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Background: People with type 1 diabetes (T1D) aged <21 years are eligible for subsidised continuous glucose monitoring (CGM) products under the Australian National Diabetes Services Scheme. There are few real‐world published studies to evaluate the benefits of CGM in young adults. Aims: To perform a real‐world observation study among youth with T1D to evaluate CGM use and benefits of CGM. Methods: Patients at the Westmead Hospital Young Adult Diabetes Clinic aged 15–21 years who commenced CGM before July 2018 were followed for 6 months post commencement of CGM. Differences in HbA1c and glucose metrics at baseline and follow up are compared between those commencing CGM and those that did not. Results: Forty‐four (38%) of 115 eligible patients commenced CGM. Demographic characteristics and baseline HbA1c did not differ significantly between those started on CGM and those that did not. At 6 months, 18 (41%) of 44 patients still used CGM, with discomfort and inconvenience the most common reasons for dropout. In CGM continuers, at 6 months compared with baseline, there was no change in HbA1c (8.2% vs 8.0%; P = 0.8), coefficient of variation of glucose (38% vs 39%; P = 0.5) or percentage time in range (52% vs 58%; P = 0.3). Six‐month follow‐up HbA1c in CGM non‐users deteriorated significantly compared with users. Mean hypoglycaemia fear scores (worry scale) were significantly decreased from baseline at 6 months (33 vs 18; P < 0.01). Conclusion: There are high rates of discontinuation in CGM use among youth with T1D. At 6 months of CGM use, there was no significant change in glycaemic control, although HbA1c in non‐users deteriorated significantly. Worry of hypoglycaemia was significantly decreased among those who continued CGM. [ABSTRACT FROM AUTHOR]

Objective: Continuous glucose monitoring (CGM) is increasingly used in type 1 diabetes management; however, funding models vary. This study determined the uptake rate and glycemic outcomes following a change in national health policy to introduce universal subsidized CGM funding for people with type 1 diabetes aged <21 years.Research Design and Methods: Longitudinal data from 12 months before the subsidy until 24 months after were analyzed. Measures and outcomes included age, diabetes duration, HbA1c, episodes of diabetic ketoacidosis and severe hypoglycemia, insulin regimen, CGM uptake, and percentage CGM use. Two data sources were used: the Australasian Diabetes Database Network (ADDN) registry (a prospective diabetes database) and the National Diabetes Service Scheme (NDSS) registry that includes almost all individuals with type 1 diabetes nationally.Results: CGM uptake increased from 5% presubsidy to 79% after 2 years. After CGM introduction, the odds ratio (OR) of achieving the HbA1c target of <7.0% improved at 12 months (OR 2.5, P < 0.001) and was maintained at 24 months (OR 2.3, P < 0.001). The OR for suboptimal glycemic control (HbA1c ≥9.0%) decreased to 0.34 (P < 0.001) at 24 months. Of CGM users, 65% used CGM >75% of time, and had a lower HbA1c at 24 months compared with those with usage <25% (7.8 ± 1.3% vs. 8.6 ± 1.8%, respectively, P < 0.001). Diabetic ketoacidosis was also reduced in this group (incidence rate ratio 0.49, 95% CI 0.33-0.74, P < 0.001).Conclusions: Following the national subsidy, CGM use was high and associated with sustained improvement in glycemic control. This information will inform economic analyses and future policy and serve as a model of evaluation diabetes technologies. [ABSTRACT FROM AUTHOR]

This article provides an overview of the Global Alliance for Behavioral Health and Social Justice, formerly known as Ortho, on its 100th anniversary. The organization has focused on promoting social justice, human rights, and reducing disparities in health and social outcomes. They have engaged in various initiatives, such as advocating for mental health inclusion in international forums, tackling policy issues, and offering conferences and symposia to promote collaboration. The special issue of the American Journal of Orthopsychiatry highlights the organization's history and future directions, covering topics such as mental health policy, interdisciplinary collaboration, social determinants of mental health, and advocacy for specific populations. The authors emphasize the importance of promoting mental health at multiple levels and acknowledge the challenges that lie ahead. [Extracted from the article]

