Clinical characteristics and cost of chickenpox hospitalization in Thai children.

PubMed

Vandepitte, Warunee Punpanich; Chanveerachai, Siriluk; Srisarang, Suchada

2014-06-01

Although primary Varicella-Zoster-Virus (VZV) infection generally causes uncomplicated illness confined to skin and mucous membrane among healthy children, it infrequently causes life-threatening infection especially among immuno-suppressed hosts or young infants. Limited information is available regarding the clinical features, outcomes, and the financial burden incurred by severe primary varicella infection in Thai children who required hospitalization. To determine clinical characteristics particularly the disease severity, prevalence of complication, case fatality rate, and use of healthcare resources in terms of length of stay as well as direct medical cost of varicella-associated hospitalization in children. A retrospective descriptive study was conducted among children aged one month to 18 years who were hospitalized with chickenpox between 2007 and 2011 at the Queen Sirikit National Institute of Child Health, Bangkok, Thailand. Information on clinical manifestations, complications, and outcomes were obtained by medical record abstraction, and data on hospital charges were obtained from the hospital financial database. A total of 101 cases of chickenpox were identified, with a median (interquartile range IQR) age of 4 (0.8, 7.25) years. Underlying predisposing conditions for severe varicella infection were identified in 35 cases (34.7%). Seventy four of 101 (73.3%) patients developed complications, with skin and soft tissue infections being the most common (50.5%), followed by pneumonia (12.7%) and neurological complications (6.4%). There were no fatal cases. Median (IQR) duration of hospitalization and hospital charges were 6 (3, 9) days and US$ 330.2 ($139.3, $1,013.5), respectively. Children with predisposing conditions for severe varicella were significantly older, incurring 6-fold higher hospital charges and 2-fold longer hospitalization compared to their counterparts. The high rate of complicated varicella and financial burden reported in this study suggested that the severity of varicella complications in children might have been previously underestimated. This study provides relevant information regarding the burden of hospitalized varicella infection among both otherwise healthy children as well as children with predisposing immuno-suppression.

Childhood Asthma Hospitalizations in the United States, 2000-2009

PubMed Central

Hasegawa, Kohei; Tsugawa, Yusuke; Brown, David F.M.; Camargo, Carlos A.

2013-01-01

Objectives To examine temporal trends in the US incidence of childhood asthma hospitalizations, inhospital mortality, mechanical ventilation use, and hospital charges between 2000 and 2009. Study design A serial, cross-sectional analysis of a nationally-representative sample of children hospitalized with acute asthma. The Kids Inpatient Database was used to identify children <18 years of age with asthma by International Classification of Diseases, Ninth Revision, Clinical Modification code 493.xx. Outcome Measures were asthma hospitalization incidence, in-hospital mortality, mechanical ventilation use, and hospital charges. We examined temporal trends of each outcome, accounting for sampling weights. Hospital charges were adjusted for inflation to 2009 US dollars. Results The four separated years (2000, 2003, 2006, and 2009) of national discharge data included 592 805 weighted discharges with asthma. Between 2000 and 2009, asthma hospitalization incidence decreased from 21.1 to 18.4 per 10 000 person-years among all US children (13% decrease; Ptrend<.001). Mortality declined significantly after adjusting for confounders (OR for comparison of 2009 with 2000, 0.37; 95%CI, 0.17-0.79). By contrast, there was an increase in mechanical ventilation use (0.8% to 1.0%; 28% increase; Ptrend<.001). Nationwide hospital charges also increased from $1.27 billion to $1.59 billion (26% increase; Ptrend<.001); this increase was driven by a rise in the geometric mean of hospital charges per discharge, from $5940 to $8410 (42% increase; Ptrend<.001). Conclusions Between 2000 and 2009, we found significant declines in asthma hospitalization and in-hospital mortality among US children. By contrast, mechanical ventilation use and hospital charges for asthma significantly increased over this same period. PMID:23769497

Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children’s school performance

PubMed Central

Gifford, Elizabeth J.; Sloan, Frank A.; Evans, Kelly E.

2015-01-01

Objective This study examined the intergenerational effects of parental conviction of a substance-related charge on children’s academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. Method State administrative data from North Carolina courts, birth records, and school records were linked for 2005–12. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Results Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics, e.g., mother’s educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. Conclusion While the children of convicted parents fared worse on average, much—but not all—of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children. PMID:26460705

[Digital radiography in young children. Considerations based on experiences in practice].

PubMed

Berkhout, W E R; Mileman, P A; Weerheijm, K L

2004-10-01

In dentistry, digital radiology techniques, such as a charge-coupled device and a storage phosphor plate, are gaining popularity. It was the objective of this study to assess the importance of the advantages and disadvantages of digital radiology techniques for bitewing radiography in young children, when compared to conventional film. A group of dentists received a questionnaire regarding their experiences with digital radiology techniques or conventional films among young children. Using the Simple Multi-Attributive Rating Technique (SMART) a final weighted score was calculated for the charge-coupled device, the phosphor plate, and conventional film. The scores were 7.40, 7.38, and 6.98 respectively. The differences were not statistically significant (p > 0.47). It could be concluded that, on the basis of experiences in practice, there are no statistically significant preferences for the use of digital radioogy techniques for bitewing radiography in young children.

Exiting Foster Care: A Case Study of Former Foster Children Enrolled in Higher Education in Kansas

ERIC Educational Resources Information Center

Schwandt, Jamie R.

2013-01-01

In the United States, foster care is provided to children to avert maltreatment and abuse of children in distressed families by providing a temporary home or a foster home. Courts with jurisdiction over families have been charged by Congress to find appropriate homes when necessary circumstances occur. In fiscal year 2009, there were 423,773…

Medical injuries among hospitalized children

PubMed Central

Meurer, J R; Yang, H; Guse, C E; Scanlon, M C; Layde, P M

2006-01-01

Background Inpatient medical injuries among children are common and result in a longer stay in hospital and increased hospital charges. However, previous studies have used screening criteria that focus on inpatient occurrences only rather than on injuries that also occur in ambulatory or community settings leading to hospital admission. Objective To describe the incidence and outcomes of medical injuries among children hospitalized in Wisconsin using the Wisconsin Medical Injury Prevention Program (WMIPP) screening criteria. Methods Cross sectional analysis of discharge records of 318 785 children from 134 hospitals in Wisconsin between 2000 and 2002. Results The WMIPP criteria identified 3.4% of discharges as having one or more medical injuries: 1.5% due to medications, 1.3% to procedures, and 0.9% to devices, implants and grafts. After adjusting for the All Patient Refined‐Diagnosis Related Groups disease category, illness severity, mortality risk, and clustering within hospitals, the mean length of stay (LOS) was a half day (12%) longer for patients with medical injuries than for those without injuries. The similarly adjusted mean total hospital charges were $1614 (26%) higher for the group with medical injuries. Excess LOS and charges were greatest for injuries due to genitourinary devices/implants, vascular devices, and infections/inflammation after procedures. Conclusions This study reinforces previous national findings up to 2000 using Wisconsin data to the end of 2002. The results suggest that hospitals and pediatricians should focus clinical improvement on medications, procedures, and devices frequently associated with medical injuries and use medical injury surveillance to track medical injury rates in children. PMID:16751471

77 FR 27671 - Medicaid Program; Payments for Services Furnished by Certain Primary Care Physicians and Charges...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Primary Care Physicians and Charges for Vaccine Administration Under the Vaccines for Children Program... medicine, general internal medicine, or pediatric medicine, and also applies to services paid through... vaccines to federally vaccine-eligible children under the Pediatric Immunization Distribution Program, more...

Healthcare resource utilization and epidemiology of pediatric burn-associated hospitalizations, United States, 2000.

PubMed

Shields, Brenda J; Comstock, R Dawn; Fernandez, Soledad A; Xiang, Huiyun; Smith, Gary A

2007-01-01

The objective of this study was to describe the epidemiology and financial burden of burn-associated hospitalizations for children younger than 18 years in the United States. Retrospective data analysis of pediatric burn-associated hospitalizations was done using the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2000. An estimated 10,000 children younger than 18 years were hospitalized for burn-associated injuries in the United States in 2000. These children spent an estimated 66,200 days in the hospital with associated hospital charges equal to USD 211,772,700. Total charges and length of stay for pediatric burn-associated hospitalizations in the United States during 2000 were associated with degree of burn, percentage of total body surface area burned, child's age, region of the United States, hospital location, and hospital type. Children 2 years old or younger were more likely to be nonwhite, be hospitalized for burns, and burn their hands/wrists, compared with children 3 to 17 years of age. Male children in both age groups were more likely to be hospitalized for burns than female children. Children 2 years old or younger were more likely to be burned by hot liquids/vapors and contact with hot substances/objects, while children 3 to 17 years were more likely to be burned by fire/flames. This study is the first national study on healthcare resource utilization for pediatric burn-associated hospitalizations to utilize the KID database. Burns are a major source of pediatric morbidity and are associated with significant national healthcare resource utilization annually. Future burn prevention efforts should emphasize implementing passive injury prevention strategies, especially for young children who are nonwhite and live in low-income communities.

Costs, mortality likelihood and outcomes of hospitalized US children with traumatic brain injuries.

PubMed

Shi, Junxin; Xiang, Huiyun; Wheeler, Krista; Smith, Gary A; Stallones, Lorann; Groner, Jonathan; Wang, Zengzhen

2009-07-01

To examine the hospitalization costs and discharge outcomes of US children with TBI and to evaluate a severity measure, the predictive mortality likelihood level. Data from the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were used to report the national estimates and characteristics of TBI-associated hospitalizations among US children < or =20 years of age. The percentage of children with TBI caused by motor vehicle crashes (MVC) and falls was calculated according to the predictive mortality likelihood levels (PMLL), death in hospital and discharge into long-term rehabilitation facilities. Associations with the PMLL, discharge outcomes and average hospital charges were examined. In 2006, there were an estimated 58 900 TBI-associated hospitalizations among US children, accounting for $2.56 billion in hospital charges. MVCs caused 38.9% and falls caused 21.2% of TBI hospitalizations. The PMLL was strongly associated with TBI type, length of hospital stay, hospital charges and discharge disposition. About 4% of children with fall or MVC related TBIs died in hospital and 9% were discharged into long-term facilities. The PMLL may provide a useful tool to assess characteristics and treatment outcomes of hospitalized TBI children, but more research is still needed.

Early childhood caries-related visits to emergency departments and ambulatory surgery facilities and associated charges in New York state.

PubMed

Nagarkar, Sanket R; Kumar, Jayanth V; Moss, Mark E

2012-01-01

The authors assessed the extent of early childhood caries- (ECC-) related visits to emergency departments (EDs) and ambulatory surgery facilities (ASFs) in children younger than 6 years and associated treatment charges in New York state from 2004 through 2008. The authors obtained data from the New York state's Statewide Planning and Research Cooperative System (Albany) and calculated descriptive statistics and rates according to selected indicators, as well as total and average per-visit treatment charges. From 2004 through 2008, the number of ECC-related visits to EDs and ASFs increased by 349 and 1,039, respectively. Most ECC-related visits were to ASFs. The total annual treatment charges increased from $18.5 million to $31.3 million from 2004 to 2008, and average per-visit charges increased from $4,237 to $5,501 during the same period. ECC-related visits to EDs and ASFs by children younger than 6 years and the associated treatment charges increased substantially from 2004 through 2008 in New York state. Practice Implications. Dental professionals need to determine the reasons parents seek dental care for their children in EDs and ASFs and effective strategies for preventing ECC to avoid the subsequent need for seeking dental care in EDs and ASFs.

Neural Activation Underlying Cognitive Control in the Context of Neutral and Affectively Charged Pictures in Children

ERIC Educational Resources Information Center

Lamm, Connie; White, Lauren K.; McDermott, Jennifer Martin; Fox, Nathan A.

2012-01-01

The neural correlates of cognitive control for typically developing 9-year-old children were examined using dense-array ERPs and estimates of cortical activation (LORETA) during a go/no-go task with two conditions: a neutral picture condition and an affectively charged picture condition. Activation was estimated for the entire cortex after which…

Pediatric Chest Pain-Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey.

PubMed

Harahsheh, Ashraf S; O'Byrne, Michael L; Pastor, Bill; Graham, Dionne A; Fulton, David R

2017-11-01

We conducted a study to assess test characteristics of red-flag criteria for identifying cardiac disease causing chest pain and technical charges of low-probability referrals. Accuracy of red-flag criteria was ascertained through study of chest pain Standardized Clinical Assessment and Management Plans (SCAMPs®) data. Patients were divided into 2 groups: Group1 (concerning clinical elements) and Group2 (without). We compared incidence of cardiac disease causing chest pain between these 2 groups. Technical charges of Group 2 were analyzed using the Pediatric Health Information System database. Potential savings for the US population was estimated using National Ambulatory Medical Care Survey data. Fifty-two percent of subjects formed Group 1. Cardiac disease causing chest pain was identified in 8/1656 (0.48%). No heart disease was identified in patients in Group 2 ( P = .03). Applying red-flags in determining need for referral identified patients with cardiac disease causing chest pain with 100% sensitivity. Median technical charges for Group 2, over a 4-year period, were US2014$775 559. Eliminating cardiac testing of low-probability referrals would save US2014$3 775 182 in technical charges annually. Red-flag criteria were an effective screen for children with chest pain. Eliminating cardiac testing in children without red-flags for referral has significant technical charge savings.

The burden of rotavirus hospitalizations among Medicaid and non-Medicaid children younger than 5 years old.

