'Creative Music Making' Documentary to Air on Nine Network - MPress  Maryville University News

An associate professor at the University of Toronto's Rotman School of Management calls the CFL's bid for securing financial aid from the Canadian government a "Hail Mary pass."

Amendments to the Price Increments of the 3-Year U.S. Treasury Note Futures Contract

Click here for the full text of the advisory

20-188

Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is higher than in typically developing children. The US Preventive Services Task Force and the American Academy of Pediatrics (AAP) have endorsed screening children for overweight and obesity as part of the standard of care for physicians. However, the pediatric provider community has been inadequately prepared to address this issue in children with ASD. The Healthy Weight Research Network, a national research network of pediatric obesity and autism experts funded by the US Health Resources and Service Administration Maternal and Child Health Bureau, developed recommendations for managing overweight and obesity in children with ASD, which include adaptations to the AAP’s 2007 guidance. These recommendations were developed from extant scientific evidence in children with ASD, and when evidence was unavailable, consensus was established on the basis of clinical experience. It should be noted that these recommendations do not reflect official AAP policy. Many of the AAP recommendations remain appropriate for primary care practitioners to implement with their patients with ASD; however, the significant challenges experienced by this population in both dietary and physical activity domains, as well as the stress experienced by their families, require adaptations and modifications for both preventive and intervention efforts. These recommendations can assist pediatric providers in providing tailored guidance on weight management to children with ASD and their families.

CONTEXT:

Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD).

Youth suicide is a national and global public health crisis. Pediatricians can use primary and secondary prevention strategies to intervene with youth before or after the onset of suicidal behaviors. Universal suicide risk screening programs can be used to identify youth in medical settings who may otherwise pass through the health care setting with undetected suicide risk. Pediatricians are uniquely positioned to help foster resilience in their young patients and equip families of at-risk youth with safety plans and lethal means safety counseling. Pediatricians on the frontlines of this critical public health crisis require education and training in detecting suicide risk, managing those who screen positive, and connecting their patients to much needed mental health interventions and treatments. Evidence-based suicide risk screening and assessment tools, paired with interventions, are feasible and potentially life-saving in the medical setting.

Words: Abbie Lyall

This typical dish from Puglia, the region in the south east of Italy where you see the beautiful white trulli houses in the holiday brochures, is one of our customers’ favourite dishes from the menu in our Valvona & Crolla Caffè Bar in Edinburgh.

During lockdown I’m less busy than normal so I have started making marmalade. It’s a lot of fun. Choose small oranges, lemons, grapefruit, limes…whatever you find. The rule of thumb is to use the same quantity of fruit to granulated sugar.

“Enough is enough,” said one Edinburgh resident, about the scene of desolation in Princes Street Gardens. Following this year’s bigger-than-ever Christmas Market and Hogmanay celebrations, the mudbath left after the festive village was dismantled is disgraceful. I’m tempted to say it looks as if a herd of belted galloways has run amok, but that would be unfair. Cattle don’t make half as much midden as the city’s annual cash-cow.

On the potholed drive home from the pub the other night, a creature ran into the beam of our lights. Long, low and lean, for a moment it looked like an otter. One has occasionally been sighted in our village, though like Loch Ness’s fabled monster this is a source of some dispute. But in another second it was clear that this beast was not from the riverbank but the woods.

I dimly remember a time when the subject of keeping a house warm would have left me cold. In a previous existence, my brother-in law would visit in the depths of winter and complain about how chilly the place was. The problem was not our thermostat, however, but that he chose to sit in a bay window overlooking the Firth of Forth, through which the wind would find him in his short-sleeved shirt.

A young American dressed for the hills wandered past our cottage last week with the air of someone lost. Alan who, since we moved here, has found his calling as a human Google map, asked if she was looking for something. “Yeah,” she said, “a Diet Coke.” He told her that, despite our community’s many attractions, a shop wasn’t one of them. Pointing her in the other direction, towards a village two miles away, he said she’d find what she needed there.

