"Do we sometimes feel uneasy that our business-as-mission and vocation models are so dependent on the very people that we are trying to reach? Does this make us feel powerless and needy?" asks Seang Pin.

“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.

Inverness Botanic Gardens

AN EDINBURGH-BASED hydrogen technology firm is to open the first public hydrogen refuelling station for vehicles in Scotland’s central belt.

WHETHER through shrewd planning, good fortune or a bit of both, Edinburgh managed to complete the bulk of their business for next season before rugby came grinding to a halt. When precisely play resumes is, of course, unknown and out of their control, but they are at least confident that they will be in good shape to hit the ground running.

EDINBURGH coach Richard Cockerill has taken two vital steps in rebuilding his squad for next season by signing stand-off Jono Lance from Worcester and centre Matt Gordon from London Scottish. With Simon Hickey and Matt Scott leaving at the end of the season, cover for both positions was a priority.

Edinburgh Rugby have announced the signing of three Scottish qualified youngsters in Nathan Chamberlain, Ben Muncaster and Dan Gamble on academy deals which will turn into full-time contracts next summer, and head coach Richard Cockerill has promised that three current academy prospects in Rory Darge, Connor Boyle and Sam Grahamslaw will soon be elevated to the senior squad ahead of next season.

A SCOTTISH clean energy company has secured a key part in a six-figure contract for a hydrogen fuel project in Northern Ireland.

For a limited time, the 7-inch Fire 7 Kids Edition is $40 off while the 8- and 10-inch models are both $50 off. These tablets make a great gift for 3-to-12-year olds.

FIVE new nursery extensions being built at schools across Edinburgh have been thrown into doubt after the company building the facilities entered administration.

The school funding group EdBuild finds neighborhood attempts to secede popping up in more school districts, with racial and economic isolation increasing in their wake.

The parents of a 16-year-old who died last fall from football-related brain trauma are suing the New York school districts he played for and the medical responders who tended to him the night he sustained his fatal injury.

Music

ASHLEY STORRIE, COMEDIAN

IT’S all too easy to lose track of many of the quirky, moving, interesting films that have been shot in Scotland over the years. Some of the sparkling gems on these pages attracted decent reviews upon release before fading from view; others slipped under most people’s radar. The 10 films here are funny, or dark, or insightful. All have something to say; all are worth tracking down, and watching, whether it’s for the first time, or the first time since they were released.

LIKE many of your readers, I would imagine, I am a fairly enthusiastic armchair football supporter with no real club affiliation.

What's the story?

When the Coronavirus Health Protection Regulations were introduced by the UK’s governments on March 26 (two days later, in Northern Ireland), they included the provision that they be reviewed after 21 days, a deadline now approaching.

You can learn almost anything on YouTube. It is very handy. But navigating through the crud to get to that educational material is a nightmare.

Tax-credit scholarship programs in 17 states collected $1.1 billion in contributions in 2017, a new analysis from the GAO finds.

For three decades now, the artist and playwright John Byrne has been sitting regularly for photographer David Eustace, the Glasgow-born photographer who left school at 16 and joined first the navy and then the prison service before settling on a career behind a camera.

The newly formed group, which plans to challenge the Council for Accreditation of Educator Preparation for market share, wants feedback from the public on its proposed standards and processes.

The current system for accrediting schools of education isn't working, argue two former senior U.S. Department of Education officials. They think school districts and philanthropists can help.

Marc Tucker explores the critical importance of trust in successful education systems and how trust was lost in U.S. education.

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.

The National Children's Study, a large-scale, longitudinal, birth cohort study of US children that endeavors to identify preventable and environmental origins of chronic diseases, has begun recruitment.

In a highly diverse, urban setting, pregnant women can be recruited to participate in the National Children's Study at rates similar to those obtained in clinic settings. Refinements to the pregnancy screener and other components are needed to optimize implementation. (Read the full article)

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)

No studies have focused on the financial impact of fellowship training in pediatrics.

The results from this study can be helpful to current pediatric residents as they contemplate their career options. In addition, the study may be valuable to policy makers who evaluate health care reform and pediatric workforce-allocation issues. (Read the full article)

Although gastroenteritis guidelines describe the need to perform oral rehydration, it remains underused, resulting in excessive use of intravenous rehydration. Other interventions, such as antiemetic administration, vary according to location, often resulting in differences in cost and outcomes.

In this nationwide cohort, intravenous rehydration use varied dramatically. Use was associated with the institution providing care and an increase in the need for future health care provider visits. Use of ondansetron also varied significantly across Canada. (Read the full article)

The pathophysiology of pediatric sports-related concussion (SRC) is largely unknown. Studies of concussed adults have identified neuronal and axonal injury and time-limited metabolic disruptions. An experimental animal model has also demonstrated physiologic perturbations, including reduced cerebral blood flow (CBF).

