Sudden cardiac death in young athletes is an uncommon but devastating event. Addition of routine electrocardiogram (ECG) screening to standard preparticipation care may reduce the number of sudden deaths. Lack of data regarding effectiveness and costs has prevented widespread implementation.

Adding ECG screening to current preparticipation evaluation is not cost-effective. Cost is driven primarily by the evaluation of the large number of false-positive findings. An ECG-only screening strategy is more cost-effective. (Read the full article)

A policy of intubation, mechanical ventilation, and surfactant administration is commonly used for the treatment of respiratory distress syndrome worldwide; however subsequent development of bronchopulmonary dysplasia remains as risk with this standard approach.

Noninvasive surfactant administration technique during spontaneous breathing (Take Care) along with nasal continuous positive airway pressure support successfully reduces the need for further respiratory support and bronchopulmonary dysplasia rate in very low birth weight infants. (Read the full article)

Only 2 randomized controlled trials have addressed effects of ultrasound screening for developmental hip dysplasia. Both concluded that adding universal or selective ultrasound to routine clinical examination gave a nonsignificant reduction in rates of late presenting cases, but higher treatment rates.

This maturity review assesses long-term outcome of one of these trials. Rates of radiographic findings indicating acetabular dysplasia and degenerative change were similar across the 3 screening groups in young adulthood. Increased treatment rates were not associated with avascular necrosis. (Read the full article)

The intestinal microbiome may play a role in immune system maturation, and it has been postulated that early-life probiotic administration may reduce the risk of allergies and asthma in childhood. To date, however, results from clinical trials have been inconsistent.

In this meta-analysis, administration of probiotics in early life may reduce total immunoglobulin E level and protect against atopic sensitization but do not seem to protect against asthma/wheezing. Future trials should carefully select probiotic strains and include longer follow-up. (Read the full article)

Preterm infants can be successfully resuscitated with <100% oxygen (O₂); however, initiation with room air remains controversial. Current Neonatal Resuscitation Program (NRP) guidelines suggest using air or blended O₂ to titrate O₂ to meet target preductal saturation goals.

This is the first trial to compare a limited O₂ strategy to target NRP–recommended transitional goal saturations versus a high O₂ strategy in preterm infants. The limited O₂ strategy decreased integrated excess oxygen and oxidative stress and improved respiratory outcomes. (Read the full article)

The management of term and near-term newborns suspected of early-onset sepsis, particularly when they are not clearly symptomatic, remains controversial. Methods for quantifying risk that combine maternal factors with a newborn's evolving clinical examination have been lacking.

This study provides a method for predicting risk of early-onset sepsis. It combines maternal risk factors with objective measures of a newborn's clinical examination and places newborns into 3 risk groups (treat empirically, observe and evaluate, and continued observation). (Read the full article)

Quality measures developed by the Pediatric Quality Measures Program are required to assess disparities in performance according to special health care need status. Methods are needed to identify children according to level of medical complexity in administrative data.

The Pediatric Medical Complexity Algorithm is a new, publicly available algorithm that identifies the small proportion of children with complex chronic disease in Medicaid claims and hospital discharge data with good sensitivity and good to excellent specificity. (Read the full article)

Most therapeutic products used in children have not been studied in that population. There is a need for special incentives and market protection (pediatric exclusivity) to compensate drug sponsors for studying these products in children.

Of 189 products studied under pediatric exclusivity, 173 (92%) received new labeling information. Pediatric efficacy was not established for 78 (42%), including 81% of oncology drugs. Probability of demonstrating efficacy was related to therapeutic area and year exclusivity was granted. (Read the full article)

National adolescent vaccination coverage estimates in 2013 among 13- to 17-year-olds are 86% for Tdap vaccine and 78% for MCV4. Comparatively, coverage with ≥3 doses of HPV vaccine is 38% among girls and 14% among boys.

One-fourth of 11-year-olds had HPV vaccine co-administered with Tdap vaccine, compared with two-thirds who had MCV4 co-administered. Whereas by age 17 years, >92% received Tdap vaccine and MCV4, only half of girls and one-fifth of boys completed HPV vaccination. (Read the full article)

Immune-related bioactive proteins are highly concentrated in the colostrum of mothers who deliver preterm infants. Oropharyngeal administration was proposed as a safe and feasible alternative method of providing colostrum to immunocompromised premature infants.

Oropharyngeally administered colostrum during the first few days of life increased urinary secretory immunoglobulin A and lactoferrin, decreased urinary interleukin-1β, reduced salivary transforming growth factor-β1 and interleukin-8, and reduced the occurrence of clinical sepsis in extremely premature infants. (Read the full article)

The number of nurse practitioner graduates in the United States has nearly doubled over the past 2 decades. However, the number of pediatric nurse practitioner (PNP) graduates has remained relatively flat, although the demand for PNPs is expected to increase.

This study estimates the best-case shortage of PNPs over the next 25 years. We propose possible policy interventions to address key areas of the PNP workforce system and we compute their impact on the forecasted PNP shortage. (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)

Noninvasive ventilation (NIV) reduced the need of intubation in preterm infants with RDS. However, randomized studies comparing nasal synchronized intermittent positive pressure ventilation and bilevel continuous positive airway pressure are still lacking.

The present study shows no differences in short-term outcomes between 2 different NIV strategies, nasal synchronized intermittent positive pressure ventilation and bilevel continuous positive airway pressure, in preterm infants for the initial treatment of RDS. (Read the full article)

Childhood bacteremia caused by vaccine-preventable organisms has substantially declined over the last decade. Recognition of bacteremia in children is difficult, and delayed administration of antibiotics is associated with poor outcomes. Adults with health care–associated Gram-negative bacteremia experience delays in receiving appropriate antibiotics.