Individuals with type 1 diabetes (T1D) frequently fail to achieve glycemic goals and have excess cardiovascular risk and premature death. Adjunctive agents may play a role in reducing morbidity, mortality, and the adverse sequelae of insulin treatment. A surge in type 2 diabetes drug development has revealed agents with benefits beyond glucose lowering, including cardiovascular risk reduction. Could these benefits translate to T1D? Specific trials for T1D demonstrate substantial hemoglobin (Hb)A1c reductions with sodium glucose cotransporter inhibitors (SGLTis) and glucagon-like peptide (GLP)1 agonists, and modest improvements with metformin, dipeptidyl peptidase-4 inhibitor (DPP4i), and pramlintide. Studies exploring cardiovascular risk reduction are warranted. This review synthesizes the emerging literature for researchers and clinicians treating people with T1D. Challenges in T1D research are discussed. Therapies developed for use in T2D have cardiovascular and renal protective properties. Clinical trials testing these agents in T1D assess their ability to mitigate side effects of insulin (weight gain and hypoglycemia) and improve achievement of glycemic goals. There is little focus on cardiovascular endpoints in current clinical trials. Conducting clinical trials in T1D has unique challenges. Adjunctive agents in T1D have potential to close morbidity and mortality gaps, but this is yet to be verified by the current evidence base. [ABSTRACT FROM AUTHOR]

The article discusses methods to identify pregnant women who consume alcohol in order to prevent fetal alcohol spectrum disorders (FASD), and tackles interventions for infants and children with FASD. Topics include the etiology and pathophysiology of FASD, the recommendation to collaborate with the nurse midwife or obstetrician of the patient to prevent FASD, and the role of advanced practice registered nurses (APRNs) in dealing with FASD.

The article presents the nursing advocacy of the American Nurses Association (ANA) and Oncology Nursing Society (ONS) which advocates for patients, nursing profession and nurses. The advocacy in leadership and management includes the themes such as importance of staffing levels, healthy work environments and continuing education.

Initiated in 1991, the Federal Healthy Start Program includes 105 community-based projects in 39 states, the District of Columbia and Puerto Rico. Healthy Start projects work collaboratively with stakeholders to ensure participants' continuity of care during pregnancy through 2 years postpartum. This evaluation of Healthy Start projects examined relationships between implementation of nine core service and system program components and improvements in birth and project outcomes. Program components and outcomes were examined using data from a 2010 Healthy Start project director (PD) survey (N = 104 projects) and 2009 performance measure data from the Maternal and Child Health Bureau Discretionary Grant Information System (N = 98 projects). We explored bivariate relationships between the nine core program components and (a) intermediate and long-term project outcomes and (b) birth outcomes. We assessed independent associations of implementation of all core program components with birth outcomes, adjusting for project characteristics and activities. In 2010, 57 projects implemented all nine core program components: 104 implemented all five core service components and 69 implemented all four core systems components. Implementation of all core program components was significantly associated with several PD-reported intermediate and long-term project outcomes, but was not associated with singleton low birth weight or infant mortality among participants' infants. This evaluation revealed a mixed set of relationships between Healthy Start projects' implementation of the core program components and achievement of project outcomes. Although the findings demonstrated a positive impact of Healthy Start projects on birth outcomes, only a few associations were statistically significant. [ABSTRACT FROM AUTHOR]

Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend the observed differences and sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. [ABSTRACT FROM AUTHOR]

While family engagement at the individual level of health care, such as families partnering with providers in decision-making about health care for an individual child has been well studied, family engagement in systems-level activities (e.g., participation in advisory and other decision-making groups, or creation and revision of policies) that impact the health services families and children receive has not. This note from the field presents a framework that describes the information and supports that help families partner with professionals and contribute to systems-level activities. Without attention to these components of family engagement, family presence and participation may be only token. We engaged an expert Family/Professional Workgroup whose members represented key constituencies and diverse geography, race/ethnicity, and areas of expertise; conducted a review of peer-reviewed publications and grey literature; and conducted a series of key informant interviews to identify best practices for supporting meaningful family engagement at the systems level. Based on an analysis of the findings, the authors identified four action-oriented domains of family engagement and key criteria that support and strengthen meaningful family engagement in systems-level initiatives. Child- and family-serving serving organizations can use this Family Engagement in Systems framework to support meaningful family engagement in the design of policies, practices, services, supports, quality improvement projects, research, and other systems-level activities. [ABSTRACT FROM AUTHOR]