PubMed

Ma, Liyuan; El Khoury, Antoine C; Itzler, Robbin F

2009-10-01

We sought to compare the burden of hospitalizations associated with rotavirus gastroenteritis (RGE) in children younger than 5 years in US Medicaid and non-Medicaid populations in 2000 and 2003. We used the Kids' Inpatient Database (KID) to examine the burden of RGE-associated hospitalizations in terms of numbers and rates of hospitalizations, lengths of stay, and hospital charges. Two indirect methods were also used to estimate RGE-associated hospitalizations, because rotavirus testing is not routinely performed. Approximately 40% of children younger than 5 years were enrolled in Medicaid in 2003, but this population accounted for nearly 50% of all RGE-associated hospitalizations and 60% of total charges. Children enrolled in Medicaid had significantly greater hospitalization rates, average lengths of stay, and average charges per stay than did those not enrolled. Although RGE affects all socioeconomic groups, the Medicaid population accounted for a disproportionate number of the hospitalizations. With the inclusion of rotavirus vaccines in the pediatric immunization schedule, it is important that US children, especially those enrolled in Medicaid programs, are vaccinated to reduce the burden of RGE.

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-emergency use of the emergency room. For Federal FY 2009, for targeted low-income children whose household...-institutional services, up to a maximum amount of $11.35 for services furnished in a hospital emergency room if... 42 Public Health 4 2013-10-01 2013-10-01 false Maximum allowable cost-sharing charges on targeted...

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-emergency use of the emergency room. For Federal FY 2009, for targeted low-income children whose household...-institutional services, up to a maximum amount of $11.35 for services furnished in a hospital emergency room if... 42 Public Health 4 2014-10-01 2014-10-01 false Maximum allowable cost-sharing charges on targeted...

42 CFR 447.53 - Applicability; specification; multiple charges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... categorically or medically needy individuals for the following: (1) Children. Services furnished to individuals..., such as hypertension, diabetes, urinary tract infection, and services furnished during the postpartum... must specify— (1) The service for which the charge is made; (2) The amount of the charge; (3) The basis...

Tranexamic Acid Use in US Children’s Hospitals

PubMed Central

Nishijima, Daniel K.; Monuteaux, Michael C.; Faraoni, David; Goobie, Susan M.; Lee, Lois; Galante, Joseph; Holmes, James F.; Kuppermann, Nathan

2016-01-01

Background The prevalence of tranexamic acid (TXA) use for trauma and other conditions in children is unknown. Objective The objective of this study was to describe the use of TXA in US children’s hospitals for children in general, and specifically for trauma. Methods We conducted a secondary analysis of a large, administrative database of 36 US children’s hospitals. We included children younger than 18 years who received TXA (based on pharmacy charge codes) from 2009 to 2013. Patients were grouped into the following diagnostic categories: trauma, congenital heart surgery, scoliosis surgery, craniosynostosis/craniofacial surgery, and other, based on ICD-9 principle procedure and diagnostic codes. TXA administration and dosage, in-hospital clinical variables, and diagnostic and procedure codes were documented. Results A total of 35,478 pediatric encounters with a TXA charge were included in the study cohort. The proportions of children who received TXA were similar across the years 2009–2013. Only 110 encounters (0.31%) were for traumatic conditions. Congenital heart surgery accounted for more than one-half of the encounters (22,863, 64%).. Overall the median estimated weight-based dose of TXA was 22.4 mg/kg (IQR 7.3 to 84.9 mg/kg). Conclusions We identified a wide frequency of use and range of doses of TXA for several diagnostic conditions in children. The use of TXA among injured children, however, appears to be rare despite its common use and efficacy among injured adults. Further work is needed to recommend appropriate indications for TXA, and provide dosage guidelines among children with a variety of conditions, including trauma. PMID:27017532

Where are lengths of stay longer and total charges higher for pediatric burn patients?

PubMed

Myers, John; Lehna, Carlee

2014-01-01

Treatment of pediatric burn patients is costly and may require long length of stay in the hospital (LOS). Establishing where these LOS and charges are highest is warranted. The current study investigated whether pediatric burn patients had higher total charges and longer LOS when seen at teaching hospitals, when compared with nonteaching hospitals. The study reviewed inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 by using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-947 were used to define burn injury, LOS, total charges, and type of hospital. The authors tested for differences between the LOS and total charges between children seen at three types of hospitals (pediatric, nonpediatric/teaching, nonpediatric/nonteaching) while adjusting for traditional risk factors (eg age, total burn surface area) by using generalized linear mixed-effects modeling. A total of N=28,777 children had burn injuries (n=16,115, 56.0% seen at pediatric hospitals; n=9353, 32.5% seen at nonpediatric/teaching hospitals; and n=3309, 11.5% seen at nonpediatric/nonteaching hospitals). Pediatric burn patients seen at pediatric hospitals, unadjusted, have significantly longer LOS (5.54 days vs 4.25 days and 4.00 days, P<.001) and more total charges in 2009 dollars ($31,319 vs $24,413 and $21,499, P<.001). In addition, patients seen at pediatric hospitals had significantly more total burn surface area (P<.001), more comorbidities (P=.021), and were younger (P<.001). After adjusting for total burn surface area, number of comorbidities, and age, no differences existed between teaching and nonteaching hospitals for LOS (P=.481) or total charges (P=.758). Although pediatric burn patients may have increased LOS and total charges when seen at teaching hospitals, when taking an unadjusted perspective, this may be an artifact that teaching hospitals see pediatric burn patients who are younger, have more comorbidities, and have more total burn surface area. As such, after adjustment, type of hospital may have no influence on LOS and total charges.

Retropharyngeal and Parapharyngeal Abscesses Among Children and Adolescents in the United States: Epidemiology and Management Trends, 2003-2012.

PubMed

Woods, Charles R; Cash, Elizabeth D; Smith, Aaron M; Smith, Michael J; Myers, John A; Espinosa, Claudia M; Chandran, Swapna K

2016-09-01

The epidemiology and hospital course of children with retropharyngeal abscess (RPA) or parapharyngeal abscess (PPA) have not been fully described at the national level in the United States. Pediatric discharges for PPA and RPA were evaluated by using the Kids' Inpatient Database from 2003, 2006, 2009, and 2012. Cases were identified by using International Classification of Disease, Ninth Revision, Clinical Modification codes 478.22 and 478.24 for PPA and RPA, respectively. Nationally representative incidence data were calculated by using weighted case estimates and US census data. Demographic and cost analyses were conducted by using unweighted analyses. There were 2685 hospital discharges for PPA and 6233 hospital discharges for RPA during the 4 study years combined. The incidence of RPA increased from 2.98 per 100 000 population among children <20 years old in 2003 to 4.10 per 100 000 in 2012. The incidence of PPA peaked at 1.49 per 100 000 in 2006. Incidences were highest among children <5 years old and boys in all age groups for PPA and RPA. Winter-to-spring seasonality also was evident for both. PPA was managed surgically in 58.1% of the cases, and RPA was managed surgically in 46.7%. Surgery was performed most often on the day of admission or the following day, was more frequent at teaching hospitals, and was associated with higher hospital charges. The mean hospital length of stay was longer for children who had surgery versus those who did not (4.4 vs 3.1 days [for PPA] and 4.8 vs 3.2 days [for RPA], respectively; both P < .001). The median charges for RPA and PPA were similar. The proportions of children with RPA or PPA covered by Medicaid increased during the study period. PPA and RPA represent relatively common male-predominant childhood infections with similar epidemiologies. The incidence of hospital discharges with a diagnosis of RPA increased during the study period. Substantial proportions of children with PPA or RPA are now managed without surgery. Surgical drainage was associated with higher hospital charges and longer lengths of stay. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Burden of Rotavirus Hospitalizations Among Medicaid and Non-Medicaid Children Younger Than 5 Years Old

PubMed Central

El Khoury, Antoine C.; Itzler, Robbin F.

2009-01-01

Objectives. We sought to compare the burden of hospitalizations associated with rotavirus gastroenteritis (RGE) in children younger than 5 years in US Medicaid and non-Medicaid populations in 2000 and 2003. Methods. We used the Kids' Inpatient Database (KID) to examine the burden of RGE-associated hospitalizations in terms of numbers and rates of hospitalizations, lengths of stay, and hospital charges. Two indirect methods were also used to estimate RGE-associated hospitalizations, because rotavirus testing is not routinely performed. Results. Approximately 40% of children younger than 5 years were enrolled in Medicaid in 2003, but this population accounted for nearly 50% of all RGE-associated hospitalizations and 60% of total charges. Children enrolled in Medicaid had significantly greater hospitalization rates, average lengths of stay, and average charges per stay than did those not enrolled. Conclusions. Although RGE affects all socioeconomic groups, the Medicaid population accounted for a disproportionate number of the hospitalizations. With the inclusion of rotavirus vaccines in the pediatric immunization schedule, it is important that US children, especially those enrolled in Medicaid programs, are vaccinated to reduce the burden of RGE. PMID:19797754

Clinical Characterization of Children Presenting to the Hospital with Enterovirus D68 Infection During the 2014 Outbreak in St. Louis

PubMed Central

Orvedahl, Anthony; Padhye, Amruta; Barton, Kevin; O’Bryan, Kevin; Baty, Jack; Gruchala, Nancy; Niesen, Angela; Margoni, Angeliki; Srinivasan, Mythili

2016-01-01

Background The largest known outbreak of enterovirus D68 (EV-D68) infections occurred during 2014. The goal of our study is to characterize the illness severity and clinical presentation of children infected with enterovirus-D68 (EV-D68) in comparison to non-EV-D68-Human Rhino/Enteroviruses (HR/EV). Method Our study is a retrospective analysis of severity level, charges and length of stay of children who presented to St. Louis Children’s Hospital from 8/31/2014–10/31/2014 and tested positive for EV-D68 in comparison to non-EV-D68-HR/EV infected patients. Chart review was performed for all EV-D68 infected patients and age and severity matched non-EV-D68-HR/EV infected patients. Result There was a striking increase in hospital census in August of 2014 in our hospital with simultaneous increase in the number of patients with EV-D68 infection. There was no significant difference in severity of illness, length of stay or total charges between EV-D68 and non-EV-D68-HR/EV infected children. EV-D68 infection was characterized by presenting complaints of difficulty breathing (80%) and wheezing (67%), and by findings of tachypnea (65%), wheezing (71%) and retractions (65%) on examination. The most common interventions were albuterol (79%) and corticosteroid (68%) treatments and the most common discharge diagnosis was asthma exacerbation (55%). Conclusion EV-D68 caused a significant outbreak in 2014 with increased hospital admissions and associated increased charges. There was no significant difference in severity of illness caused by EV-D68 and non-EV-D68-HR/EV infections suggesting that the impact from EV-D68 was due to increased number of infected children presenting to the hospital and not necessarily due to increased severity of illness. PMID:26771663

Proven germline mosaicism in a father of two children with CHARGE syndrome.

PubMed

Pauli, S; Pieper, L; Häberle, J; Grzmil, P; Burfeind, P; Steckel, M; Lenz, U; Michelmann, H W

2009-05-01

CHARGE syndrome is an autosomal dominant malformation syndrome caused by mutations in the CHD7 gene. The majority of cases are sporadic and only few familial cases have been reported. In these families, mosaicism in one parent, as well as parent- to-child transmission of a CHD7 mutation, has been described. In some further cases, germline mosaicism has been suggested. Here, we report the first case in which germline mosaicism could be demonstrated in a father of two affected children with CHARGE syndrome. The truncating mutation c.7302dupA in exon 34 of the CHD7 gene was found in both affected children but was not detected in parental lymphocytes. However, in DNA extracted from the father's spermatozoa, the c.7302dupA mutation could be identified. Furthermore, mutation analysis of DNA isolated from 59 single spermatozoa revealed that the c.7302dupA mutation occurs in 16 spermatozoa, confirming germline mosaicism in the father of the affected children. This result has a high impact for genetic counselling of the family and for their recurrence risk in further pregnancies.

Autism Spectrum Disorders in Hispanics and Non-Hispanics

ERIC Educational Resources Information Center

Chaidez, Virginia; Hansen, Robin L.; Hertz-Picciotto, Irva

2012-01-01

Objectives: To compare differences in autism between Hispanic and non-Hispanics. We also examined the relationship between multiple language exposure and language function and scores of children. Methods: The Childhood Autism Risks from Genetics and the Environment (CHARGE) study is an ongoing population-based case-control study with children…

The Rise of Alternative Schools. Implications for Social Studies Education.

ERIC Educational Resources Information Center

Fox, Tom

This paper reviews what some leading critics of public schools say about social studies curriculum and suggests implications of the growing "free schools" movement. The social studies have been charged with the socialization of children into the existing majority culture, and with teaching the knowledge and skills required for effective…

Child and Adolescent Behavior Inventory (CABI): A New Instrument for Epidemiological Studies and Pre-Clinical Evaluation

PubMed Central

Cianchetti, Carlo; Pittau, Andrea; Carta, Valeria; Campus, Grazia; Littarru, Roberta; Ledda, Maria Giuseppina; Zuddas, Alessandro; Fancello, Giuseppina Sannio

2013-01-01

Background: Some questionnaires have already been elaborated to collect information from parents of children and adolescents, both as preparation for clinical evaluation and for screening and epidemiological studies. Here a new questionnaire, the CABI, is proposed, and it is validated in a population of 8-10 year-old children. Compared to existing questionnaires, the CABI has been organized so as to be of medium length, with items concerning the most significant symptoms indicated by the DSM-IV-TR for the pertinent disorders, and covering a wider range than existing instruments. There is no charge for its use. Methods: The answers of the parents of 302 children in the last 3 years of primary school provided the normative data. A discriminant validation was done for internalizing and externalizing disorders and as a comparison with self-administered anxiety and depression scales. Exploratory factor analysis and internal consistency were also performed. Results: Distribution of scores on the main scales in the normal population shows positive skewness, with the most frequent score being zero. A highly discriminant capability was found in regard to the sample of children with internalizing and externalizing disorders, with high correlation with the self-administered anxiety and depression scales. Conclusion: The CABI appears to be capable, at least for 8-10 year-old children, of effectively discriminating those with pathological symptoms from those without. Compared with the widely- used CBCL, it has the advantages of a lower number of items, which should facilitate parental collaboration especially in epidemiological studies, and of being free of charge. PMID:23539369

Volatile anesthetic rescue therapy in children with acute asthma: innovative but costly or just costly?.

