs establish expectations and design implementation interventions. (Read the full article)

Early psychosocial exposures are increasingly recognized as crucial to health throughout life. A possible mechanism is physiologic dysregulation due to stress. Cortisol in hair is a new biomarker assessing long-term hypothalamic-pituitary-adrenal axis activity.

Added early psychosocial exposures seem to increase infant long-term hypothalamic-pituitary-adrenal axis activity and risk of common childhood diseases in a cumulative manner, supporting the model of physiologic dysregulation as a plausible mechanism through which early detrimental exposures determine health outcomes. (Read the full article)

Insulin resistance plays a role in obesity. Recently it has been associated with increased risk of AD. Aβ42 and PSEN1 are molecules associated with increased risk of later AD. Patients affected by AD show elevated levels of plasma Aβ42.

Levels of Aβ42 and PSEN1 are significantly elevated in obese adolescents and correlated with the degree of both adiposity and systemic insulin resistance. (Read the full article)

Conventional invasive pneumococcal disease (IPD) definition using laboratory confirmation lacks sensitivity. Using a vaccine-probe design, the FinIP trial showed that IPD disease burden and vaccine-preventable disease incidence were fourfold higher when a more sensitive outcome, clinically suspected IPD, was used.

Vaccine-preventable disease incidence (ie, absolute reduction due to PCV10 vaccination) during routine vaccination program was threefold with the more sensitive outcome of clinically suspected IPD compared with the conventional IPD definition. This has major implications for cost-effectiveness of PCVs. (Read the full article)

Associations have been reported between celiac disease (CD) and numerous autoimmune conditions in adults and children. However, current screening guidelines do not consider patients with rheumatic diseases to be at high risk for CD.

The prevalence of CD in children presenting for rheumatology evaluation was found to be 2% by routine serologic screening. The majority of screening-detected CD cases had no CD-associated symptoms. Gluten restriction was found to relieve some musculoskeletal complaints. (Read the full article)

Prenatal diagnosis may lead to benefits in outcomes for certain forms of critical congenital heart disease. Despite recognized benefits, single-center studies and focused regional efforts suggest that prenatal detection rates for congenital heart disease remain low in the United States.

We describe prenatal detection rates for a large cohort of neonates and infants undergoing heart surgery across a range of congenital heart defects. Additionally, this study adds new information by demonstrating geographic variability of prenatal detection rates across the United States. (Read the full article)

Making a diagnosis of Kawasaki disease (KD) is often a diagnostic dilemma. This dilemma is confounded when children present with symptoms consistent with known, common respiratory viruses and/or with KD symptoms that could potentially be attributed to a respiratory virus.

Patients with KD commonly have a concurrent respiratory viral infection. Clinicians should not dismiss the diagnosis of KD based on the presence of respiratory symptoms. Furthermore, a positive respiratory virus test result should not be used to exclude the diagnosis of KD. (Read the full article)

Unsupervised medication exposures increased during the previous decade, despite child-resistant packaging and caregiver education. To achieve the Healthy People 2020 objective of reducing emergency department visits for unintentional pediatric medication overdoses, targeted interventions including improved safety packaging may be needed.

Since 2010, emergency department visits for unsupervised medication exposures started to decrease. Most visits involved solid dose medications, typically for adult use. Most liquid medication exposure visits involved 4 over-the-counter pediatric products and may be more readily amenable for interventions. (Read the full article)

Previous studies have shown racial differences in invasive pneumococcal disease (IPD) rates. Recent studies demonstrated a national decline in IPD rates after 13-valent pneumococcal conjugate vaccine (PCV13) introduction. The impact of PCV13 on racial and regional differences in IPD rates among Tennessee children is unknown.

After introduction of PCV13, pediatric IPD rates, including disease due to antibiotic-resistant strains, declined substantially. Racial and regional differences in IPD rates were no longer significant. Our study illustrates the impact of PCV13 and the importance of continued IPD surveillance. (Read the full article)

Children with cystic fibrosis demonstrate gas exchange abnormalities and increased respiratory loads during sleep independent of lung function, age, and BMI. Assessment of breathing patterns during sleep provides an opportunity for detection of early lung disease progression.

Children with cystic fibrosis demonstrated increased respiratory loads and gas exchange abnormalities during sleep compared with controls. Based on these findings, sleep assessment in this patient population can identify markers for the early detection of lung disease progression. (Read the full article)

Rick talks with Larry Rosenstock, education icon, the founder and CEO of High Tech High, and recent recipient of the WISE Prize for Education, about what he's learned after a half century in education.

