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Using Otoacoustic Emissions to Screen Young Children for Hearing Loss in Primary Care Settings

The incidence of permanent hearing loss doubles between birth and school age. Otoacoustic emissions screening has been used successfully in early childhood educational settings to identify children with losses not found through newborn screening.

Using otoacoustic emissions to screen the hearing of young children during routine health care visits is feasible and can lead to the identification of permanent hearing loss overlooked by providers relying solely on subjective methods. (Read the full article)




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Variation in Resource Use and Readmission for Diabetic Ketoacidosis in Children's Hospitals

Diabetic ketoacidosis (DKA) is a short-term complication of type 1 diabetes and is a major cause of preventable hospitalization in children. Hospital resource utilization and readmission rates for DKA across the US are not known.

Readmission for DKA within a year of hospitalization is common, accounting for one-fifth of all DKA admissions. Resource use, hospital length of stay, and readmission rates vary widely across major US children’s hospitals, even after adjusting for hospital differences in patients. (Read the full article)




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Remission and Persistence of Asthma Followed From 7 to 19 Years of Age

The natural history of asthma during adolescence is dynamic because both remission and relapse are common. Remission has consistently been associated with mild asthma and the absence of sensitization.

One in 5 children with asthma remitted from age 7 to 19. Remission was defined as no wheezing and no medication for ≥3 years and was inversely related to female gender, sensitization to furred animals, and asthma severity at baseline. (Read the full article)




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Blood Cultures in the Evaluation of Uncomplicated Skin and Soft Tissue Infections

Blood cultures are a common investigation in children admitted to the hospital with skin and soft tissue infections. The yield of blood cultures in this condition is unknown.

Blood cultures are not useful in children admitted to the hospital with uncomplicated skin and soft tissue infections, and they may be associated with increased length of hospital stay. (Read the full article)




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Measuring Hospital Quality Using Pediatric Readmission and Revisit Rates

Readmissions have been identified as a priority area for pediatric inpatient quality measurement nationally. However, it is unknown whether readmission rates vary meaningfully across hospitals and how many hospitals would be identified as high- or low-performers.

Only a few hospitals that care for children are high- or low-performers when their condition-specific revisit rates are compared with average rates across hospitals. This limits the usefulness of condition-specific readmission or revisit measures in pediatric quality measurement. (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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Screening for Behavioral Health Issues in Children Enrolled in Massachusetts Medicaid

Use of behavioral health (BH) screens in pediatrics have increased identification of children with BH issues. Screening rates increased in Massachusetts after it was mandated, as did the volume of some mental health services.

This is the first study of children after Massachusetts mandated behavioral screening began. Almost 40% of children who screened positive were newly identified. Being male, having a BH history, and being in foster care predicted a positive screen. (Read the full article)




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Health Care Worker Exposures to Pertussis: Missed Opportunities for Prevention

The incidence of pertussis has significantly increased, and infection can result in severe disease among young children. This highly contagious disease may frequently be transmitted in pediatric health care settings, necessitating effective infection control practices to reduce exposure risk.

Despite institutional guidelines, pediatric health care workers (HCWs) are frequently exposed to pertussis because of delayed or incomplete adherence to infection control practices. Inconsistent reporting may also result in missed HCW exposures, increasing the risk of subsequent transmission to patients. (Read the full article)




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Cotinine in Children Admitted for Asthma and Readmission

Serum and salivary cotinine have previously been identified as reliable biomarkers for exposure to tobacco smoke.

We found that detectable serum and salivary cotinine is common among children admitted for asthma and is associated with readmission. This finding may inform clinical care for children at increased risk of asthma morbidity. (Read the full article)




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Readmissions Among Children Previously Hospitalized With Pneumonia

Pneumonia is a leading cause of hospitalization among children, and readmissions after discharge are common.

Eight percent of children experience a readmission within 30 days after hospital discharge for pneumonia. Readmissions are most common among young children and those with chronic medical conditions, and are associated with substantial costs. (Read the full article)




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Variation in Emergency Department Admission Rates in US Children's Hospitals

There is substantial variation in the medical care provided to pediatric patients across diverse clinical settings. This variation raises concerns about whether every patient is receiving optimal care and whether more standardized approaches around clinical decisions are needed.

