Denver Newsroom, May 8, 2020 / 05:29 pm (CNA).- Mother’s Day is going to look different for most families this year, due to the coronavirus pandemic.

For Catholics, some churches are in the process of slowly re-opening public Masses, but the dispensation from the Sunday obligation continues to stand, as the virus has not gone away and a cure or vaccine has yet to be found.

While most Catholics are eager to return to Mass, a small group of Catholics are relieved that they will not be sitting in a public pew this Mother’s Day.

“We actually heard from one woman who said, ‘I kind of feel badly about saying this, but I'm sort of glad that we won't be in the pews this year for Mother's Day,’” Ann Koshute, founder of Springs in the Desert Catholic ministry, told CNA.


“That's something that we hear and that everybody I think on the team has experienced at one point in this journey,” she said - the desire to avoid Mass on Mother’s Day. That’s because Koshute, along with other members of her ministry, have had painful experiences with infertility, and the customary Mother’s Day blessing given to mothers at many parishes that day can bring their grief and sense of loss poignantly to the fore.


“I think that so often people in our own families, our friends, and even our pastors don't really understand the full extent of the pain and the grief or even the full extent of the issue of infertility, of how many couples are really dealing with it,” she said.


The pain of infertility, and the lack of resources available to Catholics on the subject, was why Koshute and her friend, Kimberly Henkel, founded Springs in the Desert, a Catholic ministry to spiritually and emotionally support women and couples experiencing infertility and infant loss. Originally, Henkel and Koshute, who have both experienced infertility, thought they might write a book. But they decided to start with a ministry website and a blog that could bring people together and allow for other women and couples to share their experiences. The group is relatively new, and held its first retreat in Philadelphia in December. They were set to hold a second one this weekend - Mother’s Day weekend - in the Diocese of Fort Wayne-South Bend, when, well, the pandemic hit.

Now, they’ve moved the retreat online and opened it up to Catholics across the country - and they’ve been overwhelmed by the response.

“We thought that we would be really excited if maybe a couple dozen people found out about it and came. We are over 100 participants now. And it's free and it's going to be available all weekend,” Koshute said. The retreat is trying to address the emotional and spiritual experience of infertility and loss for a broad range of people, Henkel said - from mothers who have miscarried, to women who are past child-bearing years and still grieving the loss of infertility, to women “who feel like their biological clocks are ticking and just haven’t met the right guy.” But now that it's a virtual, pre-recorded, watch-at-your-leisure retreat, it also has the potential to reach a population that is often more reluctant to gather in groups and talk about their experiences of infertility: men. “It's mostly women who are emailing us (about the retreat), although we know that many of their husbands will watch with them. But we've also had a few men email us,” Koshute said.


“One in particular, it just really touched my heart. And he said that he was searching the web for help for his wife on Mother's Day. And I was just so filled with praise and thanksgiving to God for that, for a husband to see that hurt in his wife and to want to find a way to help her,” she added. Men and women typically experience the grief of infertility quite differently, Koshute noted. “For us women, it's so visceral because life is conceived within us and we carry that life. But for a man, it's so different,” she said.

“(Men are) kind of distant from that experience until the child is actually born. And so I think many times men, the grief and the burden that they carry is their wife's. They really carry her sadness and I think feel at a loss because they want to make everything right. They want to fix this, and they want to make her whole. And the mystery of infertility is that it's not that simple. And that's one of the things that makes it so difficult,” she said. Henkel said she experienced her own difficulties in trying to discuss infertility with her husband. Now that they’ve experienced the joy of growing their family through adoption, she said, he is much more open to inviting other men to share their experiences. Henkel said she is hoping that an additional benefit of this retreat being online is that it will facilitate discussions between couples watching the videos together. Both Henkel and Koshute said that while the experience of infertility and loss is painful, and they want to help couples acknowledge and accept that pain, they also want Springs in the Desert to be a positive and supportive experience for couples and women, where they can find hope and redemption even in their suffering. One of the topics they focus on is how all women are called to motherhood in their lives, whether it is spiritual or biological.