An underground stall in Seoul's Yongsan district holds one of the biggest classic video game malls you'll ever see. Take a tour through our photos.

Editor’s note: This event has been canceled as a result of the statewide response to the global coronavirus outbreak.

As I attended the annual Storage Visions conference a couple of weeks ago, I was struck again by just how much flash is being used in enterprise systems, and what the potential is for future uses going forward.

Alors que se préparent les célébrations du cinquantenaire de l’indépendance de la République démocratique du Congo, le 30 juin prochain, deux événements très récents viennent rappeler l’extrême fragilité du processus de reconstruction de l’Etat entrepris depuis l’élection de Joseph Kabila en 2006, et les risques existants pour la stabilité du pays.

Le 20 août, Pierre Nkurunziza a été investi pour la troisième fois. Son investiture, annoncée le matin même, a eu lieu presque en catimini et les ambassadeurs européens et américains accrédités à Bujumbura étaient visiblement absents tout comme l’Union africaine. La multiplication des assassinats en août a conduit la présidence à organiser l’investiture à la sauvette.

Objectives: Carbapenemase-producing Enterobacterales and specifically KPC-producing Klebsiella pneumoniae (KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than if caused by carbapenem-susceptible isolates.

Study design and methods: This is a retrospective cohort study of patients with VAP due to K. pneumoniae from a 35-bed polyvalent Intensive Care Unit in a university hospital (> 40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression).

Results. We analyze 69 cases of K. pneumoniae VAP of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/mL). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [lsqb]HR[rsqb] 1.25; 95% CI: 0.46–3.41). Adequate targeted therapy (HR 0.03; 95% CI: <0.01–0.23) was associated with all-cause mortality.

Conclussion. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible K. pneumoniae when appropriate treatment is used.

Chagas disease, caused by the protozoan Trypanosoma cruzi, is one of the main causes of death due to cardiomyopathy and heart failure in Latin American countries. The treatment of Chagas disease is directed at eliminating the parasite, decreasing the probability of cardiomyopathy, and disrupting the disease transmission cycle. Benznidazole (BZ) and nifurtimox (NFX) are recognized as effective drugs for the treatment of Chagas disease by the World Health Organization, but both have high toxicity and limited efficacy, especially in the chronic disease phase. At low doses, aspirin (ASA) has been reported to protect against T. cruzi infection. We evaluated the effectiveness of BZ in combination with ASA at low doses during the acute disease phase and evaluated cardiovascular aspects and cardiac lesions in the chronic phase. ASA treatment prevented the cardiovascular dysfunction (hypertension and tachycardia) and typical cardiac lesions. Moreover, BZ+ASA-treated mice had a smaller cardiac fibrotic area than that in BZ-treated mice. These results were associated with an increase in the number of eosinophils and reticulocytes and level of nitric oxide in the plasma and cardiac tissue of ASA-treated mice relative to respective controls. These effects of ASA and BZ+ASA in chronically infected mice were inhibited by pretreatment with the LXA₄ receptor antagonist, Boc-2, indicating that the protective effects of ASA are mediated by ASA-triggered lipoxin. These results emphasize the importance of exploring new drug combinations for treatments of acute phase of Chagas disease that are beneficial for chronic patients.

Oil was headed for the longest run of daily gains in more than nine months on signs the worst of the supply glut may be over as production cuts start to take effect.

The rand strengthened against the greenback as it peaked at a session high of R18.30 before it was recorded trading 1.41% firmer at R18.32/$ at 17.00

Timing, preparation and control are essential to getting paid fairly. This infographic by Adzuna is guide on how you can navigate your way to a salary increase.

Andrea T. Cruz
Apr 8, 2020; 0:peds.2020-0834v2-e20200834
COMMENTARY

Are you sure you know what the "insurance speak" in your policy means?

CONTEXT:

Pneumococcal conjugate vaccines (PCVs) (pneumococcal 13-valent conjugate vaccine [PCV-13] and pneumococcal 10-valent conjugate vaccine [PCV-10]) are available for prevention of pneumococcal infections in children.

India, this magical land, has irresistibly captivated crowds of visitors because of definite motives: incredible Indian charms, numerous residues of past ages, and various sacred points for pilgrimage. Tourism in India has always been among the most full-blown spheres of the state's politics. India tourism allows traveling to all the most famous places, you may wish to visit. Among them, there are illustrious palaces and groves, forts built in both oriental and English colonial manners, and...

