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Bladder Function After Fetal Surgery for Myelomeningocele

Urologic outcomes of prenatal myelomeningocele closure have previously been reported. This study, however, represents a large, prospectively followed cohort of these patients and presents detailed findings of urologic outcomes. To our knowledge, this is the largest study of this type.

Our study is the only trial to compare urologic outcomes in children with myelomeningocele having undergone prenatal closure with those who had postnatal repair in a prospective and systematic manner. We report our findings at 12 and 30 months. (Read the full article)




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Development of the Children With Disabilities Algorithm

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)




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Effectiveness and Cost of Bidirectional Text Messaging for Adolescent Vaccines and Well Care

Adolescent vaccination rates lag behind other childhood vaccines. Text messaging to improve uptake of adolescent vaccines has been shown to be effective in academic centers but has not been studied in other settings.

This study, done in 5 private and 2 safety-net practices, used a bidirectional text message as a behavioral prompt and showed text messaging was effective at increasing uptake of all adolescent vaccines. Costs were similar to other reminder/recall methods. (Read the full article)




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Hospital Use in the Last Year of Life for Children With Life-Threatening Complex Chronic Conditions

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)




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Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

Deferral of consent avoids delaying emergency interventions while ensuring consent to ongoing participation and use of data. Deferred consent is particularly important for enabling trials in pediatric settings, where many medicines and devices are unlicensed and untested for use.

Approaches for seeking deferred consent should balance the potential burden of obtaining consent against risk of bias due to outcome-related attrition. Ethics committees could consider approving data use when best efforts to obtain deferred consent are met with no response. (Read the full article)




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Early Substance Use and Subsequent DUI in Adolescents

Research demonstrates that substance use, beliefs about use, and influence from family and friends can put young adults at risk for DUI and RWDD. Much of this research is cross-sectional and focuses on risk factors identified in young adults.

This longitudinal study emphasizes the importance of prevention efforts in early adolescence at multiple levels to reduce high school DUI/RWDD, because marijuana beliefs and marijuana use by peers and family members during middle school were associated with high school DUI/RWDD. (Read the full article)




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Incidence of Dravet Syndrome in a US Population

De novo mutations of the sodium channel gene SCN1A are the major cause of Dravet syndrome, an infantile-onset epileptic encephalopathy. The incidence of this genetic disorder in the United States is unclear.

Dravet syndrome due to SCN1A mutation is twice as common in the United States as previously thought. Genetic testing should be considered in children with ≥2 prolonged febrile seizures by 1 year of age. (Read the full article)




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Testing for Abuse in Children With Sentinel Injuries

Several injuries have been suggested to be disproportionately associated with abuse in young children, but rates of abuse among children with these injuries are not currently known.

Abuse is diagnosed commonly in children with sentinel injuries, including the majority of children <24 months with rib fractures. (Read the full article)




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Hospital Variation in Health Care Utilization by Children With Medical Complexity

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)




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Stigma and Parenting Children Conceived From Sexual Violence

Maternal–child relationships among women raising children from sexual violence-related pregnancies (SVRPs) are not well understood. Limited case reports suggest widely varied and complex relationships. The determinants of these relationships are unknown.

With its large sample size, this article quantifies and analyzes maternal–child relationships among women raising children from SVRPs, and assesses the impact of stigma, acceptance, and maternal mental health on these relationships. (Read the full article)




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Risk Factors for Central Nervous System Tuberculosis

Central nervous system (CNS) tuberculosis has high morbidity and mortality, and it frequently affects children aged <5 years.

In California, children who were US-born, Hispanic, and aged <5 years were at increased risk of CNS tuberculosis. Children with CNS tuberculosis were more likely to die. Specific populations of US-born infants might benefit from additional prevention measures. (Read the full article)




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Point-of-Care Quantitative Measure of Glucose-6-Phosphate Dehydrogenase Enzyme Deficiency

Glucose-6-phosphate dehydrogenase deficiency remains a global as well as a North American burden for extreme hyperbilirubinemia and kernicterus and is often unpredictable during the first few days after birth. Newborn screening for this enzyme deficiency is not universally available but debated.

Point-of-care screening, using digital microfluidics, provides accurate, low blood volume, and affordable technology for rapid newborn glucose-6-phosphate dehydrogenase enzyme screening that could guide clinicians before infants’ discharge from well-child nurseries and meet existing American Academy of Pediatrics’ recommendations. (Read the full article)




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Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort

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)




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Outpatient Visits and Medication Prescribing for US Children With Mental Health Conditions

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)




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Early-Onset Neutropenia in Small-for-Gestational-Age Infants

Small for gestational age neonates (weight <10th percentile) are at risk for neutropenia during the first days after birth. However, the duration, responsible mechanism, and outcomes of this variety of neonatal neutropenia are not precisely known.