“My experience has shown me that my motherhood is really engaged in so many ways that I never considered before,” Koshute said.

“Not just with my godson or with other children in my family, but with women who are older than I who are friends and who might come to me with a difficulty or problem and I can help them,” or by helping family members in need or through charitable works, she added. “That's one of the messages that we try to get across to women and to couples as well, that those kinds of things, what we would maybe refer to as spiritual motherhood, is not illegitimate,” she said.

“It's not second-place. It's a real way of engaging and living out our motherhood. It's also not a replacement for a baby. So it's not as if you go out and volunteer in your community and now you won't have this longing for a child anymore. But we've really found through our own experience and through talking with other women that the more we kind of put ourselves out there and give ourselves to others, the more that we can begin to see that motherhood enacted in us.”

Henkel said she also likes to encourage couples to look at the ways God is calling them to be fruitful in their marriages outside of biological children.

“We really encourage these couples that they are not forgotten, they're not being punished. That God loves them so much and that he has something amazing for them. He's using this to draw them near to him and to allow them to cry out to him and ask for him to guide them, to lead them, to give them his love and show them what fruitfulness he has for them, what place in ministry and mission he has for them.” Henkel and her husband in particular like to share with couples their experience of foster care as one example of where God might be calling them to be fruitful. After a frustrating and expensive experience with some adoption agencies, Henkel and her husband decided to look into giving a home to children through foster care.

“Here is a situation where these children really need families,” she said. “It's hard because there's no guarantee you're going to get to keep this child, so there's a sense of this new greater level of having to learn how to trust God.” “I think that with a couple discerning that fruitfulness, it's also discerning - where is God really calling you? There's so much need in this world. And he wants to use us.”

Couples interested in the Springs in the Desert Mother’s Day weekend retreat can sign up for free online at the Springs in the Desert website. Content will be uploaded and available for anyone who registers, Henkel said, even if they register late. The retreat team will also be hosting a live talk on Sunday, May 10 at 2 p.m. Eastern on the ministry’s Facebook page.

“There's a place for you in Springs of the Desert,” Henkel added. “There's so many women who have reached out to us in Philly. We added several more women to our group, to our team, our official team, women who came to the retreat. One woman had come there and she said she had had a miscarriage, and neither one of us has experienced that. So we said, please join us. We want your voice.”

“We're trying to really bring the voices of many different women to our team so that people will feel there is somebody that is talking they can really relate to. Because there are all of these different situations, but they've got obviously a very similar undercurrent.”

CNA Staff, Apr 23, 2020 / 01:30 pm (CNA).- Iran has sentenced a 21 year-old Christian woman to prison and lashing for “disturbing public order,” after she protested the destruction of a passenger jet by the military.

Mary (Fatemeh) Mohammadi, a 21 year-old Iranian convert to Christianity, was arrested on Jan. 12 after taking part in anti-government protests that followed the shooting down of a passenger jet, Ukrainian Air Flight 752, by the Iranian Revolutionary Guard (IRG).  Iran announced several days after the incident that the IRG mistakenly shot the plane down, resulting in the deaths of all 176 people on board the flight.

In an Instagram post on Wednesday, Mohammadi said her sentence of three months and one day in prison is suspended for one year. She was also sentenced to 10 lashes.

Mohammadi said she has been tortured in prison and suffered “terrible conditions” for “protesting against the slaughter of human beings.” She said she did not appeal her sentence “because the appeal courts have turned into affirmative tribunals.” 

The U.S. Commission on International Religious Freedom (USCIRF) tweeted a condemnation of Mohammadi’s sentencing on Wednesday, saying that “No peaceful activist should be targeted on the basis of their religious beliefs.”

President Trump highlighted her case in his remarks at the National Prayer Breakfast on Feb. 6, saying that she “was seized and imprisoned in Iran because she converted to Christianity and shared the Gospel with others.

U.S. Secretary of State Mike Pompeo also discussed Mohammadi’s case in a Feb. 12 interview with Tony Perkins on Washington Watch. Perkins is also the chair of USCIRF.

