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)

Clinical decisions must be medically necessary to be approved by insurers. There is a federally mandated medical necessity standard for children in Medicaid, but not in private plans. American Academy of Pediatrics policy calls on pediatricians to help define pediatric medical necessity.

This study reviewed pediatric medical necessity definitions in Medicaid state statutes, regulations, and provider manuals. The federal standard was not replicated on all levels, and provider manuals were least likely to have it. Pediatricians should engage in defining pediatric standards. (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

Still using your kid's birthday as your universal password? You're heading toward trouble. With a password manager, you can have a unique and strong password for every secure website. We've evaluated two dozen of the best password managers to help you choose.

‘Offering a complicated range of highly specialised funds defeats the aim of simplicity’.

In this blended, mix-and-match, do-it-yourself world of education, what is curriculum, and who develops it? How do we know if it works?

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.

Money market fund managers need to pre-empt interest rate movements.

Investec's Value Fund has for the first time since 2000 ditched any exposure to big four banking stocks and major retail groups.

They may incur multiple levels of investment costs and performance dilution, but multi-managers still have a part to play, says an expert.

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 […]

Rohit Sharma is hoping that the BCCI and Cricket Australia will find a solution for the four-match Test series to get underway whenever sports return after the coronavirus pandemic.

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.

 Monthly reporting by Portfolio Managers

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