PubMed

Char, Danton S; Ibsen, Laura M; Ramamoorthy, Chandra; Bratton, Susan L

2013-05-01

To describe volatile anesthesia (VA) use for pediatric asthma, including complications and outcomes. Retrospective cohort study. Children's hospitals contributing to the Pediatric Health Information System between 2004-2008. Children 2-18 years old with a primary diagnosis code for asthma supported with mechanical ventilation. Those treated with VA were compared to those not treated with VA or extracorporeal membrane oxygenation. Hospital VA use was grouped as none, <5%, 5-10% and >10% among intubated children. One thousand five hundred and fifty-eight patients received mechanical ventilation at 40 hospitals for asthma: 47 (3%) received VA treatment at 11 (28%) hospitals. Those receiving a VA were significantly less likely to receive inhaled b-agonists, ipratropium bromide, and heliox, but more likely to receive neuromuscular blocking agents than patients treated without VA. Length of mechanical ventilation, hospital stay (length of stay [LOS]) and charges were significantly greater for those treated with VA. Aspiration was more common but death and air leak did not differ. Patients at hospitals with VA use >10% were significantly less likely to receive inhaled b agonist, ipratropium bromide, methylxanthines, and heliox, but more likely to receive systemic b agonist, neuromuscular blocking agents compared to those treated at hospitals not using VA. LOS, duration of ventilation, and hospital charges were significantly greater for patients treated at centers with high VA use. Mortality does not differ between centers that use VA or not. Patients treated at centers with high VA use had significantly increased hospital charges and increased LOS.

Write a Better Ending: 2008 Annual Report

ERIC Educational Resources Information Center

Association for Children of New Jersey, 2008

2008-01-01

This paper presents the annual report of the Association for Children of New Jersey (ACNJ) for 2008. In 2008, ACNJ wrote a better ending for children by: (1) Advancing universal health care for children. ACNJ's assistant director chaired a state task force charged with getting more uninsured children enrolled in New Jersey's child health insurance…

"In Charge of the Truffula Seeds": On Children's Literature, Rationality and Children's Voices in Philosophy

ERIC Educational Resources Information Center

Johansson, Viktor

2011-01-01

In this paper I investigate how philosophy can speak for children and how children can have a voice in philosophy and speak for philosophy. I argue that we should understand children as responsible rational individuals who are involved in their own philosophical inquiries and who can be involved in our own philosophical investigations--not because…

Trends in Resource Utilization by Children with Neurological Impairment in the United States Inpatient Health Care System: A Repeat Cross-Sectional Study

PubMed Central

Berry, Jay G.; Poduri, Annapurna; Bonkowsky, Joshua L.; Zhou, Jing; Graham, Dionne A.; Welch, Chelsea; Putney, Heather; Srivastava, Rajendu

2012-01-01

Background Care advances in the United States (US) have led to improved survival of children with neurological impairment (NI). Children with NI may account for an increasing proportion of hospital resources. However, this assumption has not been tested at a national level. Methods and Findings We conducted a study of 25,747,016 US hospitalizations of children recorded in the Kids' Inpatient Database (years 1997, 2000, 2003, and 2006). Children with NI were identified with International Classification of Diseases, 9th Revision, Clinical Modification diagnoses resulting in functional and/or intellectual impairment. We assessed trends in inpatient resource utilization for children with NI with a Mantel-Haenszel chi-square test using all 4 y of data combined. Across the 4 y combined, children with NI accounted for 5.2% (1,338,590) of all hospitalizations. Epilepsy (52.2% [n = 538,978]) and cerebral palsy (15.9% [n = 164,665]) were the most prevalent NI diagnoses. The proportion of hospitalizations attributable to children with NI did not change significantly (p = 0.32) over time. In 2006, children with NI accounted for 5.3% (n = 345,621) of all hospitalizations, 13.9% (n = 3.4 million) of bed days, and 21.6% (US$17.7 billion) of all hospital charges within all hospitals. Over time, the proportion of hospitalizations attributable to children with NI decreased within non-children's hospitals (3.0% [n = 146,324] in 1997 to 2.5% [n = 113,097] in 2006, p<.001) and increased within children's hospitals (11.7% [n = 179,324] in 1997 to 13.5% [n = 209,708] in 2006, p<0.001). In 2006, children with NI accounted for 24.7% (2.1 million) of bed days and 29.0% (US$12.0 billion) of hospital charges within children's hospitals. Conclusions Children with NI account for a substantial proportion of inpatient resources utilized in the US. Their impact is growing within children's hospitals. We must ensure that the current health care system is staffed, educated, and equipped to serve this growing segment of vulnerable children. Please see later in the article for the Editors' Summary PMID:22272190

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2012 CFR

2012-10-01

... maximum amount of $11.35 for services furnished in a hospital emergency room if those services are not... 42 Public Health 4 2012-10-01 2012-10-01 false Maximum allowable cost-sharing charges on targeted... Requirements: Enrollee Financial Responsibilities § 457.555 Maximum allowable cost-sharing charges on targeted...

Clival Malformations in CHARGE Syndrome.

PubMed

Mahdi, E S; Whitehead, M T

2018-06-01

CHARGE syndrome is a multisystemic congenital disorder, most commonly including coloboma, heart malformations, choanal atresia, developmental delay, and genital and ear anomalies. The diagnostic criteria for CHARGE syndrome have been refined with time. However, limited reports describe skull base and craniocervical junction abnormalities. Recently, a coronal clival cleft has been identified in association with CHARGE syndrome. The aim of our study was to assess the prevalence of clival pathology in CHARGE syndrome. In this retrospective study, the CT/MR imaging data base at a single academic children's hospital was queried for the phrase "CHARGE syndrome" during a 17-year period (2001-2017). Electronic medical records were reviewed to confirm the diagnosis. Images were assessed for skull base anomalies, specifically clival hypoplasia and dysplasia. The search yielded 42 examinations (21 CTs and 21 MRIs) from 15 distinct patients (mean age, 4.1 ± 5.6 years; range, 2 days to 19 years). CHARGE syndrome diagnosis was confirmed either by clinical and genetic testing ( n = 6) or by clinical diagnosis only ( n = 9). A coronal clival cleft was identified in 87% of patients (37 examinations, n = 13 patients), either partial (53%) or complete (33%). Clival hypoplasia without clefting was present in all 5 examinations from the remaining 2 patients. Clival pathology is universal in CHARGE syndrome. Coronal clival clefts are extremely common, representing a useful additional diagnostic finding. Detection of a clival cleft should alert the radiologist to examine the palate, choana, eyes, ears, and olfactory centers for other signs of CHARGE syndrome. © 2018 by American Journal of Neuroradiology.

Assertiveness with 'Special' Children.

ERIC Educational Resources Information Center

Rosenberg, Shelley K.; Stillman-Powell, Patricia

The author examines issues related to adult assertiveness in controlling and setting limits for handicapped children. Reasons for adults not wishing to be in charge include feelings of guilt, lack of consistency in enforcing rules, and a sense of sympathy for special children. Assertiveness is distinguished from aggressiveness, and suggestions for…

Bathroom safety - children

MedlinePlus

Well child - bathroom safety ... Children younger than 6 years old should NOT be left unattended in the bathtub. They should also ... NOT be put in charge of a younger child's safety. There should be an adult in the ...

High turnover stays for pediatric asthma in the United States: analysis of the 2006 Kids' Inpatient Database.

PubMed

Macy, Michelle L; Stanley, Rachel M; Sasson, Comilla; Gebremariam, Achamyeleh; Davis, Matthew M

2010-09-01

Pediatric observation units provide an alternative to traditional hospitalization. The extent to which observation units could replace inpatient care for asthmatic children is unknown. To describe brief inpatient ("high-turnover," HTO) stays for US children hospitalized with a principal discharge diagnosis of asthma, to characterize cases that may be appropriate for observation. We analyzed the 2006 Kids' Inpatient Database, a nationally representative sample of hospital discharges. HTO stays were defined as hospitalizations of 0 or 1 night in duration. We conducted descriptive statistics and case-mix adjusted, sample-weighted regression analysis of HTO stays, and associated hospital charges. Discharges among children aged 2 to 20 years with a principal discharge diagnosis of asthma. HTO stays and total charges. Overall, 34,592 (34%) pediatric asthma hospitalizations were HTO, accounting for 66,278 hospital days in 2006. HTO stays were associated with younger age, uncomplicated asthma, and private insurance. Freestanding children's hospitals had the highest proportion of HTO stays, 38% (95% CI: 34%-42%) compared with 32% (95% CI: 28%-36%) for children's units and 33% (95% CI: 31%-34%) for general hospitals. In multivariate regression analyses, charges were significantly higher across hospital types when HTO stays begin in the emergency department. The presence of a large number of HTO stays for children hospitalized for asthma suggests the need to explore opportunities to restructure care for this condition, perhaps through the development of physically or operationally distinct observation units.

Immigrant children's reliance on public health insurance in the wake of immigration reform.

PubMed

Pati, Susmita; Danagoulian, Shooshan

2008-11-01

We sought to determine whether the reversal of the public charge rule of the Illegal Immigration Reform and Immigrant Responsibility Act, which may have required families to pay for benefits previously received at no cost, led to immigrant children becoming increasingly reliant on public health insurance programs. We conducted a secondary data analysis focusing on low-income children sampled in the 1997 through 2004 versions of the National Health Interview Survey. Between 1997 and 2004, public health insurance enrollments and the numbers of uninsured foreign-born children in the United States increased by 3.1% and 2.7%, respectively. Using multinomial logistic regression models to account for the substantial differences in socioeconomic status between foreign-born and US-born children, we found that low-income US-born children were just as likely as foreign-born children to have public health insurance coverage (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.89, 1.52) and that, after 2000, foreign-born children were 1.59 times (95% CI = 1.24, 2.05) more likely than were US-born children to be uninsured (vs publicly insured). In the wake of the reversal of the public charge rule, immigrant children are increasingly likely to be uninsured as opposed to relying on public health insurance.

Immigrant Children's Reliance on Public Health Insurance in the Wake of Immigration Reform

PubMed Central

Danagoulian, Shooshan

2008-01-01

Objectives. We sought to determine whether the reversal of the public charge rule of the Illegal Immigration Reform and Immigrant Responsibility Act, which may have required families to pay for benefits previously received at no cost, led to immigrant children becoming increasingly reliant on public health insurance programs. Methods. We conducted a secondary data analysis focusing on low-income children sampled in the 1997 through 2004 versions of the National Health Interview Survey. Results. Between 1997 and 2004, public health insurance enrollments and the numbers of uninsured foreign-born children in the United States increased by 3.1% and 2.7%, respectively. Using multinomial logistic regression models to account for the substantial differences in socioeconomic status between foreign-born and US-born children, we found that low-income US-born children were just as likely as foreign-born children to have public health insurance coverage (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.89, 1.52) and that, after 2000, foreign-born children were 1.59 times (95% CI = 1.24, 2.05) more likely than were US-born children to be uninsured (vs publicly insured). Conclusions. In the wake of the reversal of the public charge rule, immigrant children are increasingly likely to be uninsured as opposed to relying on public health insurance. PMID:18799772

Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

ERIC Educational Resources Information Center

Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

2015-01-01

Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

Otitis Media in a New Mouse Model for CHARGE Syndrome with a Deletion in the Chd7 Gene

PubMed Central

Tian, Cong; Yu, Heping; Yang, Bin; Han, Fengchan; Zheng, Ye; Bartels, Cynthia F.; Schelling, Deborah; Arnold, James E.; Scacheri, Peter C.; Zheng, Qing Yin

2012-01-01

Otitis media is a middle ear disease common in children under three years old. Otitis media can occur in normal individuals with no other symptoms or syndromes, but it is often seen in individuals clinically diagnosed with genetic diseases such as CHARGE syndrome, a complex genetic disease caused by mutation in the Chd7 gene and characterized by multiple birth defects. Although otitis media is common in human CHARGE syndrome patients, it has not been reported in mouse models of CHARGE syndrome. In this study, we report a mouse model with a spontaneous deletion mutation in the Chd7 gene and with chronic otitis media of early onset age accompanied by hearing loss. These mice also exhibit morphological alteration in the Eustachian tubes, dysregulation of epithelial proliferation, and decreased density of middle ear cilia. Gene expression profiling revealed up-regulation of Muc5ac, Muc5b and Tgf-β1 transcripts, the products of which are involved in mucin production and TGF pathway regulation. This is the first mouse model of CHARGE syndrome reported to show otitis media with effusion and it will be valuable for studying the etiology of otitis media and other symptoms in CHARGE syndrome. PMID:22539951

Prosecuting Child Sexual Abuse: The Importance of Evidence Type

ERIC Educational Resources Information Center

Walsh, Wendy A.; Jones, Lisa M.; Cross, Theodore P.; Lippert, Tonya

2010-01-01

Corroborating evidence has been associated with a decrease in children's distress during the court process, yet few studies have empirically examined the impact of evidence type on prosecution rates. This study examined the types of evidence and whether charges were filed in a sample of child sexual abuse cases (n = 329). Cases with a child…

An exploratory analysis of behavioral health care use within families.

PubMed

Lave, Judith R; Peele, Pamela B; Xu, Ying; Scholle, Sarah H; Pincus, Harold Alan

2002-06-01

The authors studied enrollees in employer-sponsored managed health plans to determine the extent of multiple behavioral health consumers within families, use of behavioral health services by employees who have another family member using such services, congruence of diagnoses between two family members using behavioral health services, and the effect on covered charge per behavioral health consumer when other family members use behavioral health services. Claims data from 911 plans sold or managed by a single managed behavioral health care company were examined. The plans provided coverage for 724,789 employees and covered about 1.7 million lives. Family members of employees were identified by the relationship codes on the claims. Service utilization rates were calculated for employees overall and for employees who had spouses or children who used behavioral health services. Mean and median covered charges were determined and were examined by number and type of consumers in the family. The use of behavioral health services was greater among employees whose children or spouses used behavioral health services. Utilization rates varied by the child's or spouse's diagnoses. More than 50 percent of male employees whose children received treatment for a depressive disorder also received such treatment. Congruence of diagnoses within families was noted. Covered charges per person generally increased with the number of family members who used behavioral health services. Greater knowledge about patterns of use of behavioral health services within families may help in improving access to care and developing more effective family interventions.