Highlights: [•] N-Arylmethylene and methine pyrroles were electropolymerised into polymers and copolymers. [•] N-arylmethylene pyrrole monomers readily formed stable homopyrrole polymer films. [•] N-alkylmethine pyrrole monomers only formed stable copolymers films with pyrrole. [•] N-(1,2-dicarboxyethyl)-1H-pyrrole films readily complexed Cu+ or Cd2+ ions under a applied–ve field. [ABSTRACT FROM AUTHOR]

Background: Limited studies have compared outcomes between emerging adults with type 1 diabetes mellitus (T1D) attending a diabetes transition support programme using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Aims: To assess glycaemic control and service utilisation in emerging adults with T1D on MDI or CSII attending a young adult diabetes clinic (YAC). Methods: A retrospective cohort analysis was conducted from January 2013 to December 2015. Data collected included clinic visits per year, after‐hours mobile telephone use, diabetic ketoacidosis (DKA) admissions and all HbA1c levels. Independent t‐test was used to compare continuous variables whilst Pearson's Chi‐squared test was used for categorical variables. Linear mixed effects models explored mean changes in HbA1c levels over time. Results: Over 3 years, 318 youth with T1D (176 MDI, 121 CSII, 21 switched from MDI to CSII) attended our YAC. Aggregated mean HbA1c levels remained similar between modalities (CSII 9.1% vs MDI 9.3%; P = 0.23); however, mean change in HbA1c at 3 years was significantly increased in CSII users at 0.55% (95% CI 0.15–0.95; P < 0.01) compared with no significant change in MDI users. Clinic visits per year were improved in CSII users (CSII 2.8 vs MDI 2.5; P = 0.02), while DKA admissions remained similar between MDI and CSII users (3.6 admissions per 100 patient‐years). Conclusion: In our YAC cohort, glycaemic control in CSII and MDI users was similar but well below recommended international glycaemic targets (HbA1c level < 7.0%). Despite increased clinical engagement occurring in CSII users, glycaemic deterioration was observed over the 3 years. [ABSTRACT FROM AUTHOR]

The article discusses the influenza vaccination of health-care personnel (HCP) in the U.S. during the 2011-2012 influenza season. The Advisory Committee on Immunization has recommended their vaccination. Data showed that vaccination was effective in minimizing the risk for medical care-acquired influenza illnesses among physicians and nurses. The Centers for Medicare & Medicaid Services (CMS) plans to require hospitals to report HCP influenza vaccination levels beginning in January 2013.

The article discusses the influenza vaccination of pregnant women in the U.S. during the 2011-2012 influenza season. The Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) have recommended their vaccination. Data showed that vaccination was effective in minimizing the risk for influenza among pregnant women. Some women expressed concern over vaccination's safety risk to their baby.

The article offers insights of Seton Healthcare Family cancer care team clinical nurse manager Joni Watson and University of Alabama's School of Nursing nurse practitioner Deborah K. Walker on how they build their brands as oncology nurse. Watson relates her use of Twitter and blogs that giver her chance to be involved with the Oncology Nursing Society (ONS). Meanwhile, Walker mentions that her involvement to the local ONS chapter and her work in writing helps her build her career.

The article reports on the influenza vaccination coverage among pregnant women in the U.S. from 2010-2011, based on a survey conducted by the U.S. Centers for Disease Control and Prevention (CDC). Data show the percentage of pregnant women aged 18-49 years who received influenza vaccination before, during, or after pregnancy baby month of delivery or expected month of delivery. The top reasons of the respondents for not receiving influenza vaccination were concerns about the possible safety risks to the baby if vaccinated, the risk to influenza to the mother if vaccinated, and doubt over the effectiveness of the vaccine to prevent flu. INSET: What is already known on this topic?.

