Pneumococcal conjugate vaccines are effective in preventing pneumococcal disease but are also costly. Although the current US immunization schedule recommends 4 doses, many countries have adopted 3-dose schedules that have worked well, but may provide less protection against pneumococcal disease.

Changing the US 13-valent pneumococcal conjugate vaccine schedule from 3 to 2 primary doses while keeping a booster dose would save $412 million annually but might lead to moderate increases in pneumococcal disease, especially otitis media and pneumonia. (Read the full article)

Critical congenital heart disease (CCHD) was recently added to the US Recommended Uniform Screening Panel for newborns.

Routine screening could cost an estimated additional $6.28 per newborn and $40 385 per life-year gained. The incremental cost of screening might be approximately $0.50 per newborn with reusable sensors. Future analysis of newborn screening programs may help refine these projections. (Read the full article)

Persons with sickle cell anemia are known to have increased medical expenses, but little is known about the effects of hydroxyurea treatment on costs. In adults with severe sickle cell anemia, hydroxyurea has been reported to reduce expenses from hospitalization.

In this randomized placebo-controlled prospective multicenter trial of hydroxyurea in very young children with sickle cell anemia, not selected for severity, hydroxyurea was associated with significant medical cost savings due to a reduction in hospitalization expenses. (Read the full article)

Infant postexposure prophylaxis prevents perinatal hepatitis B (HepB) virus transmission and mortality and morbidity caused by chronic HepB virus infection. The US Perinatal Hepatitis B Prevention Program (PHBPP) identifies and manages infants born to HepB surface antigen–positive women.

It presents the first estimates of the long-term costs and outcomes of postexposure prophylaxis with the PHBPP. It analyzes the effects of the PHBPP, and alternative immunization scenarios, on health and economic outcomes for the 2009 US birth cohort. (Read the full article)

Violence is a leading cause of death. The emergency department (ED) can prevent violence through proven interventions; however, these interventions are not broadly implemented. There is little evidence to inform decision-makers of the costs associated with preventing violence.

We report the costs of a brief violence prevention intervention in the ED. We highlight the economic impact of implementation, showing that brief interventions in the ED are an inexpensive way the health care system can prevent violence in adolescents. (Read the full article)

Congenital heart disease is known to be a commonly treated and resource-intense condition across children’s hospitals, yet knowledge regarding the degree of cost variation across hospitals and associated factors is lacking.

Using a linked clinical and administrative data set, we establish benchmarks for hospital costs for common congenital heart operations, and demonstrate wide variation in cost between hospitals related in part to differences in length of stay and complications. (Read the full article)

The pediatric mental health burden is substantial, with >4 million children meeting criteria for a mental health disorder. Mental health is a key priority for national pediatric inpatient quality measures, but little is known about admitted patients and their diagnoses.

Nationally, nearly 10% of hospitalizations in children >3 years are for primary mental health diagnoses. The most common and costly are depression, bipolar disorder, and psychosis. Fewer free-standing children’s hospitalizations (3%) were for mental health admissions, although diagnostic distributions were similar. (Read the full article)

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)

Children with shaken-baby syndrome, or abusive head trauma (AHT), have lasting health and development problems. The long-term medical cost of AHT is unknown.

Patients with AHT had higher inpatient, outpatient, and drug costs compared with other children for 4 years after their abuse diagnosis, amounting to tens of thousands of dollars in excess and preventable medical care per patient with AHT. (Read the full article)

Numerous studies have demonstrated clinical benefits of medical emergency team (MET) implementation, including reductions in mortality, cardiac arrests, and critical deterioration events. No studies have evaluated the financial costs and benefits of METs.

The costs of operating an MET can plausibly be recouped with a modest reduction in critical deterioration events. Hospitals reimbursed with bundled payments could see real financial savings by reducing critical deterioration events with a MET. (Read the full article)

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an important risk factor for neonatal jaundice in Nigeria. It is associated with severe hyperbilirubinemia among infants exposed to icterogenic agents. Elevated bilirubin levels have occasionally been demonstrated in G6PD-deficient infants without exposure to icterogenic agents.

Even without exposure to known icterogens, G6PD-deficient infants have a more rapid hematocrit decline and higher bilirubin levels than their G6PD-intermediate and G6PD-normal counterparts throughout the first week of life. (Read the full article)

In 2003, the US Food and Drug Administration issued warnings about hyperglycemia and diabetes with second-generation antipsychotics (SGAs). Since 2004, hyperglycemic and diabetes risk with SGAs has been stated in product labels, and published guidelines have recommended baseline metabolic screening.