Asthma and Allergies in Children With Autism Spectrum Disorders: Results From the CHARGE Study.

PubMed

Lyall, Kristen; Van de Water, Judy; Ashwood, Paul; Hertz-Picciotto, Irva

2015-10-01

Immune aberrations are often noted in children with autism spectrum disorder (ASD), but whether asthma and allergy are related to ASD is not well defined. This study examined asthma and allergies in association with ASD and phenotypic subsets. Participants were 560 children with confirmed ASD and 391 typically developing children from the CHildhood Autism Risks from Genetics and the Environment study. Maternally reported child asthma and allergy was compared between cases and controls, and in association with cognitive and behavioral test scores. Prevalence of asthma and overall allergies did not differ between cases and controls, but overall allergy in children with ASD was associated with higher stereotypy scores as measured by the Aberrant Behavior Checklist. In addition, reported food allergies were significantly associated with ASD (adjusted odds ratio = 2.23, 95% confidence interval 1.28, 3.89). Our results suggest food allergies and sensitivities may be more common in children with ASD, and that these issues may correlate with other behaviors. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Democratic Citizenship: Responsible Life in a Free Society

ERIC Educational Resources Information Center

Power, F. Clark; Scott, Sarah E.

2014-01-01

The Convention on the Rights of Child charges educators not only to respect children's rights but also to prepare children to develop as responsible citizens in a free society. The Convention enriches the perspective of school psychologists by emphasizing the need to respect children's rights while also promoting their competencies as political…

Equal Protection, Immigration, and Education: "Plyler v. Doe"

ERIC Educational Resources Information Center

Feinberg, Joseph R.; Doppen, Frans H.; Hollstein, Matthew S.

2014-01-01

When the Texas state legislature passed a law in the 1970s allowing school districts to deny enrollment or charge tuition to illegal immigrant children, the Tyler Independent School District instituted a $1,000 tuition rate for illegal immigrant children. Sixteen undocumented children from four Mexican families in Tyler filed a class-action suit…

Limb anomalies in DiGeorge and CHARGE syndromes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prasad, C.; Quackenbush, E.J.; Whiteman, D.

1997-01-20

Limb anomalies are not common in the DiGeorge or CHARGE syndromes. We describe limb anomalies in two children, one with DiGeorge and the other with CHARGE syndrome. Our first patient had a bifid left thumb, Tetralogy of Fallot, absent thymus, right facial palsy, and a reduced number of T-cells. A deletion of 22q11 was detected by fluorescence in situ hybridization (FISH). The second patient, with CHARGE syndrome, had asymmetric findings that included right fifth finger clinodactyly, camptodactyly, tibial hemimelia and dimpling, and severe club-foot. The expanded spectrum of the DiGeorge and CHARGE syndromes includes limb anomalies. 14 refs., 4 figs.

Is Hospital Teaching Status a Key Factor in Hospital Charge for Children with Hip Fractures?

PubMed Central

Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C.

2013-01-01

OBJECTIVE Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selec-tion bias. METHODS The 2006 Healthcare Cost and Uti-lization Project (HCUP) Kids’ Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classifi-cation of Diseases, 9th Revision, Clinical Modifica-tion codes 820.0, 820.2 and 820.8 under Section “Injury and Poisoning (800-999)” with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. RESULTS In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based ad-justment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Conclusions Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay. PMID:24027472

Is hospital teaching status a key factor in hospital charge for children with hip fractures?: preliminary findings from KID database.

PubMed

Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C

2013-01-01

Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selection bias. The 2006 Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820.0, 820.2 and 820.8 under Section "Injury and Poisoning (800-999)" with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based adjustment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes.

PubMed

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.

Treatment patterns of children with spine and spinal cord tumors: national outcomes and review of the literature.

PubMed

Shweikeh, Faris; Quinsey, Carolyn; Murayi, Roger; Randle, Ryan; Nuño, Miriam; Krieger, Mark D; Patrick Johnson, J

2017-08-01

Tumors of the spine in children are rare, and further clinical description is necessary. This study investigated epidemiology, interventions, and outcomes of pediatric patients with spine and spinal cord tumors. The National Inpatient Sample and Kids' Inpatient Database were used for the study. Outcomes were studied, and bivariate significant trends were analyzed in a multivariate setting. Analysis of 2870 patients between 2000 and 2009 found a median age of diagnosis of 11 years (Tables 1 and 2). Most were white (65.2%) and had private insurance (62.3%), and 46.8% of procedures were emergent operations. Treatment occurred at teaching (93.6%) and non-children's hospitals (81.1%). Overall mortality rate was 1.7%, non-routine discharges occurred at a rate 19.9%, complications at 21.1%, and average total charges were $66,087. A majority of patients (87.5%) had no intervention, and of those patients receiving treatment, 78.2% underwent surgery and 23.1% had radiotherapy. Treatment with surgery alone increased significantly over time (p < 0.0001). Odds ratio (OR) of mortality was significantly higher in 2006 (OR 3.5) and 2009 (OR 2.6) when compared to 2000. Complications (OR 7.9) and disease comorbidities (OR 1.5) were associated with significantly increased odds of mortality. Hospital characteristics, length of stay, and charges remained relatively unchanged. In recent years, there has been a decreasing incidence of spine and spinal cord tumors in children. Notably, a higher mortality rate is evident over time in addition to an increase in the proportion of patients undergoing surgery. The high percentage of emergent operations suggests a weak recognition of spine tumors in children and should prompt a call for increased awareness of this cancer. In spite of these findings, lack of tumor type identification was a limitation to this study.

Homework Emotion Management at the Secondary School Level: Antecedents and Homework Completion

ERIC Educational Resources Information Center

Xu, Jianzhong

2011-01-01

Background/Context: For many children, doing homework becomes an emotionally charged event and one of the most disappointing aspects of school life. It is surprising to note, however, that homework emotion management is noticeably absent from much contemporary homework literature. Purpose: The primary propose of the present study was to propose…

Job-Related Stress and Depression in Orphanage and Preschool Caregivers in Ukraine

ERIC Educational Resources Information Center

Raskin, Maryna; Kotake, Chie; Easterbrooks, M. Ann; Ebert, Marina; Miller, Laurie C.

2015-01-01

Emotional well-being of child care providers is important to the welfare of their young charges. Elevated depression and job-related stress may affect caregivers' ability to establish empathic connections with children. This study examined work conditions, job-related stress, and depression in 51 orphanage workers and 69 preschool teachers in…

School Board Decision-Making and the Elimination of Sport Participation Fees

ERIC Educational Resources Information Center

Heinze, Kathryn L.; Zdroik, Jennifer

2018-01-01

Public schools in the US are increasingly charging "pay-to-play" fees for participating in sports. Although these fees can cause reductions in participation, particularly for children from lower-income families, pay-to-play has become a legitimate practice within the field of public education. This study examines what leads some school…

Child pornography offenses are a valid diagnostic indicator of pedophilia.

PubMed

Seto, Michael C; Cantor, James M; Blanchard, Ray

2006-08-01

This study investigated whether being charged with a child pornography offense is a valid diagnostic indicator of pedophilia, as represented by an index of phallometrically assessed sexual arousal to children. The sample of 685 male patients was referred between 1995 and 2004 for a sexological assessment of their sexual interests and behavior. As a group, child pornography offenders showed greater sexual arousal to children than to adults and differed from groups of sex offenders against children, sex offenders against adults, and general sexology patients. The results suggest child pornography offending is a stronger diagnostic indicator of pedophilia than is sexually offending against child victims. Theoretical and clinical implications are discussed. Copyright 2006 APA, all rights reserved.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes

PubMed Central

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children’s developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation. PMID:29388595

The Economic Burden of Musculoskeletal Disease in Children and Adolescents in the United States.

PubMed

Rosenfeld, Scott B; Schroeder, Katherine; Watkins-Castillo, Sylvia I

2018-04-01

Musculoskeletal conditions are among the most common and costly conditions suffered by Americans. In 2011, there was an estimated $213 billion in annual cost of direct treatment for and lost wages due to musculoskeletal disease in the United States. Data on economic burden, however, comes mostly from the adult population, with significantly less information regarding the burden of these conditions in young patients available. The purpose of this report is to provide data on the economic burden of musculoskeletal diseases in children and adolescents in the United States. Eleven diagnosis categories were identified, with health care visits and hospitalization data derived from ICD-9-CM codes for each of the conditions searched. The largest database utilized was the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID). Total visits came from the KID, HCUP NEDS (emergency department), NCHS NHAMCS OP (outpatient), and NCHS NAMCS (physician office) databases. The National Health Interview Survey (NHIS) child sample was additionally searched to obtain patient/parent-reported data. In 2012, more than 19 million children and adolescents received treatment in medical centers, physicians' offices, and hospitals for a musculoskeletal-related condition. The most common reason for treatment (68%) was traumatic injury, followed by a pain syndrome (13%) and deformity (9%). Total hospital charges in 2012 for children and adolescents with a primary musculoskeletal-related diagnosis totaled $7.6 billion. Trauma (43%) and deformity (38%) were the major contributors to total hospital charges. Although we found that hospital-related charges for musculoskeletal diseases for children and adolescents in 2012 totaled $7.6 billion, this number underestimates the total cost for all pediatric musculoskeletal conditions. Musculoskeletal conditions accounted for 5.4% of hospital charges in the pediatric population. However, only 1.4% of pediatric research funding is designated to musculoskeletal research. Going forward, the data in this report may be used to further research and to stimulate development of better methods with which to measure the direct and indirect costs of musculoskeletal conditions in children. Level IV-economic and decision analysis.

The charges for seizures in the pediatric emergency room: a single center study.

PubMed

Caron, Elena; Wheless, Catherine E; Patters, Andrea B; Wheless, James W

2015-05-01

The direct charges for emergency department visits resulting from recurrent seizures are significant, and home intervention with abortive medications can be cost-saving. Over a 1-year period, we evaluated children with seizures who were seen in the emergency department, stabilized, and released. The information is necessary to assess the pharmacoeconomic advantages of at-home interventions for seizure emergencies. We did a retrospective chart review of 90 patients and divided them into febrile versus nonfebrile seizures and existing versus new-onset seizure disorder. The hospital accounting department performed a charge analysis. The total charges for all 90 patients treated for seizures in the emergency department were $219,945. The minimum was $370, for a patient with no history of febrile seizures. The maximum was $17,126, for a patient with a nonfebrile seizure and a history of seizures. This information allows a comparison with the cost of preventive medications, such as diazepam rectal gel or intranasal midazolam. Copyright © 2015 Elsevier Inc. All rights reserved.

Developing Literacy in Second-Language Learners: Report of the National Literacy Panel on Language-Minority Children and Youth

ERIC Educational Resources Information Center

August, Diane, Ed.; Shanahan, Timothy, Ed.

2006-01-01

This volume reports the findings of the National Literacy Panel on Language-Minority Children and Youth. The formal charge to the panel--a distinguished group of expert researchers in reading, language, bilingualism, research methods, and education--was to identify, assess, and synthesize research on the education of language-minority children and…

Group Activities for Mentally Retarded Children: A Symposium. Bulletin, 1933, No. 7

ERIC Educational Resources Information Center

Martens, Elise H., Comp.

1933-01-01

In every school system the education of mentally handicapped children presents serious problems. In the larger cities where such pupils may be gathered from the various classes in the school and placed in one room in charge of a specially prepared teacher, the problems are somewhat simplified. In the country schools where children cannot be so…

Nightmares, Idylls, Mystery, and Hope: "Walk Two Moons" and the Artifice of Realism in Children's Fiction

ERIC Educational Resources Information Center

Roberts, Lewis

2008-01-01

Sharon Creech's "Walk Two Moons" is a defining example of contemporary realistic fiction for children. This article argues that "Walk Two Moons" models storytelling as a tool which children need to understand their own relationship to reality and to literature. Rather than employing a grim verisimilitude, as some critics have charged, Creech has…

Cost analysis of mandibular distraction versus tracheostomy in neonates with Pierre Robin sequence.

PubMed

Runyan, Christopher M; Uribe-Rivera, Armando; Karlea, Audrey; Meinzen-Derr, Jareen; Rothchild, Dawn; Saal, Howard; Hopkin, Robert J; Gordon, Christopher B

2014-11-01

To evaluate costs associated with surgical treatment for neonates with Pierre Robin sequence (PRS). Retrospective cohort study. Cincinnati Children's Hospital Medical Center. With Institutional Review Board approval, we retrospectively studied neonates with PRS treated from 2001 to 2009 with either tracheostomy (Trach), mandibular distraction (MD), or Trach with subsequent MD (Trach+MD). Actual charges over a 3-year period associated with operative costs, hospital stay, imaging and sleep studies, clinic visits, and related emergency room visits were collected. Home tracheostomy care charges were estimated individually for each patient. Charges were compared using regression and appropriate statistical analyses. Forty-seven neonates were included in the study (MD, n = 26; Trach, n = 12; Trach+MD, n = 9). Trach group patients had 2.6-fold higher charges than the MD group despite no difference in length of hospital stay. This difference increased to 7.3-fold when including home trach care-related costs. Trach+MD group patients had longer hospital lengths of stay and higher operation room (OR) fees, but no increased total charges compared with the Trach only group. For patients with severe PRS, mandibular distraction provides significant cost savings over tracheostomy ($300,000 per patient over 3 years). Increased costs with tracheostomy come from greater hospital-related charges, more frequent airway procedures, a higher incidence of gastrostomy tube feeds, and home trach care costs. A careful examination of long-term outcomes will be critical as mandibular distraction continues to gain acceptance for treatment of PRS. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.

