Medicaid made substantial investments in enhanced prenatal and postnatal care programs to address maternal and infant health, including infant mortality. Evaluations of population-based programs are few, and although some have reported reductions in infant mortality, they have methodological limitations.

A population-based home visitation program can be a successful approach to reduce infant mortality. The reduced risk of infant death is consistent with previous findings on the effects of the program on health care utilization and birth outcomes. (Read the full article)

Although existing analyses of inpatient pediatric pulmonary hypertension (PH) care have established an association with substantial morbidity and mortality, these investigations have been limited to small single-institution series or focused registries representative of selected patient subgroups.

This study provides the first contemporary, national trend analysis of inpatient care for children with PH. Pediatric PH is associated with a rapidly increasing number of hospital discharges and magnitude of resource utilization, and the makeup of this population is changing. (Read the full article)

Infant screening is valued by members of the lay public, but how different benefits are independently valued, and whether harms are disvalued, is not known. Public expectations of screening can inform decisions about what diseases to screen for.

The public values clinical benefits of screening and disvalues harms, with tolerance for harm proportional to clinical benefit. These findings support newborn screening policies prioritizing clinical benefits over solely informational benefits, coupled with concerted efforts to avoid or minimize harms. (Read the full article)

Hospital quality-of-care measures are publicly reported to inform consumer choice and stimulate quality improvement. The number of hospitals and states with a sufficient number of pediatric hospital discharges to detect worse-than-average pediatric inpatient care quality remains unknown.

Most children are admitted to hospitals in which all-condition measures of inpatient quality are powered to show differences in performance from average, but most condition-specific measures are not. Policy on incentives for pediatric inpatient quality should take these findings into account. (Read the full article)

Studies on the risk of mortality and morbidities of extremely preterm infants of multiple gestation births have shown inconsistent results. Perinatal antecedents, admission status and severity of illness after birth can adversely affect outcomes of the extremely premature infants.

Preterm multiple gestation infants have increased risk of mortality but similar risk of major morbidities compared with singletons. Outcomes improved over time and all adverse outcomes, including mortality, were comparable between multiples and singletons in the most recent 5-year epoch. (Read the full article)

Weak recommendations exist to guide emergent neuroimaging decisions in children with first, unprovoked seizures. The prevalence of and risk factors associated with clinically relevant abnormalities on neuroimaging have not been well defined in prospective studies.

Clinically relevant intracranial abnormalities on neuroimaging occur in 11% of children with first, unprovoked seizures. Emergent/urgent abnormalities, however, occur in <1%, suggesting that most of these children do not require emergent neuroimaging. Specific clinical findings identify patients at higher risk. (Read the full article)

The routine childhood immunization schedule is crowded during the first 2 years, leading to deferred doses and limiting the addition of new vaccines. Combination vaccines can reduce the "shot burden" and improve coverage rates and timeliness.

Antibody response rates to antigens contained in an investigational hexavalent vaccine (DTaP5-IPV-Hib-HepB) were noninferior to licensed comparator vaccines when given as a 3-dose infant series. The safety profile was similar to control except for increased rates of mild-to-moderate, self-limited fever. (Read the full article)

A previous multivariable statistical model, using individual patient data, estimated the probability of abusive head trauma based on the presence or absence of 6 clinical features: rib fracture, long-bone fracture, apnea, seizures, retinal hemorrhage, and head or neck bruising.

The model performed well in this validation, with a sensitivity of 72.3%, specificity of 85.7%, and area under the curve of 0.88. In children <3 years old with intracranial injury plus ≥3 features, the estimated probability of abuse is >81.5%. (Read the full article)

There has been increasing legislative and regulatory focus on the relationships of pediatric prescribers and industry. Pediatric professional medical association (PMA) and industry relationships, however, are relatively unstudied and lack a systematic method of assessment.

This cross-sectional study used a new quantitative scale, the industry relationship index, to systematically rate 9 pediatric PMAs with respect to best practice guidelines on interactions with the biomedical industry, revealing significant variation in PMA practices. (Read the full article)

The American Academy of Pediatrics recommends parent-child reading from infancy through at least kindergarten, the span of maximal brain growth. Home literacy environment, including reading behaviors and access to books, has been shown to promote oral language and print concepts.

Home reading environment is positively associated with activation of brain areas supporting narrative comprehension and mental imagery in preschool children. This offers novel insight into the neurobiological foundations of emergent literacy and potential effect of shared reading during early childhood. (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)

Childhood inflammatory mediators are associated with adult obesity, but the stimuli that initiate and perpetuate chronic inflammation start in early life are largely unknown.

Childhood infection-related hospitalization was independently associated with adverse adult metabolic variables, which suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases. (Read the full article)

High bilirubin levels are associated with sensorineural hearing loss. Exchange transfusions are recommended when bilirubin levels reach certain thresholds. However, the relative and excess risks of hearing loss in infants with bilirubin levels at/above exchange transfusion thresholds are unknown.

