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David Torrance: Why playing the history card could be key to Labour's resurgence

The Scottish Labour Party, I think it’s fair to say, hasn’t had a good decade.




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Is Your School Affirming Institutional Racism During Black History Month?

One particularly tense staff meeting helped educator Robert Parker rethink how his school celebrated Black History Month.




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Why Do Schools Hang On to Discriminatory Dress Codes?

School dress codes are clashing with students, parents, and researchers who see the rules and their enforcement as rife with racism and sexism. Some school leaders say the codes are important for safety and teaching kids to comply.




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In Alabama Case, Desegregation History Defeats District's Secession Effort

The appeals court put the brakes on a predominantly white community's racially tinged efforts to secede from a larger school system.




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Biden's Segregation Comments Resurrect His Anti-Busing History

Former Vice President Joe Biden’s recent remarks on his willingness to work with segregationists resurrected his long-ago efforts to oppose school busing. Will it hurt his campaign?




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Serkan stunner sets up Istanbul victory

Hosts Istanbul have the early initiative in Group A after a stunning long-range strike from Serkan Uysal, a free-kick and a late penalty earned a 3-0 win against Ukraine's Ingulec.




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Why Bilingual Education Should Be Mandatory

While foreign language requirements have long been a core requirement for high school graduation--second language classes at an earlier age would improve overall fluency for most students.




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Biden's Segregation Comments Resurrect His Anti-Busing History

Former Vice President Joe Biden’s recent remarks on his willingness to work with segregationists resurrected his long-ago efforts to oppose school busing. Will it hurt his campaign?




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Noninvasive Ventilation for Respiratory Distress Syndrome: A Randomized Controlled Trial

Nasal continuous positive airway pressure (NCPAP) has been the initial respiratory support for many preterm infants with respiratory distress syndrome (RDS). Nasal intermittent positive-pressure ventilation (NIPPV) seems to increase the beneficial effects of NCPAP by combining it with ventilatory inflations.

This study suggests that NIPPV, as an intial respiratory support for preterm infants with RDS, is feasible and safe and may have beneficial effects, when compared with NCPAP. (Read the full article)




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Corticosteroid Pulse Combination Therapy for Refractory Kawasaki Disease: A Randomized Trial

The efficacy of intravenous immunoglobulin and corticosteroid pulse combination therapy for refractory Kawasaki disease has been established. The Egami score can be used to predict which patients are likely to have refractory Kawasaki disease.

As a new strategy for primary treatment, intravenous immunoglobulin and corticosteroid pulse combination therapy is safe and effective for patients predicted to have refractory Kawasaki disease based on the Egami score. (Read the full article)




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Childhood Cumulative Risk and Obesity: The Mediating Role of Self-Regulatory Ability

Pediatric weight gain is a critical aspect of the obesity epidemic. Chronic stress produces physiologic perturbations capable of altering brain mechanisms related to eating as well as those implicated in self-regulatory behaviors.

We show that early childhood risk exposures are associated with weight gain in adolescence, independent of childhood BMI. We also find that deficiencies in self-regulatory processes help explain the link between chronic stress and adiposity. (Read the full article)




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The Natural Course of Infantile Spinal Muscular Atrophy With Respiratory Distress Type 1 (SMARD1)

Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a progressive, inherited neuromuscular disease manifesting with diaphragmatic paralysis in the first year of life. All patients need mechanical ventilation.

We describe the natural course of SMARD1, developed a scoring system, and defined prognostic values. The clinical outcome of the patients was heterogeneous, and residual enzymatic activity of the IGHMBP2 protein was associated with a more benign disease course. (Read the full article)




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Human Rhinoviruses in Severe Respiratory Disease in Very Low Birth Weight Infants

Human rhinovirus infections are common in children. Although historically associated with upper respiratory tract illness, rhinoviruses are increasingly recognized for their role in the exacerbation of asthma. Their role in bronchiolitis and severe lung disease in premature infants is unclear.

The authors of this study prospectively explore the role of rhinoviruses in premature infants using molecular techniques and identify these agents as the most frequent cause of hospitalization in this population. (Read the full article)




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RCT of Montelukast as Prophylaxis for Upper Respiratory Tract Infections in Children

Upper respiratory tract infections (URIs) are very common in children. Currently, there are no effective preventive measures for URI. There are no studies on the effect of montelukast for prevention of URI.