25 CFR 36.76 - Who is in charge of all homeliving operations?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who is in charge of all homeliving operations? 36.76 Section 36.76 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY SITUATIONS...

25 CFR 36.76 - Who is in charge of all homeliving operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Who is in charge of all homeliving operations? 36.76 Section 36.76 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY SITUATIONS...

25 CFR 36.76 - Who is in charge of all homeliving operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Who is in charge of all homeliving operations? 36.76 Section 36.76 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY SITUATIONS...

25 CFR 36.76 - Who is in charge of all homeliving operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who is in charge of all homeliving operations? 36.76 Section 36.76 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY SITUATIONS...

25 CFR 36.76 - Who is in charge of all homeliving operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Who is in charge of all homeliving operations? 36.76 Section 36.76 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY SITUATIONS...

Influence and Challenges of the Capitation Grant on Education Delivery in Basic Schools in Ghana

ERIC Educational Resources Information Center

Pajibo, Edison; Tamanja, Emmanuel M. J.

2017-01-01

In Ghana, some children do not attend school, because their parents are unable to afford levies and fees charged by schools. This led to the introduction of the Capitation Grant Scheme in 2005. This study investigates the influence of the Capitation Grant Scheme on education delivery in basic schools in Ghana, through a close study of the Ga West…

Pediatric facial fractures: current national incidence, distribution, and health care resource use.

PubMed

Vyas, Raj M; Dickinson, Brian P; Wasson, Kristy L; Roostaeian, Jason; Bradley, James P

2008-03-01

To date, reports on the incidence and distribution of pediatric facial fractures have been inconsistent and have originated only from institutional studies. The need for current national data exists. We examined the Kids' Inpatient Database and the Nationwide Inpatient Sample to obtain national information on facial fracture discharges from 1997 to 2003. Data showed that pediatric patients (age, 0-17 years) make up 14.7% of all facial fractures, with children aged 1 to 4 years comprising only 5.6% of the total and children 15 to 17 years old making up more than half the group. The male-to-female ratio was 2.5. Significantly lengthier hospitalizations were observed with female patients, Medicaid insurance, teaching hospitals, government hospitals, and metropolitan hospitals. Significantly higher charges were associated with patients aged 1 to 4 years, Medicaid insurance, Western US geography, teaching hospitals, metropolitan hospitals, and children's hospitals. During the 6-year period of this study, there was a trend toward (1) increased hospital charges (with stable costs), (2) more patients treated at teaching hospitals, and (3) a convergence in length of stay between hospitals with differing ownerships (with government hospitals having progressively shorter hospitalizations, whereas private for-profit hospitals have progressively lengthier hospitalizations). The incidence of facial fractures in children is small yet significant and has remained stable during the past few decades. Certain patient populations are prone to facial fractures, and various patient and hospital factors are associated with lengthier and more expensive hospitalizations. An understanding of disparities in resource use among various patient, hospital, and geographic settings is critical for physicians and policy makers.

Characteristics of child abuse in immigrant Korean families and correlates of placement decisions.

PubMed

Chang, Janet; Rhee, Siyon; Weaver, Dale

2006-08-01

This study examined the characteristics and patterns of child abuse among immigrant Korean families in Los Angeles and critical variables that contribute to the type of placement made by the child protective services (CPS) system. Data were obtained from reviewing and analyzing 170 active Korean case files maintained by the Asian Pacific Unit (APU) of the Los Angeles County Department of Children and Family Services (LAC-DCFS) during July through September, 2001. Logistic regression analysis was employed to examine the odds of children being kept in or removed from the home. Some of the major findings from this study include: (1) immigrant Korean families are more likely to be charged with physical abuse (49.4%) and less likely to be charged with neglect (20.6%) in comparison with all other groups in Los Angeles (13.2% and 27.1%, respectively); (2) the circumstance under which physical abuse occurred most frequently was corporal punishment used by Korean parents with an intention to discipline their children; and (3) the context under which emotional abuse occurred among the Korean families was likely to be children's witnessing domestic violence. In addition, the logistic regression showed that response status, referral source, living arrangement, victim's relationship to perpetrator, and chronicity of abuse were significant in predicting out-of-home placement. An analysis of Korean child abuse cases reported to child protective service revealed that culture and child rearing practices shaped the patterns of child maltreatment. A culturally sensitive approach is strongly suggested for effective child abuse prevention and intervention services with this group by CPS agencies.

Pediatric abusive head trauma and stroke.

PubMed

Khan, Nickalus R; Fraser, Brittany D; Nguyen, Vincent; Moore, Kenneth; Boop, Scott; Vaughn, Brandy N; Klimo, Paul

2017-08-01

OBJECTIVE Despite established risk factors, abusive head trauma (AHT) continues to plague our communities. Cerebrovascular accident (CVA), depicted as areas of hypodensity on CT scans or diffusion restriction on MR images, is a well-known consequence of AHT, but its etiology remains elusive. The authors hypothesize that a CVA, in isolation or in conjunction with other intracranial injuries, compounds the severity of a child's injury, which in turn leads to greater health care utilization, including surgical services, and an increased risk of death. METHODS The authors conducted a retrospective observational study to evaluate data obtained in all children with AHT who presented to Le Bonheur Children's Hospital (LBCH) from January 2009 through August 2016. Demographic, hospital course, radiological, cost, and readmission information was collected. Children with one or more CVA were compared with those without a CVA. RESULTS The authors identified 282 children with AHT, of whom 79 (28%) had one or more CVA. Compared with individuals without a CVA, children with a stroke were of similar overall age (6 months), sex (61% male), and race (56% African-American) and had similar insurance status (81% public). Just under half of all children with a stroke (38/79, 48%) were between 1-6 months of age. Thirty-five stroke patients (44%) had a Grade II injury, and 44 (56%) had a Grade III injury. The majority of stroke cases were bilateral (78%), multifocal (85%), associated with an overlying subdural hematoma (86%), and were watershed/hypoperfusion in morphology (73%). Thirty-six children (46%) had a hemispheric stroke. There were a total of 48 neurosurgical procedures performed on 28 stroke patients. Overall median hospital length of stay (11 vs 3 days), total hospital charges ($13.8 vs $6.6 million), and mean charges per patient ($174,700 vs $32,500) were significantly higher in the stroke cohort as a whole, as well as by injury grade (II and III). Twenty children in the stroke cohort (25%) died as a direct result of their AHT, whereas only 2 children in the nonstroke cohort died (1%). There was a 30% readmission rate within the first 180-day postinjury period for patients in the stroke cohort, and of these, approximately 50% required additional neurosurgical intervention(s). CONCLUSIONS One or more strokes in a child with AHT indicate a particularly severe injury. These children have longer hospital stays, greater hospital charges, and a greater likelihood of needing a neurosurgical intervention (i.e., bedside procedure or surgery). Stroke is such an important predictor of health care utilization and outcome that it warrants a subcategory for both Grade II and Grade III injuries. It should be noted that the word "stroke" or "CVA" should not automatically imply arterial compromise in this population.

Retrieval of a penny from the pediatric esophagus: a cost analysis.

PubMed

Goins, Jeanne L; Evans, Adele K

2011-12-01

As part of the oral phase of development, children commonly ingest foreign bodies. The most common lodged foreign body, requiring operative removal, in the United States is the penny. Valued at 1 cent, comprised of materials valued at less than 1 cent, costing 1.62 cents to manufacture, and being never removed from circulation, pennies are aplenty. But ingestion can lead to mucosal damage, the consequences of which can be esophageal perforation or stricture formation. We hypothesize that the monetary value of the penny is far less than the cost of its ingestion and removal. This quality assurance study examines the effect of the penny on the purse. This retrospective review identified 180 foreign bodies in children under the age of 18 over a five year period. Eighty-two were pennies. Operative notes revealed degree of injury. Hospital charge assessments revealed the "cost" of each visit. There were no esophageal perforations, and cases were divided evenly among injury grades 0-III. The average total charge for all penny-related injuries was $7164.78. The purpose was to examine the actual cost of a penny (more than its value in production) and the potential cost of its damage (thousands of dollars in measurable costs, untold immeasurable costs). The goal of this study is to draw healthcare professional and public attention to a potentially serious and yet highly preventable injury in young children. Published by Elsevier Ireland Ltd.

Social Skills Assessment and Intervention for Children and Youth

ERIC Educational Resources Information Center

Gresham, Frank M.

2016-01-01

Children and youth with deficits in social competence present substantial challenges for schools, teachers, parents and peers. These challenges cut across disciplinary, instructional and interpersonal domains and they frequently create chaotic home, school and classroom environments. Schools are charged with teaching an increasingly diverse…

Cost of influenza hospitalization at a tertiary care children's hospital and its impact on the cost-benefit analysis of the recommendation for universal influenza immunization in children age 6 to 23 months.

PubMed

Hall, Jennifer L; Katz, Ben Z

2005-12-01

To calculate the costs of influenza hospitalization at a tertiary care children's hospital as the basis of a cost-benefit analysis of the new influenza vaccine recommendation for children age 6 to 23 months. We reviewed the medical records of all patients admitted to Children's Memorial Hospital (CMH) in 2002 diagnosed with influenza. Total hospital costs were obtained from the Business Development Office. Thirty-five charts were analyzed. Both of the 2 patients requiring mechanical ventilation and 4 of 6 patients admitted to the intensive care unit had high-risk underlying medical conditions. Nine children were age 6 to 23 months; 4 of these 9 had no preexisting medical conditions. Had all 18 high-risk children over age 6 months been protected from influenza, approximately $350,000 in hospital charges could have been saved. Preventing the additional 4 hospitalizations in the otherwise low-risk children age 6 to 23 months for whom vaccine is currently recommended would have cost approximately $281,000 ($46/child) more than the hospital charges saved. When all children age 6 to 23 months are considered, influenza vaccination is less costly than other prophylactic measures. Addition of indirect costs, deaths, outpatient costs, and the cost of secondary cases would favor the cost:benefit ratio for influenza vaccination of all children age 6 to 23 months.

Child molestations by homosexual foster parents: Illinois, 1997--2002.

PubMed

Cameron, Paul

2005-02-01

Do those who engage in homosexuality disproportionately sexually abuse foster or adoptive children as reported by child protective services? Illinois child services reported sexual abuse for 1997 through 2002. 270 parents committed "substantiated" sexual offenses against foster or subsidized adoptive children: 67 (69%) of 97 of these mother and 148 (86%) of 173 of these father perpetrators sexually abused girls; 30 (31%) of the mothers and 25 (14%) of the father perpetrators sexually abused boys, i.e., 92 (34%) of the perpetrators homosexually abused their charges. Of these parents 15 both physically and sexually abused charges: daughters by 8 of the mothers and 4 of the fathers, sons by 3 of the mothers, i.e., same-sex perpetrators were involved in 53%. Thus, homosexual practitioners were proportionately more apt to abuse foster or adoptive children sexually.

Intimate partner violence. Mothers' perspectives of effects on their children.

PubMed

Lemmey, D; McFarlane, J; Willson, P; Malecha, A

2001-01-01

Intimate partner violence not only affects adults but also the children living within that "war zone." The present study expands our understanding about how children are affected when they observe violence in their own homes, as reported by their mothers. This descriptive study was conducted to describe mothers' perspectives of the impact of the violence on their children. A consecutive sample of 72 mothers attempting to file assault charges were interviewed in a private room by a registered nurse and were asked to describe the effect of witnessing intimate partner violence on their child's behavior. Each response was written verbatim by the interviewer. A majority (72%) of the mothers reported negative behaviors in their children that they believed were as a result of witnessing their mother's violent experiences. The most common negative traits were distress-indicating behaviors such as sleep disturbances, clinging, and fretful behaviors followed by problems with the abuser, problems in school, and problems with mother. Because intimate partner violence affects children, health care providers should become familiar with behaviors indicative of this problem. To promote the well being and development of children, recommendations for assessment and intervention for women experiencing intimate partner violence are discussed.

In Swimming Branch, Identification of Family Burden of Families of Mentally Disabled Athletes

ERIC Educational Resources Information Center

Nacar, Eyyup; Karahuseyinoglu, M. Fatih; Karatas, Baykal; Altungul, Oguzhan

2017-01-01

The families of individuals with Down-syndrome, autism, and mental problem who need for special requirements experience physical problems, tiredness, and antisocial life, which bring additional cost to family budget, from time to time due to difficulties of their children The aim of this study is to identify family burdens charged by kids with…

Out-of-pocket costs for paediatric admissions in district hospitals in Kenya

PubMed Central

Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

Objective To describe out-of-pocket costs of inpatient care for children under 5 years of age in district hospitals in Kenya. Methods A total of 256 caretakers of admitted children were interviewed in 2-week surveys conducted in eight hospitals in four provinces in Kenya. Caretakers were asked to report care seeking behaviour and expenditure related to accessing inpatient care. Family socio-economic status was assessed through reported expenditure in the previous month. Results Seventy eight percent of caretakers were required to pay user charges to access inpatient care for children. User charges (mean, US$ 8.1; 95% CI, 6.4–9.7) were 59% of total out-of-pocket costs, while transport costs (mean, US$ 4.9; 95% CI, 3.9–6.0) and medicine costs (mean, US$ 0.7; 95% CI, 0.5–1.0) were 36% and 5%, respectively. The mean total out-of-pocket cost per paediatric admission was US$ 14.1 (95% CI, 11.9–16.2). Out-of-pocket expenditures on health were catastrophic for 25.4% (95% CI, 18.4–33.3) of caretakers interviewed. Out-of-pocket expenditures were regressive, with a greater burden being experienced by households with lower socio-economic status. Conclusion Despite a policy of user fee exemption for children under 5 years of age in Kenya, our findings show that high unofficial user fees are still charged in district hospitals. Financing mechanisms that will offer financial risk protection to children seeking care need to be developed to remove barriers to child survival. PMID:22716184

Homosexual parents: a comparative forensic study of character and harms to children.