We observed wide variation in admission rates for common pediatric conditions across US children’s hospitals. Our findings highlight the need for greater focus on the standardization of decisions regarding hospitalization of patients presenting to the emergency department. (Read the full article)




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Missed Opportunities for HPV Vaccination in Adolescent Girls: A Qualitative Study

Rates of human papillomavirus (HPV) vaccination lag behind other adolescent vaccines. Research indicates that provider recommendation is the key to improving HPV vaccination rates and that most adolescents who are unvaccinated received other vaccines, indicating missed opportunities for HPV vaccination.

This study explores in-depth the content of provider–patient conversations that either create or prevent opportunities for HPV vaccination. Effective and ineffective conversations are presented with the goal of providing practical tools to improve communication regarding HPV vaccines. (Read the full article)




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Off-Hours Admission to Pediatric Intensive Care and Mortality

Admissions to the ICU during off-hours (nights and weekends) have been variably associated with increased mortality in both adults and children. Changes in staffing patterns, patient characteristics, or other factors may have influenced this relationship over time.

This study demonstrates in a large, current, multicenter database sample that off-hours admissions to PICUs are not associated with increased risk-adjusted mortality. Admissions in the morning from 6:00 am to 10:59 am are associated with increased mortality and warrant further attention. (Read the full article)




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Early Discharge of Infants and Risk of Readmission for Jaundice

Studies examining early postnatal discharge and readmission for jaundice report conflicting results. Infants born 37 to 38 weeks’ gestation have an increased risk for readmission for jaundice; however, the impact of early discharge on this group has not been investigated.

Early postnatal discharge was significantly associated with readmission for jaundice. Of the infants discharged early, those born 37 to 38 weeks’ gestation, born via vaginal delivery, born to Asian mothers, or were breastfed had the greatest risk for readmission. (Read the full article)




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Misdiagnosis and Missed Diagnoses in Foster and Adopted Children With Prenatal Alcohol Exposure

Researchers speculate that children with fetal alcohol spectrum disorders often are not recognized or diagnosed correctly.

This is the first study to assess the rate of missed diagnoses and misdiagnosis in foster and adopted children with fetal alcohol spectrum disorders. (Read the full article)




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Timing of Initial Well-Child Visit and Readmissions of Newborns

Current recommendations for the first outpatient visit for newborns are based on known health risks during the first week of life. Knowledge of the relationship between early well child visits and hospital readmissions may inform newborn health policy interventions.

Newborns who have a first well child visit within the recommended time period after hospital discharge are substantially less likely be readmitted. Obstacles to early follow-up should be addressed to reduce the risk of readmission in this population. (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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Characteristics of Physicians Who Dismiss Families for Refusing Vaccines

The American Academy of Pediatrics discourages providers from dismissing families who refuse vaccines for their children, yet some providers continue to do so.

We show that ~1 in 5 pediatricians dismiss families who refuse vaccines, and there is significant regional variation in the practice. Dismissing families for refusing vaccines was also associated with stricter state nonmedical exemption policies. (Read the full article)




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The Medical Home and Hospital Readmissions

Receiving primary care in a high-quality medical home may lead to reductions in hospital or emergency department (ED) utilization; however, the relationship between the medical home and postdischarge hospitalizations and ED visits is poorly understood.

Readmission rates vary markedly based on data source and definition. Unplanned readmissions were associated with absence of a usual source of well and sick care but not other medical home components. Lack of parent confidence at discharge identified patients at high risk for readmissions and ED visits shortly after discharge. (Read the full article)




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The Missing Ingredient in Our Democracy: Math

Political numeracy is as important as it is overlooked, argues Wellesley mathematics professor Ismar Volić.




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Fin24.com | Regulator issues warning about funeral parlour, burial society

The Financial Sector Conduct Authority warns the public not to conduct financial services business with Masibekele Funeral Parlour and MISI Burial Society.




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Public Libraries Add Multimedia Learning to Digital Mission

Public libraries are moving deeper into digital learning, often in partnership with schools and other institutions, to help prepare students for the skills they'll need for college and careers.




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Fin24.com | Saudi stocks plunge as Trump vows punishment over missing journo's fate

Saudi Arabian equities slumped on concern the U.S. may take measures against the kingdom if it’s linked to the disappearance of Washington Post writer Jamal Khashoggi.




