In 2009, only 58% of pediatricians were using electronic health records (EHRs), most of which were lacking pediatric functionality. The American Recovery and Reinvestment Act (ARRA) of 2009 accelerated the implementation of EHRs in pediatric offices.

The effects of ARRA have remained largely unmeasured in pediatrics. This study provides information on the prevalence and functionalities of EHRs, as well as physicians’ perceptions. (Read the full article)

Although pediatric professional guidelines emphasize addressing a child’s social environment in the context of well child care, it remains unclear whether screening for unmet basic needs at visits increases low-income families’ receipt of community-based resources.

This study demonstrates that systematically screening and referring for social determinants of health during primary care can lead to the receipt of more community resources for families. (Read the full article)

Little is known about the mental health of extremely low birth weight survivors in their 30s. It is also unclear whether being born small for gestational age or being exposed to antenatal corticosteroids increases risk in this group.

In their 30s, extremely low birth weight survivors are less likely to have substance problems but are at elevated risk for other psychiatric disorders. Those born small for gestational age are at higher risk, but those exposed to antenatal corticosteroids are at the greatest risk of all. (Read the full article)

Increasing data suggest that neonatal pain has long-term consequences. Pharmacologic interventions for minor pain are ineffective, and nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used.

The taste of sucrose has been shown to be an effective and widely used analgesic for infants, and this study demonstrates that combining brief exposure to natural radiant warmth with the taste of sucrose improves the analgesic effect for the infant. (Read the full article)

After the recent economic recession, policy interventions including austerity measures led to reductions in government spending on health care in many countries. However, there is limited research into the effects of changes in government health care spending on child health.

Reductions in government health care spending are associated with long-lasting adverse effects on child health globally, especially in low-income countries. Given pressures to diminish health expenditures, we caution that reduced spending should be achieved through increased efficiency of care delivery. (Read the full article)

Microvasculature alterations are associated with increased risk of hypertension in adults. Not much is known about the association of retinal vessel caliber with cardiovascular risk factors among children.

Narrower retinal arteriolar caliber is associated with higher blood pressure, mean arterial pressure, and pulse pressure in school-age children, whereas wider retinal venular caliber is associated with higher carotid-femoral pulse wave velocity. Microvascular adaptations might influence cardiovascular health from childhood onward. (Read the full article)

Children with special health care needs are a growing population in developed countries. They are at risk for poorer learning and behavioral outcomes, and their parents are more likely to have poorer mental health.

Four distinct and replicable special health care need profiles across 2 childhood epochs were categorized as none, transient, emerging, and persistent. The cumulative burden of special health care needs shaped adverse outcomes more than did point prevalence. (Read the full article)

Disparities in asthma morbidity are exacerbated by underutilization of preventive controller medications. Community pharmacies are well positioned for an increased role in population health. The Asthma Medication Ratio, currently used at the patient-level, could be adapted for use at the pharmacy-level.

A newly developed Pharmacy-level Asthma Medication Ratio was associated with population-level childhood asthma morbidity. Collaborative relationships between physicians, community pharmacists, and patients (and families) have the potential to promote testable interventions aimed at reducing asthma morbidity and cross-community disparities. (Read the full article)

Care coordination is a central part of the medical home model. Little is known about how care coordination is implemented in pediatrics and how it changes over time in primary care practices successfully adopting medical home principles.

In high-performing medical homes, care coordination evolved toward designing and carrying out routine activities and policies that aimed to forestall disruptions in care delivery. Investing in medical home teams, engaging electronic medical record systems, and improving workflow supported these changes. (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)

The US Preventive Services Task Force recommends primary care clinicians apply fluoride varnish to the teeth of all young children, but no studies have examined the effect of comprehensive preventive oral health services on children’s clinical oral health status.

Comprehensive preventive oral health services delivered by primary care clinicians can help improve the oral health of Medicaid-enrolled children, but more work is needed to link medical and dental offices to ensure the continuity of dental care for these children. (Read the full article)

More than 200 million children <5 years are not reaching their developmental potential. Lack of stimulating caregiving is a major cause, and effective scalable interventions are needed. Integrating parenting with health services has been recommended, but there are few evaluations.

An innovative parenting intervention can be delivered at routine visits for primary health care, with benefits to child cognitive development and parenting knowledge. This approach using films, discussion, and practice has the potential for delivery at scale. (Read the full article)

War-affected youth often suffer from multiple co-occurring mental health problems. The relationship of these conditions to later mental health has yet to be thoroughly investigated. There is a need to explore potential targets for mental health interventions.

After controlling for preexisting conditions and contemporary confounders, internalizing (depression and anxiety) remained the major predictor of future mental health symptoms (internalizing symptoms, prosocial attitudes/behaviors, and posttraumatic stress symptoms). Interventions targeting internalizing in war-affected youth hold promise. (Read the full article)

Interactive activities and routines promote early childhood language skills and subsequent educational achievement. Population studies describing parent-child participation in interactive activities and their associations with early child development among vulnerable populations are needed.

