School-based health centers (SBHCs) are known to increase access to medical care and mental health services for at-risk adolescents. Policymakers have suggested that SBHCs could function as patient-centered medical homes, but SBHCs have not been evaluated in that context.

Using the constructs of the patient-centered medical home as defined by the American Academy of Pediatrics (accessibility, continuity, comprehensiveness, family-centeredness, coordination, and compassion), this study shows that SBHCs have the potential to function as medical homes from the perspective of adolescents and parents. (Read the full article)

Medication errors involving children represent a frequently occurring public health problem. Since 2003, >200 000 out-of-hospital medication errors have been reported to US poison control centers annually, and ~30% of these involve children <6 years of age.

During 2002–2012, an average of 63 358 children <6 years experienced out-of-hospital medication errors annually, or 1 child every 8 minutes. There was a significant increase in the number and rate of non–cough and cold medication errors during the study period. (Read the full article)

Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. Telomere length and perceived facial age are 2 indicators of accelerated aging.

Perinatal complications predicted greater signs of accelerated aging "inside," as measured objectively by leukocyte telomere length, an indicator of cellular aging, and "outside," as measured subjectively by perceived age, an indicator of declining integrity of tissues. (Read the full article)

The population of youth with chronic medical conditions is growing and many attend college. Yet we know little about US colleges’ capacity to identify and care for these youth, nor how transition guidelines and financing models should incorporate college health.

This is the first study to find that although many colleges can provide some clinical care for youth with chronic conditions, few colleges have systems to identify and track these students, elucidating gaps that pediatricians and institutions need to address. (Read the full article)

Family engagement in the care of hospitalized children may improve outcomes, including medication safety. Although family-centered rounds (FCRs) provide a venue for family engagement in care, how families use this venue to influence medication-related topics is unknown.

Most families initiated medication-related dialogue during FCRs, discussing inpatient and home medications. Topics raised were important for medication adherence and safety, even altering treatment plans. Findings suggest specific medication topics that health care team members can anticipate addressing during FCR. (Read the full article)

In adults, adverse drug events account for 5% to 25% of all hospital admissions and 12% of emergency department (ED) visits of which 50% to 70% are preventable. There remains a significant gap in our understanding of the magnitude and impact of medication-related ED visits in pediatrics.

This study is the largest and most rigorous study performed evaluating the impact of medication-related visits to the ED in pediatrics and provides important information regarding the magnitude of this problem in our health care system. (Read the full article)

Medical home transformation is led by practice-level assessment, but much of the evidence supporting the medical home derives from individual-level assessment based on parental perception. The association between these 2 levels of assessment is unknown.

Among Boston-area community health centers, there was no association between the individual- and practice-level assessments of the medical home. This highlights the need for studies supporting the child health benefits of medical home practice transformation. (Read the full article)

Using large nationwide registers, we were unable to detect any association between augmentation of labor and ADHD in offspring. Our findings do not support a causal role of perinatal exposure to oxytocin during delivery on the development of ADHD. (Read the full article)

Patients with sickle cell disease frequently express dissatisfaction with emergency department treatment of painful crises. Time to opioid administration has been suggested as a quality of care measure for painful crises.

Although not associated with hospital admission, time to opioid administration in sickle cell disease painful crises was associated with secondary outcomes including improvement between the first 2 pain scores, decreased pain score area under the curve at 4 hours, decreased emergency department length of stay, and increased total opioids. (Read the full article)

Although the rates of antipsychotic medication treatment are rising for children and adolescents, little is known about the factors associated with this practice.

This study provides some of the first data regarding when and why clinicians decide to use antipsychotic medications. It reveals clues as to how prescribing might better follow best practice guidelines. (Read the full article)

Existing literature discusses the unique medical and psychological needs of sex trafficking victims and highlights the importance of screening patients with risk factors. However, little is known about providers’ knowledge and confidence in their ability to provide care to victims.

The study summarizes the knowledge gaps and barriers providers face when assisting pediatric sex trafficking victims. It also highlights the impact of training on providers’ confidence and ability to appropriately care for victims. (Read the full article)

Disparities in asthma morbidity are exacerbated by underutilization of preventive controller medications. Community pharmacies are well positioned for an increased role in population health. The Asthma Medication Ratio, currently used at the patient-level, could be adapted for use at the pharmacy-level.

A newly developed Pharmacy-level Asthma Medication Ratio was associated with population-level childhood asthma morbidity. Collaborative relationships between physicians, community pharmacists, and patients (and families) have the potential to promote testable interventions aimed at reducing asthma morbidity and cross-community disparities. (Read the full article)

Care coordination is a central part of the medical home model. Little is known about how care coordination is implemented in pediatrics and how it changes over time in primary care practices successfully adopting medical home principles.

