Welcoming remarks by Mr Fernando Restoy, Chairman, Financial Stability Institute, Bank for International Settlements, at the FSI-IADI conference on crisis management, resolution and deposit insurance: what's next and how to prepare, Basel, 4 September 2019.

Penn State Mont Alto unveiled its new project and supply chain management degree in response to a local and global need.

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.

Polycystic ovary syndrome (PCOS) is a common female reproductive disorder that often manifests during adolescence and is associated with disruptions in health-related quality of life. Prompt evaluation and clinical support after diagnosis may prevent associated complications and optimize overall health management. This article incorporates the most recent evidence and consensus guidelines to provide an updated review of the pathogenesis, clinical presentation, diagnostic evaluation, and management strategies for adolescents with this complex condition. We will review the recent international guidelines on PCOS; because the diagnosis of PCOS remains controversial, management of this condition is inconsistent. In 2019, PCOS remains a common, yet neglected, condition, in part, because of the lack of agreement around both diagnosis and management.

In response to the growing impact of the current opioid public health crisis in the United States on adolescents and young adults, pediatricians have an expanding role in identifying opioid use early, preventing escalation of risky use, reducing opioid-related harms, and delivering effective therapies. Research and expert consensus suggest the use of brief interventions focused on reducing risks associated with ongoing opioid use and using motivational interviewing strategies to engage youth in treatment. Because fatal opioid overdose remains a major cause of opioid-related mortality among youth, delivering overdose education as part of any visit in which a youth endorses opioid use is one evidence-based strategy to decrease the burden of opioid-related mortality. For youth that are injecting opioids, safe injection practices and linkage to needle or syringe exchanges should be considered to reduce complications from injection drug use. It is crucial that youth be offered treatment at the time of diagnosis of an opioid use disorder (OUD), including medications, behavioral interventions, and/or referral to mutual support groups. The 2 medications commonly used for office-based OUD treatment in adolescents are extended-release naltrexone (opioid antagonist) and buprenorphine (partial opioid agonist), although there is a significant treatment gap in prescribing these medications to youth, especially adolescents <18 years of age. Addiction is a pediatric disease that pediatricians and adolescent medicine physicians are uniquely poised to manage, given their expertise in longitudinal, preventive, and family- and patient-centered care. Growing evidence supports the need for integration of OUD treatment into primary care.

The new question-of-the-week is: What are your best classroom-management tips?

Dr. Debbie Silver, Dr. PJ Caposey, Serena Pariser, Timothy Hilton, Dr. Beth Gotcher, Paula Mellom, Rebecca Hixon, and Jodi Weber offer their commentaries on how best to handle classroom management.

Cindy Garcia, Gianna Cassetta, Amanda Koonlaba, Ed.S., Chelonnda Seroyer, Dennis Griffin Jr., Janice Wyatt-Ross, Barry Saide, and Dr. Vance Austin contribute their classroom-management suggestions.

The video-sharing platform is a huge hit with teens and some teachers are beginning to integrate it into their lessons. But cyberbullying and data privacy are big concerns, experts say.

When teachers use more praise and fewer reprimands in the classroom, it seems to help students stay on-task and behave better, according to a new study.

Febrile neutropenia is a common complication in children with cancer. Traditionally, even low-risk episodes have been managed entirely in an inpatient setting, and discharge of the patients has been delayed until resolution of fever and sustainable hematopoietic recovery.

The results of this decision-analytic model evaluating low-risk febrile neutropenia episodes suggest that the substantially higher costs of inpatient management cannot be justified on the basis of safety and efficacy considerations or patient/parent preferences. Uncertainty remains whether intravenous or oral treatment might be the preferable route of drug administration in an ambulatory setting. (Read the full article)

Neurocognitive testing is recommended for the assessment of sport-related concussions. Computerized neurocognitive tests are more sensitive and more efficient than traditional neuropsychological testing in assessing sport-related concussions.