This article discusses a study on influenza vaccination coverage among pregnant women in the U.S. in 2010 and 2011. Conducted by the Centers for Disease Control and Prevention, the study used weighted analyses, confidence intervals and chi-square tests to analyze differences in vaccination coverage levels among subgroups. It showed higher prevalence of vaccination after pregnancy for women delivering early in the vaccination period.

Acute promyelocytic leukemia (APL), once described as the form of leukemia with the highest mortality, is now the most potentially curable subtype of adult acute myeloid leukemia. A brief review of the history of APL will describe the advances in research and clinical practice and their impact on patient outcomes. Oncology nurses should familiarize themselves with the nuances of APL because of the critical role nurses play in providing support for patients. This article provides an overview of APL, including the epidemiology and pathophysiology that distinguishes APL from other types of acute leukemia. Clinical presentation and diagnostic workup for patients suspected of having APL will be reviewed, as will the treatment course. Nursing implications and management will be provided related to potential treatment complications specific to APL, including coagulopathies, differentiation syndrome, and QT prolongation with the use of arsenic trioxide, as will the side effects and complications that can occur in any patient with leukemia, such as infection, hyperleukocytosis, tumor lysis, and increased intracranial pressure. [ABSTRACT FROM AUTHOR]

While there is a considerable evidence base showing links between drug use and offending and clear evidence of the impact of treatment engagement on drug-related offending, there is a much smaller UK evidence base on 'what works' in treatment and criminal justice partnerships, particularly in the UK. The current study used police arrest data to measure changes in offending behaviour in 116 drug-using offenders who had tested positive for opiates or cocaine in custody suites on at least three occasions in the previous year. Participants were assigned to either an intensive form of 'quasi-coercive' treatment (the High Crime Causing Users, HCCU) or to treatment as usual from the community Drug Interventions Programme team. The study compares changes in offending in a high-rate offending group with a standard treatment intervention. The assessment of the effectiveness of the intervention was based on arrest rates in the 12 months before and after engagement with the programme, supplemented by data collected from treatment case notes. Data analysis showed a significant reduction in offending in those engaged in the HCCU, who had higher pre-entry offending, but no change in offending for those accessing treatment as usual. There was some indication that greater retention in treatment was linked to better outcomes, and that medical sessions were associated with greater reductions in crime. The results provide some support for intensive partnership working between criminal justice drug services and the police, and suggest that intensive community work with high-rate drug-using offenders can be effective. [ABSTRACT FROM AUTHOR]

Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff’s perceptions of these components’ influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements. [ABSTRACT FROM AUTHOR]

The article considers the potential of the nursing profession to influence the public conversation on health care ahead of the 2016 U.S. presidential election. Issues and concerns discussed are the concern of Americans over healthcare costs and insurance, health care issues in the platforms of the Republican and Democratic parties including the Affordable Care Act (ACA), and the respective stance of presidential candidates Hillary Clinton and Donald Trump on health care issues.

Abstract: The diacylglycerol lipases (DAGLα/β) synthesize 2-arachidonylglycerol (2-AG), the major endocannabinoid in the developing and adult brain (eCB). This lipid acts on cannabinoid receptors to regulate axonal growth and guidance, activity-dependent synaptic plasticity and adult neurogenesis, and can also protect neurons from excitotoxicity. 2-AG action is generally terminated by monoacylglycerol lipase (MAGL), however we know very little about the mechanisms that regulate neuronal sensitivity to eCBs. In the present study we show that the brain-derived neurotrophic factor (BDNF) can determine neuronal sensitivity to eCBs. In this context, in cultured cerebellar granule neurons (CGNs) BDNF increases the expression of CB1 receptor transcripts and decreases expression of MAGL transcripts. Using phosphorylation of Akt as the readout, we show that BDNF can promote a stable increase in neuronal sensitivity to eCBs. For example, concentrations of 2-AG and noladin either (NE) that normally do not lead to Akt phosphorylation in control neurons do so in neurons pre-treated with BDNF. In addition, Akt phosphorylation in response to a wide range of concentrations of NE was always greater in neurons pre-treated with BDNF. Our data suggests the existence of a positive feedback loop that might sustain neuronal survival in the normal brain. [Copyright &y& Elsevier]

The article focuses on the ways that French filmmaker Alain Resnais has adapted theatrical works into film. The author focuses on the film "Smoking, No Smoking," which was adapted from a play by the British author Alan Ayckbourn. The author discusses the ways that the films of Resnais relate to and refer to the theatrical works from which it is based.