Using MRI techniques, we found no evidence of neuronal, axonal, or metabolic disruptions in 12 children with SRC. However, when compared with controls, statistically significant alterations in CBF were defined and frequently persisted beyond 30 days after injury. (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)

Over 500 000 children in the United States sustain a traumatic brain injury (TBI) each year. Headaches are commonly reported after TBI in adults, but little is known about the epidemiology of headache after pediatric TBI.

Headaches are more common 3 months after pediatric TBI than after arm injury. The frequency of headache after TBI is related to patient gender, age, and injury severity. Headaches after mild TBI were most common among girls and teenagers. (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)

Gallbladder disease in children is an evolving entity and studies suggest an increasing frequency of symptomatic pediatric gallbladder disease and resultant cholecystectomies.

Hispanic ethnicity and obesity are epidemiologically significant risk factors for symptomatic gallbladder disease in the pediatric population. (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)

Available clinical prediction rules to identify children with cerebrospinal fluid pleocytosis at low risk for Lyme meningitis include headache duration, cranial nerve palsy, and percent cerebrospinal fluid mononuclear cells. These rules require independent validation.

These clinical prediction rules accurately identify patients at low risk for Lyme meningitis in our large multicenter cohort. Children at low risk may be considered for outpatient management while awaiting Lyme serology. (Read the full article)

Previous analyses have suggested that center volume is associated with outcome in children undergoing heart surgery. There are limited data regarding factors that may mediate this volume–outcome relationship.

A multicenter analysis of 35 776 children revealed that the higher mortality observed at lower volume centers may be related to a higher rate of mortality in those with postoperative complications, rather than a higher rate of complications alone. (Read the full article)

Over the past decade, drug oversight committees and professional organizations have debated the evidence regarding cardiac screening to identify undiagnosed disorders associated with sudden cardiac death in youth with attention-deficit/hyperactivity disorder before beginning treatment with stimulants.

How practicing pediatricians have responded to this controversy is not known. We present results from a national sample of pediatricians regarding current attitudes, barriers, and practices for cardiac screening in youth with attention-deficit/hyperactivity disorder before prescribing stimulants. (Read the full article)

In the United States, drowning is the second leading cause of unintentional injury death among children (1–19), accounting for >1000 deaths per year. Total lifetime costs in 2000 were estimated to be $2.6 billion for children aged 0 to 14.

National trends in pediatric drowning hospitalizations by age and gender have not been reported. This study provides benchmarks that can be used for state and regional comparisons and monitoring of injury prevention efforts. (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)

Previous research has demonstrated that young children with traumatic brain injury are at elevated risk of poor outcomes, particularly following severe injuries. These deficits persist until at least 5 years postinsult. Factors predicting outcomes in this age group have not been established.

This study follows survivors of very early traumatic brain injury into adolescence. Results indicate that severe injury is associated with poorest outcome, but after 3 years, the gap between children with severe traumatic brain injury and peers stabilizes. (Read the full article)

In the previous decade, graduating pediatric residents generally experienced success in finding desired jobs, but they also experienced increased debt and flat starting salaries.

This study highlights trends over the past several years (2003–2009) including high levels of satisfaction among graduating pediatric residents, increasing ease in obtaining postresidency positions, and a modest decline in interest in primary care practice. (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)

Nonconvulsive status epilepticus (NCSE) is the diagnosis for encephalopathy caused by continuous epileptic activity on EEG. It is a well-known cause of morbidity and mortality in critically ill adults and neonates. NCSE is increasingly reported in critically ill children.

We show that NCSE is common in all inpatient settings, not only in the critically ill. Key risk factors that should dramatically increase suspicion of NCSE in clinical practice include a history of convulsive seizure and acute imaging abnormalities. (Read the full article)

Recent studies report that overall computed tomography utilization in the emergency department has continued to rise. Increased computed tomography use is concerning because of the association with radiation exposure and the potential risk of radiation-induced malignancy, which is highest in children.

Our data showed no overall increase in computed tomography utilization through 2010. In areas where alternative non–radiation-based modalities were options, there were decreased trends in computed tomography use and increased use of potential alternative non–radiation-based modalities. (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)

Early administration of oral corticosteroids is essential for children presenting to emergency departments with moderate to severe acute asthma exacerbations, because subsequent admission need is directly related to time to receipt of systemic steroids, yet delays to administration remain long.

A medical directive allowing nurse initiation of oral corticosteroids before physician assessment was associated with improved quality and efficiency of care provided in the pediatric emergency department by ensuring implementation of evidence-based practice. (Read the full article)