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Growth Patterns of Large for Gestational Age Children up to Age 4 Years

Preterm (PT) birth is negatively associated with growth. Particularly small for gestational age PT infants are at risk for delays in growth, whereas knowledge about the consequences regarding growth of large for gestational age PT birth is lacking.

During infancy, growth in height, weight, and head circumference of large for gestational age PT infants was well balanced and sufficient. Subsequently, however, weight gain accelerated and resulted in high BMIs compared with the World Health Organization Multicentre Growth Reference Study population. (Read the full article)




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Patterns of Mobile Device Use by Caregivers and Children During Meals in Fast Food Restaurants

Mobile devices are ubiquitous in children’s lives, but how caregivers and children use them in everyday situations, and how use of devices affects caregiver–child interactions, has not been studied.

In naturalistic mealtime observations, we documented the behavior of many caregivers whose attention was highly absorbed in their mobile devices, with varying child reactions to this absorption. This study raises several hypotheses about mobile device use and caregiver-child interaction. (Read the full article)




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Motor Vehicle-Pedestrian Collisions and Walking to School: The Role of the Built Environment

Many studies have demonstrated that the built environment is related to both collision risk and walking to school. However, little research examines the influence of the built environment on the relationship between walking to school and pedestrian collision risk.

Increased walking was not associated with increased pedestrian collision once the effects of the built environment and socioeconomic status were modeled. Safety was related primarily to the built environment and specifically features related to road crossing. (Read the full article)




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United States Birth Weight Reference Corrected For Implausible Gestational Age Estimates

Population-based references of birth weight for gestational age are useful indices of birth size in clinical and research settings.

This article uses 2009–2010 US natality data and corrects for likely errors in gestational age dating to yield an up-to-date birth weight for gestational age reference. (Read the full article)




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Validity of a Single Item Food Security Questionnaire in Arctic Canada

Food insecurity is best measured by comprehensive assessments. However, rapid assessments can be useful in certain circumstances, but their validity is not characterized.

Rapid assessment of food insecurity is feasible among Inuit adults and children. (Read the full article)




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Gestational Age and Age at Sampling Influence Metabolic Profiles in Premature Infants

Prematurely born infants commonly have abnormal metabolic screens.

Both gestational and chronological age influence metabolic profiles used to screen for inborn errors of metabolism. (Read the full article)




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A Parent Questionnaire for Developmental Screening in Infants Born Late and Moderately Preterm

Children born late and moderately preterm are at increased risk of developmental problems compared with term-born peers. Screening for developmental problems in the early years may thus aid in the early identification of children at risk for adverse outcomes.

The Parent Report of Children’s Abilities-Revised has good concurrent validity and 90% sensitivity and 76% specificity for identifying moderate/severe cognitive developmental delay in infants born late and moderately preterm. This parent questionnaire may be used as a clinical screening tool. (Read the full article)




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Gestational Age and Risk of Venous Thromboembolism From Birth Through Young Adulthood

Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown.

In a large national cohort, low gestational age at birth was associated with increased risk of VTE in infancy, early childhood, and young adulthood. These findings call for better awareness of the long-term risk of VTE among preterm birth survivors. (Read the full article)




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An Innovative Nonanimal Simulation Trainer for Chest Tube Insertion in Neonates

Practitioners caring for critically ill infants need to acquire competence in insertion of chest tubes for pneumothorax. Ethical and logistic concerns inhibit the use of animals, and there are no realistic simulation models available for neonatal chest tube insertion training.

An inexpensive, nonanimal chest tube insertion model can be easily constructed and used effectively to train interns and residents to improve their knowledge, clinical skills, and comfort levels to perform the chest tube insertion procedure in infants. (Read the full article)




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Herpes PCR Testing and Empiric Acyclovir Use Beyond the Neonatal Period

Herpes encephalitis outside the neonatal period is typically severe and recognizable to clinicians. Excessive testing for herpes encephalitis is associated with increased medical costs and hospital length of stay, and risks patient harm.

Herpes testing and empirical acyclovir treatment in older and less unwell patients has been increasing in US pediatric hospitals over the past decade, which may reflect a more fundamental problem in current approaches to clinical decision-making. (Read the full article)




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Establishing Benchmarks for the Hospitalized Care of Children With Asthma, Bronchiolitis, and Pneumonia

With the publication of evidence-based guidelines for asthma, bronchiolitis, and pneumonia, numerous efforts have been made to standardize and improve the quality of care. However, despite these guidelines, variation in care exists.