We describe the current prevalence of computerized neurocognitive testing, the relative use of the various computerized programs, the types of clinicians interpreting test scores, and associations of computerized tests with timing of return-to-play and medical provider type managing the athlete. (Read the full article)

Community-acquired pneumonia (CAP) is a common pediatric illness caused by Streptococcus pneumoniae. New pediatric Infectious Diseases Society of America CAP guidelines are now available recommending ampicillin as empirical treatment of children hospitalized with uncomplicated CAP.

This study found that a CAP guideline led to an increase in the narrow-spectrum antibiotic ampicillin. Additionally, an increase in the use of amoxicillin at discharge was observed. Furthermore, change in therapy did not lead to increased adverse outcomes. (Read the full article)

Adherence to guidelines has generally been shown to improve patient care and reduce the cost of care. Current understanding of the varying reasons why clinicians deviate from guidelines is based on surveys and retrospective reviews.

We examined clinician deviations from guidelines in a prospective fashion and attempted to categorize those deviations. Better elucidation of clinician reasoning behind deviations may inform care improvement and help define strategies to eliminate unjustifiable deviations. (Read the full article)

There are limited data on current testing and treatment patterns for children hospitalized with pneumonia, and on whether institutional guidelines affect care.

The use of institutional clinical practice guidelines was not associated with changes in diagnostic testing, hospital length of stay, or costs for children hospitalized with pneumonia, but was associated with increased use of narrow-spectrum antibiotics. (Read the full article)

In the era of widespread conjugate vaccine use, the prevalence of bacterial meningitis has declined. However, the impact of this decline on the rate of emergency department visits for viral meningitis and cost of caring for these children is unknown.

There was a decline in the rate of diagnosis of viral meningitis in US children’s hospitals between 2005 and 2011. Most children diagnosed with viral meningitis are treated with antibiotics and are hospitalized, accounting for considerable health care costs. (Read the full article)

Before the introduction of conjugate pneumococcal vaccines and routine penicillin prophylaxis, febrile patients with sickle cell disease were known to have a 3% to 5% risk of bacteremia. Consequently, hospitalization rates for febrile episodes are >70%.

We observed no mortality or morbidity among those managed completely as outpatients, and bacteremia occurred in <1%. Physicians should strongly consider outpatient management of febrile children with sickle cell disease if there are no other indications for admission. (Read the full article)

Racial/ethnic differences in care for adult and pediatric patients in the emergency department have been documented.

This study reveals racial/ethnic differences in analgesic administration and prolonged length of stay for pediatric emergency department visits for abdominal pain. Documenting such disparities is an important first step needed to improve the equity of care for this and other conditions. (Read the full article)

Bronchiolitis is a leading cause of hospitalization for children, yet variability in its management persists. To promote evidence-based care, the American Academy of Pediatrics published practice guidelines in 2006 that advocate primarily supportive care for this self-limited disease.

Since publication of the guidelines in 2006, few studies have evaluated their impact on diagnostic testing and treatment. This study documents positive changes in resource use among hospitalized patients with bronchiolitis over an 8-year period. (Read the full article)

Recommended management of febrile neonates (≤28 days) includes blood, urine, and cerebrospinal fluid cultures with hospital admission for antibiotic therapy. No study has reported adherence to standard recommendations in the management of febrile neonates in US pediatric emergency departments.

There is wide variation in adherence to recommended management of febrile neonates. High rates of serious infections in admitted patients but low return rates for missed infections in discharged patients suggest additional studies needed to understand variation from current recommendations. (Read the full article)

Corrosive substance ingestion is a public health issue in developing countries. Stricture formation is a late complication of corrosive substance ingestion. The role of corticosteroids in preventing corrosive-induced strictures is controversial.

High doses of methylprednisolone therapy lead to less frequent stricture formation in grade IIb esophageal burns in children who ingested caustic substances and may improve prognosis. (Read the full article)

Asthma and food allergy are common chronic conditions impacting 14% and 8% of US school-aged children, respectively. School districts must be prepared to track students who have these conditions to ensure proper daily management and emergency response.