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Fin24.com | Deutsche Bank, Siemens CEOs waver on attending Saudi event after journo goes missing

The heads of Deutsche Bank and Siemens, two of Germany’s biggest companies, are among a dwindling number of high-profile delegates still scheduled to attend an investment conference in Saudi Arabia following the disappearance of dissident journalist Jamal Khashoggi.




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Stuckeman School graduate student earns Alumni Association Dissertation Award

Stuckeman School graduate student Debora Verniz, who is a doctoral candidate in architecture, has been awarded the 2020 Alumni Association Dissertation Award from the Graduate School at Penn State for her research work in planning affordable housing structures in low-income areas.




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Fin24.com | Solly Moeng | The missing link in managing a pandemic - public trust

Government went to war against Covid-19 with very low supplies in citizen trust and financial reserves, says Solly Moeng.




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Burundi: The Issues at Stake. Political Parties, Freedom of the Press and Political Prisoners




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Maintain the UN Mission in the Democratic Republic Of Congo




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Will Burundi Miss Out on Democratic Consolidation?

5 mois après la publication du rapport Burundi : du boycott électoral à l’impasse politique, la dynamique de régression que nous décrivions en détails dans ce texte produit ses effets dévastateurs. La fin du consensus d’Arusha et le pourrissement du climat politique consécutif au boycott électoral de 2010 ont conduit à une violence qui, en dépit du lénifiant discours officiel, ne cesse de prendre de l’ampleur.




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Central African Republic - Making the Mission Work

By failing to engage when Crisis Group and others warned that the Central African Republic had become a phantom state, the international community has now had to become much more heavily involved, at much greater expense, after horrifying loss of life and massive displacement, with much greater odds of failure.




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Afrique Centrale: Pour une mission efficace en République centrafricaine

Incapable d’agir quand Crisis Group et d’autres organisations envoyaient des signaux d’alerte et qualifiaient la Centrafrique d’Etat fantôme, la communauté internationale doit dorénavant s’impliquer massivement, à des coûts largement supérieurs, suite aux pertes humaines considérables et aux déplacements massifs de population, et avec des chances de succès beaucoup plus faibles.




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Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy

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.

METHODS:

Participants (n = 148; ages 9–18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.

RESULTS:

Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P < .01). Youth reported large improvements in body dissatisfaction (P < .001), small to moderate improvements in self-report of depressive symptoms (P < .001), and small improvements in total anxiety symptoms (P < .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.

CONCLUSIONS:

Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




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Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




iss

Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




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Rangers vice-chairman John Bennett criticises 'cynical tactics' of SPFL and insists issue not just Gers vs governing body

Rangers vice-chairman John Bennett has criticised the SPFL for their 'cynical tactics' over their labelling of the club's dossier as a "smoking gun" - and insists the issue is not merely Gers vs the governing body.




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Vouchers Are Still an Issue in Milwaukee

So many years after vouchers began, we still can't agree on their benefits.




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School Leader Accountability Is Missing in Action

Teachers need coaching from proactive and intentional leaders who see everything in their buildings as their responsibility, writes guest blogger Michael Sonbert. Until then, teachers will bear the brunt of our national criticism.




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Communications alumnus' latest thriller focuses on college admissions scandal

Penn State alumnus and author Paul Levine's latest novel, "Cheater's Game," focuses on the college admissions scandal.




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Reducing greenhouse gas emissions using microwave plasma technology

A multi-disciplinary collaborative relationship, developed between Penn State EMS Energy Institute researchers and a Pittsburgh-based start-up company, may hold the answer to reducing global greenhouse gas (GHG) emissions while also paving the way to disrupt the chemical and material industries.




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Missing Idaho kids' uncle died of blood clot in Arizona

A pulmonary blood clot killed the brother of an Idaho woman who’s facing charges in the disappearance of her children — a case that attracted worldwide attention with revelations of her doomsday beliefs and connection to three mysterious deaths




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Students With Disabilities Fear Fallout From College Admissions Scandal

Allegations that some students lied about having disabilities so they could get special accommodations on college entrance exams have the disabilities community worried about a backlash.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




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Nissan e-4ORCE Makes Electric Vehicles Drive Like Sports Cars

By providing instant torque to all four wheels you can drive as normal in all conditions according to Nissan, while also feeling like you're in a sports car.




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Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




iss

An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




iss

Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




iss

An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




iss

Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.