Pompeo said the U.S. was “deeply concerned” of reports of Mohammadi’s arrest, and said she was “targeted by the regime because she made the choice to convert to Christianity.”

According to the All Party Parliamentary Group for International Freedom of Religion or Belief, Mohammadi was “physically and emotionally abused during her arrest and transfer to Qarchak prison,” and was questioned about her faith at her hearing.

Correction: This article originally stated that Mohammadi was one of a group of survivors of religious persecution who met with President Trump last July at the White House, as reported in the Christian Post. It was a different Iranian Christian, Dabrina Bet Tamraz, who met with Trump, not Mohammadi.

German translation of the BIS press release about the BIS Quarterly Review, September 2017

German translation of the BIS press release about the BIS Quarterly Review, December 2017

German translation of Press Release on the pre-release of two special chapters of the Annual Economic Report of the BIS, 17 June 2018. Trust is the missing link in today's cryptocurrencies - Cryptocurrencies' model of generating trust limits their potential to replace conventional money, the Bank for International Settlements (BIS) writes in its Annual Economic Report (AER), a new title launched this year.

The post Get 50% Off SOLIDWORKS Certification Exams appeared first on The SOLIDWORKS Blog.

Hailed as transitional by local observers, the latest polls were expected to usher in a new type of leadership in FRELIMO, with Filipe Nyussi being the first non-liberation northern leader in a southern dominated elite; they would also see opposition parties RENAMO and MDM alter their strategies and become more politically relevant; and would possibly be the last polls before the country became a mass resource-producing economy. However, the Presidential and parliamentary elections of 15 October have made the political setting, the prospects for improved governance and wealth redistribution more opaque, and the implementation of the new peace agreement harder.

Denver Newsroom, May 8, 2020 / 05:29 pm (CNA).- Mother’s Day is going to look different for most families this year, due to the coronavirus pandemic.

For Catholics, some churches are in the process of slowly re-opening public Masses, but the dispensation from the Sunday obligation continues to stand, as the virus has not gone away and a cure or vaccine has yet to be found.

While most Catholics are eager to return to Mass, a small group of Catholics are relieved that they will not be sitting in a public pew this Mother’s Day.

“We actually heard from one woman who said, ‘I kind of feel badly about saying this, but I'm sort of glad that we won't be in the pews this year for Mother's Day,’” Ann Koshute, founder of Springs in the Desert Catholic ministry, told CNA.


“That's something that we hear and that everybody I think on the team has experienced at one point in this journey,” she said - the desire to avoid Mass on Mother’s Day. That’s because Koshute, along with other members of her ministry, have had painful experiences with infertility, and the customary Mother’s Day blessing given to mothers at many parishes that day can bring their grief and sense of loss poignantly to the fore.


“I think that so often people in our own families, our friends, and even our pastors don't really understand the full extent of the pain and the grief or even the full extent of the issue of infertility, of how many couples are really dealing with it,” she said.


The pain of infertility, and the lack of resources available to Catholics on the subject, was why Koshute and her friend, Kimberly Henkel, founded Springs in the Desert, a Catholic ministry to spiritually and emotionally support women and couples experiencing infertility and infant loss. Originally, Henkel and Koshute, who have both experienced infertility, thought they might write a book. But they decided to start with a ministry website and a blog that could bring people together and allow for other women and couples to share their experiences. The group is relatively new, and held its first retreat in Philadelphia in December. They were set to hold a second one this weekend - Mother’s Day weekend - in the Diocese of Fort Wayne-South Bend, when, well, the pandemic hit.

Now, they’ve moved the retreat online and opened it up to Catholics across the country - and they’ve been overwhelmed by the response.