This study establishes clinically achievable benchmarks of care for asthma, bronchiolitis, and pneumonia. Using a published method for achievable benchmarks of care, we calculated average utilization among the high-performers, which can serve as achievable goals for local quality improvement. (Read the full article)




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Restrictive Eating Disorders Among Adolescent Inpatients

Recent case reports have described acute life-threatening complications in adolescents who present to health services having lost large amounts of weight but who are not underweight. Little is known about the frequency of life-threatening complications in these adolescents.

Over 6 years, we found more than a fivefold increase in the incidence of hospitalized adolescents who, apart from not being underweight, have diagnostic features of anorexia nervosa. This group experienced a similar profile of acute complications of anorexia nervosa. (Read the full article)




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Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

Lung ultrasound outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. In the pediatric age, lung ultrasound has been also successfully applied to the fluid-to-air transition after birth and to rapid pneumonia diagnosis.

Nasal ventilation has dramatically decreased the need for invasive mechanical respiratory support. This study demonstrates that, after a short trial on nasal continuous positive airway pressure, lung ultrasonography reliably predicts the failure of noninvasive ventilation unlike the conventional chest radiogram. (Read the full article)




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Emergency Hospitalizations for Unsupervised Prescription Medication Ingestions by Young Children

Despite child-resistant packaging requirements for most medications and safe storage education for all medicines, tens of thousands of young children are brought to emergency departments and thousands are hospitalized annually after ingesting prescription medications. Targeted prevention efforts may be needed.

Twelve medications were implicated in nearly half of hospitalizations for prescription medication ingestions. Buprenorphine and clonidine were most commonly implicated and had the highest hospitalization rates when accounting for outpatient use. Prevention efforts should focus on most commonly implicated medications. (Read the full article)




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Prophylactic Indomethacin and Intestinal Perforation in Extremely Low Birth Weight Infants

Prophylactic indomethacin in extremely low birth weight infants decreases severe intraventricular hemorrhage and patent ductus arteriosus but it is unknown whether concurrent enteral feeding and prophylactic indomethacin is associated with increased risk of spontaneous intestinal perforation.

The combination of prophylactic indomethacin and enteral feeding during the first 3 days after birth does not increase the risk of spontaneous intestinal perforation. (Read the full article)




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Antimicrobial Stewardship Programs in Freestanding Children's Hospitals

Antibiotic overuse is common and is a major public health threat. The prevalence of antimicrobial stewardship programs in children’s hospitals is growing. Single-center studies reveal that antimicrobial stewardship programs are effective in reducing unnecessary antibiotic use. Multicenter evaluations are needed.

Antibiotic use is declining overall across a large network of freestanding children’s hospitals. Hospitals with formalized antimicrobial stewardship programs experienced greater reductions in antibiotic use than other hospitals, suggesting that these interventions are an effective strategy to address antibiotic overuse. (Read the full article)




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Sleep Duration, Restfulness, and Screens in the Sleep Environment

Inadequate sleep has been identified as a risk factor for obesity and other outcomes. Screen time and the presence of a television in the bedroom have been associated with inadequate sleep, but little is known about small screens (eg, smartphones).

Among 2048 fourth- and seventh-graders, children who slept near a small screen reported shorter sleep durations and perceived insufficient rest or sleep. Presence of a television in the bedroom and more screen time were also associated with poorer sleep. (Read the full article)




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Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

Expert consensus recommends rest after concussion with stepwise return to activity. Animal and retrospective human data suggest that early mental and physical activity may worsen outcome. There are no pediatric studies testing the efficacy of recommending strict rest after concussion.

Recommending strict rest postinjury did not improve outcome and may have contributed to increased symptom reporting. Usual care (rest for 1–2 days with stepwise return to activity) is currently the best discharge strategy for pediatric mild traumatic brain injury/concussion. (Read the full article)




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Gestational Age and Developmental Risk in Moderately and Late Preterm and Early Term Infants

There is growing evidence reporting that moderately preterm, late preterm, and early term infants are at increased risk of developmental delay. The characteristics of this association are not well established in the literature.

In a sample of infants born between 32 and 41 weeks, there was an inverse and "dose response" relationship between gestational age and developmental delay risk using the ASQ at 8 and 18 months of corrected postnatal age. (Read the full article)




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Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule

Some parents choose to "spread out" the recommended vaccine schedule for their child by decreasing the number of simultaneous vaccines or delaying certain vaccines until an older age. Epidemiologic studies demonstrate increasing numbers of parents are choosing to delay vaccines.