In high-performing medical homes, care coordination evolved toward designing and carrying out routine activities and policies that aimed to forestall disruptions in care delivery. Investing in medical home teams, engaging electronic medical record systems, and improving workflow supported these changes. (Read the full article)

US parents trust the health care system and bring their infant children in for preventive care. Previous studies have demonstrated the ability of health care systems to identify, and sometimes address, the economic needs of low-income families.

Families of newborns at a safety-net primary care center have high levels of economic hardship. Compared with controls, Developmental Understanding and Legal Collaboration for Everyone families had accelerated access to concrete supports, improved rates of on-time immunization and preventive care, and decreased emergency department utilization. (Read the full article)

Previous research has described important variability in the medical evaluation of suspected child physical abuse. This variability may contribute to bias and reduce reliability in the medical diagnosis of abuse.

A panel of child abuse pediatricians participated in a Delphi Process, defining critical elements for the medical evaluation of suspected physical abuse in children. Results can be used to reduce practice variability that may contribute to potential bias in evaluation. (Read the full article)

Medicaid made substantial investments in enhanced prenatal and postnatal care programs to address maternal and infant health, including infant mortality. Evaluations of population-based programs are few, and although some have reported reductions in infant mortality, they have methodological limitations.

A population-based home visitation program can be a successful approach to reduce infant mortality. The reduced risk of infant death is consistent with previous findings on the effects of the program on health care utilization and birth outcomes. (Read the full article)

There has been increasing legislative and regulatory focus on the relationships of pediatric prescribers and industry. Pediatric professional medical association (PMA) and industry relationships, however, are relatively unstudied and lack a systematic method of assessment.

This cross-sectional study used a new quantitative scale, the industry relationship index, to systematically rate 9 pediatric PMAs with respect to best practice guidelines on interactions with the biomedical industry, revealing significant variation in PMA practices. (Read the full article)

Rudeness is routinely experienced by hospital-based medical teams. Individuals exposed to mildly rude behavior perform poorly on cognitive tasks, exhibit reduced creativity and flexibility, and are less helpful and prosocial.

Rudeness had adverse consequences on diagnostic and procedural performance of members of the NICU medical teams. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. (Read the full article)

Increasing percentages of youth are living with chronic medical conditions. Although adolescents face peak risks for onset and intensification of alcohol and marijuana use, we know little about these behaviors and their associations with treatment adherence among chronically ill youth.

This study quantifies alcohol and marijuana use behaviors among a heterogeneous sample of chronically ill youth in aggregate and by condition, and measures associations between alcohol use/binge drinking and knowledge about alcohol interactions with medications/laboratory tests and also treatment nonadherence. (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)

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)

Seven percent of children in the United States receive mental health services each year. There are more pediatric outpatient mental health care visits to primary care physicians (PCPs) than to psychiatrists. Mental health utilization patterns regarding different conditions and medication prescribing are unknown.

One-third of children with mental health conditions see PCPs only. A greater proportion of children with attention-deficit/hyperactivity disorder see PCPs for this than do those with anxiety/mood disorders. Children seeing PCPs are prescribed psychotropic medications more often than those seeing psychiatrists. (Read the full article)

Receiving primary care in a high-quality medical home may lead to reductions in hospital or emergency department (ED) utilization; however, the relationship between the medical home and postdischarge hospitalizations and ED visits is poorly understood.

Readmission rates vary markedly based on data source and definition. Unplanned readmissions were associated with absence of a usual source of well and sick care but not other medical home components. Lack of parent confidence at discharge identified patients at high risk for readmissions and ED visits shortly after discharge. (Read the full article)

A health expert discusses what late joiner penalties are and how to avoid them.

There has been a distinct trend of consolidation among private medical schemes in South Africa, according to an actuarial specialist at Alexander Forbes.

​Religious intolerance is a growing but seriously underestimated risk in Cameroon, both between and inside the major faiths. To halt the spread of violent extremism in the country, Cameroon needs to bring all sects into a new social compact and within the bounds of a charter for religious tolerance.

L’image de havre de paix dans une région en proie aux conflits dont bénéficiait le Cameroun a volé en éclats depuis l’irruption de Boko Haram en 2013 au nord du pays. Ce mouvement, devenu l’Etat islamique en Afrique de l’Ouest en mars 2015, revendique son affiliation à Daech. Néanmoins, l’apparition brutale et sanglante de ce djihadisme africain est moins liée à l’essor de Daech en Irak et en Syrie qu’aux bouleversements du paysage religieux de l’Afrique en général et du Cameroun en particulier.

BACKGROUND:

Orphan drug development is crucial for children, who are disproportionately affected by rare diseases. Data are lacking on the number, nature, and benefit of recently approved pediatric orphan indications.

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.

Penn State Health has appointed Don McKenna as president of Penn State Health Hampden Medical Center.