Six percent of small for gestational age neonates had neutrophils <1000/μL, with an average neutropenia duration of 7 days. Neutropenia was more closely linked with small for gestational age status than maternal hypertension. This neutropenia is associated with elevated nucleated red blood cell count and increased odds of necrotizing enterocolitis. (Read the full article)




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Lithium in the Acute Treatment of Bipolar I Disorder: A Double-Blind, Placebo-Controlled Study

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)




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Racial and Regional Differences in Rates of Invasive Pneumococcal Disease

Previous studies have shown racial differences in invasive pneumococcal disease (IPD) rates. Recent studies demonstrated a national decline in IPD rates after 13-valent pneumococcal conjugate vaccine (PCV13) introduction. The impact of PCV13 on racial and regional differences in IPD rates among Tennessee children is unknown.

After introduction of PCV13, pediatric IPD rates, including disease due to antibiotic-resistant strains, declined substantially. Racial and regional differences in IPD rates were no longer significant. Our study illustrates the impact of PCV13 and the importance of continued IPD surveillance. (Read the full article)




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Safety of Botulinum Toxin Type A for Children With Nonambulatory Cerebral Palsy

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)




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Derivation of Candidate Clinical Decision Rules to Identify Infants at Risk for Central Apnea

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)




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Polysomnographic Markers in Children With Cystic Fibrosis Lung Disease

Children with cystic fibrosis demonstrate gas exchange abnormalities and increased respiratory loads during sleep independent of lung function, age, and BMI. Assessment of breathing patterns during sleep provides an opportunity for detection of early lung disease progression.

Children with cystic fibrosis demonstrated increased respiratory loads and gas exchange abnormalities during sleep compared with controls. Based on these findings, sleep assessment in this patient population can identify markers for the early detection of lung disease progression. (Read the full article)




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Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer

Many families share genetic cancer risk information with their children, and some parents and providers believe BRCA1/2 testing should be permitted in adolescence. The psychosocial effects and impact on health and risk behaviors of this knowledge is unknown.

In our cohort of 869 mother-daughter pairs, we found no differences in general adjustment, but 10- to 13-year-old girls with breast cancer family histories reported higher breast cancer–specific distress and perceived breast cancer risk. Mother distress was associated with daughter distress. (Read the full article)




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Incidence and Characteristics of Autoimmune Hepatitis

Pediatric autoimmune hepatitis is an uncommon condition; children and youth can present with a diverse and insidious clinical course and biochemical features. Response to treatment is generally good, and transplantation is rarely needed.

This population-based study adds knowledge regarding the incidence of pediatric autoimmune hepatitis in Canada, as well as a description of diagnostic and therapeutic approaches among centers. Long-term outcomes are also described. (Read the full article)




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Treating EEG Seizures in Hypoxic Ischemic Encephalopathy: A Randomized Controlled Trial

Continuous conventional EEG video is currently gold standard for identifying neonatal seizures and a substantial proportion of neonatal seizures are electrographic. Currently there is no direct evidence that EEG monitoring, seizure identification, or treatment impacts long-term outcomes.

In neonates with hypoxic ischemic encephalopathy, EEG monitoring and treatment of electrographic seizures results in significant reduction in seizure burden. Increasing seizure burden is associated with more severe brain injury and significantly lower performance scores on Bayley Scales of Infant Development III. (Read the full article)




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Growth Charts for Children With Down Syndrome in the United States

Children with Down syndrome (DS) grow differently from other children. Advances in medical care, access to care, and improved life expectancy suggest that contemporary growth patterns may have improved over recent decades for children with DS in the United States.

New growth charts are presented for length/height, weight, head circumference, and BMI for children with DS (birth to 20 y). Weight gain in children <36 months, and stature for males are improved compared with older growth charts. (Read the full article)




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Prescription Opioids in Adolescence and Future Opioid Misuse

Legitimate opioid is a risk factor for subsequent misuse of opioids among adults. This study provides the first population-based estimate of the risk of future opioid misuse associated with legitimate opioid use among adolescents.

Use of prescribed opioids before the 12th grade is independently associated with future opioid misuse among patients with little drug experience and who disapprove of illegal drug use. (Read the full article)




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Physician and Nurse Nighttime Communication and Parents' Hospital Experience

Communication between parents and providers is an important driver of parent experience of care. The impact of nighttime communication, which has become increasingly relevant after changes in resident physician duty hours, on parent experience is unknown.