In this Northern California population of term and late preterm infants, elevated bilirubin levels were not associated with an increased risk of sensorineural hearing loss unless the levels were at least 10 mg/dL above exchange transfusion thresholds. (Read the full article)

Historically, children with end-stage renal disease who initiated chronic dialysis during the first year of life were far less likely to survive or successfully receive a kidney transplant compared with those who initiated chronic dialysis at older ages.

In recent years, survival has improved markedly among children who initiate chronic peritoneal dialysis at <1 year of age. Among those infants who initiate dialysis after the neonatal period and later undergo kidney transplantation, graft survival has improved as well. (Read the full article)

Concern of the risk of malignancy from ionizing radiation has prompted many to advocate for judicious use of computed tomography (CT) and as low as necessary radiation doses administered per scan. Recent analysis has shown a decline in CT utilization.

We identified decreases in CT utilization between 2004 and 2012 for the 10 most common diagnostic groups receiving CT. Decreases were typically associated with increases in alternate imaging modalities. We provide a possible reason for the decrease in CT utilization. (Read the full article)

Infants with neonatal abstinence syndrome are hospitalized for longer after birth and are more likely to be from highly vulnerable families. Determining long-term outcomes is difficult because this is a large and chaotic population.

(Read the full article)

Neurodevelopmental outcomes after cardiac surgery in early life provide critical information for understanding and improving care. Studies show these children are at risk for arterial ischemic stroke and acquired brain injury; further characterization of motor impairment is needed.

This study focuses on the presence of chronic neuromotor disabilities including cerebral palsy and motor impairments after acquired brain injury in children surviving early complex cardiac surgery, providing information on the frequency, characteristics, and predictors that may assist in prevention. (Read the full article)

Guidelines for postdischarge monitoring of hyperbilirubinemia for neonates of white descent are available from the American Academy of Pediatrics; however, such information for healthy term and late preterm Chinese neonates is lacking.

A classification model for predicting the risk of significant hyperbilirubinemia in Chinese neonates was developed that combines a transcutaneous bilirubin–based nomogram with clinical risk factors. It classified newborns into 6 risk groups, which can guide clinicians in planning appropriate follow-up strategies. (Read the full article)

Urethral catheterization is a painful, yet common procedure to obtain a sterile urine sample in young children. There are conflicting results regarding the effectiveness of lidocaine to reduce pain, and it is unclear if it should be routinely used.

In young children, combined topical and intraurethral lidocaine does not reduce pain during urethral catheterization and is associated with more pain than nonanesthetic lubricant during instillation. Clinicians should use noninvasive methods of analgesia during this painful procedure. (Read the full article)

There are no validated claims-based algorithms for identifying children with disabilities (CWD) to facilitate larger-scale studies of care quality for CWD.

This study develops the CWD algorithm, a claims-based algorithm for identifying diagnostic codes with a ≥75% chance of indicating CWD, and triangulates the algorithm against parent report and physician chart abstraction. (Read the full article)

Children with life-threatening complex chronic conditions (LT-CCCs) experience high hospital use.

Hospital use in the last year of life for these children varies by type and number of LT-CCCs. Most children with ≥3 LT-CCCs are admitted to the hospital for more than 2 months in the last year of life. (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)

Strictly-defined pediatric bipolar I disorder (BP-I) is a serious condition. Although lithium is a benchmark treatment and has shown effectiveness in adults for decades, no definitive efficacy or long-term safety studies had been performed in pediatric patients with BP-I.

This study provides evidence to support the efficacy of lithium in the acute treatment of youths with BP-I who are currently in a manic or mixed state. Lithium had an adverse effect profile that was acceptable for most patients. (Read the full article)

Children with marked cerebral palsy (CP) are considered at greater risk of adverse events (AEs) after intramuscular injections of BoNT-A. To date there has been no randomized controlled trial examining safety of intramuscular BoNT-A injections in children with marked CP.

Children with nonambulatory CP had no greater risk of moderate or serious AEs after intramuscular injections of BoNT-A compared with a sham/control group. There was no greater risk of AEs for children receiving 2 compared with 1 episode of BoNT-A. (Read the full article)

Central apnea sometimes complicates bronchiolitis. Because apnea tends to occur early in the course of bronchiolitis, there is a danger that infants may be discharged from the emergency department only to subsequently develop apnea at home.

This study prospectively derived clinical decision rules to help emergency physicians admit infants at risk for apnea while discharging those not at risk. (Read the full article)

Previous studies have evaluated separately the effects of brief education and reminder/recall intervention strategies to increase human papillomavirus vaccine coverage. None have examined if intervention effects varied by race/ethnicity.

When compared with a general adolescent vaccine brochure, human papillomavirus vaccine-specific educational materials increased 1-dose coverage among Hispanic but not black individuals. Recalls for doses 2 and 3 were effective in increasing 3-dose coverage for both racial/ethnic groups. (Read the full article)

Maternal gestational weight gain is associated with childhood overweight. It is unknown whether gestational weight gain programs the child’s health or whether gestational weight gain is an indicator of postnatal behavioral factors.