In a randomized, double-blind, placebo-controlled study of preschool-aged children, 12-week prophylactic treatment with montelukast did not reduce the incidence of URI. (Read the full article)




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Nasal Continuous Positive Airway Pressure With Heliox in Preterm Infants With Respiratory Distress Syndrome

Nasal continuous positive airway pressure (NCPAP) is a noninvasive ventilatory support that may reduce the need for mechanical ventilation in preterm infants with respiratory distress syndrome. Heliox, a helium-oxygen mixture, has shown positive effects, especially in obstructive diseases.

NCPAP with heliox reduces the need for mechanical ventilation in preterm infants with respiratory distress syndrome in comparison with NCPAP with medical air. (Read the full article)




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Morbidity and Mortality of Neonatal Respiratory Failure in China: Surfactant Treatment in Very Immature Infants

Although China has the largest birth population in the world and a number of multicenter studies of neonatal respiratory failure are reported, there is a paucity of data regarding outcome measurement of very premature neonates requiring respiratory care and surfactant therapy.

This study is the largest survey, to date, in a Chinese network of 55 NICUs that presents the incidence, morbidity, and mortality rates, with risk factors of neonatal respiratory failure, with special emphasis on surfactant-treated very immature infants. (Read the full article)




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Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children

Some but not all randomized trials have shown effects of probiotics on incidence and duration of diarrhea and respiratory tract infections among children in developing countries. Calcium improves resistance to intestinal infections in adults, but efficacy in children is unknown.

Lactobacillus reuteri DSM17938 may prevent diarrhea, especially in children with lower nutritional status. Regular calcium milk, alone or with Lactobacillus casei CRL431, did not reduce diarrhea. None of the interventions affected respiratory tract infections in these Indonesian children. (Read the full article)




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Risk Factors for Hospitalization With Lower Respiratory Tract Infections in Children in Rural Alaska

Rural Alaska children have high rates of hospitalization with lower respiratory tract infections from a variety of pathogens. Past studies of risk factors for respiratory syncytial virus infection associated medically high-risk status, household crowding, and infant feeding practices with hospitalization.

This study reveals the importance of medically high-risk status and infant feeding practices as important factors in respiratory hospitalization. In addition, we identified woodstove use and the absence of 2 or more sinks in household as risk factors for hospitalization. (Read the full article)




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Respiratory Tract Illnesses During the First Year of Life: Effect of Dog and Cat Contacts

Respiratory infectious symptoms are common during the first year of life. Day care attendance, older siblings, and lack of breastfeeding have been considered as possible factors influencing early respiratory tract infections.

Children with early dog contacts seem to have fewer infectious respiratory symptoms and diseases, especially otitis, during the first year of life. (Read the full article)




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An Evaluation of Mother-Centered Anticipatory Guidance to Reduce Obesogenic Infant Feeding Behaviors

Childhood obesity occurs in 20% of children before they enter kindergarten. Treatment is difficult, making prevention desirable, but little is known about effective methods using anticipatory guidance to prevent obesity in pediatric primary care.

This study provides a comparison of 2 approaches versus usual care using anticipatory guidance to improve infant feeding during the first year of life, and demonstrates positive specific feeding behavior differences at 1 year in the intervention groups. (Read the full article)




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Randomized Trial of Vitamin D Supplementation and Risk of Acute Respiratory Tract Infection in Mongolia

A growing number of epidemiologic studies suggest that individuals with lower vitamin D levels are at higher risk of acute respiratory tract infection. Randomized controlled trials are needed to determine if vitamin D supplementation would decrease this risk.

In a randomized controlled trial of 247 Mongolian children with vitamin D deficiency in winter, with double-blinding and 99% follow-up, vitamin D supplementation significantly reduced the risk of acute respiratory tract infections. (Read the full article)




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Hypertension Screening During Ambulatory Pediatric Visits in the United States, 2000-2009

The American Academy of Pediatrics and National Heart, Lung, and Blood Institute recommend routine blood pressure measurement in children. Little is known about the frequency with which blood pressure is currently measured in ambulatory pediatric settings in the United States.

Between 2000 and 2009, providers measured blood pressure during only one-third of ambulatory pediatric visits and two-thirds of pediatric preventive visits. The current rate of screening is especially low for children aged 3 to 7 years. (Read the full article)




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Factors Influencing Participation in a Population-based Biorepository for Childhood Heart Disease

Understanding human disease genomics requires large population-based studies. There is lack of standardization, as well as social and ethical concerns surrounding the consent process for pediatric participation in a biorepository.