There was a time when I would sit up late in bed, reading novels. As a reviewer, this was often for work, but that didn’t diminish the pleasure of ending the day in another world. Of late, however, I’ve hurried through ordinary books the way you rush the main course in expectation of pudding. The reason? I’ve discovered the joy of gardening catalogues, and of roses in particular. As a result, my evening ritual is extended to include a last look at roses that ramble over walls, or join hand

When I first moved to the country, I anticipated taking long sturdy walks every few days, filling my lungs with fresh air, and gradually – proudly – achieving the weathered complexion of a Norwegian fisherman. Such is the variation in outdoor complexions in rural parts, Farrow & Ball could start a new range: shepherd’s sunburn, builder’s brick red, farmer’s frozen snout.

One of the loveliest towns in Italy is the walled city of San Gimignano, an hour’s drive from Florence. When I first visited it was bleak midwinter and all but a few shops and cafes were shuttered against the sleet. Its claim to fame is a profusion of medieval towers, hence its hyperbolic label as the Manhattan of Tuscany. When I arrived these fortresses soared overhead, making shadowy streets even darker.

In search of peanuts for the birds, I stumbled across an agricultural shop in a nearby village. From the outside it was unspectacular, but opening the door was like stepping into an episode of The Archers. They did indeed have peanuts, in sacks the size of whisky barrels. I wouldn’t have been able to drag one as far as the till, and I wondered if other weaklings had ever secretly slashed them open and let nuts pour into their pockets, gloves and wellie boots, before staggering out like overstu

There is little to like about the present predicament, but one thing I don’t miss is checking my diary every evening for a reminder of what tomorrow will bring. Our social life is not what you’d call a whirl, so usually memory can be relied on for the occasional gatherings. Here in Hoolet, socialising is often impromptu, a random encounter leading to a casual evening drink a few hours later, or a last-minute supper in a kitchen, so soon after the invite that nobody could possibly forget.

Sunday, April 19, 2020.

A seven-month investigation into an alleged sexual assault by a high school football player in a small Missouri town has set the internet ablaze.

Nebraska Gov. Pete Ricketts signed a bill into law Wednesday that expands the state's anti-hazing regulations to elementary, middle, and high schools rather than just post-secondary institutions.

Lorraine Wilson

While the number of principals running for office has been dwarfed by teachers, school leaders are hoping to change policies in statehouses and in Washington that they say impact their students and families.

Many patient and family demographic characteristics are well-known risk factors for nonurgent emergency-department use. No previous study has examined the primary care physician perspective on parental decisions regarding specific nonurgent emergency-department visits by children.

When discussing specific instances when families in their practices sought nonurgent care for children in the emergency department, physicians believed that parents acted appropriately. Neither parents nor primary care physicians saw nonurgent emergency-department visits as a significant enough problem to warrant change. (Read the full article)

Primary hypertension is a growing concern in adolescents due to its association with the obesity epidemic. Recent studies have examined underdetection and underdiagnosis of hypertension in adolescents but medical management of primary hypertension in adolescents is not well-described.

Our study describes patterns of antihypertensive prescribing for adolescents with primary hypertension including the use of monotherapy versus combination therapy by physicians of different specialties and factors associated with receipt of antihypertensive therapy over a multi-year period. (Read the full article)

Palivizumab administration to well-defined, high-risk groups results in reductions of hospital days, but the intervention is costly. The American Academy of Pediatrics has recommended which groups should be administered palivizumab for the best clinical and cost-effective outcomes.

In a primary practice, palivizumab was frequently used for children outside the recommended groups. Through close oversight and education, the use of palivizumab outside of recommendations was decreased. Palivizumab primary practice usage issues such as proper numbers of doses and timely administration need improvement. (Read the full article)

Recommendations in pediatrics call for general developmental screening of young children; however, research suggests social-emotional development, in particular, is important as an initial indicator of general well-being versus risk, and may warrant inclusion in screening protocols.

Via a social-emotional screening program, significant percentages of children can be identified as being at risk for social-emotional problems, and colocation of an early childhood psychologist promotes the ability to effectively address young children’s social-emotional development within their medical home. (Read the full article)

Clinic-based weight control treatments for youth have largely been designed for preadolescent children and their families by using family-based care, a strategy that may be less appealing to adolescents as they become increasingly motivated by peer acceptance rather than parental influence.