PubMed

Cameron, P; Cameron, K

1998-06-01

40 appeals cases of custody disputes drawn systematically from all cases involving a homosexual parent in the United States were compared to 38 appeals cases involving heterosexual custody disputes drawn randomly from listings under parental "character" and 18 appeals cases drawn randomly from "general" cases in Dicennial Digest from 1966 to 1991. Each case involving homosexual vs heterosexual claimants was examined for recorded information about (1) the character of the homosexual parent, the associates of the homosexual parent, the heterosexual parent, and the associates of the heterosexual parent, (2) the effects, particularly harms, upon the child(ren), and (3) psychiatric opinion. 82% of the homosexual vs 18% of the heterosexual parents and 54% of the homosexual's associates vs 19% of the heterosexuals' associates were recorded as having poor character in cases involving a homosexual claimant. Of the 66 recorded harms, e.g., molestation, physical abuse, to the 73 children, homosexual persons accounted for 64 (97%). Of the 32 lesbians, 6 were recorded as having engaged in criminal activity and 3 of bringing false charges of child sexual abuse against the father. Psychiatric opinion, however, ran 25 to 12 in favor of custody for the homosexual parent. In the 56 heterosexual vs heterosexual comparison cases, 38% of the heterosexual parents and 28% of their associates were recorded as having poor character. Six harms to their 105 children and 3 instances of criminality but no false charges of sexual abuse were recorded. In the appeals court literature, homosexual parents were disproportionately of poor character and disproportionately associated with various harms to their children.

The Education of Homeless Children and Youth in New Jersey: A Plan for State Action.

ERIC Educational Resources Information Center

Doolan, Jay; And Others

This state plan is New Jersey's response to the charge of the Stewart B. McKinney Homeless Assistance Act of 1987 (the McKinney Act) to assure educational access for homeless children and youth. The introductory section discusses the following issues: (1) the changing face of homelessness; (2) homeless children and youth; (3) the McKinney Act; and…

34 CFR 222.30 - What is “free public education”?

Code of Federal Regulations, 2010 CFR

2010-07-01

... tuition charge to the child or the child's parents; and (ii) Federal funds, other than funds under the Act... EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Payments for Federally Connected Children Under... public supervision and direction, except with respect to children with disabilities. (2) For the purpose...

34 CFR 222.30 - What is “free public education”?

Code of Federal Regulations, 2011 CFR

2011-07-01

... tuition charge to the child or the child's parents; and (ii) Federal funds, other than funds under the Act... EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Payments for Federally Connected Children Under... public supervision and direction, except with respect to children with disabilities. (2) For the purpose...

34 CFR 222.30 - What is “free public education”?

Code of Federal Regulations, 2013 CFR

2013-07-01

... tuition charge to the child or the child's parents; and (ii) Federal funds, other than funds under the Act... EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Payments for Federally Connected Children Under... public supervision and direction, except with respect to children with disabilities. (2) For the purpose...

Human Services for Mexican-American Children.

ERIC Educational Resources Information Center

Tijerina, Andres A., Comp.

A compilation of five readings uses the Chicano perspective to analyze the interaction between Mexican American families, their children, and the institutions charged with the child welfare concerns of the society, and to attempt to reverse the existing negative and destructive views that lead to insensitive and ineffective services. A variety of…

RX for Children's Television.

ERIC Educational Resources Information Center

Johnson, Nicholas

In his remarks delivered at the Second National Symposium on Children and Television, Federal Communications Commissioner Nicholas Johnson charges that television is not adequately serving those 20 million Americans under the age of five. He scores the networks for the inane, if not actually harmful, nature of their programming and for the…

26 CFR 1.848-1 - Definitions and special provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... rates used by the insurance company in determining the periodic mortality charges applied to the policy... for members of the group, their spouses, or their dependent children) is (or is treated as) a separate... satisfied for the supplemental coverage, a member's spouse and dependent children are treated as members of...

26 CFR 1.848-1 - Definitions and special provisions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... rates used by the insurance company in determining the periodic mortality charges applied to the policy... for members of the group, their spouses, or their dependent children) is (or is treated as) a separate... satisfied for the supplemental coverage, a member's spouse and dependent children are treated as members of...

26 CFR 1.848-1 - Definitions and special provisions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... rates used by the insurance company in determining the periodic mortality charges applied to the policy... for members of the group, their spouses, or their dependent children) is (or is treated as) a separate... satisfied for the supplemental coverage, a member's spouse and dependent children are treated as members of...

26 CFR 1.848-1 - Definitions and special provisions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... rates used by the insurance company in determining the periodic mortality charges applied to the policy... for members of the group, their spouses, or their dependent children) is (or is treated as) a separate... satisfied for the supplemental coverage, a member's spouse and dependent children are treated as members of...

Empowering Our Children to Succeed

ERIC Educational Resources Information Center

Quigley, Richard

2014-01-01

Children must be empowered to find their unique path to personal pride and respect. The concept of empowering youth is widely touted but often misunderstood and underutilized. Young people cannot fully develop their strengths and independence without being empowered to take charge of their lives. The polar opposite of coercion, empowerment is…

A Population Intervention to Improve Outcomes in Children With Medical Complexity.

PubMed

Noritz, Garey; Madden, Melissa; Roldan, Dina; Wheeler, T Arthur; Conkol, Kimberly; Brilli, Richard J; Barnard, John; Gleeson, Sean

2017-01-01

Children with medical complexity experience frequent interactions with the medical system and often receive care that is costly, duplicative, and inefficient. The growth of value-based contracting creates incentives for systems to improve their care. This project was designed to improve the health, health care value, and utilization for a population-based cohort of children with neurologic impairment and feeding tubes. A freestanding children's hospital and affiliated accountable care organization jointly developed a quality improvement initiative. Children with a percutaneous feeding tube, a neurologic diagnosis, and Medicaid, were targeted for intervention within a catchment area of >300 000 children receiving Medicaid. Initiatives included standardizing feeding tube management, improving family education, and implementing a care coordination program. Between January 2011 and December 2014, there was an 18.0% decrease (P < .001) in admissions and a 31.9% decrease (P < .001) in the average length of stay for children in the cohort. Total inpatient charges were reduced by $11 764 856. There was an 8.2% increase (P < .001) in the percentage of children with weights between the fifth and 95th percentiles. The care coordination program enrolled 58.3% of the cohort. This population-based initiative to improve the care of children with medical complexity showed promising results, including a reduction in charges while improving weight status and implementing a care coordination program. A concerted institutional initiative, in the context of an accountable care organization, can be part of the solution for improving outcomes and health care value for children with medical complexity. Copyright © 2017 by the American Academy of Pediatrics.

A Comparison of Ambulatory Care Sensitive Hospitalizations Among Children With and Without Autism Spectrum Disorder.

PubMed

Carbone, Paul S; Young, Paul C; Stoddard, Gregory J; Wilkes, Jacob; Trasande, Leonardo

2015-01-01

To compare the prevalence of hospitalizations for ambulatory care sensitive conditions (ACSC) in children with and without autism spectrum disorder (ASD) and to compare inpatient health care utilization (total charges and length of stay) for the same conditions in children with and without ASD. The 2009 Kids' Inpatient Database was used to examine hospitalizations for ACSC in children within 3 cohorts: those with ASD, those with chronic conditions (CC) without ASD, and those with no CC. The proportion of hospitalizations for ACSC in the ASD cohort was 55.9%, compared with 28.2% in the CC cohort and 22.9% in the no-CC cohort (P < .001). Hospitalized children with ASD were more likely to be admitted for a mental health condition, epilepsy, constipation, pneumonia, dehydration, vaccine-preventable diseases, underweight, and nutritional deficiencies compared with the no-CC cohort. Compared with the CC cohort, the ASD cohort was more likely to be admitted for mental health conditions, epilepsy, constipation, dehydration, and underweight. Hospitalized children with ASD admitted for mental health conditions had significantly higher total charges and longer LOS compared with the other 2 cohorts. The proportion of potentially preventable hospitalizations is higher in hospitalized children with ASD compared with children without ASD. These data underscore the need to improve outpatient care of children with ASD, especially in the areas of mental health care and seizure management. Future research should focus on understanding the reasons for increased inpatient health care utilization in children with ASD admitted for mental health conditions. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The Use of Anatomical Dolls as a Demonstration Aid in Child Sexual Abuse Interviews: A Study of Forensic Interviewers' Perceptions

ERIC Educational Resources Information Center

Hlavka, Heather R.; Olinger, Sara D.; Lashley, Jodi L.

2010-01-01

Given that most cases of child sexual abuse lack external corroborating evidence, children's verbal accounts of their experiences are of paramount importance to investigators. Forensic interviewers are charged with interviewing child victims and oftentimes use anatomical dolls. Yet, research on dolls has not caught up to practice in the field.…

A Case-Control Study on the Impact of Ventilator-Associated Tracheobronchitis in the PICU.

PubMed

Wheeler, Derek S; Whitt, John D; Lake, Michael; Butcher, John; Schulte, Marion; Stalets, Erika

2015-07-01

Hospital-acquired infections increase morbidity, mortality, and charges in the PICU. We implemented a quality improvement bundle directed at ventilator-associated pneumonia in our PICU in 2005. We observed an increase in ventilator-associated tracheobronchitis coincident with the near-elimination of ventilator-associated pneumonia. The impact of ventilator-associated tracheobronchitis on critically ill children has not been previously described. Accordingly, we hypothesized that ventilator-associated tracheobronchitisis associated with increased length of stay, mortality, and hospital charge. Retrospective case-control study. Critically ill children admitted to a quaternary PICU at a free-standing academic children's hospital in the United States. None. We conducted a retrospective case control study, with institutional review board approval, of 77 consecutive cases of ventilator-associated tracheobronchitis admitted to our PICU from 2004-2010. We matched each case with a control based on the following criteria (in rank order): age range (< 30 d, 30 d to 24 mo, 24 mo to 12 yr, > 12 yr), admission Pediatric Risk of Mortality III score ± 10, number of ventilator days of control group (> 75% of days until development of ventilator-associated tracheobronchitis), primary diagnosis, underlying organ system dysfunction, surgical procedure, and gender. The primary outcome measured was PICU length of stay. Secondary outcomes included ventilator days, hospital length of stay, mortality, and PICU and hospital charges. Data was analyzed using chi square analysis and p less than 0.05 was considered significant. We successfully matched 45 of 77 ventilator-associated tracheobronchitis patients with controls. There were no significant differences in age, gender, diagnosis, or Pediatric Risk of Mortality III score between groups. Ventilator-associated tracheobronchitis patients had a longer PICU length of stay (median, 21.5 d, interquartile range, 24 d) compared to controls (median, 18 d; interquartile range, 17 d), although not statistically significant (p = 0.13). Ventilator days were also longer in the ventilator-associated tracheobronchitis patients (median, 17 d; IQR, 22 d) versus control (median, 10.5 d; interquartile range, 13 d) (p = 0.01). There was no significant difference in total hospital length of stay (54 d vs 36 d; p = 0.69). PICU mortality was higher in the ventilator-associated tracheobronchitis group (15% vs 5%; p = 0.14), although not statistically significant. There was an increase in both median PICU charges ($197,393 vs $172,344; p < 0.05) and hospital charges ($421,576 vs $350,649; p < 0.05) for ventilator-associated tracheobronchitis patients compared with controls. Ventilator-associated tracheobronchitis is a clinically significant hospital-acquired infection in the PICU and is associated with longer duration of mechanical ventilation and healthcare costs, possibly through causing a longer PICU length of stay. Quality improvement efforts should be directed at reducing the incidence of ventilator-associated tracheobronchitis in the PICU.

Emotional and rational product appeals in televised food advertisements for children: analysis of commercials shown on US broadcast networks.

PubMed

Page, Randy M; Brewster, Aaron

2007-12-01

The aggressive advertising and marketing of high caloric food products to children is implicated as a potential causative factor in the childhood obesity epidemic. This study analyzed 147 commercials appearing during children's programming on U.S. broadcast networks for a wide range of potential emotional and rational advertising appeals. The most prominent emotional appeals were fun/happiness and play followed by fantasy/ imagination, social enhancement/peer acceptance, and coolness/hipness. Many of the products used the term ;super-charged' or a similar adjective to describe the powerful taste or other physical properties of the product. More than one-third of all the commercials used a fruit appeal or association. Statements or depictions that a product was healthy or nutritious were quite rare among the commercials. This seems to imply that health and nutrition claims are understood by food marketers to not be salient concerns among children and as such are not a selling point to children. Commercials for high sugar cereal products and fast food restaurants differed in several respects. This study can serve to guide child health care professionals and other child advocates in designing measures that counter food advertising messages directed at children.

Emergency department visits by pediatric patients for poisoning by prescription opioids.

PubMed

Tadros, Allison; Layman, Shelley M; Davis, Stephen M; Bozeman, Rachel; Davidov, Danielle M

2016-09-01

Prescription medication abuse is an increasingly recognized problem in the United States. As more opioids are being prescribed and abused by adults, there is an increased risk of both accidental and intentional exposure to children and adolescents. The impact of pediatric exposures to prescription pain pills has not been well studied. We sought to evaluate emergency department (ED) visits for poisoning by prescription opioids in pediatric patients. This retrospective study looked at clinical and demographic data from the Nationwide Emergency Department Sample (NEDS) from 2006 to 2012. There were 21,928 pediatric ED visits for prescription opioid poisonings and more than half were unintentional. There was a bimodal age distribution of patients, with slightly more than half occurring in females. The majority of patients were discharged from the ED. More visits in the younger age group (0-5 years) were unintentional, while the majority of visits in the adolescent age group (15-17 years) were intentional. Mean charge per discharge was $1,840 and $14,235 for admissions and surmounted to over $81 million in total charges. Poisonings by prescription opioids largely impact both young children and adolescents. These findings can be used to help target this population for future preventive efforts.