Bacteremia in children presenting to the emergency department is increasingly health care associated and resistant to empirical antibiotics. These infections are associated with increased length of stay. Rates of Gram-negative bacteremia have increased, and children with Gram-negative bacteremia experience delayed antibiotic administration. (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 studies have shown that concomitant administration of the quadrivalent human papillomavirus vaccine with MCV4 and Tdap was generally well tolerated and did not interfere with the immune responses to the respective vaccines.

Concomitant administration of the novel 9-valent human papillomavirus vaccine with MCV4 and Tdap, 2 vaccines that are currently recommended for routine vaccination of adolescents, did not compromise the safety, tolerability, and immunogenicity of the individual vaccines. (Read the full article)

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.

A Fin24 reader who bought a property in December 2019 sent his registration papers off just before the lockdown was announced, which was unfortunately too late. A property law expert responds.

The requests put the nation's special education administrators in conflict with disability rights advocates who fear waivers will place millions of special education students at risk.

The Institutes of Energy and the Environment, in collaboration with Stewarding Our Planet's Resources, announced two separate community forums aimed at providing reports on existing energy and environmental activities and strategic opportunities as well as soliciting community input and recommendations for the future.

Fin24 users speak of their frustrations with banks, calling for a crackdown on debit order fraud that sees payments they didn't authorise being deducted from their bank accounts each month.

There are three challenges facing investors going forward, HSBC chief market strategist at HSBC Private Bank tells Fin24.

The requests put the nation's special education administrators in conflict with disability rights advocates who fear waivers will place millions of special education students at risk.

New ways of paying teachers launched by districts such as Denver and Houston are alone unlikely to produce the sweeping change that is needed on the compensation front, a report from the National Governors Association says.

Whether you're a first-year student looking to get a head start on your college career, a current student looking to get ahead or catch up, or a student at another college or university looking to earn credits over the summer, Penn State Brandywine offers numerous summer learning opportunities. Registration remains open for summer classes.

Students report that schools' filters, firewalls, and blockage of social media sites are obstacles to their use of educational technology.

052 - Further analysis of national team competitions needed

I hit the phone a few more times to try to cancel my TV service, and found even sketchier behavior on the part of Verizon Fios.

Customer relationship management spent the last couple of years going social. Make sure your CRM strategy incorporates this important new capability in 2020.

There's no one-stop shop to get everything you need from education policy, politics, and practice, writes academic Deven E. Carlson.

The organization hopes the change, which will take place starting with the next round of exams in November, will make it more affordable for students to take the tests.

The DJI Mavic Mini weighs just 249 grams, so you can fly it in the US—and many other regions—without having to register it with the government. It has very capable specifications, but also some artificial limitations we're not happy to see.

Coalition of 21 attorneys general argues changes violate federal law and judicial precedent Attorney General Kathy Jennings joined Friday a group of 21 state attorneys general to challenge the Trump administration’s proposed changes to asylum standards. If implemented, these changes would allow the Executive branch to arbitrarily deny asylum claims to immigrants seeking haven from […]

Attorney General Kathy Jennings today announced that she is joining a lawsuit opposing the Trump Administration’s new rule circumventing the Flores Settlement Agreement, which has governed the treatment of children in immigration custody since 1997. In the complaint before the U.S. District Court for the Central District of California, the coalition argues that the rule eliminates several critical protections […]

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.

The Delaware Division of the Arts and the National Arts Program® present the 9th Annual Delaware State Employee Art Exhibition Dover, Del. (December 9, 2019) – The Delaware State Employee Art Exhibition is designed to give Delaware state employees and their families, at any skill level, a unique opportunity to exhibit their artwork and to […]

In digital advertising today, innovation is the name of the game. The idea is to create customer-centric campaigns that leverage reach, hold attention and help in conversion.

The US is working to temporarily ban the issuance of some work-based visas like H-1B, popular among highly-skilled Indian IT professionals, as well as students visas and work authorisation that...

The Delaware Office of State Planning Coordination announces the release of the draft 2015 Strategies for State Policies and Spending Update.

Director Ann Shepard Visalli will conclude her tenure leading Delaware’s Office of Management and Budget (OMB) next month following more than seven years leading the Markell Administration’s efforts to balance challenging budgets while making key investments that have strengthened the economy, improved the education system, and enhanced quality of life throughout the state.

Administrative Tribunal Act, 1985

Visitors to the Delaware State Fair can learn how to cook Japanese foods, carve a chicken, eat healthy on a budget and make a watermelon banana split – all in one place, at the Department of Agriculture’s Education Building. Starting Friday, July 19, DDA and its partners will offer a lineup of free food and cooking demonstrations every day of the fair.

Following up on the recent announcement of USDA’s approval of Delaware’s Domestic Hemp Production Program, the Delaware Department of Agriculture released their registration materials online Friday, February 7.

Here Mudassar Ahmed Khan has explained with an example, how to build a simple user Registration and Login forms in ASP.Net MVC Razor. The user Registration and Login forms will be built using SQL Server Database. The Database connection and operations for user Registration and Login forms will be performed using Entity Framework in ASP.Net MVC Razor.

Agency: OMB Closing Date: 6/3/2020

NEW CASTLE (March 27, 2018) – The annual Volunteer Delaware Conference, the state’s leading conference for organizations and individuals making a difference in their communities through volunteerism, is set for April 30 in Dover. Presented by the Delaware State Office of Volunteerism (SOV) and the Delaware Association of Volunteer Administrators (DAVA), the conference will feature […]