To our knowledge, this is the first study to demonstrate the efficacy of a primary care–based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females and demonstrating a sustained effect (at 12 months) extending beyond the active 5-month intervention. (Read the full article)

There are known gaps in quality measures for children. More clinical effectiveness research is needed. The patient-centered medical home may serve as a model to guide the development of quality measures, particularly for children with complex medical conditions.

This study combined systematic literature review and the Rand/University of California Los Angeles appropriateness method to develop quality measures for children with complex medical conditions. These are valid and feasible quality measures based on the patient-centered medical home framework that may be used to assess care. (Read the full article)

Clinical decision support systems offer a way to help physicians use evidence-based guidelines for screening. Screening patients for common developmental, psychosocial, and behavioral issues informs the clinical decision-making process and may improve patient outcomes.

The Child Health Improvement through Computer Automation system, a clinical decision support system and an electronic medical record, is able to effectively screen patient families in the waiting room by using a tailored questionnaire. The study reveals positive screening rates for identifiable risks in a very large representative urban population by using Child Health Improvement through Computer Automation’s questionnaire. (Read the full article)

Primary care settings provide an important venue for early detection of substance use and intervention, but adolescent screening rates need improvement. Screening and brief interventions appear effective in reducing adult problem drinking but evidence for effectiveness among adolescents is needed.

A computer-facilitated system for screening, feedback, and provider brief advice for primary care can increase adolescent receipt of substance use screening across a variety of practice settings, and shows promise for reducing adolescents’ use of alcohol and cannabis. (Read the full article)

Overweight children are at risk for becoming obese adults, especially if they have an obese parent. Family-based behavioral interventions, largely implemented in specialized settings, have shown efficacy in weight control in youth aged ≥8 years.

This study demonstrates the efficacy of a family-based behavioral weight control program translated to be implemented in the primary care setting. The work underscores the importance of pediatricians intervening early and shifting their focus from the child to the family. (Read the full article)

Filling a prescription is the first step in medication adherence. Unfilled prescriptions are a documented component of nonadherence in adult and pediatric emergency departments and family practices. No one has reported the proportion of unfilled prescriptions in pediatric primary care.

This study identifies the proportion of unfilled prescriptions in a large sample of primary care pediatric patients. It describes clinical and demographic factors associated with prescription filling and suggests that electronic prescribing may improve adherence. (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)

Racial disparities in health care have been reported in multiple settings, but not thoroughly examined at the clinician level. The frequent occurrence of respiratory tract infections allows the evaluation of differences in the management of children seen by the same clinician.

Racial differences in the management of common pediatric infections occur among children treated by the same clinician. Given persistent concerns about nonjudicious antibiotic use, examining racial differences may inform our understanding of prescribing practices and identify opportunities for intervention. (Read the full article)

The incidence of permanent hearing loss doubles between birth and school age. Otoacoustic emissions screening has been used successfully in early childhood educational settings to identify children with losses not found through newborn screening.

Using otoacoustic emissions to screen the hearing of young children during routine health care visits is feasible and can lead to the identification of permanent hearing loss overlooked by providers relying solely on subjective methods. (Read the full article)

Internet, smartphones, and online social media offer new platforms for health promotion and disease management. Few studies have evaluated the use of digital technology among families receiving care in an urban pediatric primary care setting.

Caregivers in an urban pediatric primary care setting have access to and frequently use the Internet, smartphones, and online social media. These technologies may help reach a traditionally hard-to-reach population. (Read the full article)

Pneumococcal conjugate vaccines are effective in preventing pneumococcal disease but are also costly. Although the current US immunization schedule recommends 4 doses, many countries have adopted 3-dose schedules that have worked well, but may provide less protection against pneumococcal disease.

Changing the US 13-valent pneumococcal conjugate vaccine schedule from 3 to 2 primary doses while keeping a booster dose would save $412 million annually but might lead to moderate increases in pneumococcal disease, especially otitis media and pneumonia. (Read the full article)

Because of high costs of newer vaccines, financial risk to private vaccination providers has increased. Previous studies have shown general dissatisfaction with payment for the cost of vaccines and administration fees, with some providers considering no longer providing childhood vaccines.