Resource savings and outcomes associated with outpatient laparoscopic appendectomy for nonperforated appendicitis.

PubMed

Gurien, Lori A; Burford, Jeffrey M; Bonasso, Patrick C; Dassinger, Melvin S

2017-11-01

Postoperative admission for acute appendicitis utilizes health care system resources. We evaluated outcomes and hospital charges for children with nonperforated appendicitis who underwent outpatient laparoscopic appendectomy. A retrospective chart review was performed for patients ≤18years old who underwent laparoscopic appendectomy for acute appendicitis in 2015. Patients were categorized into discharge from postanesthesia care unit (PACU) (outpatient), admission for <24-h, and admission for >24-h. Continuous variables were compared using analysis of variance and categorical variables were compared using chi-square test, with p<0.05 considered significant. Of the 171 patients identified, 63 (37%) were discharged from the PACU, 94 (55%) were admitted <24-h, and 14 (8%) were admitted >24-h. There were no differences in postoperative emergency department/clinic visits, complications, or readmissions. Hospital charges for admission <24-h and >24-h were $1007 and $2237 more per patient than the PACU-discharge group, respectively. Outpatient laparoscopic appendectomies became more common over time, occurring in only 20% of patients with acute appendicitis in the first quarter of the year versus 49% of patients in the last quarter. Outpatient laparoscopic appendectomy for nonperforated appendicitis in children is a safe practice that decreases length of stay and hospital charges. Adoption of an outpatient strategy allows for better standardization of care and can lead to savings in health care resources. III (Treatment: retrospective comparative study). Copyright © 2017 Elsevier Inc. All rights reserved.

Examining the Roles and Experiences of Fathers of Children With Chronic Kidney Disease

PubMed Central

Nicholas, David B.

2017-01-01

This study examined roles and experiences of fathers of children with chronic kidney disease (CKD). Based on interpretive description, semistructured interviews were conducted with 22 fathers of children receiving a range of treatments (transplant, peritoneal dialysis, hemodialysis, and CKD not requiring renal replacement therapy). Fathers described various experiences and means of adjusting to shifts associated with pediatric CKD. These included loss of personal control, a sense of personal isolation, and a stance of remaining strong amidst personal suffering. Nuanced differences according to modality of CKD care were identified. Fathers engaged in strategies that fostered coping, such as remaining positive and taking charge. They conveyed deep love for their child, and demonstrated ingenuity and persistence in care. Few resources of support were accessed by fathers. Study recommendations invite holistic approaches to health care, with improved resources for families—including fathers—in addressing the needs of this population. PMID:28508021

Taking Charge: A Handbook for Parents Whose Children Have Emotional Handicaps.

ERIC Educational Resources Information Center

Kelker, Katharin A.

The manual is designed to provide information and support to parents of emotionally disturbed children. The first chapter, "Feelings Come First," deals with such topics as identifying unusual behavior, impact on parents and other family members, coming to terms with feelings, and advice from other parents. Chapter 2, "Finding Some Help," defines…

Scoping the Meaning of "Critical" in Mathematical Thinking for Initial Teacher Education

ERIC Educational Resources Information Center

Furness, Jane; Cowie, Bronwen; Cooper, Beverley

2017-01-01

Current strong emphasis on literacy and numeracy in New Zealand educational policy, as elsewhere, reverberates in different ways in institutions charged with children's and adults' learning. A common response is to locate literacy and numeracy centrally in programmes aimed at preparing children for and enhancing adult participation in 21st century…

Traumatic Symptoms in Sexually Abused Children: Implications for School Counselors

ERIC Educational Resources Information Center

Brown, Sarah D.; Brack, Greg; Mullis, Frances Y.

2008-01-01

School counselors have a duty to formulate strategies that aid in the detection and prevention of child sexual abuse (American School Counselor Association, 2003). School counselors are charged with helping sexually abused children by recognizing sexual abuse indicators based on a child's symptomatology and/or behavior, and understanding how this…

Medically Fragile Children: Report from State Committee on Medically Fragile Child Referent Group.

ERIC Educational Resources Information Center

Michigan State Dept. of Education, Lansing. Special Education Services.

This report is the product of a committee charged to define "medically fragile," explore the array of educational services available and/or needed for children in Michigan considered medically fragile, identify current information and gaps in the information, and identify areas of interagency collaboration. The report discusses critical…

The Age of Discovery

ERIC Educational Resources Information Center

Cook, Nancy

2006-01-01

Whether it is volcanoes or video games, teachers know that when children enjoy a subject, they are far more motivated to take charge of their education. What teachers are learning now is that offering high interest topics may be less important than offering kids challenging tasks--new problems to solve--that tap into the way children's brains are…

Emergency department vaccination of preschool-age children during a measles outbreak.

PubMed

Schlenker, T L; Risk, I; Harris, H

1995-09-01

To determine the effectiveness of an emergency department vaccination program for preschool-age children during a measles outbreak. Cross-section study. Urban pediatric ED with an annual census of 24,000. Children, 12 to 59 months old, who presented to our ED between April 1 and April 30, 1994. Staff trained in rationale for and protocol of ED vaccination offered measles-mumps-rubella (MMR) vaccine, free of charge, to all eligible children. Of the 541 children seen, 7% lacked measles vaccination; MMR vaccination status could not be determined in 10%. From history it was determined that all the others had been vaccinated. Of the vaccination-eligible children, 25% were vaccinated in the ED. Of the eligible children who were not vaccinated, parents declined in half of the cases and physicians did not offer vaccination in the other half. Eligible children with physical injury were more likely to be vaccinated, and those with upper respiratory tract infections were less likely to be vaccinated than were eligible children with other diagnoses (P < .05). During a measles outbreak, few children receiving care at a busy pediatric ED were definitively identified as vaccination eligible. Only a few children identified as eligible for vaccination were vaccinated. Significant logistic barriers to effective ED vaccination exist.

Positive events protect children from causal false memories for scripted events.

PubMed

Melinder, Annika; Toffalini, Enrico; Geccherle, Eleonora; Cornoldi, Cesare

2017-11-01

Adults produce fewer inferential false memories for scripted events when their conclusions are emotionally charged than when they are neutral, but it is not clear whether the same effect is also found in children. In the present study, we examined this issue in a sample of 132 children aged 6-12 years (mean 9 years, 3 months). Participants encoded photographs depicting six script-like events that had a positively, negatively, or a neutral valenced ending. Subsequently, true and false recognition memory of photographs related to the observed scripts was tested as a function of emotionality. Causal errors-a type of false memory thought to stem from inferential processes-were found to be affected by valence: children made fewer causal errors for positive than for neutral or negative events. Hypotheses are proposed on why adults were found protected against inferential false memories not only by positive (as for children) but also by negative endings when administered similar versions of the same paradigm.

Severe bronchiolitis and respiratory syncytial virus among young children in Hawaii.

PubMed

Yorita, Krista L; Holman, Robert C; Steiner, Claudia A; Effler, Paul V; Miyamura, Jill; Forbes, Susan; Anderson, Larry J; Balaraman, Venkataraman

2007-12-01

Lower respiratory tract infections are a leading cause of hospitalization and mortality among children worldwide. Our objective was to describe the incidence and epidemiology of severe bronchiolitis, respiratory syncytial virus (RSV), and pneumonia among children in Hawaii. Retrospective analysis of the patient-linked hospital discharge data associated with bronchiolitis, RSV, and pneumonia among Hawaii residents younger than 5 years of age during 1997 through 2004 using the Hawaii State Inpatient Database. During 1997 through 2004, the average annual incidence rates for bronchiolitis, RSV, and pneumonia were 3.8, 2.7, and 6.8 per 1000 children younger than 5 years, respectively. The incidence of each condition was higher for infants younger than 1 year (15.1, 9.8, and 15.9 per 1000 infants, respectively) than the incidence for children 1-4 years of age, and higher for boys compared with girls. The incidence of each condition was highest among Native Hawaiian and other Pacific Islander children compared with children of other race groups living in Hawaii. Most hospitalizations occurred during the months of October through February. Estimated median hospital charges were $4806 (bronchiolitis), $5465 (RSV) and $5240 (pneumonia), with overall average annual charges of $11.5 million. The incidence and hospitalization rates for bronchiolitis, RSV, and pneumonia among children younger than 5 years of age in Hawaii were low; the corresponding hospitalization rates were lower than those for the general U.S. population. However, the hospitalization rates for each condition among Hawaiian and other Pacific Islander children were much higher than those for other race groups or for the U.S. population.

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2011 CFR

2011-10-01

... requirements must be met: (1)(i) For Federal FY 2009, any co-payment or similar charge the State imposes under a fee-for-service delivery system may not exceed the amounts shown in the following table: State...) For Federal FY 2009, any co-payment that the State imposes for services provided by a managed care...

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirements must be met: (1)(i) For Federal FY 2009, any co-payment or similar charge the State imposes under a fee-for-service delivery system may not exceed the amounts shown in the following table: State...) For Federal FY 2009, any co-payment that the State imposes for services provided by a managed care...

The Case of Three Karen Refugee Women and Their Children: Literacy Practices in a Family Literacy Context

ERIC Educational Resources Information Center

Quadros, Sabrina; Sarroub, Loukia K.

2016-01-01

The lack of research about the Karen, one of 135 ethnic groups from Myanmar limits literacy educators charged with educating this refugee population in public schools. In this case study the authors explore the literacy practices of Karen families when at school and in their homes and within an ESL family literacy program. The case of these…

Is Maternal Influenza or Fever During Pregnancy Associated with Autism or Developmental Delays? Results from the CHARGE (CHildhood Autism Risks from Genetics and Environment) Study

ERIC Educational Resources Information Center

Zerbo, Ousseny; Iosif, Ana-Maria; Walker, Cheryl; Ozonoff, Sally; Hansen, Robin L.; Hertz-Picciotto, Irva

2013-01-01

We analyzed data from case groups of 538 children with autism spectrum disorders (ASD) and 163 with developmental delays (DD), and from 421 typically developing controls to assess associations with maternal influenza or fever during pregnancy. Exposure information was obtained by telephone interviews, and outcomes were clinically confirmed. Though…

Disparities in clinical and economic outcomes in children and adolescents following surgery for tethered cord syndrome in the United States.

PubMed

Shweikeh, Faris; Al-Khouja, Lutfi; Nuño, Miriam; Johnson, J Patrick; Drazin, Doniel; Adamo, Matthew A

2015-04-01

Tethered cord syndrome (TCS) is a common spinal abnormality. In this study, the authors analyzed demographics, complications, and outcomes in children and adolescents who underwent surgery for TCS. Using the national Kids' Inpatient Database (KID), the authors retrospectively identified patients with a primary diagnosis of TCS who were treated with spinal laminectomy and discharged in 2000, 2003, 2006, and 2009. Descriptive analysis was provided for patient- and hospital-level characteristics. Mortality, complications, non-routine discharges, in-hospital length of stay (LOS), and total charges were documented for the entire cohort and age-specific cohorts (0-5, 6-10, 11-15, and 16-20 years). Comparisons by complications and age groups were conducted. A total of 7397 children and adolescents met the criteria in the 4 studied years. The mean age was 5.7 years; 55.3% of patients were younger than 5 years, 21.5% were 6-10 years, and 16.2% were 11-15 years. Most surgeries were performed in patients who were female (55.0%) and white (64.4%) and were performed at large (49.8%), teaching (94.2%), and urban (99.1%) children's (89.3%) hospitals. The trend showed an increase in prevalence from 2000 (19.9%) to 2009 (29.6%). Common comorbidities included anomalies in spinal curvature (16.7%), urinary or bladder dysfunction (14.3%), and spinal stenosis/spondylosis (1.4%). Non-routine discharges (3.3%) were significantly higher with advancing age, increasing from 2.2% in those younger than 5 years to 9.0% in those older than 15 years (p < 0.0001). There was a similar increasing trend for complications (6.8% to 13.9%, respectively, p < 0.0001) and average LOS (3.5 to 5.1 days, respectively, p < 0.0001). Hospital charges increased with age from an average of $28,521 in those younger than 5 years to $36,855 in those older than 15 years (p < 0.0001). There was a steady trend of increasing operative treatment for TCS over the more recent years. The nationwide analysis was also indicative of an existing disparity, based on age, in complications, outcomes, and charges following TCS surgical correction. Older children tended to have more complications, longer LOS, more non-routine discharges, and higher hospital costs. The results are highly supportive of surgery at a younger age for this condition. Future research should investigate this correlation, especially considering the efforts to control and reduce health care costs.

[Sex education : representations of 13- to 15-year-old junior high school children and slow learners].

PubMed

Berger, Dominique; Rochigneux, Jean-Claude; Bernard, Sandie; Morand, Josette; Mougniotte, Alain

2015-01-01

In France, the National Education system has attributed an important health and sex education role to its teachers, based on a global and positive vision of sexuality Parents, teachers, public services and specialized resources each have a role to play in sex education for children and adolescents so that each young person can receive an education allowing him or her to enjoy a healthy sexuality. This study investigated the individual representations of sexuality, declared practices and knowledge of junior high schoolchildren and Section d'Enseignement G6n6ral et Professionnel Adapt6 (SEGPA) students, a structure for children with serious learning difficulties. The study methodology was based on administration of questionnaires (n = 524) to the two cohorts concerned. The secondary objective was to compare these two populations and identify the specificities of SEGPA pupils. The conclusions of this study should allow adults in charge of sex education in junior high schools and SEGPA to adapt sex education tools.

Parents' Role in the Academic Motivation of Students with Gifts and Talents

ERIC Educational Resources Information Center

Garn, Alex C.; Matthews, Michael S.; Jolly, Jennifer L.

