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Rains cause tragedy in Central America

After a week of heavy rains in Central America, the area is left in tragedy. OM Guatemala is desperate to help.




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The blessings of sports ministry in Central America

OM SportsLink in Latin America takes part in a training for workers in sports ministry in Honduras and an outreach in Guatemala.




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Central American adventure

Nathan Schmutz of Switzerland has enjoyed the challenge of immersing himself in a whole new culture.




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RingCentral Fax

RingCentral Fax offers lots of pages per month and a modern multi-platform experience, but it costs a lot per month and its fax quality could be better.




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Fin24.com | Australia faces record economic contraction, even as it plans to lift lockdown

Australia's central bank has predicted that the country is facing its biggest economic contraction on record.




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Fin24.com | IMF: Previous warnings of global economic contraction were too optimistic

The head of the International Monetary Fund said Friday that previous estimates for the world economy to contract by three percent this year were too optimistic.




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Edinburgh firm to open first public hydrogen refuelling station in central belt

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




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How To Be an 'Intrapreneur' Within a School

Entrepreneurship is a powerful tool that can be used within an established institution to foster innovation and accelerate promising initiatives. Leading a startup project within an organization is called "intrapreneurship" and there are many ways to do that within a school setting.




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TV review: State of Happiness; Inside Central Station; The A Word; First Dates Hotel

SOMETIMES, for a giggle, I like to imagine what Scotland would have been like had we kept the oil for ourselves. Like Saudi Arabia without the weather and executions, maybe? Or more like canny Norway, investing the cash in a big brolly for some future rainy day?




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Late Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease

The effectiveness of intravenous immunoglobulin treatment of patients with Kawasaki disease within 9 days of illness has been established. However, the effectiveness of such treatment ≥10 days after illness onset has not yet been clarified.

Intravenous immunoglobulin treatment ≥10 days after illness onset was observed to be effective for achieving inflammation resolution. Patients who are strongly suspected to have Kawasaki disease and demonstrate ongoing inflammation should therefore be treated as soon as possible. (Read the full article)




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Intrapartum Temperature Elevation, Epidural Use, and Adverse Outcome in Term Infants

Previous observational studies and randomized trials have reported an association between the use of epidural analgesia for pain relief in labor and intrapartum maternal fever. Studies have also reported an increase in adverse neonatal outcomes with intrapartum maternal fever.

Among low-risk women receiving epidural analgesia, intrapartum maternal temperature >99.5°F was associated with adverse neonatal outcomes, with the rate of adverse outcomes increasing directly with maximum maternal temperature. Without temperature elevation, epidural use was not associated with adverse neonatal outcomes. (Read the full article)




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Pharmacy Communication to Adolescents and Their Physicians Regarding Access to Emergency Contraception

Emergency contraception is a safe and effective method of pregnancy prevention after unprotected intercourse.

Pharmacies commonly communicate misinformation, both to adolescents and to physicians, concerning who is able to access emergency contraception and through what means. (Read the full article)




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Obese Mexican American Children Have Elevated MCP-1, TNF-{alpha}, Monocyte Concentration, and Dyslipidemia

Nearly one-third of all US children are overweight or obese, with even higher prevalence among Mexican American children. Overweight and obesity increase systemic inflammation, contributing to increased risk for chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease.

Obese Mexican American children had concurrent alterations in both inflammatory markers and traditional disease risk markers, relative to healthy weight children. Our results provide evidence partially explaining the health disparity for disease in Mexican American children who are overweight/obese. (Read the full article)




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Evaluation of a Clinical Dehydration Scale in Children Requiring Intravenous Rehydration

Evaluating dehydration severity is a challenging task. Clinical dehydration scores that combine multiple clinical findings are promising. One clinical dehydration scale score has been developed and subsequently evaluated; however, few participants in the derivation and validation studies were significantly dehydrated.

In children requiring intravenous rehydration, the dehydration scale displayed moderate reliability and weak associations with objective measures. Thus, although the scale can assist in assessing dehydration, it should not be used in isolation to dictate interventions (eg, intravenous rehydration, hospitalization). (Read the full article)




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Trends in Candida Central Line-Associated Bloodstream Infections Among NICUs, 1999-2009

Emphasis on preventing central line-associated bloodstream infections (CLABSIs) in US health care facilities and prophylactic antifungal medication use in neonates may impact incidence of Candida spp. CLABSIs. However, data on trends in incidence of neonatal Candida spp. CLABSIs are lacking.