“We thought that we would be really excited if maybe a couple dozen people found out about it and came. We are over 100 participants now. And it's free and it's going to be available all weekend,” Koshute said. The retreat is trying to address the emotional and spiritual experience of infertility and loss for a broad range of people, Henkel said - from mothers who have miscarried, to women who are past child-bearing years and still grieving the loss of infertility, to women “who feel like their biological clocks are ticking and just haven’t met the right guy.” But now that it's a virtual, pre-recorded, watch-at-your-leisure retreat, it also has the potential to reach a population that is often more reluctant to gather in groups and talk about their experiences of infertility: men. “It's mostly women who are emailing us (about the retreat), although we know that many of their husbands will watch with them. But we've also had a few men email us,” Koshute said.


“One in particular, it just really touched my heart. And he said that he was searching the web for help for his wife on Mother's Day. And I was just so filled with praise and thanksgiving to God for that, for a husband to see that hurt in his wife and to want to find a way to help her,” she added. Men and women typically experience the grief of infertility quite differently, Koshute noted. “For us women, it's so visceral because life is conceived within us and we carry that life. But for a man, it's so different,” she said.

“(Men are) kind of distant from that experience until the child is actually born. And so I think many times men, the grief and the burden that they carry is their wife's. They really carry her sadness and I think feel at a loss because they want to make everything right. They want to fix this, and they want to make her whole. And the mystery of infertility is that it's not that simple. And that's one of the things that makes it so difficult,” she said. Henkel said she experienced her own difficulties in trying to discuss infertility with her husband. Now that they’ve experienced the joy of growing their family through adoption, she said, he is much more open to inviting other men to share their experiences. Henkel said she is hoping that an additional benefit of this retreat being online is that it will facilitate discussions between couples watching the videos together. Both Henkel and Koshute said that while the experience of infertility and loss is painful, and they want to help couples acknowledge and accept that pain, they also want Springs in the Desert to be a positive and supportive experience for couples and women, where they can find hope and redemption even in their suffering. One of the topics they focus on is how all women are called to motherhood in their lives, whether it is spiritual or biological.

“My experience has shown me that my motherhood is really engaged in so many ways that I never considered before,” Koshute said.

“Not just with my godson or with other children in my family, but with women who are older than I who are friends and who might come to me with a difficulty or problem and I can help them,” or by helping family members in need or through charitable works, she added. “That's one of the messages that we try to get across to women and to couples as well, that those kinds of things, what we would maybe refer to as spiritual motherhood, is not illegitimate,” she said.

“It's not second-place. It's a real way of engaging and living out our motherhood. It's also not a replacement for a baby. So it's not as if you go out and volunteer in your community and now you won't have this longing for a child anymore. But we've really found through our own experience and through talking with other women that the more we kind of put ourselves out there and give ourselves to others, the more that we can begin to see that motherhood enacted in us.”

Henkel said she also likes to encourage couples to look at the ways God is calling them to be fruitful in their marriages outside of biological children.

“We really encourage these couples that they are not forgotten, they're not being punished. That God loves them so much and that he has something amazing for them. He's using this to draw them near to him and to allow them to cry out to him and ask for him to guide them, to lead them, to give them his love and show them what fruitfulness he has for them, what place in ministry and mission he has for them.” Henkel and her husband in particular like to share with couples their experience of foster care as one example of where God might be calling them to be fruitful. After a frustrating and expensive experience with some adoption agencies, Henkel and her husband decided to look into giving a home to children through foster care.

“Here is a situation where these children really need families,” she said. “It's hard because there's no guarantee you're going to get to keep this child, so there's a sense of this new greater level of having to learn how to trust God.” “I think that with a couple discerning that fruitfulness, it's also discerning - where is God really calling you? There's so much need in this world. And he wants to use us.”

Couples interested in the Springs in the Desert Mother’s Day weekend retreat can sign up for free online at the Springs in the Desert website. Content will be uploaded and available for anyone who registers, Henkel said, even if they register late. The retreat team will also be hosting a live talk on Sunday, May 10 at 2 p.m. Eastern on the ministry’s Facebook page.

“There's a place for you in Springs of the Desert,” Henkel added. “There's so many women who have reached out to us in Philly. We added several more women to our group, to our team, our official team, women who came to the retreat. One woman had come there and she said she had had a miscarriage, and neither one of us has experienced that. So we said, please join us. We want your voice.”