The article comments on the paper "The Relationship Between Cultural Competence Education and Increasing Diversity in Nursing Schools and Practice Settings," by Dula Pacquiao. It asserts that there are arguments for cultural competence education for all health care professionals. Moreover, the role of ethnic minority health professionals in the improvement of diverse patient outcomes is also addressed.

The incidence of fetal alcohol spectrum disorders (FASD) is increasing, even though it is 100% preventable. This study examined use of, knowledge about, and attitudes toward alcohol of women requesting emergency contraception (EC) and/or a pregnancy test, and evaluated whether a brief intervention would be effective in educating them about the risks of FASD. Fifty women from two outpatient clinics participated. Information was collected on demographic and personal health habits, alcohol use, and knowledge of and attitudes toward alcohol. As a brief intervention to increase knowledge about FASD, participants read a short pamphlet about the risks of alcohol exposure in pregnancy and then completed a post-test questionnaire. Descriptive statistics, including means, standard deviations, and skewness, were calculated for all variables. Pearson correlations were computed to assess relationships between demographic/lifestyle variables and attitudes toward and knowledge about alcohol. Paired t-tests were used to analyze the relationship between pretest and post-test knowledge scores. The majority of participants were single (76%), college educated (94%), and received EC at the clinic visit (60%). The average age was 24 years. Slightly over half (52%) reported drinking beer at least once a week, with one to six cans on occasion. Younger women expressed more tolerant attitudes toward alcohol use ( p= .02) and drank significantly more beer on occasion ( p= .015). Women who reported drinking alcohol when they last had sex were significantly ( p= .017) less tolerant in their attitudes toward alcohol use. The intervention used in this study was effective in communicating knowledge about FASD to this population ( p < .0001). These findings suggest that young women may be engaging in behaviors that could put potential offspring at risk for exposure to alcohol. Clinicians are advised to take a thorough history to determine alcohol use in all women of childbearing age and to provide information regarding FASD prevention. [ABSTRACT FROM AUTHOR]

Bacterial transglycosylases are enzymes that couple the disaccharide subunits of peptidoglycan to form long carbohydrate chains. These enzymes are the target of the pentasaccharide antibiotic moenomycin as well as the proposed target of certain glycopeptides that overcome vancomycin resistance. Because bacterial transglycosylases are difficult enzymes to study, it has not previously been possible to evaluate how moenomycin inhibits them or to determine whether glycopeptide analogues directly target them. We have identified transglycosylase assay conditions that enable kinetic analysis of inhibitors and have examined the inhibition of Escherichia coil penicillin-binding protein lb (PBPlb) by moenomycin as well as by various glycopeptides. We report that chlorobiphenyl vancomycin analogues that are incapable of binding substrates nevertheless inhibit E. coil PBPlb, which shows that these compounds interact directly with the enzyme. These findings support the hypothesis that chlorobiphenyl vancomycin derivatives overcome vanA resistance by targeting bacterial transglycosylases. We have also found that moenomycin is not competitive with respect to the lipid II substrate of PBPlb, as has long been believed. With the development of suitable methods to evaluate bacterial transglycosylases, it is now possible to probe the mechanism of action of some potentially very important antibiotics. [ABSTRACT FROM AUTHOR]

Examines the value of external safety and safety rewards in motivating the workforce in Great Britain. Strengthening of community relations; Disadvantages and limitations; Features of the awards; Comments about award schemes.

Comments on the importance of affirmative action programs on wage differentials between men and women. Effects of industry characteristics on the differentials; Correlation between industry employment and a large gender wage gap; Effectiveness of the programs.