Parent communication with nighttime doctors and nurses, and parent perceptions of communication and teamwork between these providers, may be important drivers of parent experience. Efforts to improve nighttime communication, both with parents and between team members, may improve parent experience. (Read the full article)




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HPV Vaccination Coverage of Male Adolescents in the United States

HPV is the most common sexually transmitted infection in the United States. More than 50% of sexually active men and women will acquire HPV infection in their lifetime. In 2011, HPV was recommended for routine use among male adolescents.

(Read the full article)




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Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial

The impact of neonatal abstinence syndrome is of concern because the number of newborns showing symptoms of withdrawal after intrauterine drug exposure is increasing worldwide. Newborns developing neonatal abstinence syndrome require prolonged medical treatment and longer hospital admission after birth.

This first randomized controlled trial presents data on newborns with neonatal abstinence syndrome treated with laser acupuncture. The findings suggest that adjuvant laser acupuncture has the potential to reduce duration of morphine therapy and length of hospital stay. (Read the full article)




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Testing and Treatment After Adolescent Sexual Assault in Pediatric Emergency Departments

National guidelines recommend testing and prophylaxis for chlamydia, gonorrhea, and pregnancy for adolescent sexual assault victims. Little is known about rates of testing and prophylaxis in adolescent victims of sexual assault evaluated in pediatric emergency departments.

There is significant variation in testing and prophylaxis practices in the pediatric emergency department evaluation of adolescent victims of sexual assault. Adolescents cared for in emergency departments with clinical pathways are more likely to receive recommended prophylaxis. (Read the full article)




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Exposure and Use of Mobile Media Devices by Young Children

Interactive mobile media devices have revolutionized children’s access to and experience of media, but research is lagging behind its adoption. A critical first step is to understand when and how young children adopt mobile media devices.

Our study found almost universal exposure, early adoption, and use of mobile media devices among young children in an urban, low-income, minority community. Studies are needed to update guidelines on the use of mobile media by young children. (Read the full article)




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Apple Enables iOS In-App Purchase Gifting

Before now, you could gift a paid iOS app, but not paid in-app purchases. An update to the review guidelines changes this, most likely as a reaction to more paid content only being available through in-app purchases.




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Apple Solves the Accidental App Store Subscription Problem

It was far too easy to accidentally start an app subscription if you own an iPhone with Touch ID. Apple just solved the problem with a pop-up.




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March 24 Open House




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Accounting student lands position with PwC

John Boland accepted an offer as an audit associate at the highly competitive firm after just a few months in the Master of Professional Accounting program offered by Penn State Great Valley.




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Sweden beat favourites, Behringer saves Germany

Lisa Dahlkvist's penalty won Sweden an Olympic shoot-out against favourites the United States, and Germany forged on, but France did not make it to the last four.




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Germany to meet Sweden in Olympic final

The Olympic women's football final will be an all-European affair after Sweden ousted hosts Brazil on penalties and Germany beat Canada in Tuesday's semi-finals.




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Olympic final in numbers: Sweden v Germany

History overwhelmingly favours Germany against Sweden on Friday, but in Pia Sundhage, Sweden are led by a coach bidding for a third successive Olympic gold.




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Germany see off Sweden for Olympic gold

Silvia Neid brought down the curtain on her 11-year reign as Nationalelf coach triumphantly as Germany overcame a spirited Sweden side 2-1 to win their first Olympic title.




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2019 Women's World Cup qualifying entries

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.




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Neid named best women's coach in FIFA awards

Silvia Neid, who led Germany to Olympic gold in 2016, was named best coach at The Best FIFA Football Awards as Melanie Behringer just missed out on the top player gong.




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Women's World Cup preliminary round draw

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.




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Kerr appointed Scotland women's team coach

Former Scotland captain Shelley Kerr will replace Anna Signeul as coach after UEFA Women's EURO 2017, the ex-defender saying she is "extremely proud and honoured".




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Women's World Cup preliminary round report

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




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Women's World Cup qualifying group stage draw

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.




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Women's World Cup qualifying: how it works

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.




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Women's World Cup qualifying: September update

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.




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Iceland stun Germany to end two-decade run

It had been 19 years since Germany lost a qualifier but Iceland ended that run in stunning style with a 3-2 away win that finished some incredible runs by the twice world champions.




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Women's World Cup qualifying: October update

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




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Women's World Cup qualifying: November update

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




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Women's Player of the Year shortlist: Harder, Hegerberg, Henry

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