We demonstrate that almost all providers encounter requests to spread out vaccines in a typical month and, despite concerns, increasing numbers are agreeing to do so. Providers report many strategies in response to requests but think few are effective. (Read the full article)




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Validity of the Strengths and Difficulties Questionnaire in Preschool-Aged Children

Although the psychometric properties of the school-age Strengths and Difficulties Questionnaire (SDQ) have been extensively examined by using longitudinal data, the preschool version of the SDQ has only been explored in a limited number of cross-sectional studies.

This is the first psychometric study of the preschool SDQ using longitudinal data. We report measurement invariance over time, satisfactory reliability, construct and criterion validity, and predictive utility for subsequent behavioral problems (4 years) and clinical disorders (2 years). (Read the full article)




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Estimated Number of Infants Detected and Missed by Critical Congenital Heart Defect Screening

Newborn screening for critical congenital heart defects (CCHDs) has been implemented in many hospitals, yet there is uncertainty about the number of infants with CCHDs that might be detected through universal implementation of newborn CCHD screening in the United States.

We estimated that ~875 infants with CCHDs might be detected, and ~880 missed, annually through universal CCHD screening in the United States. Increases in prenatal diagnosis are unlikely to substantially impact the number of infants detected through CCHD screening. (Read the full article)




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A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation

Pediatric patients suffer higher mortality due to the shortage of transplantable organs. Factors influencing families’ donation decisions are similar for pediatric and adult patients. However, the general perception that families of pediatric patients are less willing to donate persists.

Communication emerged as a critical factor of family authorization, reinforcing its importance in the organ donation process. Patient age (ie, adult versus pediatric) was not predictive of family authorization. (Read the full article)




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Cognition and Brain Structure Following Early Childhood Surgery With Anesthesia

Permanent neuronal deletion and neurocognitive impairment after anesthetic exposure in animals raised substantial concern that similar effects occur in children. Human studies were equivocal but have not combined structural and intelligence tests in otherwise healthy children after childhood anesthesia.

Anesthetic exposure for surgery did not lead to measurable neuronal elimination in brain regions previously identified in animals. However, language comprehension and performance IQ were decreased in exposed children and associated with decreased gray matter, primarily in posterior brain regions. (Read the full article)




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Trends in Morbidity and Mortality of Extremely Preterm Multiple Gestation Newborns

Studies on the risk of mortality and morbidities of extremely preterm infants of multiple gestation births have shown inconsistent results. Perinatal antecedents, admission status and severity of illness after birth can adversely affect outcomes of the extremely premature infants.

Preterm multiple gestation infants have increased risk of mortality but similar risk of major morbidities compared with singletons. Outcomes improved over time and all adverse outcomes, including mortality, were comparable between multiples and singletons in the most recent 5-year epoch. (Read the full article)




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Thrombocytopenia in Small-for-Gestational-Age Infants

Small-for-gestational-age neonates are at risk for thrombocytopenia during the first days and weeks after birth. However, the incidence, duration, severity, responsible mechanism, value of platelet transfusions, and risk of death from this variety of neonatal thrombocytopenia are unknown.

Ten percent of thrombocytopenic small-for-gestational-age neonates have a recognized cause for low platelets (aneuploidy, extracorporeal membrane oxygenation, disseminated intravascular coagulation); they have a high mortality rate (65%). Ninety percent have a moderate, transient (2 weeks), hyporegenerative thrombocytopenia with a low mortality rate (2%). (Read the full article)




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Testing for Abuse in Children With Sentinel Injuries

Several injuries have been suggested to be disproportionately associated with abuse in young children, but rates of abuse among children with these injuries are not currently known.

Abuse is diagnosed commonly in children with sentinel injuries, including the majority of children <24 months with rib fractures. (Read the full article)




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Early-Onset Neutropenia in Small-for-Gestational-Age Infants

Small for gestational age neonates (weight <10th percentile) are at risk for neutropenia during the first days after birth. However, the duration, responsible mechanism, and outcomes of this variety of neonatal neutropenia are not precisely known.

Six percent of small for gestational age neonates had neutrophils <1000/μL, with an average neutropenia duration of 7 days. Neutropenia was more closely linked with small for gestational age status than maternal hypertension. This neutropenia is associated with elevated nucleated red blood cell count and increased odds of necrotizing enterocolitis. (Read the full article)




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Maternal Gestational and Postdelivery Weight Gain and Child Weight

Maternal gestational weight gain is associated with childhood overweight. It is unknown whether gestational weight gain programs the child’s health or whether gestational weight gain is an indicator of postnatal behavioral factors.