Omaveloxolone is a nuclear factor (erythroid‐derived 2)‐like 2 activator approved in the United States and the European Union for the treatment of patients with Friedreich ataxia aged ≥16 years, with a recommended dosage of 150 mg orally once daily on an empty stomach. The effect of the US Food and Drug Administration (FDA) high‐fat breakfast on the pharmacokinetic profile of omaveloxolone observed in study 408‐C‐1703 (NCT03664453) deviated from the usual linear correlation between fed/fasted maximum plasma concentration (Cmax) and area under the concentration–time curve (AUC) ratios reported for various oral drugs across 323 food effect studies. Here, physiologically based biopharmaceutics modeling (PBBM) was implemented to predict and explain the effect of the FDA high‐fat breakfast on a 150‐mg dose of omaveloxolone. The model was developed and validated based on dissolution and pharmacokinetic data available across dose‐ranging, food effect, and drug–drug interaction clinical studies. PBBM predictions support clinical observations of the unique effect of a high‐fat meal on omaveloxolone pharmacokinetic profile, in which the Cmax increased by 350% with only a 15% increase in the AUC. Key parameters influencing omaveloxolone pharmacokinetics in the fasted state based on a parameter sensitivity analysis included bile salt solubilization, CYP3A4 activity, drug substance particle size distribution, and permeability. Mechanistically, in vivo omaveloxolone absorption was solubility and dissolution rate limited. However, in the fed state, higher bile salt solubilization led to more rapid dissolution with predominant absorption in the upper gastrointestinal tract, resulting in increased susceptibility to first‐pass gut extraction; this accounts for the lack of correlation between Cmax and AUC for omaveloxolone. [ABSTRACT FROM AUTHOR]

Presents a study which determined the capacity of cemadotin, a water-soluble synthetic analogue of dolastin that inhibits cell proliferation in vitro and the growth of human tumor xenographs, to bind with tubulin and suppress the microtubule dynamics of cancer cells. Physiologic effects of cemadotin; Methodology; Results; Discussion.

A 2-year follow-up study assessed the stability of special education students' mobility, status, and classification labels. A total of 1,184 students were selected in fall 1982 from the elementary special education programs of three cities. Two years later. 92% remained in their school district. Of these, 71% stayed in special education with the same classification, 12% remained with a different classification, and 17% were no longer receiving special education services. The child's original primary classification was the strongest predictor of reclassification and termination. Family background contributed most to mobility. Implications for practice and research are discussed. [ABSTRACT FROM AUTHOR]

Data from two random population surveys are used to assess the relationship between parental smoking and the prevalence of asthma in children aged 0-17. Data from a 1977 Midwestern urbanized county indicate that, if mothers smoked, the prevalence of parent reported asthma increased from 5.0 per cent to 7.7 per cent (estimated relative risk of 1.5), and the prevalence of functionally impairing asthma increased from 1.1 per cent to 2.2 per cent (relative risk of 2.0). In a more rural Eastern county in 1980, a lower overall prevalence of asthma was noted. However, similar estimated relative risks of asthma (1.8) and functionally impairing asthma (2.4) were found to be associated with maternal smoking. Inconsistent relationships were found between the estimated prevalence of asthma and paternal smoking. When multivariate controls were introduced, the relationships between maternal smoking and asthma persisted. Estimated attributable risks indicate that between 18 per cent and 34 per cent of the asthma reported in these samples can be attributed to maternal smoking. Implications of these findings for primary care physicians are discussed. [ABSTRACT FROM AUTHOR]

Provides guidelines which can be used to monitor the care of children with chronic diseases, with reference to the increase in the number of children who are joining managed care plans. Problems experienced when attempting to care for children with chronic conditions; How children with chronic conditions can benefit from managed care plans.

Parents of children with a wide variety of chronic health conditions (N = 910) were surveyed about their use of health services, out-ofpocket expenses for health care and related items, and ratings of the importance of health and support services The financial burden on this middle-class, insured sample was substantial with about half indicating some out-ofpocket expenses for travel, parking fees, drugs and medication, bills after insurance payments, and doctor charges The commonalities found in parents reporting of important services needed support the use of a noncategorical approach to program planning and policy development for children with special health care needs. [ABSTRACT FROM AUTHOR]

Focuses on the Brookline early education project of the public schools in Brookline, Massachusetts. Rationale for the project; Description of the programs for parents and children; Evaluation procedure for the project; Characteristics of the children involved in the project.