The study identifies specific barriers to pediatric participation in biorepositories relative to adults, and proposes strategies to improve ethical and responsible participation of pediatric-aged patients in large-scale genomics and biorepository-driven research without significantly increasing research burden for affected families. (Read the full article)




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Autism After Infection, Febrile Episodes, and Antibiotic Use During Pregnancy: An Exploratory Study

It has been suggested that maternal immune activation during pregnancy is associated with cardinal behaviors of autism in the offspring. Epidemiologic studies have yielded conflicting results concerning the association between any infection during pregnancy and the development of autism.

This population-based cohort study investigated the association between specific common infectious diseases, febrile episodes, or use of antibiotics during pregnancy by using maternal population-based self-reported data. (Read the full article)




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Single ABCA3 Mutations Increase Risk for Neonatal Respiratory Distress Syndrome

Neonatal respiratory distress syndrome is the most common respiratory cause of mortality and morbidity among US infants aged <1 year. Although neonatal respiratory distress syndrome is a heritable disorder, common genetic variants do not fully explain disease heritability.

Single ABCA3 mutations are overrepresented among term and late preterm (≥34 weeks’ gestation) European-descent infants with RDS. Although ABCA3 mutations are individually rare, they are collectively common in the European- and African-descent general population, present in ~4% of individuals. (Read the full article)




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Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn

Knowledge is limited regarding the epidemiology of persistent pulmonary hypertension of the newborn (PPHN). Previous work has implicated a host of perinatal risk factors and a few antenatal antecedents of PPHN, including maternal consumption during pregnancy of nonsteroidal antiinflammatory medications.

In contrast to results of previous studies, we found no association between PPHN and maternal consumption during late pregnancy of nonsteroidal antiinflammatory drugs in general or ibuprofen in particular. (Read the full article)




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Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children

Accurately identifying ill hospitalized children with vital signs concerning for clinical deterioration is fundamental to inpatient pediatrics. Normal vital sign ranges for healthy children are useful for outpatient practice but have limited application to detecting deterioration in the hospital setting.

Percentile curves for heart and respiratory rate in hospitalized children were developed and validated. The distributions differed from existing reference ranges and early warning scores. They may be useful to identify vital signs deviating from ranges expected among hospitalized children. (Read the full article)




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Heated, Humidified High-Flow Nasal Cannula Versus Nasal CPAP for Respiratory Support in Neonates

Heated, humidified high-flow nasal cannula (HHHFNC) is a noninvasive mode of respiratory support that is commonly used in the majority of US NICUs. No large randomized trial has evaluated safety or efficacy of HHHFNC.

This large randomized controlled trial suggests that HHHFNC is as effective as nCPAP for noninvasive respiratory support and can be safely applied to a wide range of neonates. (Read the full article)




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Safety and Utilization of Influenza Immunization in Children With Inflammatory Bowel Disease

Yearly influenza immunization is recommended in patients with inflammatory bowel disease (IBD). However, concern regarding vaccine-related adverse events may limit uptake, and case reports in the literature detail disease flares after immunization.

Influenza immunization rates in children with IBD are low but immunization did not result in increased outpatient visits, hospitalizations or emergency visits. Immunization was associated with fewer IBD-related visits in the post-vaccine period, which may indicate protection against IBD symptoms. (Read the full article)




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Cardiorespiratory Fitness and Adiposity in Metabolically Healthy Overweight and Obese Youth

Obesity is associated with cardiometabolic risk factors and chronic conditions, such as type 2 diabetes. However, a proportion of overweight and obese youth remain free from cardiometabolic risk factors and are considered metabolically healthy.

This study provides insight into the determinants of cardiometabolic risk factors and the concept in health promotion of "fitness versus fatness." Hepatic lipid accumulation and not fitness level appears to drive cardiometabolic risk factor clustering among overweight and obese youth. (Read the full article)




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Respiratory Syncytial Virus-Associated Hospitalizations Among Children Less Than 24 Months of Age

Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. Most estimates of RSV hospitalization rates are imprecise, having been calculated by using retrospective discharge diagnosis data and stratified age groups no narrower than 6 to 12 months.

Prospective, population-based surveillance data for infants hospitalized with laboratory-confirmed RSV infection were combined with birth certificate information to yield more precise age-specific hospitalization rates. These data should help determine priorities for the use of existing and future RSV prophylaxis strategies. (Read the full article)




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A Randomized Trial of Nasal Prong or Face Mask for Respiratory Support for Preterm Newborns

Respiratory support is commonly given to newborn infants via a face mask in the delivery room. Respiratory support given to preterm infants via a single nasal prong may be more effective.