“We're trying to really bring the voices of many different women to our team so that people will feel there is somebody that is talking they can really relate to. Because there are all of these different situations, but they've got obviously a very similar undercurrent.”

Missionaries share the gospel and bring freedom in a little farming village.

Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is higher than in typically developing children. The US Preventive Services Task Force and the American Academy of Pediatrics (AAP) have endorsed screening children for overweight and obesity as part of the standard of care for physicians. However, the pediatric provider community has been inadequately prepared to address this issue in children with ASD. The Healthy Weight Research Network, a national research network of pediatric obesity and autism experts funded by the US Health Resources and Service Administration Maternal and Child Health Bureau, developed recommendations for managing overweight and obesity in children with ASD, which include adaptations to the AAP’s 2007 guidance. These recommendations were developed from extant scientific evidence in children with ASD, and when evidence was unavailable, consensus was established on the basis of clinical experience. It should be noted that these recommendations do not reflect official AAP policy. Many of the AAP recommendations remain appropriate for primary care practitioners to implement with their patients with ASD; however, the significant challenges experienced by this population in both dietary and physical activity domains, as well as the stress experienced by their families, require adaptations and modifications for both preventive and intervention efforts. These recommendations can assist pediatric providers in providing tailored guidance on weight management to children with ASD and their families.

Property index exchange-traded fund Proptrax is a cheap and easy way to gain exposure to the property market, says an analyst.

The Importance of Being Earnest

Valverde Vega Sarchí is filled with sadness after suffering a 7.9 earthquake in September, but even amidst the sadness are a few smiles.

Staying home can save you money. You won't be spending your cash on your commute, on eating out or going to the pub whilst in lockdown, but that's not all. There are other ways you can be savvy with your spending and find ways to save.

Are you frightened of your garden? Terrified of killing your plants and overwhelmed by the sheer choice of species?

If you're yearning for all the gardening shows that have been cancelled, you can still be inspired by exploring gorgeous virtual gardens now and throughout the summer, from the comfort of your armchair.

British Olympic Association chairman Sir Hugh Robertson has been selected to lead an independent governance review of World Rugby.

Celtic Connections

The Celtic Connections roots and traditional music festival recorded 100,000 visits this January.

From Thursday 16 January to Sunday 2 February 2020, musicians from across the world will take part in over 300 events in venues throughout Glasgow for the UK's premier celebration of celtic music.

scrolling through Amazon in the same way has turned up some great deals on iPads. Right now the latest models are available at all-new low prices.

Belle Robertson has played just one round of golf this year. She’ll double that tally with another today.

WHAT’S a little distancing between us? Go on, stick your nose closer to the page or screen. Let’s snuggle in a little closer.

It's resulted in a creepy Orwellian environment where Google, Facebook, Amazon, and others have replaced Big Brother.

GLUMNESS settles on a large part of the nation whenever the subject of comedy comes up now. The lockdown has led to a more frenetic search for entertainment, and the current state of humour hasn’t wanted for critics. This week, Royle Family star Ricky Tomlinson, 80, said it was dire, and listed several comedians, adding: “They should be done under the Trade Description Act.”

Those anxious to reverse the aggressive federal role in education resulting from No Child Left Behind should not rush to simply push the pendulum as hard as possible in the other direction.

The Albert L. Evans Jr. Honorary Scholarship is a tribute to Bert Evans and his example of generous philanthropy.

It has been well documented that exposure to tobacco marketing is a risk factor for smoking initiation among youth. However, few studies have tested the specificity of this association.

This study extends findings from other studies and shows (from a longitudinal design) that exposure to cigarette advertising is significantly associated with youth smoking initiation, whereas exposure to advertising for other commercial products is not. (Read the full article)

Primary hypertension is a growing concern in adolescents due to its association with the obesity epidemic. Recent studies have examined underdetection and underdiagnosis of hypertension in adolescents but medical management of primary hypertension in adolescents is not well-described.