Presents a study which examine the importance of N-Alkylmethine pyrroles and arylpyrroles as intermediates in the formation of modified pyrrole polymers. Information on the use of the materials in molecular electronics and sensors; Details on the methods used in the preparation of the materials; Observation of the reactions of the materials.

Abstract. In April 1987, a census of children dependent on medical technology was carried out in Massachusetts to determine the one-month point prevalence. All medical and educational providers in the state who were likely to interact with such children were contacted and asked to complete a two-sided data form on youngsters (aged 3 months to 18 years) with tracheostomies, supplementary oxygen, respirators, auctioning, gastric feeding, central venous lines, ostomies, ureteral diversion, urethral catheterization and dialysis. Nearly 1250 children were found meeting these criteria. Capture-recapture analysis set the lower bound for technology dependence at 0.08% of the state's children. An analysis of the organ systems involved showed that 57% of the children had neurologic involvement--13% multisystem, 7% gastrointestinal-metabolic, 4% renal-genitourinary, and 3% musculoskeletal. Less than 1% of the children were reported as having immunologic or "other" disorders. Review of putative etiologies indicated that 45% of the children had congenital anomalies, 33% chronic medical diseases, 9% perinatal conditions, 7% hereditary-genetic disorders, 5% injuries, 2% infections, and 3% "other." The substantial prevalence of technology dependency among children creates challenges at the social, economic, and policymaking levels. It will be important to carry out systematic reporting and monitoring activities throughout time and across sites. This census is an example of one such statewide effort. [ABSTRACT FROM AUTHOR]

Abstract. Children with a chronic health condition have long been considered at excess risk for psychosocial morbidity. Despite an increasing prevalence of chronic childhood conditions and heightened concerns for the quality of life of the chronically ill, population-based studies of behavior problems among children with chronic physical conditions are rare. Findings on the epidemiology of behavior problems in a nationally representative sample of 11 699 children and adolescents aged 4 to 17 years in the United States are reported. Data included a 32-item parent-reported behavior problem index, measures of chronic childhood conditions, measures of school placement and performance, and sociodemographic variables. Analyses confirmed that chronic physical conditions were a significant risk factor for behavior problems, independent of sociodemographic variables. Among children these differences were observed across all subscales; among adolescents the largest differences were found for the Depression/Anxiety and Peer Conflict/Social Withdrawal subscales. Rates of extreme behavior problem scores (those in the top 10th percentile) were 1.55 times higher among children with a chronic health condition compared with children without a chronic condition (95% confidence interval 1.29 to 1.86). These independent odds were lowered to 1.44 when covariates for confounding were introduced via a multivariate logistic regression. Other independent risks included the absence of either biologic parent (odds ratio 2.05), male gender (1.53), low vs high family income (1.30), low vs high maternal education (1.51), and young vs old maternal age at childbirth (2.57). Chronic health conditions were also a major risk factor for placement in special education classes and having to repeat... [ABSTRACT FROM AUTHOR]

The article offers information on a study related to the association of insulin dose, cardiometabolic risk factors, and cardiovascular disease in type 1 diabetes during 30 years of follow-up in the Diabetes Control and Complications Trial. Topics discussed include increased insulin doses in the intensive diabetes treatment; demonstration of cardiovascular risk benefit; and non-physiologic subcutaneous insulin delivery.

This study is an exploratory comparison of 69 Hispanic students enrolled in first-semester general chemistry (Chem I) who attended either a Hispanic-Serving or emerging Hispanic-Serving Institution and were not successful in Chem I. Students' automaticity skills (what can be done without the aid of a calculator) in arithmetic and quantitative reasoning were analyzed based on students' personal characteristics such as gender, prior knowledge in chemistry and mathematics, entry college (i.e., STEM or not), and parents' academic background. Findings indicate that without basic automaticity skills, students enter Chem I at a deficit, but these at-risk students can be identified early in the semester to help them succeed. Results also indicate that arithmetic automaticity is more influential than quantitative reasoning in predicting academic success. A suggested high-impact practice is presented as a possible correction for these deficits. [ABSTRACT FROM AUTHOR]

The article discusses the influenza vaccination coverage in health-care personnel (HCP) as recommended by the U.S. Centers for Disease Control & Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP). It mentions that vaccination of HCP can help reduce serious consequences among them and their family members, and their patients. It informs that recommendation was based on a survey conducted by the CDC which found that overall 66.9 per cent of HCP reported having had an influenza vaccination for the 2011-2012 season.