Compared with a face mask, using a single nasal prong to deliver respiratory support to preterm newborns did not result in less intubation and ventilation in the delivery room. (Read the full article)




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Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

Stuttering is extremely common, with 8.5% of children affected by age 3 years in a prospective community-ascertained cohort of Australian children. The natural history and comorbidities of early stuttering are uncertain at the population level.

The cumulative incidence of stuttering was 11% by 4 years. Stuttering children were similar in temperament and social-emotional development but had better verbal and nonverbal skills than their peers. Recovery from stuttering was low; 6.3% 12 months after onset. (Read the full article)




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Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

Preterm birth is associated with increased morbidity during childhood. Many studies have focused on outcomes for preterm births before 32 weeks’ gestation, but there are few follow-up data for late preterm infants (34–36 weeks’ gestation).

The risk of respiratory admission during childhood decreased with each successive week in gestation up to 40 to 42 weeks. The increased risk is small for late preterm infants, but the number affected is large and has an impact on health care services. (Read the full article)




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Identifying Potential Kidney Donors Among Newborns Undergoing Circulatory Determination of Death

The demand for donor kidneys for transplantation exceeds supply. En bloc kidney transplantation and donation after determination of circulatory death from pediatric donors increases the potential donor pool.

Newborn infants undergoing elective withdrawal of life support in the NICU are a previously unrecognized source of potential kidney donors. (Read the full article)




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Acute Lower Respiratory Infection Among Bacille Calmette-Guerin (BCG)-Vaccinated Children

Bacille Calmette-Guerin (BCG) vaccination may provide benefits beyond protecting against pediatric tuberculosis. Evidence suggests links between cell-mediated immunity from tuberculosis and bacterial/viral-related pneumonia but the impact of BCG on acute lower respiratory infection is not fully known.

BCG-vaccinated children had a lower risk of suspected acute lower respiratory infection. Protection was amplified when children were vaccinated against diphtheria-tetanus-pertussis (DTP). Number of DTP doses did not modify this effect, but order in which vaccines were received did. (Read the full article)




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Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

Quantitative real-time polymerase chain reaction allows sensitive detection of respiratory viruses. The clinical significance of detection of specific viruses is not fully understood, however, and several viruses have been detected in the respiratory tract of asymptomatic children.

Our results indicate that quantitative real-time polymerase chain reaction is limited at distinguishing acute infection from detection in asymptomatic children for rhinovirus, bocavirus, adenovirus, enterovirus, and coronavirus. (Read the full article)




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Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

Childhood attention-deficit/hyperactivity disorder has been associated with both childhood and adult obesity, whereas treatment with stimulants has been associated with delayed child growth. No longitudinal studies with details about dates of diagnosis, treatment, and duration of stimulant use have been published.

Using electronic health record data, this was the first study to evaluate the independent associations of attention-deficit/hyperactivity disorder diagnosis, stimulant treatment, age at first stimulant use, and duration of stimulant use on longitudinal BMI trajectories throughout childhood and adolescence. (Read the full article)




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Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Down syndrome is an independent risk factor for severe respiratory syncytial virus infection and subsequent hospitalization.

This observational study suggests that immunoprophylaxis may reduce respiratory syncytial virus-related hospitalization by 3.6-fold (95% confidence interval, 1.5–8.7) in children with Down syndrome overall. (Read the full article)




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Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Inadequate nutrient intake can compromise a child’s nutritional status, which may affect immune function. Improving dietary intake via a follow-up formula may support appropriate immune responses and improve a child’s ability to resist infection.

Children who consumed an experimental follow-up formula had fewer episodes and shorter duration of acute respiratory infections, as well as less antibiotic treatment, and fewer days missed of day care due to illness. (Read the full article)




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The Natural History of Jaundice in Predominantly Breastfed Infants

Newborn infants who are predominantly breastfed are much more likely to develop prolonged hyperbilirubinemia than those fed formula, but the prevalence of prolonged hyperbilirubinemia in a largely white, North American, breastfed population is unknown.

Practitioners can be reassured that it is normal for 20% to 30% of predominantly breastfed infants to be jaundiced at age 3 to 4 weeks and for 30% to 40% of these infants to have bilirubin levels ≥5 mg/dL. (Read the full article)




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Hospitalizations for Severe Lower Respiratory Tract Infections

Lower respiratory tract infections (LRTIs), including pneumonia, are in the top 10 causes of death among children in the United States. In high-income countries, 3% to 14% of LRTI hospitalizations have been reported to require admission to an ICU.