We disentangled these influences by studying the effect of gestational weight gain simultaneously with postdelivery maternal weight change as an indicator for shared family lifestyle on child’s weight development and found that both had an independent effect. (Read the full article)

Given the efforts to decrease the use of ionizing radiation in pediatric patients, there is significant variability in head computed tomography (CT) scan use in pediatric emergency departments for minor head trauma.

This study characterized variability in CT scan rates for all body regions in emergency department, observation, and inpatient encounters across 30 tertiary pediatric hospitals. Two-fold variation remained after case-mix adjustment, with higher volume hospitals having lower rates of CT scanning. (Read the full article)

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)

In a 5-4 decision, the Supreme Court sided with four iPhone owners who contend the company has been inflating the prices on the App Store. Current antitrust laws allow the plaintiffs to recover three times the amount of damages.

Saif Khalil, founder and CEO of Aevumed, won first place at the REV-UP Center for Entrepreneurship's Lion Cage pitch competition. Aevumed develops medical devices designed to help reduce rotator cuff re-tear rates.

Forty-six teams have entered European qualifying for the 2019 FIFA Women's World Cup in France, with 16 involved in the preliminary round draw on 19 January.

Debutants Kosovo will make the short trip to Albania as the 16 FIFA Women's World Cup preliminary round entrants discovered their groups for April.

Kazakhstan, Albania, Israel, the Faroe Islands and best runners-up Moldova will progress to the qualifying group stage after coming through the preliminary round.

Two-time winners Germany will take on Iceland, the Czech Republic, Slovenia and the Faroe Islands in Group 5 following the qualifying group stage draw in Nyon.

As the 2019 FIFA Women's World Cup qualifying group stage kicks off, we explain how Europe's eight berths alongside hosts France will be decided with tight ties in prospect.

The FIFA Women's World Cup qualifying group stage has begun with the likes of England, Norway, Germany, Iceland and Austria all in goalscoring form.

European champions the Netherlands opened qualifying with a dramatic defeat of Norway as Iceland shocked Germany before being held themselves in October's fixtures.

England, Switzerland, Sweden, Italy, Spain and Finland maintained their perfect records but European champions the Netherlands were held by the Republic of Ireland.

Pernille Harder, Ada Hegerberg and Amandine Henry are shortlisted for the 2017/18 UEFA Women's Player of the Year award.

Scotland, Norway, Germany and Sweden have joined hosts France, England, Italy and Spain in the finals by winning their qualifying groups.

Lyon trio Lucy Bronze, Ada Hegerberg and Amandine Henry are the UEFA Women's Player of the Year nominees.

Source: www.mirror.co.uk - Saturday, May 09, 2020
At least the garish crystal cheetah clutches aren't as saucy as the hamper sent to Kim Kardashian from cheeky Khloé as the family shower each other with odd gifts

Source: www.brooklynpaper.com - Saturday, May 09, 2020
The owner of the iconic Park Slope events venue Grand Prospect Hall, Michael Halkias, died from COVID-19 on Wednesday. He was 82. Halkias’ death sent shockwaves throughout Brooklyn, where community leaders and friends remember him as a passionate, generous figure. “ He was a Brooklyn character for sure in the best sort of way,” said Randy Peers, president and CEO of the Brooklyn Chamber of Commerce. “He was larger than life.” Halkias and his wife Alice bought Grand Prospect Hall in 1984 and turned the extravagant Prospect Avenue building into an opulent catering hall. The space became a New York icon because of the its long-running, popular commercials, where Alice Halkias declares in a Greek accent, “We make your dreams come true!” Saturday Night Live spoofed the famous commercial in February of 2019, and the pair appeared on Jimmy Kimmel Live in October to remake the ad with Mets player Pete Alonso. Grand Prospect Hall, a Victorian banquet hall built in 1892, attracted big names such as dancer Fred Astaire and mafioso Al Capone during its heyday in the early 20th century — and boasted some of the borough’s oldest treasures, such as Brooklyn’s first reported elevator, which functions to this day. But by the 1980s, the landmarked building had fallen into disrepair: its walls had been painted black, molding had been stripped off the walls, and the chandeliers were gone, Halkias told Brooklyn Paper in 2004. The couple spent 20 yea

At Battle High School in Columbia, Mo., students in geometry class have swapped their compasses and protractors for hammers and hard hats. And they're doing it for a good cause.

Comic books and graphic novels, popular in many language arts and social studies classes, are just now tiptoeing into the world of K-12 math.

A Fin24 reader nearing retirement wants to know if he can access his retirement annuity now while still employed or only after officially retiring.

A health expert discusses what late joiner penalties are and how to avoid them.

Experts say if you can afford to continue repaying your debts, resist the temptation to take a payment holiday, even if you qualify for the relief.