Background/Objectives: Lipid metabolism plays an important role in maternal health and fetal development. There is a gap in the knowledge of how lipid metabolism changes during pregnancy for Black women who are at a higher risk of adverse outcomes. We hypothesized that the comprehensive lipidome profiles would show variation across pregnancy indicative of requirements during gestation and fetal development. Methods: Black women were recruited at prenatal clinics. Plasma samples were collected at 8–18 weeks (T1), 22–29 weeks (T2), and 30–36 weeks (T3) of pregnancy. Samples from 64 women who had term births (≥37 weeks gestation) were subjected to "shotgun" Orbitrap mass spectrometry. Mixed-effects models were used to quantify systematic changes and dimensionality reduction models were used to visualize patterns and identify reliable lipid signatures. Results: Total lipids and major lipid classes showed significant increases with the progression of pregnancy. Phospholipids and glycerolipids exhibited a gradual increase from T1 to T2 to T3, while sphingolipids and total sterol lipids displayed a more pronounced increase from T2 to T3. Acylcarnitines, hydroxy acylcarnitines, and Lyso phospholipid levels significantly decreased from T1 to T3. A deviation was that non-esterified fatty acids decreased from T1 to T2 and increased again from T2 to T3, suggestive of a potential role for these lipids during the later stages of pregnancy. The fatty acids showing this trend included key fatty acids—non-esterified Linoleic acid, Arachidonic acid, Alpha-linolenic acid, Eicosapentaenoic acid, Docosapentaenoic acid, and Docosahexaenoic acid. Conclusions: Mapping lipid patterns and identifying lipid signatures would help develop intervention strategies to reduce perinatal health disparities among pregnant Black women. [ABSTRACT FROM AUTHOR]

The article presents the author's comments on the challenges facing public health programs in the U.S. on local, national and global levels. The author suggests that with a change in the country's administration the focus should be on developing a political will to improve the public health system. A major investment in the public health services is needed to counter the high cost of health care so that the services reach a larger part of the population, the author says.

The article reports on home‐based multidimensional survivorship programmes for breast cancer survivors. Topics include advancements in detection, adjuvant chemotherapy and radiological techniques, and hormonal and targeted therapies; use of supportive care needs after years of post-treatment; and conclusions which revealed short‐term beneficial effect on breast cancer‐specific quality of life.

The article provides information on a study which examined how women with metastatic breast cancer (MBC) are affected by breast surgery. Topics discussed include comparison between breast surgery plus systemic therapy versus systemic therapy alone in women with MBC, results of the study, and suggestion to nurses caring for those with MBC.

Deals with the implications of the passage of the Education for All Handicapped Children Act by the United States Congress on pediatricians. Medical issues addressed by the law; Significance of the law on the pediatricians' relationship with handicapped children; Overview of the formulation of the law.

This editorial explains the need for a new name for the American Orthopsychiatric Association (ORTHO). As ORTHO continues their work into the 21st century, they want to better reflect their global membership and focus, increasing the number of partnerships with individuals and organizations, and commitment to a just society. Therefore, ORTHO is changing their name to the Global Alliance for Behavioral Health and Social Justice. It is crucial to underscore that, although the organizations name is changing, the values and principles that inform their work will remain the same. The mission statement of the Global Alliance for Behavioral Health and Social Justice is "to inform policy, practice, and research to prevent behavioral health disorders and to promote conditions to ensure that people with disorders can be full participants in society." (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org. [ABSTRACT FROM AUTHOR]

A correction notice is presented related to the article "Family Engagement at the Systems Level: A Framework for Action" which was published on May 11, 2023 issue of the periodical.