A new plan from Democratic presidential candidate and former special educator Elizabeth Warren touches on some glaring issues in special education: graduation disparities, hard-to-access school buildings, and discipline practices that disproportionately affect black, Latino, and Native American stud

Rangers vice-chairman John Bennett has criticised the SPFL for their 'cynical tactics' over their labelling of the club's dossier as a "smoking gun" - and insists the issue is not merely Gers vs the governing body.

Partick Thistle have released, in full, a letter sent by the club to SPFL chiefs following the news that league reconstruction has been scrapped - confirming the Jags' relegation.

Staff from NHS England have been asked to travel hundreds of miles to Scotland to be tested for coronavirus, according to reports.

Barbara J. Stoll
May 1, 2011; 127:817-826
ARTICLES

Mary Ellen Avery
Jan 1, 1987; 79:26-30
ARTICLES

Cynthia L. Ogden
Jan 1, 2002; 109:45-60
ARTICLES

UEFA's 'Women's football across the national associations 2017' report shows how the female game has evolved over the past five years, and offers a snapshot of the sport in each of UEFA's 55 member associations.

The experiences that Chris Eggerman, a 2017 graduate, had while at Penn State gave him a glimpse of the challenges and rewards he would enjoy in a career, and, paired with his education in the College of Information Sciences and Technology, equipped him with the skills he uses in his current profession as a security adviser at Liberty Mutual.

Fifty students of Penn State Fayette, The Eberly Campus have generated $71,063.48 in donations for the annual Penn State IFC/Panhellenic Dance Marathon (THON), held Feb. 22 to 23 in the Bryce Jordan Center at University Park.

Most states have raised their expectations for what constitutes proficiency on state math and reading tests in the last decade, according to a new study.

The Coronavirus and International Affairs Roundtable, taking place 9:30 a.m. Friday, April 17, via Zoom, will bring together experts in law and international affairs from Asia, Europe, the Middle East, North America, and the Caribbean to discuss the broader impact of COVID-19.

Unit trusts make investing possible for everyone.

Don't rely on Facebook's self-regulation to save us from election interference in this year's critical elections. In fact, despite a PR push to the contrary, the company is doubling down on the access it sells to would-be meddlers.

Mathilde, a French teen, describes her trip to Bosnia-Herzegovina. She and others will raise funds for a youth centre where Bosnian teens can discover God.

French teens attend TeenStreet 2012 and help raise money for youth ministry in Bosnia-Herzegovina.

California's proposed curriculum guide in ethnic studies is being sent back for substantial revision after a pileup of criticism that it's anti-Semitic.

A new supercapacitor based on manganese oxide could combine the storage capacity of batteries with the high power and fast charging of other supercapacitors, according to researchers at Penn State and two universities in China.

Noise cancellation removes unwanted sounds. The best noise-cancelling headphones let you block out the world around you to enjoy your music...or the sweet sound of silence.

Sennheiser's GSP 670 wireless gaming headset feels comfortable, sounds terrific, and features Bluetooth so you can use it with your phone.

A distance education home-school program in Alaska has seen consistent growth from rural families.

Budget 2018 initiatives to stimulate industrialisation in various sectors of the economy is a welcome issue, says Zweli Mkhize, former ANC treasurer general.

Everyone's thinking about the Coronavirus Disease 2019 (COVID-19), and wondering if there are any cases near where they live. I recently used SAS Software to create a dashboard with a world map showing which countries had reported cases. And now that the virus has spread around the world, a world/country-level [...]

The post Tracking the Coronavirus Disease 2019 (COVID-19) in the United States appeared first on Graphically Speaking.

Now that COVID-19 is spreading in the US, I thought it might be helpful to view the data at a more granular level. Follow along as I plot the county data on a map and discuss how the color-binning can influence people's perception of the data. Maps like this can [...]

The post Tracking Coronavirus Disease 2019 (COVID-19) in the US at the state/county level appeared first on Graphically Speaking.

The Trust Fund helps Delaware veterans cover emergency expenses DOVER, DE – Delaware State Housing Authority employees have raised $1,580 for the Delaware Veterans Trust Fund, an account created in 2013 to help Delaware veterans pay for emergency costs, including medical expenses, utility bills and home repairs. Delaware’s Commission of Veterans Affairs administers the Trust […]