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We sought to determine whether pediatric primary care interventions targeting positive parenting among low socioeconomic status mothers resulted in reduced referrals to the New York City Early Intervention Program (NYC-EIP). Participants in Building Blocks (BB) and the Video Interaction Project (VIP) were linked with the NYC-EIP administrative dataset to determine referrals. In all, 139 of 422 study participants (31.4%) meeting inclusion criteria were referred to the NYC-EIP. Although referrals did not differ overall by group (VIP 29.8%; BB 33.8%; control 35.3%), differences were found for mothers with education/literacy of seventh grade or higher (interaction p = 0.02). In that subgroup, VIP was associated with reduced referrals by age 3 years (22.4%; adjusted odds ratio 0.53; 95% confidence interval [0.29, 0.97]), compared with BB (35.0%) and controls (34.3%), with survival analysis showing reduced cumulative risk (p = 0.04). We conclude that VIP resulted in reduced referrals for early intervention evaluation among children of mothers with seventh-grade education or higher.

The registration of dental occlusion is essential for prosthodontic treatment. However, studies on time-dependent changes of static and dynamic occlusion that may affect definitive restorations are lacking. The purpose of this prospective clinical study was to use conventional and digital occlusal registration techniques to evaluate time-dependent fluctuations in static and dynamic occlusion. The static and dynamic occlusion of 19 healthy individuals (14 women and 5 men with a mean ±standard deviation age of 30.8 ±4.8 years) was examined 3 times a day using occlusal foil (12-μm occlusion foil) and a digital sensor (T-Scan III). The procedure was repeated after 14 days. The statistical analysis covered all registrations referencing the first measurement point to assess occurring differences, and changes per tooth and arch were determined (α=.05). Potential influencing factors were calculated by using mixed logistic regression. Marginal probabilities were calculated considering the registration technique and the time of measurement. Significant differences were found between registered occlusal patterns and the different registration techniques. Occlusal changes per maxillary dental arch were observed with static foil registration (P <.001; 98.8%), left laterotrusion foil registration (P =.001; 29.6%), right laterotrusion foil registration (P =.001; 29.6%), static sensor registration (P <.001; 20.3%), left laterotrusion sensor registration (P =.001; 71.7%), and right laterotrusion sensor registration (P =.005; 67.7%). None of the techniques showed higher probabilities of occlusal changes at a given time of day with respect to time-dependent changes. The study revealed that occlusion cannot be considered constant and that the topography and intensity of the contact points vary. Circadian occlusion variance can be assumed without preferring a specific time of the day. This differentiated view of occlusion as a changing system helps to clarify the challenge of dental restorations for both the patient and the practitioner. [ABSTRACT FROM AUTHOR]

Parental engagement is critical to children's educational achievement. Before and during elementary school, it is crucial for parents to be involved in their children's education in order to foster development and achievement. Hispanic parents' immigrant status, coupled with a lack of English proficiency, means that they often find themselves of low socioeconomic status (SES). Being low SES also means that parents possess fewer resources for engaging with their children. The current study seeks to understand low-income, primarily Hispanic mothers' perceptions of their roles in their first grade children's education. Mothers were interviewed regarding parenting confidence related to teaching their children, and responses were analyzed using qualitative research methods. Mothers in this study associated their roles in their children's education with two primary areas: helping their children to learn, and raising their children to be well-behaved and respectful. The main barrier to parental confidence in these roles appeared to be mothers' lack of English proficiency. This is consistent with previous research demonstrating that Hispanic parents maintain the perception of a lack of proficiency in English as a significant barrier to parental involvement in their children's education in the United States. Future interventions with teachers and parents may benefit from these findings in consideration of the optimal ways to involve parent related to their perceived personal strengths regarding parental engagement.

To examine the efficacy of palonosetron in preventing postoperative nausea and/or vomiting (PONV) within the first 24 hours in adults undergoing gynecologic surgery. Retrospective chart review and analysis. Tertiary care center performing high-volume gynecologic surgery in Seattle, WA. A total of 1,235 adult participants (>18 years old) undergoing inpatient and outpatient laparoscopic and open gynecologic surgery, including benign and malignant conditions. The treatment arm includes patients who were given 0.075mg of palonosetron (N=261) intraoperatively versus the control arm including patients who received standard-of-care (N=974) PONV prophylaxis with ondansetron. The average age was similar in both groups, 47 years (SD=13.6). Average operative duration between groups was similar, 126 (SD=55) and 124 (SD=73) minutes for palonosetron and standard-of-care, respectively (p=0.68). In total, 39% (477/1,235) were inpatients and 61% (758/1,235) outpatients. The primary endpoint was incidence of PONV within 24 hours of surgery. Of patients who received palonosetron, 16.1% (42/261) experienced PONV as compared to 25.9% (252/974) of patients who received standard-of-care PONV prophylaxis (p < 0.05). An unadjusted subgroup analysis indicated a reduction in PONV in outpatients who received palonosetron compared to standard-of-care (4.8% vs 11.9%, p=0.0075), whereas inpatient data showed a non-significant trend towards benefit in those that received palonosetron compared to standard-of-care (36.6% vs 47.4%, p=0.059). Palonosetron confers greater efficacy in prevention of PONV as compared to standard prophylaxis with ondansetron in patients undergoing laparoscopic gynecologic surgery. [ABSTRACT FROM AUTHOR]

We sought to define the incidence and outcomes of pediatric hanging and strangulation injuries to inform best practices for trauma triage and management. A retrospective review was conducted that included all patients who presented after hanging or strangulation to a Level I Pediatric Trauma Center from 2011 through 2021. Patient demographics, injury characteristics, and clinical outcomes were collected. All imaging modalities of the head and neck were reviewed to determine if a bony fracture or vascular injury was present. Over the 11-year study period, 128 patients met inclusion criteria. The median age of the cohort was 13 years [IQR: 8.5–15], most patients were male (60.9%), and the median GCS was 11 [3, 15]. There were 96 cases (75%) that were intentional injuries. 76 patients (59.4%) received imaging in the form of plain radiographs, CT, or MRI of the neck and cervical spine. No fractures were identified and there were 0 clinically significant cervical spine injuries. CT angiograms of the neck identified no cerebral vascular injuries. Mortality was high (32%), and 25% of patients with nonaccidental injuries had a documented prior suicide attempt. We identified no cervical spine fractures and no blunt cerebral vascular injuries after a hanging or strangulation in over 10 years at a Level 1 Pediatric Trauma Center. Use of CT and CT angiography of the neck and cervical spine should be minimized in this patient population without high clinical index of suspicion and/or significant mechanism. IV. • What is currently known about this topic? • Cross-sectional imaging is utilized to diagnose cervical spine fractures and blunt cerebral vascular injuries after pediatric hangings or strangulations. However, the incidence of these injuries is rare. • What new information is contained in this article? • In over 10 years at a Level I Pediatric Trauma Center, we identified no cervical spine fractures or blunt cerebral vascular injuries in this patient population. [ABSTRACT FROM AUTHOR]