We show that many providers are dissatisfied with payment for vaccine purchase and administration from all types of payers and that, for new vaccines, providers are using a variety of strategies with parents to handle uncertainty about insurance coverage. (Read the full article)

Primary HHV-7 infection is almost universal by age 5 years and is causally associated with exanthem subitum, febrile seizures, and febrile status epilepticus. The consequences of delayed primary infection are unknown, although encephalitis has been reported in one adult.

Delayed primary HHV-7 infection can cause serious neurologic disease as identified in 3 adolescents, 2 with encephalitis and 1 with Guillain-Barré syndrome. Serologic tests to distinguish primary from past HHV-7 infection are imperative when HHV-7 DNA is present in CSF. (Read the full article)

The Centers for Disease Control and Prevention recommends that health departments in all 50 states deliver AFIX (Assessment, Feedback, Incentives, and eXchange) consultations to 25% of federally funded vaccine providers each year. AFIX effectively raises vaccination coverage among young children.

AFIX consultations achieved short-term gains in coverage for 11- to 12-year-olds for vaccines in the adolescent platform. No gains occurred for older adolescents or over the long term. Consultations were equally effective when delivered in-person or by webinar. (Read the full article)

A substantial gap exists between what is recommended for effective primary care of children and what takes place. Patient-centered health information technologies have been used to gather information and counsel parents, however, have not been integrated directly with electronic health records nor been speech-based to improve decision-making at the point-of-care.

This study shows that a ubiquitous technology, the telephone, can be successfully used to automatically assess and counsel parents before pediatric primary care visits as well as inform their primary care clinicians in a way that is feasible and effective for multiple important issues. (Read the full article)

Overweight and peer victimization are common in childhood and negatively affect health and well-being. Overweight may predispose children to peer victimization, but whether adiposity also increases the risk of bullying perpetration is unclear.

A high BMI at school entry predicts bullying involvement, according to reports of teachers and children themselves. Although trends were visible across the whole BMI spectrum, particularly obese children were victimized and likely to be bully perpetrators. (Read the full article)

Primary ciliary dyskinesia presents in infancy with unexplained neonatal respiratory distress, yet diagnosis is often delayed until late childhood. Earlier diagnosis facilitates earlier onset of therapy, which may help to reduce long-term pulmonary morbidity and mortality.

A diagnostic workup for primary ciliary dyskinesia should be considered in a term infant presenting with unexplained respiratory distress and either lobar collapse, situs inversus, or a prolonged oxygen therapy requirement (>2 days). (Read the full article)

Childhood obesity rates in the United States remain at historic highs. The pediatric primary care office represents an important, underutilized source of intervention. There is a need to test the efficacy of motivational interviewing for pediatric obesity in primary care.

This is among the first large-scale randomized trials to show significant reductions in BMI and that motivational interviewing, delivered by trained providers in the primary care setting, can be an important and feasible part of addressing childhood obesity. (Read the full article)

More than a quarter of child deaths in the United Kingdom are estimated to have identifiable failures in care. Although children account for 40% of the family practice workload, little is known about iatrogenic harm to children in this setting.

This is the first analysis of nationally collected pediatric safety incident reports from family practice. To mitigate harm to children, priority areas requiring improvement include medication provision, referral of unwell children, provision of evidence-based treatment, and adequate diagnosis and assessment. (Read the full article)

More than 200 million children <5 years are not reaching their developmental potential. Lack of stimulating caregiving is a major cause, and effective scalable interventions are needed. Integrating parenting with health services has been recommended, but there are few evaluations.

An innovative parenting intervention can be delivered at routine visits for primary health care, with benefits to child cognitive development and parenting knowledge. This approach using films, discussion, and practice has the potential for delivery at scale. (Read the full article)

Mar 1, 1992; 89:525-527
ARTICLES

The STOP-ROP Multicenter Study Group
Feb 1, 2000; 105:295-310
ARTICLES

Shoba Sivaprasad Wadhia, Samuel Weiss Faculty Scholar and clinical professor of law at Penn State Law at University Park, is the recipient of the 2020 Rosemary Schraer Mentoring Award.