This study examines the demographic distribution of asthma and food allergy and the existence of school health management plans in a large, urban school district. The findings show that school health management plans are underused for both conditions. (Read the full article)

Quality improvement (QI) studies generally do not account for concurrent trends of improvement and it is difficult to distinguish the impact of a multihospital collaborative QI project without a contemporary control group.

A multihospital collaborative QI model led to greater declines in hypothermia and invasive ventilation rates in the delivery room compared with an individual NICU QI model and NICUs that did not participate in formal QI activities. (Read the full article)

Previous studies have demonstrated racial and ethnic differences in glycemic control even after adjustment for variables such as insulin dosage, diabetes duration, and socioeconomic status. It is controversial whether genetic, physiologic, cultural, socioeconomic, and/or provider-related factors underlie these disparities.

This study in a large, racially/ethnically diverse sample of children with type 1 diabetes demonstrates that racial disparities in insulin treatment methods and diabetes outcomes remain even after adjustment for socioeconomic status. (Read the full article)

The value of ultrasound imaging for the diagnosis, prognosis, and surgical planning of cryptorchidism is limited at best.

Ultrasound remains grossly overused by referring physicians throughout Ontario, Canada, which resulted in a 3-month delay to definitive surgery and unnecessary expenditures. (Read the full article)

Every time an education institution loses a funding source, rethinks program delivery, revises positions, incorporates technology, or changes curriculum, it is making an investment in change. These are sizable, important investments, so why not protect them?

Even before the recent news of the season’s first confirmed spotted lanternfly hatches in the Philadelphia region, homeowners in many parts of Pennsylvania were gearing up for their annual battle with the destructive pest.

BACKGROUND AND OBJECTIVES:

Children with medical complexity (CMC) comprise only 6% of the pediatric population, account for ~40% of pediatric health care spending, and provide an important opportunity for cost saving. Savings in this group can have an important impact on pediatric health care costs. The objective of this study was to assess the impact of a multicenter care management program on spending and use in CMC.

Wolfgang Lindner
May 1, 1999; 103:961-967
ARTICLES

Julie A. Jaskiewicz
Sep 1, 1994; 94:390-396
COMMENTARY

Inventory management is more than simply knowing what's left in the warehouse. Today these systems track the warehouse, a product's shelf life, and even your customers' experience. We test top players to help you choose.

Document management solutions have evolved from simple file storage engines to sophisticated workflow and data classification systems. We review and rank the top 10 players in this field.

Managing identity across an ever-widening array of software services and other network boundaries has become one of the most challenging aspects of the IT profession.. We test 10 end-to-end identity management solutions that can help.

Grace McStravock, who will graduate Saturday, May 9 with a 3.98 GPA in actuarial science and minors in mathematics and statistics, has been selected as Smeal’s spring 2020 risk management student marshal.

The Weather Risk Management Club has continued meeting via Zoom during the remote learning period, carrying on their work examining the impacts of severe weather events on the economy.

Ashish Bhasin, CEO, Dentsu Aegis Network (DAN) Greater South, will now take on the newly created role of CEO, DAN, APAC. Based in Singapore, Bhasin will report to Takaki Hibino, executive chairman, DAN APAC . He will remain the chairman of DAN India. Anand Bhadkamkar, the former COO and CFO, South Asia, has been promoted […]

The Delaware Office of Management and Budget will be holding three public hearings to gather public comment on regulations under Governor Markell’s Executive Order 36, a statewide review by all agencies to identify and remove regulatory hurdles.

"Invading Your Forest," a workshop on managing invasive species in Delaware woodlands, will be held on Friday, January 17 from 9:30 a.m. to 4 p.m. at the ACE building-Delaware State Fairgrounds, Harrington.

Delmarva farmers interested in learning more about protecting commodities revenue and crop insurance sign-ups before the March 15 deadline can attend a free risk management workshop next month. The March 5 event will be 8 a.m. to 3:30 p.m. at the Carvel Research and Education Center, Georgetown.

Agency: HSS Closing Date: 7/9/2020