Penn State Health Milton S. Hershey Medical Center has begun enrolling participants in an international clinical trial evaluating an investigational antiviral drug, remdesivir, for treatment of coronavirus disease 2019 (COVID-19).

Katherine H. Burns
Oct 1, 2010; 126:638-646
ARTICLES

Penn State Health has opened two regional clinics to care for patients with confirmed or suspected COVID-19 who have health care needs that are serious enough to warrant a face-to-face appointment.

The staff of Hershey Medical Center is one of only several academic hospitals in the country with specialized infrastructure and and training geared around offering care during a contagion outbreak. But they have another advantage, too. “We are all a family,” says one doctor. “And we look out for one another.”

Reports of suspected child abuse have declined in Pennsylvania since the onset of social distancing guidelines. But experts in the Penn State Center for the Protection of Children say this does not correlate with an actual decline in abuse cases.

029 - Six clubs fulfil conditions set out by CFCB

Successful intervention for inborn errors of metabolism (IEMs) is a triumph of modern medicine. For many of these conditions, medical foods are the cornerstone of therapy and the only effective interventions preventing disability or death. Medical foods are designed for patients with limited or impaired capacity to ingest, digest, absorb, or metabolize ordinary foods or nutrients, whereby dietary management cannot be achieved by modification of the normal diet alone. In the United States today, access to medical foods is not ensured for many individuals who are affected despite their proven efficacy in the treatment of IEMs, their universal use as the mainstay of IEM management, the endorsement of their use by professional medical organizations, and the obvious desire of families for effective care. Medical foods are not sufficiently covered by many health insurance plans in the United States and, without insurance coverage, many families cannot afford their high cost. In this review, we outline the history of medical foods, define their medical necessity, discuss the barriers to access and reimbursement resulting from the regulatory status of medical foods, and summarize previous efforts to improve access. The Advisory Committee on Heritable Disorders in Newborns and Children asserts that it is time to provide stable and affordable access to the effective management required for optimal outcomes through the life span of patients affected with IEMs. Medical foods as defined by the US Food and Drug Administration should be covered as required medical benefits for persons of all ages diagnosed with an IEM.

If you have lost your income due to the lockdown, your options are limited.

The high-end discrete graphics cards will reportedly target the PC gaming market and data centers, putting pressure on AMD and Nvidia. Intel hired a former AMD exec to lead the effort.

The federal government’s newly-revamped tool can lead to increased costs. Commissioner Trinidad Navarro has released a rare consumer alert regarding Medicare’s newly-updated Prescription Plan Finder. Throughout this year’s open enrollment period, which ends on December 7, the Department of Insurance has received numerous complaints about the tool and anticipated prescription drug costs. The Prescription Plan […]

Dover’s Veterans Day Parade – Saturday, Nov. 4th at 9:30 am – Downtown Dover (Loockerman St. to Federal St.) The City of Dover is hosting this year’s Veterans Day Parade along with the Delaware Commission of Veterans Affairs. Please join us Saturday morning on November 4th at 9:30am. For those who are interested in participating, please […]

The Delaware General Assembly, the Delaware Commission of Veterans Affairs and the Delaware Heritage Commission will unveil a new monument this weekend honoring Delawareans who served in World War I and those who supported them on the home front

Secretary of State Jeffrey Bullock has suspended the Delaware medical license and controlled substance privileges of Gregory Villabona, in light of allegations of unprofessional conduct related to the prescription and distribution of opioid medications.

When/Where:  Saturday, November 3, 2018 at 10:00 AM – Downtown Dover – W. Loockerman Street to Legislative Avenue When/Where:  Saturday, November 3, 2018 at 12:00 PM – Downtown Dover – Legislative Avenue & Martin Luther King Jr. Boulevard The Delaware General Assembly, the Delaware Department of State, the Delaware Commission of Veterans Affairs, the Delaware […]

Secretary of State Jeffrey Bullock has suspended the Delaware medical license and controlled substance prescribing privileges of Ifeanyi Udezulu for repeatedly failing to adhere to state regulations for the safe prescribing of opioid medications.

The public is invited to attend a garden fair on Saturday, June 21, to celebrate the dedication of the Planting Hope in Delaware garden on the Herman Holloway Campus near New Castle. The free event, from 9 a.m. to noon, will include tours of the Planting Hope sensory, community and market gardens; a honey tasting from the Delaware Beekeepers Association in celebration of National Pollinator Week; story time with PAWS for People dogs; and a meditative labyrinth for walking.

DOVER, Del. – The Delaware Department of Agriculture is urging all pesticide applicators that plan to use dicamba this growing season to check the U.S. Environmental Protection Agency’s (EPA) online Bulletins Live! Two system on a monthly basis before spraying. This new online system allows agriculture and other pesticide users to easily determine where pesticide […]

Agency: HSS Closing Date: 5/29/2020

Agency: HSS Closing Date: 5/12/2020