Significant disparities exist in parenting practices that promote child development between economically advantaged and disadvantaged parents. Participating in less interactive activities was associated with increased risk of developmental delay among low-income families, suggesting a need to enrich parenting practices. (Read the full article)

In response to growing demand from trainees, many pediatric residency programs offer global health (GH) experiences for their residents. There is diversity in what is offered at programs across the country.

This is the most comprehensive assessment of US pediatric residency training opportunities in GH. These opportunities are prevalent and increasingly formalized as tracks. However there remain gaps in universal pretravel preparation and coordination across GH partnerships nationally. (Read the full article)

Unmet health care need in adolescence is associated with poor contemporaneous health outcomes. Adolescence is increasingly recognized as an important stage of the life-course, when there may be a significant opportunity for health care interventions to improve later health outcomes.

The odds of adverse adult health outcomes were 13% to 52% higher among subjects who had reported unmet health care need in adolescence, compared with subjects with similar adolescent health outcomes, insurance coverage, and sociodemographic background but no unmet need. (Read the full article)

Although nonphysician reentry transitions have been characterized in the literature, little is known about the reentry of residents after either short-term (1-month elective) or long-term (12-month training) global health experiences abroad.

Reverse culture shock may be a useful conceptual framework for understanding the range of emotions felt by pediatric residents when they reenter residency after global health experiences, particularly if these experiences were long term. (Read the full article)

Premature infants are at risk for medical and neurodevelopmental sequelae. Close monitoring is an important role for primary care providers. Premature infants have high use of health care services; however, little is known about the role of health supervision visits.

This study explores the utilization and value of health supervision visits for premature infants. Fewer than half were found to be fully adherent to the health supervision visit schedule, resulting in preventive care gaps and immunization delays. (Read the full article)

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)

A number of studies have reported an association between birth by cesarean delivery and adverse childhood health outcomes such as obesity, asthma, atopy, and a number of neurodevelopmental abnormalities. However, these studies have had limited capacity to control for confounders.

Using a prospective cohort while controlling for birth factors, social vulnerability, maternal BMI, and breastfeeding, we found few differences between children delivered by cesarean delivery and those born vaginally. Higher child BMI was explained by maternal BMI. (Read the full article)

Seven percent of children in the United States receive mental health services each year. There are more pediatric outpatient mental health care visits to primary care physicians (PCPs) than to psychiatrists. Mental health utilization patterns regarding different conditions and medication prescribing are unknown.

One-third of children with mental health conditions see PCPs only. A greater proportion of children with attention-deficit/hyperactivity disorder see PCPs for this than do those with anxiety/mood disorders. Children seeing PCPs are prescribed psychotropic medications more often than those seeing psychiatrists. (Read the full article)

Where businesses are fighting to survive, agility is the name of the game, says Mignon Reynecke.

Strategic partnerships could be used to create win-win outcomes, says Sifiso Skenjana.

Contezolid (MRX-I), a new oxazolidinone, is an antibiotic in development for treating complicated skin and soft tissue infections (cSSTI) caused by resistant Gram-positive bacteria. This was a thorough QT study conducted in 52 healthy subjects who were administered oral contezolid at a therapeutic (800 mg) dose, a supratherapeutic (1600 mg) dose, placebo, and oral moxifloxacin 400 mg in 4 separate treatment periods. The pharmacokinetic profile of contezolid was also evaluated. Time-point analysis indicated that the upper bounds of the two-sided 90% confidence interval (CI) for placebo-corrected change-from-baseline QTc (QTc) were <10 ms for the contezolid therapeutic dose at each time point. The upper bound of the 90% CI for QTc were slightly more than 10 ms with the contezolid supratherapeutic dose at 3 and 4 hours postdose, and the prolongation effect on the QT/QTc interval was less than that of the positive control, moxifloxacin 400 mg. At 3 and 4 h after the moxifloxacin dose, the moxifloxacin group met the assay sensitivity criteria outlined in ICH Guidance E14 with having a lower confidence bound ≥5 ms. The results of a linear exposure-response model which were similar to that of a time point analysis demonstrated a slightly positive relationship between contezolid plasma levels and QTcF interval with a slope of 0.227 ms per mg/L (90% CI: 0.188 to 0.266). In summary, contezolid did not prolong the QT interval at a therapeutic dose and may have a slight effect on QT interval prolongation at a supratherapeutic dose.

Durlobactam (DUR, also known as ETX2514) is a novel β-lactamase inhibitor with broad activity against Ambler class A, C, and D β-lactamases. Addition of DUR to sulbactam (SUL) in vitro restores SUL activity against clinical isolates of Acinetobacter baumannii. The safety and pharmacokinetics (PK) of DUR alone and with SUL and/or imipenem/cilastatin (IMI/CIL) were evaluated in healthy subjects. This was a randomized, placebo-controlled study. In Part A, subjects including an elderly cohort (DUR 1 g) received single ascending doses of DUR 0.25-8 g. In Part B, multiple ascending dose of DUR 0.25-2 g were administered every 6 hours (q6h) for 29 doses. In Parts C and D, the drug-drug interaction (DDI) potential, including safety, of DUR (1 g) with SUL (1 g) and/or IMI/CIL (0.5/0.5 g) was investigated after single and multiple doses. Plasma and urine concentrations of DUR, SUL, and IMI/CIL were determined. Among 124 subjects, DUR was generally safe and well tolerated either alone or in combination with SUL and/or IMI/CIL. After single and multiple doses, DUR demonstrated linear dose proportional exposure across the studied dose ranges. Renal excretion was a predominant clearance mechanism. No drug:drug interaction potential was identified between DUR and SUL and/or IMI/CIL. SUL-DUR, 1 g (of each component) administered q6h with a 3 hour IV infusion, is under development for the treatment of serious infections due to A. baumannii.