Data from a large sample of US NICUs was analyzed to assess trends in incidence over time. This analysis provides a description of the epidemiology of Candida spp. CLABSIs in a national health care-associated infections surveillance system. (Read the full article)




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Vitamin B6 Vitamer Concentrations in Cerebrospinal Fluid Differ Between Preterm and Term Newborn Infants

There is no literature on the concentrations of vitamin B6 vitamers in cerebrospinal fluid of preterm and term newborn infants. This knowledge, however, is highly important, because vitamin B6 plays a pivotal role in brain development and functioning.

In cerebrospinal fluid of newborn infants, B6 vitamer concentrations are strongly dependent on postmenstrual age, indicating that vitamin B6 homeostasis in brain differs between preterm and term newborns. This has implications for the evaluation of epilepsy and vitamin B6 deficiency. (Read the full article)




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Health Care Provider and Caregiver Preferences Regarding Nasogastric and Intravenous Rehydration

Some children with gastroenteritis fail to respond to oral rehydration. Subsequent interventions are dictated by regional preference. In North America, nasogastric rehydration is rarely administered. Caregiver and health care providers’ perspectives regarding its use have not been described previously.

Both caregivers and health care providers would select intravenous rehydration instead of nasogastric rehydration when oral rehydration fails. Greater knowledge mobilization efforts will be required for nasogastric rehydration to be adopted into clinical practice. (Read the full article)




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The Effect of an Osmotic Contrast Agent on Complete Meconium Evacuation in Preterm Infants

Delayed meconium passage impairs gastrointestinal function in premature infants. No intervention has been identified that accelerates meconium passage sufficiently. Gastrografin is an osmotic contrast agent used for radiologic examination of the bowel or for conservative treatment of uncomplicated meconium ileus.

Gastrografin did not accelerate complete meconium evacuation but stimulated gastrointestinal motility in a randomized, placebo-controlled trial in premature infants. Application shortened the time to full enteral feedings and hospital stay but was associated with necrotizing enterocolitis as a possible adverse event. (Read the full article)




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Near-Infrared Imaging in Intravenous Cannulation in Children: A Cluster Randomized Clinical Trial

Gaining intravenous access in children can be difficult. Recently, several near-infrared devices have been introduced attempting to support intravenous cannulation by visualizing veins underneath skin. Only one of those devices has been evaluated systemically thus far and results are inconclusive.

Although it was possible to visualize veins with near-infrared in most patients, the VascuLuminator did not improve the success of cannulation. An explanation is that the main problem is probably not localization of the vein but insertion of the cannula. (Read the full article)




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Sexual Initiation, Contraceptive Use, and Pregnancy Among Young Adolescents

Among adolescents younger than 15, 18% have had sex and 16 000 pregnancies occur annually; among those aged 15 to 17, 30% have had sex and 252 000 get pregnant. Information on the youngest adolescents has not been previously published.

Sexual activity and pregnancy are rare among 10-, 11-, and 12-year-olds, and sex is more likely to be nonconsensual. This arguably represents a different public health issue than sex among older teens, who have a greater need for contraception. (Read the full article)




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Patterns of Retinal Hemorrhage Associated With Increased Intracranial Pressure in Children

Retinal hemorrhage (RH) is an important sign of pediatric abusive head trauma. Raised intracranial pressure (ICP) is sometimes proposed as an alternate cause of RH in children being evaluated for possible child abuse.

Nontraumatic, markedly elevated ICP rarely causes RH in children. When it does, RH are superficial intraretinal and located adjacent to a swollen optic nerve head. This pattern does not match the widespread pattern seen in abusive head trauma. (Read the full article)




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Unexpected Relationship Between Tympanometry and Mortality in Children With Nontraumatic Coma

Tympanometry provides a measure of middle ear function. There has been no description of the relationship between measurements of middle ear function in the absence of gross anatomic defects and clinical outcome among children with acute nontraumatic coma.

This study reveals an unexpected association between abnormal middle ear function and death in childhood acute coma. These findings call for more investigations on the relationship between middle and inner ear anatomy and function and intracranial dynamics and clinical outcomes. (Read the full article)




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Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

Etiology and timing of onset of neonatal hypoxic-ischemic encephalopathy continue to be controversial. Previous studies suggest antepartum events are the main contributing factors, but have used a broad definition of encephalopathy and included infants with genetic, congenital, and developmental abnormalities.