Our study describes patterns of antihypertensive prescribing for adolescents with primary hypertension including the use of monotherapy versus combination therapy by physicians of different specialties and factors associated with receipt of antihypertensive therapy over a multi-year period. (Read the full article)

Most childhood HIV is acquired through perinatal transmission, some of which is preventable. Practitioners need to understand what proportion of perinatally acquired HIV infections are attributable to missed prevention opportunities.

Missed prevention opportunities include lack of early HIV testing for pregnant women; suboptimal use of antiretroviral medications during pregnancy, labor, or delivery or for the neonate; breastfeeding; and vaginal delivery when maternal viral load was ≥1000 copies/mL. (Read the full article)

Pertussis is a poorly controlled vaccine-preventable disease. Verifying outbreaks is challenging owing to nonspecific clinical presentations and imperfect diagnostic tests. Exclusive reliance on highly sensitive polymerase chain reaction has been associated with pseudo-outbreaks.

Contamination of specimens with vaccine derived Bordetella pertussis DNA from pediatric clinic surfaces likely resulted in misdiagnoses. Standard practices, liquid transport medium, and lack of polymerase chain reaction cutoffs for discerning weakly positive (contaminant) DNA are contributory, but modifiable factors. (Read the full article)

Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight infants and contributes to morbidity and mortality.

Pulmonary hypertension affects at least 1 in 6 extremely low birth weight infants and persists to discharge in most survivors. Routine screening of these infants with echocardiography at 4 weeks of age identifies only one-third of those affected. (Read the full article)

Infantile hypertrophic pyloric stenosis incidence varies over different regions and time periods. Recently, a decline was reported in the United States, Sweden (concurrent with a decline in sudden infant death syndrome), Scotland, and Denmark. The etiology remains unclear; therefore, epidemiologic data are valuable.

A decline in the incidence of infantile hypertrophic pyloric stenosis in Germany from 2000 to 2008 was noted but with wide regional variations. The regional distribution of infantile hypertrophic pyloric stenosis was different from that of sudden infant death syndrome. (Read the full article)

Most acute wheezing episodes in preschool children are associated with rhinovirus, which decreases extracellular adenosine triphosphate levels, leading to airway surface liquid dehydration and submucosal edema, which cause failure of mucus clearance. These children respond poorly to available treatments.

Hypertonic saline inhalation, a pro–airway surface liquid hydration therapy, significantly decreases both length of stay by 33% (1 day) and the absolute risk of hospitalization by 30% in preschool children presenting with acute wheezing episode to the emergency department. (Read the full article)

The causes of Perthes disease are unknown. There is considerable evidence that the disease has a vascular mechanism, although the nature of this is unknown. There is some suggestion that affected individuals may have a heightened cardiovascular risk in adulthood.

Children with Perthes disease have reduced vascular caliber, which is independent of body height, and abnormal functional vascular measures. These findings may be important in the mechanism of disease and may have implications on long-term vascular morbidity. (Read the full article)

Neonatal sepsis is an important cause of under-5 childhood mortality. Infants born to HIV-infected mothers are at increased risk of morbidity and mortality, even if not having acquired HIV. This association needs further study during the neonatal period.

Maternal HIV infection was associated with increased vaginal colonization by Escherichia ecoli but not group B Streptococcus. Neonates born to HIV-infected mothers were only at increased risk of sepsis if they had acquired HIV-infection, but not if HIV-uninfected. (Read the full article)

Materialism and life satisfaction are known to be associated with each other. Research among adults has shown that materialism and life satisfaction negatively affect each other, leading to a downward spiral.

In contrast to research conducted among adults, no longitudinal effect of materialism on life satisfaction was found for 8- to 11-year-olds. However, life satisfaction did negatively affect materialism, but only for children who were frequently exposed to advertising. (Read the full article)

Early life nutrition may program pubertal timing. Limited evidence suggests breastfeeding is associated with later puberty and childhood milk consumption with earlier puberty; whether these observations are biologically mediated or confounded by socioeconomic position is unclear.