Between 2006 and 2011, 11% of children 2 to 18 years starting an SGA had baseline glucose assessed. Youth at risk for diabetes may not be identified. Further, lack of screening impedes determining the contribution of SGAs to hyperglycemia. (Read the full article)

Application of antenatal corticosteroids to mothers before delivery is highly beneficial to very low birth weight infants. Yet despite widespread quality improvement efforts, many eligible infants fail to receive this therapy.

We demonstrate improvement in antenatal corticosteroid use during the study period. However, significant regional variation persists, which network-level quality improvement efforts might help eliminate. (Read the full article)

Accountable care organizations are expanding. In pediatrics, however, there is no information on cost savings or quality generated by such organizations.

Partners for Kids is a pediatric accountable care organization that increased value for Medicaid children in 34 Ohio counties, primarily through cost savings. This slowing in cost growth was achieved without diminishing the overall quality or outcomes of care. (Read the full article)

Pediatric palliative care (PPC) improves the quality of life for children with life-limiting illness and their families. The association between PPC and health care costs is unclear and has not been studied over time.

PPC recipients were more medically complex. Receipt of PPC was associated with lower costs when death was near but with greater costs among survivors. When controlling for medical complexity, costs did not differ significantly according to receipt of PPC. (Read the full article)

Mortality rates and health care expenditures are high among infants requiring surgery for necrotizing enterocolitis. The impact of different surgical managements on mortality remains equivocal. Adjusted economic differences for various surgical treatments may exist but have not been elucidated.

After performing a relatively large-scale, adjusted analysis of cost and mortality for surgical managements currently used for treating necrotizing enterocolitis, a cost-benefit for a particular surgical approach was demonstrated while accounting for comorbidities and group assignment bias. (Read the full article)

Otorrhea is common in children with tympanostomy tubes: annually, 2 of 3 children develop 1 or more episodes. Antibiotic-glucocorticoid eardrops are the most effective treatment in both the short- and long-term.

Treatment with antibiotic-glucocorticoid eardrops costs less than oral antibiotics and initial observation in children with tympanostomy tubes who develop otorrhea. Non–health care costs constitute a substantial proportion of the total costs of this condition. (Read the full article)

Biotinidase deficiency (BD) might cause severe and permanent consequences. Cases detected through newborn screening and under treatment are shown to remain asymptomatic. However, some countries, including Spain, do not provide universal BD screening within their national newborn screening programs.

It provides a first estimate of the lifetime costs and health outcomes of a Spanish birth cohort with and without neonatal screening for BD. It shows that newborn screening for BD is likely to be a cost-effective use of resources. (Read the full article)

In adults, there is significant increased length of stay, cost, and/or resource use associated with hospital-acquired conditions. Less is known about the epidemiology and impact of many hospital-acquired conditions in pediatric populations.

We find increased pediatric length of stay and costs due to venous thromboembolism and catheter-associated urinary tract infections. This is essential information for hospital administrators and safety departments who are planning interventions to reduce harm associated with these hospital-acquired conditions. (Read the full article)

Adolescent vaccination rates lag behind other childhood vaccines. Text messaging to improve uptake of adolescent vaccines has been shown to be effective in academic centers but has not been studied in other settings.

This study, done in 5 private and 2 safety-net practices, used a bidirectional text message as a behavioral prompt and showed text messaging was effective at increasing uptake of all adolescent vaccines. Costs were similar to other reminder/recall methods. (Read the full article)

Glucose-6-phosphate dehydrogenase deficiency remains a global as well as a North American burden for extreme hyperbilirubinemia and kernicterus and is often unpredictable during the first few days after birth. Newborn screening for this enzyme deficiency is not universally available but debated.

Point-of-care screening, using digital microfluidics, provides accurate, low blood volume, and affordable technology for rapid newborn glucose-6-phosphate dehydrogenase enzyme screening that could guide clinicians before infants’ discharge from well-child nurseries and meet existing American Academy of Pediatrics’ recommendations. (Read the full article)

For decades, special education advocates have urged the federal government to "fully fund" the Individuals with Disabilities Education Act. Here are some examples 'ripped from the headlines' of how the funding gap is affecting school districts.