Our study suggests that when strict criteria defining hypoxic-ischemic encephalopathy are applied with supporting neuroimaging evidence of an acute hypoxic-ischemic insult, intrapartum events are the final and necessary pathway leading to this condition. (Read the full article)




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Intravenous Magnesium Sulfate for Vaso-occlusive Episodes in Sickle Cell Disease

Vaso-occlusive episodes (VOEs) are a common complication of sickle cell disease, resulting in morbidity. Magnesium is a vasodilator and has been shown to improve red blood cell hydration. Previous small studies have suggested that treatment with magnesium may decrease VOEs.

Intravenous magnesium sulfate is well tolerated in relatively high doses but had no effect on the length of stay in hospital, pain scores, or cumulative analgesia used in children admitted with painful VOEs in sickle cell disease. (Read the full article)




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Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration

A serum 25-hydroxyvitamin D (25(OH)D) concentration of 20 ng/mL meets the requirements of at least 97.5% of the population older than 1 year. A recommended dietary intake to achieve this serum 25(OH)D concentration has not been established during infancy.

Daily maternal (during pregnancy) and then infant vitamin supplementation with 1000/400 IU or 2000/800 IU increases the proportion of infants with 25(OH)D ≥20 ng/mL during infancy with the higher dose sustaining this increase for longer. (Read the full article)




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Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

Payment arrangements that blend global budgets with pay-for-performance are proliferating. However, little is known about how these contracts affect pediatric health care quality and spending for children with and without special health care needs receiving care from large provider organizations.

A prototypical global budget contract significantly improved preventive care quality measures tied to pay-for-performance, especially for children with special health care needs. It did not alter trends for spending or for quality measures that were not tied to pay-for-performance. (Read the full article)




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Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

Cranial ultrasound is routinely used in identifying cerebral abnormalities in premature infants. Grade III and IV intraventricular hemorrhages, cystic periventricular leukomalacia, and late ventriculomegaly are all known predictors of adverse neurodevelopmental sequelae in these infants.

We reviewed neurodevelopmental outcomes among 2414 extreme preterm infants. Infants with grades I and II intraventricular hemorrhage had increased rates of neurosensory impairment, developmental delay, cerebral palsy, and deafness at 2 to 3 years’ corrected age. (Read the full article)




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Attributable Cost and Length of Stay for Central Line-Associated Bloodstream Infections

Central line–associated bloodstream infections (CLABSI) are common types of hospital-acquired infections associated with high morbidity and cost. In recent years, quality improvement initiatives have demonstrated how to reduce the incidence of CLABSI.

This study presents nationally representative estimates of the cost and length of stay attributable to pediatric CLABSI. We make the business case to justify quality improvement prevention initiatives and the adoption of strategies for cost-effective management of CLABSI. (Read the full article)




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Intranasal Triamcinolone and Growth Velocity

Previous trials reported no significant effect of triamcinolone acetonide aqueous nasal spray on growth velocity of children with perennial allergic rhinitis. However, they did not conform to Food and Drug Administration guidelines for evaluating effects of intranasal corticosteroids on growth.

This is the first published study consistent with the 2007 Food and Drug Administration–recommended study design evaluating growth velocity in children aged 3–9 years with perennial allergic rhinitis treated with triamcinolone acetonide or placebo for 12 months. (Read the full article)




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Recovery From Central Nervous System Acute Demyelination in Children

Most prospective cohort studies of acquired demyelinating syndromes in children have focused on the genetic, environmental, and neuroimaging predictors of multiple sclerosis. Less is known regarding the severity of the incident demyelinating event and predictors of residual attack–related physical disability.

In a national, prospective longitudinal study, incident acquired demyelinating syndromes in children were characterized in terms of physical deficits and acuity at onset, and recovery over the first 12 months. Follow-up evaluations up to 10 years’ postonset were analyzed. (Read the full article)




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Prevalence of and Risk Factors for Intracranial Abnormalities in Unprovoked Seizures

Weak recommendations exist to guide emergent neuroimaging decisions in children with first, unprovoked seizures. The prevalence of and risk factors associated with clinically relevant abnormalities on neuroimaging have not been well defined in prospective studies.