We disentangled these influences by studying the effect of gestational weight gain simultaneously with postdelivery maternal weight change as an indicator for shared family lifestyle on child’s weight development and found that both had an independent effect. (Read the full article)




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Testing and Treatment After Adolescent Sexual Assault in Pediatric Emergency Departments

National guidelines recommend testing and prophylaxis for chlamydia, gonorrhea, and pregnancy for adolescent sexual assault victims. Little is known about rates of testing and prophylaxis in adolescent victims of sexual assault evaluated in pediatric emergency departments.

There is significant variation in testing and prophylaxis practices in the pediatric emergency department evaluation of adolescent victims of sexual assault. Adolescents cared for in emergency departments with clinical pathways are more likely to receive recommended prophylaxis. (Read the full article)




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The Best iPad Apps for 2020

Our list of the best iPad apps can transform your iPad, iPad mini, or iPad Pro into the ultimate tablet computer for work and play.




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The Best iPhone Keyboards

Sick of the same-old on-screen keyboard you get with iOS? Download and install a new one and experience keyboard nirvana.




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The 50 Best iPad Games

Sometimes your iPhone just isn't big enough to enjoy the best of iOS gaming. Grab your iPad and take advantage of the expanded screen real estate with these games.




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Neid named best women's coach in FIFA awards

Silvia Neid, who led Germany to Olympic gold in 2016, was named best coach at The Best FIFA Football Awards as Melanie Behringer just missed out on the top player gong.




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From the NFL to MIT: How John Urschel Is Making Math More Interesting

Teachers must reject the idea that math is like eating vegetables, says former offensive lineman and current mathematician John Urschel.




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Fin24.com | MONEY CLINIC: I can save R36 000 a month. What's the best investment strategy?

A South African working abroad, able to save R36 000 per month, hopeful that he will continue these earnings, seeks the best investment strategy. Investment expert Elian Wiener responds.




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Fin24.com | MONEY CLINIC: Is it worth investing in a living annuity during the time of Covid-19?

A Fin24 reader heading into retirement seeks the opinion of an expert on investing during the uncertainty of Covid-19.




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Fin24.com | MONEY CLINIC: As a private individual, can I request a rental payment holiday?

A Fin24 reader whose son is a student at Stellenbosch University and stays at a private residence near the campus wants to know what his options are in requesting a rental payment holiday.




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Protect Your Investment in Innovation: Engage in Change Management

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?




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The Wham-O Pudding Essay Contest Theory of Educational Innovation

I regularly receive invitations to participate in essay contests devoted to rethinking American education. These competitions, I fear, are the worst way to spur real change.




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RHSU Classic: The Wham-O Pudding Essay Contest Theory of Educational Innovation

If I've learned anything after hanging out at a think tank for close to two decades, it's that dreaming up education innovations is easy. Number 12 in our countdown is my take on the goofy contests that talkers seem to be so fond of.




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The 10 Best NES Games

The Nintendo Entertainment System (NES) has a huge, diverse library of games. These are the cream of the crop for Nintendo's iconic 8-bit home console




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The 10 Best Nintendo 64 Games

The N64 game library feels historically slim compared to other Nintendo consoles, but these are the greatest Nintendo games of the 64-bit era




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Netflix Series Reignites 'The Witcher 3' Interest on Steam

The Witcher 3 is more popular on Steam today than at its launch in May 2015, thanks in large part to the Netflix series based on the popular book series.




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Early career professorship established in mechanical engineering

In honor of a recently retired professor, a generous alumnus donation has enabled the creation of the Martin W. Trethewey Early Career Professorship.




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Cuthbert's Chelsea strike named best goal: watch the top ten

Erin Cuthbert's strike for Chelsea at Lyon has been named goal of the season: watch the top ten.




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SB 13-84 Non-domestic Rates

This briefing outlines the nature and purpose of non-domestic (business) rates in Scotland and analyses the most recent data on businesses and revenues from business rates.




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SB 15-32 Non-domestic Rates

17 June 2015This briefing provides information on non-domestic rates and analyses the most recent data on revenues from these rates.




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Penn College to offer building performance training in western PA

Pennsylvania College of Technology’s National Sustainable Structures Center is adding a training site in Westmoreland County to enhance delivery of building science and energy efficiency training for the U.S. Department of Energy’s Weatherization Assistance Program.




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What about errors in antibody testing? | Ask CIDD