Mucormycosis is a life-threatening infection with high mortality that occurs predominantly in immunocompromised patients. Manogepix (MGX) is a novel antifungal that targets Gwt1, an early step in the conserved glycosylphosphotidyl inositol (GPI) post-translational modification pathway of surface proteins in eukaryotic cells. Inhibition of inositol acylation by MGX results in pleiotropic effects including inhibition of maturation of GPI-anchored proteins necessary for growth and virulence. MGX has been previously shown to have in vitro activity against some strains of Mucorales. Here we assessed the in vivo activity of the prodrug fosmanogepix, currently in clinical development for the treatment of invasive fungal infections, against two Rhizopus arrhizus strains with high (4.0 μg/ml) and low (0.25 μg/ml) minimum effective concentration (MEC) values. In both invasive pulmonary infection models, treatment of mice with 78 mg/kg or 104 mg/kg fosmanogepix, along with 1-aminobenzotriazole to enhance the serum half-live of MGX in mice, significantly increased median survival time and prolonged overall survival by day 21 post infection when compared to placebo. In addition, administration of fosmanogepix resulted in a 1-2 log reduction in both lung and kidney fungal burden. For the 104 mg/kg fosmanogepix dose, tissue clearance and survival were comparable to clinically relevant doses of isavuconazole (ISA), which is FDA approved for the treatment of mucormycosis. These results support continued development of fosmanogepix as a first in class treatment for invasive mucormycosis.

Brain infections with Cryptococcus neoformans are associated with significant morbidity and mortality. Cryptococcosis typically presents as meningoencephalitis or fungal mass lesions called cryptococcomas. Despite frequent in vitro discoveries of promising novel antifungals, the clinical need for drugs that can more efficiently treat these brain infections remains. A crucial step in drug development is the evaluation of in vivo drug efficacy in animal models. This mainly relies on survival studies or post-mortem analyses in large groups of animals, but these techniques only provide information on specific organs of interest at predefined time points. In this proof-of-concept study, we validated the use of non-invasive preclinical imaging to obtain longitudinal information on the therapeutic efficacy of amphotericin B or fluconazole monotherapy in meningoencephalitis and cryptococcoma mouse models. Bioluminescence imaging (BLI) enabled the rapid in vitro and in vivo evaluation of drug efficacy while complementary high-resolution anatomical information obtained by magnetic resonance imaging (MRI) of the brain allowed a precise assessment of the extent of infection and lesion growth rates. We demonstrated a good correlation between both imaging readouts and the fungal burden in various organs. Moreover, we identified potential pitfalls associated with the interpretation of therapeutic efficacy based solely on post-mortem studies, demonstrating the added value of this non-invasive dual imaging approach compared to standard mortality curves or fungal load endpoints. This novel preclinical imaging platform provides insights in the dynamic aspects of the therapeutic response and facilitates a more efficient and accurate translation of promising antifungal compounds from bench to bedside.

Avast is harvesting users' browser histories on the pretext that the data has been 'de-identified,' thus protecting your privacy. But the data, which is being sold to third parties, can be linked back to people's real identities, exposing every click and search they've made.

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.

For decades, special education advocates have urged the federal government to "fully fund" the Individuals with Disabilities Education Act. Here are some examples 'ripped from the headlines' of how the funding gap is affecting school districts.

Perhaps there were some who had hoped for a dossier of lurid juiciness.

CNA Staff, May 4, 2020 / 03:53 pm (CNA).- When he was just 15 years old, Fr. Geison Gerardo Ortiz Marín had to quit school and find a job to help support his family.

Faced with a difficult economy, Ortiz’s family was struggling financially. He quit school and found a job opportunity at a neighboring family’s bakery, where he worked for five years.

The priest told ACI Prensa, CNA’s Spanish language news partner, that he learned important life skills from the job, such as “knowing what it is to meet a schedule, getting up at dawn and working overtime. In short, it was an enriching experience.”

He took those life skills with him when he entered seminary at age 21. He has now been a priest for 10 years and serves as pastor of Saint Rose of Lima parish in Ciudad Queseda in northern Costa Rica.

Recently, however, Ortiz has returned to his roots as a baker to raise funds for the needy in his parish during the coronavirus pandemic.

Public Masses were suspended a month ago in Costa Rica due to the pandemic. As the lockdown continued, the priest could see the financial strain mounting on members of the community.

“A lot of people starting knocking on the rectory door asking for help, while the parish and local charitable groups weren’t getting any income from the collection,” he explained.

So Ortiz began baking. He uses around 55 lbs. of flour each workday to bake different kinds of bread, rolls and other items. A bag of baked goods sells for 1500 colones, or about $2.65.