During 2007–2011, approximately 31 289 hospitalizations for severe LRTI occurred in children each year in the United States. Children <1 year of age had the highest rates of severe LRTI and accounted for 30% of severe LRTI hospitalizations. (Read the full article)




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Bacterial Prevalence and Antimicrobial Prescribing Trends for Acute Respiratory Tract Infections

Many pediatric acute respiratory tract infections (ARTI) are viral and do not require antimicrobial treatment. Recent estimates of antimicrobial overprescribing for these infections, defined based on the published bacterial disease prevalence among all ARTI, are not available.

Based on the published bacterial prevalence rates for pediatric ARTI, antimicrobial agents are prescribed almost twice as often as expected to outpatients nationally, amounting to an estimated 11.4 million potentially preventable antimicrobial prescriptions annually. (Read the full article)




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Duration of Rhinovirus Shedding in the Upper Respiratory Tract in the First Year of Life

Rhinoviruses are commonly detected in both acutely ill and asymptomatic infants and children. The finding may represent new infection or prolonged presence of rhinovirus RNA in the respiratory tract.

In young, otherwise healthy infants, shedding of RNA from the same rhinovirus strain rarely persisted longer than 30 days. (Read the full article)




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Primary Ciliary Dyskinesia and Neonatal Respiratory Distress

Primary ciliary dyskinesia presents in infancy with unexplained neonatal respiratory distress, yet diagnosis is often delayed until late childhood. Earlier diagnosis facilitates earlier onset of therapy, which may help to reduce long-term pulmonary morbidity and mortality.

A diagnostic workup for primary ciliary dyskinesia should be considered in a term infant presenting with unexplained respiratory distress and either lobar collapse, situs inversus, or a prolonged oxygen therapy requirement (>2 days). (Read the full article)




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Breastfeeding Duration and Weight Gain Trajectory in Infancy

Although we know breastfeeding is beneficial and infant weight gain can predict obesity later in life, the relationship between breastfeeding duration and infant weight gain patterns among populations exhibiting high risk for obesity is unexplored.

This study demonstrates the greater odds of increased infant weight gain for infants who breastfed for shorter durations among those exposed to a high number of maternal biopsychosocial risk factors for obesity. (Read the full article)




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Respiratory Syncytial Virus-Associated Mortality in Hospitalized Infants and Young Children

Respiratory syncytial virus (RSV) infection is a common cause of pediatric hospitalizations. Mortality rates associated with RSV hospitalizations are based on estimates from studies conducted decades ago. Accurate understanding of mortality is required for identifying high-risk infants and children.

Mortality associated with RSV is uncommon in the 21st century, with annual deaths far lower than previous estimates. The majority of deaths occurred in infants with complex chronic conditions or in those with life-threatening conditions in addition to RSV infection. (Read the full article)




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Heterogeneity in Asthma Care in a Statewide Collaborative: the Ohio Pediatric Asthma Repository

Asthma is heterogeneous and 40% to 70% of patients fail to achieve control with current treatment strategies. To delineate relevant subphenotypes of asthma, identify key factors, and test novel interventions, comprehensive repositories linking clinical, environmental, and biologic data are required.

This is the first statewide repository for inpatient pediatric asthma. The data collected will better define asthma phenotypes, identify care practices associated with the best health outcomes, and inform personalized care plans to reduce reutilization and readmission for pediatric asthma. (Read the full article)




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Concurrent Respiratory Viruses and Kawasaki Disease

Making a diagnosis of Kawasaki disease (KD) is often a diagnostic dilemma. This dilemma is confounded when children present with symptoms consistent with known, common respiratory viruses and/or with KD symptoms that could potentially be attributed to a respiratory virus.

Patients with KD commonly have a concurrent respiratory viral infection. Clinicians should not dismiss the diagnosis of KD based on the presence of respiratory symptoms. Furthermore, a positive respiratory virus test result should not be used to exclude the diagnosis of KD. (Read the full article)




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Sensitivity of the Automated Auditory Brainstem Response in Neonatal Hearing Screening

Adding second-stage automated auditory brainstem response (ABR) testing for infants who failed the initial OAE test in a two-stage neonatal hearing screening has been shown to reduce false referrals to the hearing clinic.

Infants with hearing loss may be missed by a 2-stage hearing screening because they pass the automated ABR test. In our study, a significant number of infants with hearing loss >45 decibel hearing level passed screening with automated ABR. (Read the full article)