The off-label use of third generation cephalosporin (3GC) during in ovo vaccination or vaccination of newly hatched chicks, was a common practice worldwide. CMY-2-producing Escherichia coli have been disseminated among broiler production. The objectives of this study were to determine the epidemiological linkage of bla_CMY-2-positive plasmids among broilers both within and outside Japan because grandparent stock and parent stock were imported in Japan. We examined the whole genome sequences of 132 3GC-resistant E. coli isolates collected from healthy broilers during 2002-2014. The predominant 3GC-resistance gene was bla_CMY-2, which was detected in the plasmids of 87 (65.9%) isolates. The main plasmid replicon types were IncI1-I (n=21; 24.1%), IncI (n=12; 13.8%), IncB/O/K/Z (n=28; 32.2%), and IncC (n=22; 25.3%). Those plasmids were subjected to gene clustering and network analyses and plasmid multi-locus sequence typing (pMLST). The chromosomal DNA of isolates was subjected to MLST and single nucleotide variant (SNV)-based phylogenetic analysis.

MLST and SNV-based phylogenetic analysis revealed high diversity of E. coli isolates. ST429 harboring bla_CMY-2-positive IncB/O/K/Z was closely related to isolates from broiler in Germany harboring bla_CMY-2-positive IncB/O/K/Z. pST55-IncI and pST12-IncI1-I and pST3-IncC were prevalent in western Japan. pST12-IncI1-I and pST3-IncC were closely related to those detected in E. coli isolates from chicken in American continent, whereas 26 IncB/O/K/Z were related to those in Europe. These data will be useful to reveal the whole picture of transmission of CMY-2-producing bacteria in and out of Japan.

OBJECTIVES:

Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.

BACKGROUND AND OBJECTIVES:

Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations.

WRS Health is an innovative and clinician-centered solution that improves charting accuracy, individualizes patient-care plans, and enhances reimbursements. This application is definitely a top contender in the electronic medical record (EMR) field.

Penn State Health has appointed Don McKenna as president of Penn State Health Hampden Medical Center.

Penn State Health has enrolled its first COVID-19 patient into an experimental treatment program called convalescent plasma therapy.

Penn State Health today resumed construction of Penn State Health Cocoa Outpatient Center, an expansion of medical services at the former CocoaPlex Center location.

Kristina R. Olson
Mar 1, 2016; 137:e20153223-e20153223
ARTICLES

Katie Marshall, Penn State World Campus mental health case manager, connects students learning online to resources in their own communities.

Want to contribute to Apple's health research studies? You can sign up for programs on women's health, your heart and movement, and hearing using the Research app.

Paul W. Newacheck
Jul 1, 1998; 102:117-123
ARTICLES

Richard A. Ehrenkranz
Dec 1, 2005; 116:1353-1360
ARTICLES

Vinod K. Bhutani
Jan 1, 1999; 103:6-14
ARTICLES

Cynthia L. Ogden
Jan 1, 2002; 109:45-60
ARTICLES

Merle McPherson
Jul 1, 1998; 102:137-139
COMMENTARY

Betty R. Vohr
Jun 1, 2000; 105:1216-1226
ARTICLES

Penn State’s Sexual Assault Forensic Examination Telehealth (SAFE-T) Center is continuing to provide support to sexual-assault nurse examiners in local hospitals across the commonwealth through their innovative telehealth solution, which allows nurse examiners to partner with local-site nurses during live exams.

Penn State Health has opened two regional clinics to care for patients with confirmed or suspected COVID-19 who have health care needs that are serious enough to warrant a face-to-face appointment.

Eight Penn State Health doctors have been named among the Pennsylvania Medical Society's "Top Physicians Under 40."

When a patient comes through the Penn State Hershey Medical Center drive-through COVID-19 testing site, they're asked if they are worried about running out of food during isolation. If they say yes, they drive away with a box full of 25 meals.

Penn State Health St. Joseph has moved swiftly to tackle the COVID-19 crisis, converting portions of its hospital as COVID-19 clinics, applying tried-and-true methods and learning on the fly.

The Penn State Wilkes-Barre Alumni Society provided lunch for local, hardworking medical professionals as a way to thank them for their efforts during the ongoing coronavirus outbreak and working to keep local residents safe.

Impact of Covid-19 on care homes to be investigated by Health and Sport Committee

Deep-learning algorithms suffer from a fundamental problem: They can adopt unwanted biases from the data on which they're trained. In healthcare, this can lead to bad diagnoses and care recommendations.

To view more press releases, please visit http://ir.wintrust.com/news.aspx?iid=1024452.