“With 1500 colones here we can buy perhaps a 5-pound package of rice,” he said, adding that he has been able to help about 60 families so far.

From the sale of baked goods, he was able to raise extra funds, he said, which have ensured that anyone who has knocked on the rectory door has left with a package of rice, sugar or beans.

No one has been sent away empty handed, the priest said.

“I work all day long baking bread, selling it, and in the evenings I celebrate the Eucharist. I always tell the Lord, 'Thank you for the true bread that gives eternal life, which is the greatest of riches and is what I want our people to have, receive, taste and feel',” he said.

Ortiz encouraged other priests to find creative ways to help serve those in need during the challenging times presented by the pandemic.

“I believe that this is a special moment,” he said. “God has allowed me to return to my origins. God has allowed me to help meet the needs of our brothers. This is a moment in which the Lord is allowing us to live in solidarity and to reach out in a very special way.”

Private Internet Access graces macOS with a snazzy client, robust service, and smattering of advanced features that make it good value.

Bundles for internet, TV, and phone service might seem appealing when you sign up, but they're an intentionally complicated nightmare if you want to trim what you're paying for down the line.

And in some districts, shorter school weeks hurt the bottom line.

The pharmaceutical retailer says it was forced to increase prices of surgical masks because of suppliers' inflated quotes and to match competitors, while the commission says retailers could have been following Dis-Chem's lead.

Alexandre Lacazette's late goal in Greece has given Arsenal the advantage, although Olympiacos won their last game away to the Gunners.

Olympiacos's reward for a dramatic victory against 2019 runners-up Arsenal is another tie against English opposition, Wolverhampton Wanderers.

After a 1-1 draw in Piraeus, Wolverhampton Wanderers and Olympiacos meet at Molineux to decide their round of 16 tie.

The majority of pediatric hospitalization costs are associated with the room; improvement projects that address room costs could have the most financial impact.

Using a matched cohort design, in this study, we define the adverse clinical and financial implications of UEs in the NICU.

Just as there’s magic value in compounding interest there’s mass destruction in compounding costs.

As currently funded, $278 million project would unfairly burden electric ratepayers on Delmarva WILMINGTON, Del. – Delaware Governor John Carney and Maryland Governor Larry Hogan on Tuesday sent a letter to members of the Federal Energy Regulatory Commission, urging commissioners to expedite their review of the $278 million Artificial Island transmission line project and consider a […]

State employees, members of the public can submit ideas for cost savings, improvements across state government WILMINGTON, Del. – Governor Carney on Thursday announced the launch of a website for the Government Efficiency and Accountability Review Board, gear.delaware.gov, to identify opportunities for cost savings and system improvements across state government. In February, Governor Carney signed Executive […]

Op-ed by Rick Geisenberger, Secretary of the Delaware Department of Finance Over the next several weeks, as we complete another budget debate in Dover, we should not lose sight of Delaware’s long-term challenges and of one issue in particular: the rising cost of health care. The projected growth rate for state spending on health care […]

NEW CASTLE (Aug. 1, 2019) – As a way to improve the health of Delawareans who are covered by Medicaid, while potentially reducing overall health care spending, the Department of Health and Social Services’ two Medicaid managed care organizations are making the YMCA’s Diabetes Prevention Program available to their members who meet eligibility criteria. The […]

Like Maharashtra and Telangana, Odisha has also been forced to cut expenditure and defer some others, including salary payments to manage the finances at the current juncture.

Launched alongside the Mi 10 flagship phone and Mi Box 4K, on Friday, the Mi True Wireless Earphones 2 look a lot like the Apple AirPods but they cost way less.

However, if someone wants to buy a comprehensive health cover, it would cost them Rs 8,000-11,000 for Rs 10 lakh sum insured.

  Cocos2D is a game engine that works with various devices from PCs to smart phones. This engine supports the vast majority of the features needed to make wonderful 2D-based games; it even includes a fu...

  Last year this month Intel's CEO Brian Krzanich introduced the world to the Intel Edison chip. This year he is introducing to us the Intel Curie, a button sized module using the Intel Quark SE SoC...

With the increased WMA limit, state governments are expected to plan their market borrowings in a better way rather than bunch up their borrowings, leading to oversupply issues.

For the April-July 2019 period, domestic sales declined by 22% to 2,23,612 units (as compared to 2,86,726 units sold in the same period last fiscal).