Clinically relevant intracranial abnormalities on neuroimaging occur in 11% of children with first, unprovoked seizures. Emergent/urgent abnormalities, however, occur in <1%, suggesting that most of these children do not require emergent neuroimaging. Specific clinical findings identify patients at higher risk. (Read the full article)




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Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial

Urethral catheterization is a painful, yet common procedure to obtain a sterile urine sample in young children. There are conflicting results regarding the effectiveness of lidocaine to reduce pain, and it is unclear if it should be routinely used.

In young children, combined topical and intraurethral lidocaine does not reduce pain during urethral catheterization and is associated with more pain than nonanesthetic lubricant during instillation. Clinicians should use noninvasive methods of analgesia during this painful procedure. (Read the full article)




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Risk Factors for Central Nervous System Tuberculosis

Central nervous system (CNS) tuberculosis has high morbidity and mortality, and it frequently affects children aged <5 years.

In California, children who were US-born, Hispanic, and aged <5 years were at increased risk of CNS tuberculosis. Children with CNS tuberculosis were more likely to die. Specific populations of US-born infants might benefit from additional prevention measures. (Read the full article)




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Derivation of Candidate Clinical Decision Rules to Identify Infants at Risk for Central Apnea

Central apnea sometimes complicates bronchiolitis. Because apnea tends to occur early in the course of bronchiolitis, there is a danger that infants may be discharged from the emergency department only to subsequently develop apnea at home.

This study prospectively derived clinical decision rules to help emergency physicians admit infants at risk for apnea while discharging those not at risk. (Read the full article)




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Raising Student 'Voice and Choice' Is the Mantra. But Is It a Good Idea?

Educators are wrestling with tough questions as more schools embrace personalized learning and its accompanying belief in giving students more control over their academic experiences.




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Congo at War: A Briefing of the Internal and External Players in the Central African Conflict




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In Central Africa, an Urgent Challenge to American Leadership




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Central African Republic: Anatomy of a Phantom State




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Central African Republic: Untangling the Political Dialogue




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Pour un dialogue en Centrafrique




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Central African Republic: Keeping the Dialogue Alive




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Central African Republic: "Relancer le dialogue politique




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Le dilemme de l’assistance électorale internationale en Afrique centrale

La fièvre des élections s’empare de l’Afrique centrale. Pour la seconde fois depuis la fin des guerres qui ont dévasté la région, les scrutins s’enchaînent au Burundi, au Rwanda, en République centrafricaine et au Congo.




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The dilemma of electoral assistance in Central Africa

Election fever has spread across Central Africa. For the second time since the end of the disastrous civil wars in the region, electoral processes have been launched in Burundi, Rwanda, Central African Republic and the Congo.




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Afrique centrale : cachez ces 50 ans...

Vu du centre de l’Afrique – Tchad, République centrafricaine (RCA) et RD Congo –, le cinquantenaire des indépendances est un anniversaire à l’envers : on en parle davantage à Paris et Bruxelles qu’à N’Djamena, Bangui et Kinshasa. Sans doute parce que, en Europe, il s’agit avant tout de gérer des diasporas turbulentes et une relation bilatérale devenue épineuse tandis que, dans les capitales africaines, il s’agit d’éviter à tout prix le droit d’inventaire.




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Dangerous Little Stones: Diamonds in the Central African Republic

Extreme poverty and armed conflict in the diamond-rich areas of the Central African Republic (CAR) put thousands of lives in danger and demand urgent reform of the mining sector.




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Central African Republic: The Dark Side of Diamonds

The international watchdog which seeks to prevent diamonds from fuelling conflict, the Kimberley Process, should take a very close look at the situation in the Central African Republic




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Centrafrique: Les élections de l'instabilité

Le processus électoral hors délai constitutionnel qui se déroule depuis le 23 janvier en Centrafrique n'est pas seulement une nouvelle opportunité manquée pour la démocratisation du pays mais c'est aussi un risque sérieux pour la paix.




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Implementing Peace and Security Architecture (I): Central Africa

More than a decade after the Economic Community of Central African States (ECCAS) was requested by the African Union (AU) to give life to a new peace and security architecture, political and security cooperation on the continent is still in need of reinforcement.




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Afrique centrale : la corruption - l'obstacle majeur à la consolidation de la paix

La rechute est le risque majeur des pays post-conflit et l'une des principales raisons de cette rechute s'appelle la corruption.