In a developed non-Western setting with little socioeconomic patterning of pubertal timing, neither breastfeeding nor childhood milk consumption was associated with pubertal timing, suggesting nutritional exposures during potentially critical periods may not have long-term effects on rates of maturation. (Read the full article)

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)

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)

Prevalence of hypertension in children increased significantly over the past few decades, tracks into adulthood, and is a major risk factor for cardiovascular disease. However, current prevalence estimates in children have largely been based on studies conducted in school environments.

The current study reports the prevalence of childhood hypertension in community pediatric practice, which provides a typical pediatric examination environment, unlike blood pressure measured in school. The results show a significantly lower prevalence than what has previously been reported. (Read the full article)

Practice characteristics, such as practice size, have been associated with the readiness of adult primary care practices for medical home certification. Little is known about how ready primary care practices for children are for medical home certification.

Primary care practices for children attained only 38% of the infrastructure required for medical home certification. Smaller practice size was significantly associated with lower infrastructure scores. Medical home programs need effective approaches to support practices with limited resources. (Read the full article)

Despite high coverage with acellular pertussis vaccine (DTaP), rates of pertussis have increased substantially in 7- to 10-year-olds in recent years. Duration of protection with 5 doses of DTaP may wane earlier than expected and is currently not well described.

This evaluation reports increasing risk of pertussis in the 6 years after receipt of the fifth DTaP dose, suggesting that waning of vaccine-induced immunity is occurring before the recommended adolescent booster dose at 11 to 12 years of age. (Read the full article)

The United States switched from whole-cell to acellular pertussis vaccines during the 1990s. Whether pertussis risk during a California outbreak differed between teenagers who previously received whole-cell or acellular pertussis vaccines early in life has not been reported.

We evaluated pertussis risk in 10 to 17 year olds at Kaiser Permanente Northern California during a recent pertussis outbreak. Those given whole-cell pertussis vaccines in childhood were more protected than those given acellular pertussis vaccines. (Read the full article)

Infants aged <2 months are at highest risk for pertussis morbidity and mortality but are too young to receive pertussis vaccines. To protect young infants, the Advisory Committee on Immunization Practices recommends mothers receive 1 dose of Tdap during pregnancy.

This article evaluates the effect of Tdap during pregnancy compared with postpartum Tdap and cocooning in preventing infant pertussis cases, hospitalizations, and deaths, as well as their relative cost-effectiveness. (Read the full article)

Exemption rates for immunization requirements have until recently been stable in states permitting religious exemptions. States with easy exemption processes have seen higher rates of vaccine-preventable diseases.

In New York, the rate of religious exemptions has increased. Counties with higher rates of exemption have a greater incidence of pertussis. (Read the full article)

Brief periods of low oxygen saturation are common in infants while restrained in car safety seats. There is some evidence that an insert that allows the infant head to rest in a neutral position in sleep may reduce hypoxic episodes.

This randomized controlled study shows that the insert reduced numbers of obstructive apneas and the severity of desaturation events but did not significantly reduce the overall rate of moderate desaturations. (Read the full article)

Previous studies have shown that nonmedical exemptions (NMEs) to immunization cluster geographically and contribute to outbreaks of vaccine-preventable diseases such as pertussis. The 2010 pertussis resurgence in California has been widely attributed to waning immunity from acellular pertussis vaccines.

This study provides evidence of spatial and temporal clustering of NMEs and clustering of pertussis cases and suggests that geographic areas with high NME rates were also associated with high rates of pertussis in California in 2010. (Read the full article)

Pertussis rates are on the rise in the United States. Infants often require hospitalization for pertussis. Vaccination can change hospitalization patterns for vaccine-preventable diseases. It is unknown if vaccinating adolescents for pertussis (recommended in 2006) might change infant hospitalization utilization.

Universal vaccination policy among adolescents against pertussis appears to have been effective in 3 of the 4 years we examined postvaccination. Further vaccination efforts among adolescents and adults are needed to prevent infantile hospitalization on a more consistent basis. (Read the full article)