2012-01-01

Parents play a key role in developing their children's academic motivation, and parents of children with gifts and talents also may face additional parenting challenges that are less commonly faced by parents of average-ability learners whose needs are more readily met in the school setting. School psychologists may be charged with addressing…

Innovations in the Management of Child Protection Workers: Building Worker Resilience

ERIC Educational Resources Information Center

Yin, Robert T.

2004-01-01

Taking children away from their parents is risky business. Child protective services (CPS) workers are charged with monumental tasks and ever-increasing caseloads. As a countywide CPS supervisor in New Mexico, the author shared the pain of one caseworker who experienced daily stress, knowing that her sibling set of three young children had been…

Children Designing & Engineering: Contextual Learning Units in Primary Design and Technology

ERIC Educational Resources Information Center

Hutchinson, Patricia

2002-01-01

The Children Designing & Engineering (CD&E) Project at the College of New Jersey is a collaborative effort of the College's Center for Design and Technology and the New Jersey Chamber of Commerce. The Project, funded by the National Science Foundation (NSF), has been charged to develop instructional materials for grades K-5. The twelve…

Guidelines for Public Library Service to Children in Vermont.

ERIC Educational Resources Information Center

1989

A task force was charged with developing a revised set of guidelines for public library service to children in Vermont. Together with the results of a survey of Vermont public libraries, the help of recommendations from other states, and the expertise of individual libraries, the task force drew up a number of guidelines. In the first section the…

CHILDREN HOSPITALIZED WITH LOWER EXTREMITY FRACTURES IN THE UNITED STATES IN 2006: A POPULATION-BASED APPROACH

PubMed Central

Gao, Yubo

2011-01-01

OBJECTIVE The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006. METHODS Children aged 0 to 20 years with a diagnosis of lower extremity fracture in the 2006 Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) were included. Lower extremity fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under “Injury and Poisoning (800-999).” Patient demographic and hospitalization-related data were analyzed by chi-square testing and unbalanced analysis of variance. RESULTS There were more boys than girls with lower extremity fractures and 53% had private insurance as their primary payer. About one half of the children were between the ages of 13 and 20 years, but all ages were represented from age 0 to 20. White children accounted for 56%. Urban hospitalizations accounted for 93% of cases and 66 percent of admissions were to teaching hospitals. All patients had an average length of stay (LOS) 4.04 days, and infant patients had the longest average LOS of 5.46 days. The average number of diagnoses per patient was 3.07, and the average number of procedures per patient was 2.21. The average charge per discharge was $35,236, and the oldest patients had the largest average charge of $41,907. The average number of comorbidities increased with increasing patient age. There was a 55.6% greater mortality risk in non-teaching hospitals than in teaching hospitals and there was at least ten times the mortality risk in rural hospitals than in urban hospitals. CONCLUSIONS This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals. PMID:22096438

Children hospitalized with lower extremity fractures in the United States in 2006: a population-based approach.

PubMed

Gao, Yubo

2011-01-01

The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006. Children aged 0 to 20 years with a diagnosis of lower extremity fracture in the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were included. Lower extremity fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under "Injury and Poisoning (800-999)." Patient demographic and hospitalization-related data were analyzed by chi-square testing and unbalanced analysis of variance. There were more boys than girls with lower extremity fractures and 53% had private insurance as their primary payer. About one half of the children were between the ages of 13 and 20 years, but all ages were represented from age 0 to 20. White children accounted for 56%. Urban hospitalizations accounted for 93% of cases and 66 percent of admissions were to teaching hospitals. All patients had an average length of stay (LOS) 4.04 days, and infant patients had the longest average LOS of 5.46 days. The average number of diagnoses per patient was 3.07, and the average number of procedures per patient was 2.21. The average charge per discharge was $35,236, and the oldest patients had the largest average charge of $41,907. The average number of comorbidities increased with increasing patient age. There was a 55.6% greater mortality risk in non-teaching hospitals than in teaching hospitals and there was at least ten times the mortality risk in rural hospitals than in urban hospitals. This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals.

The CHARGE Study: An Epidemiologic Investigation of Genetic and Environmental Factors Contributing to Autism

PubMed Central

Hertz-Picciotto, Irva; Croen, Lisa A.; Hansen, Robin; Jones, Carrie R.; van de Water, Judy; Pessah, Isaac N.

2006-01-01

Causes and contributing factors for autism are poorly understood. Evidence suggests that prevalence is rising, but the extent to which diagnostic changes and improvements in ascertainment contribute to this increase is unclear. Both genetic and environmental factors are likely to contribute etiologically. Evidence from twin, family, and genetic studies supports a role for an inherited predisposition to the development of autism. Nonetheless, clinical, neuroanatomic, neurophysiologic, and epidemiologic studies suggest that gene penetrance and expression may be influenced, in some cases strongly, by the prenatal and early postnatal environmental milieu. Sporadic studies link autism to xenobiotic chemicals and/or viruses, but few methodologically rigorous investigations have been undertaken. In light of major gaps in understanding of autism, a large case–control investigation of underlying environmental and genetic causes for autism and triggers of regression has been launched. The CHARGE (Childhood Autism Risks from Genetics and Environment) study will address a wide spectrum of chemical and biologic exposures, susceptibility factors, and their interactions. Phenotypic variation among children with autism will be explored, as will similarities and differences with developmental delay. The CHARGE study infrastructure includes detailed developmental assessments, medical information, questionnaire data, and biologic specimens. The CHARGE study is linked to University of California–Davis Center for Children’s Environmental Health laboratories in immunology, xenobiotic measurement, cell signaling, genomics, and proteomics. The goals, study design, and data collection protocols are described, as well as preliminary demographic data on study participants and on diagnoses of those recruited through the California Department of Developmental Services Regional Center System. PMID:16835068

Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial.

PubMed

Holmes, James F; Kelley, Kenneth M; Wootton-Gorges, Sandra L; Utter, Garth H; Abramson, Lisa P; Rose, John S; Tancredi, Daniel J; Kuppermann, Nathan

2017-06-13

The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown. To determine if the FAST examination during initial evaluation of injured children improves clinical care. A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center. Patients were randomly assigned to a standard trauma evaluation with the FAST examination by the treating ED physician or a standard trauma evaluation alone. Coprimary outcomes were rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges. Among the 925 patients who were randomized (mean [SD] age, 9.7 [5.3] years; 575 males [62%]), all completed the study. A total of 50 patients (5.4%, 95% CI, 4.0% to 7.1%) were diagnosed with intra-abdominal injuries, including 40 (80%; 95% CI, 66% to 90%) who had intraperitoneal fluid found on an abdominal CT scan, and 9 patients (0.97%; 95% CI, 0.44% to 1.8%) underwent laparotomy. The proportion of patients with abdominal CT scans was 241 of 460 (52.4%) in the FAST group and 254 of 465 (54.6%) in the standard care-only group (difference, -2.2%; 95% CI, -8.7% to 4.2%). One case of missed intra-abdominal injury occurred in a patient in the FAST group and none in the control group (difference, 0.2%; 95% CI, -0.6% to 1.2%). The mean ED length of stay was 6.03 hours in the FAST group and 6.07 hours in the standard care-only group (difference, -0.04 hours; 95% CI, -0.47 to 0.40 hours). Median hospital charges were $46 415 in the FAST group and $47 759 in the standard care-only group (difference, -$1180; 95% CI, -$6651 to $4291). Among hemodynamically stable children treated in an ED following blunt torso trauma, the use of FAST compared with standard care only did not improve clinical care, including use of resources; ED length of stay; missed intra-abdominal injuries; or hospital charges. These findings do not support the routine use of FAST in this setting. clinicaltrials.gov Identifier: NCT01540318.

Parenting under pressure: a grounded theory of parenting young children with life-threatening congenital heart disease.

PubMed

Rempel, Gwen R; Ravindran, Vinitha; Rogers, Laura G; Magill-Evans, Joyce

2013-03-01

To report a grounded theory study to describe the process of parenting young children who have survived hypoplastic left heart syndrome to inform parent-focused interventions. Technological advances in paediatric cardiology worldwide have improved the survival rates for young children with hypoplastic left heart syndrome who undergo staged surgical palliation. These children, however, are at risk for life-threatening complications and parents are charged with the responsibility to monitor their children at home with minimal support and guidance from healthcare professionals once home. A constructivist grounded theory study. The study was conducted in 2006-2008. Participants were 25 parents (15 mothers, 10 fathers) and 28 grandparents (17 grandmothers, 11 grandfathers) of 15 young children (6 months-4·5 years) who had undergone the Sano surgical approach for hypoplastic left heart syndrome. The 53 interviews were digitally recorded, transcribed and analysed using open and focused coding, constant comparative analysis and memoing. A process of Parenting under Pressure emerged that was characterized by four overlapping and re-emerging phases: (1) realizing and adjusting to the inconceivable; (2) growing increasingly attached; (3) watching for and accommodating the unexpected; and (4) encountering new challenges. In-depth understanding of the phases of Parenting under Pressure provides direction for nurses to support parents of children who survive hypoplastic left heart syndrome. Interventions that help carers of children with complex health conditions move through the phases of our Parenting under Pressure process may help them safeguard the survival of their children, and their own survival as parents as they manage multiple demands. © 2012 Blackwell Publishing Ltd.

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus.

PubMed

Aragona, Elena; El-Magbri, Eussra; Wang, Justin; Scheckelhoff, Tessa; Scheckelhoff, Trevor; Hyacinthe, Assata; Nair, Suja; Khan, Amina; Nino, Gustavo; Pillai, Dinesh K

2016-04-01

The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus. A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (lean<85%, overweight 85%-95%, obese≥95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed. The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0-2.6). When stratified by age, overweight/obese preschool-age children (<5 years) were >2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0-5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups. Copyright © 2016 by the American Academy of Pediatrics.

Temporal trends in emergency department visits for bronchiolitis in the United States, 2006 to 2010.

PubMed

Hasegawa, Kohei; Tsugawa, Yusuke; Brown, David F M; Mansbach, Jonathan M; Camargo, Carlos A

2014-01-01

To examine temporal trends in emergency departments (EDs) visits for bronchiolitis among US children between 2006 and 2010. Serial, cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We used International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1 to identify children <2 years of age with bronchiolitis. Primary outcome measures were rate of bronchiolitis ED visits, hospital admission rate and ED charges. Between 2006 and 2010, weighted national discharge data included 1,435,110 ED visits with bronchiolitis. There was a modest increase in the rate of bronchiolitis ED visits, from 35.6 to 36.3 per 1000 person-years (2% increase; Ptrend = 0.008), due to increases in the ED visit rate among children from 12 months to 23 months (24% increase;Ptrend < 0.001). By contrast, there was a significant decline in the ED visit rate among infants (4% decrease; Ptrend < 0.001). Although unadjusted admission rate did not change between 2006 and 2010 (26% in both years), admission rate declined significantly after adjusting for potential patient- and ED-level confounders (adjusted odds ratio for comparison of 2010 with 2006, 0.84; 95% confidence interval: 0.76-0.93; P < 0.001). Nationwide ED charges for bronchiolitis increased from $337 million to $389 million (16% increase; Ptrend < 0.001), adjusted for inflation. This increase was driven by a rise in geometric mean of ED charges per case from $887 to $1059 (19% increase; Ptrend < 0.001). Between 2006 and 2010, we found a divergent temporal trend in the rate of bronchiolitis ED visits by age group. Despite a significant increase in associated ED charges, ED-associated hospital admission rates for bronchiolitis significantly decreased over this same period.

Emergency Department Visits by Pediatric Patients for Poisoning by Prescription Opioids

PubMed Central

Tadros, Allison; Layman, Shelley M.; Davis, Stephen M.; Bozeman, Rachel; Davidov, Danielle M.

2016-01-01

Background Prescription medication abuse is an increasingly recognized problem in the United States. As more opioids are being prescribed and abused by adults, there is an increased risk of both accidental and intentional exposure to children and adolescents. The impact of pediatric exposures to prescription pain pills has not been well studied. Objectives We sought to evaluate emergency department (ED) visits for poisoning by prescription opioids in pediatric patients. Methods This retrospective study looked at clinical and demographic data from the Nationwide Emergency Department Sample (NEDS) from 2006 – 2012. Results There were 21,928 pediatric ED visits for prescription opioid poisonings and more than half were unintentional. There was a bimodal age distribution of patients with slightly more than half occurring in females. The majority of patients were discharged from the ED. More visits in the younger age group (0–5 years) were unintentional while the majority of visits in the adolescent age group (15–17 years) were intentional. Mean charge per discharge was $1,840 and $14,235 for admissions and surmounted to over $81 million in total charges. Conclusion Poisonings by prescription opioids largely impact both young children and adolescents. These findings can be used to help target this population for future preventive efforts. PMID:27398815

BEST in CLASS: A Classroom-Based Model for Ameliorating Problem Behavior in Early Childhood Settings

ERIC Educational Resources Information Center

Vo, Abigail; Sutherland, Kevin S.; Conroy, Maureen A.

2012-01-01

As more young children enter school settings to attend early childhood programs, early childhood teachers and school psychologists have been charged with supporting a growing number of young children with chronic problem behaviors that put them at risk for the development of emotional/behavioral disorders (EBDs). There is a need for effective,…

The meaning of ethically charged encounters and their possible influence on professional identity in Norwegian public health nursing: a phenomenological hermeneutic study.

PubMed

Dahl, Berit Misund; Clancy, Anne; Andrews, Therese

2014-09-01

In today's health care, new health reforms focus on market values and demands of efficiency influence health workers' professional practice. Norwegian public health nurses work mainly with healthy populations, but the children, families and young people they meet can be in vulnerable and even dependent situations. Strategies in coping with ethically challenging encounters can be important for the identity of the profession. The aim of the study was to illuminate public health nurses' experiences of being in ethically charged encounters and to reflect upon how these experiences can influence their professional identity. A purposive sample of 23 Norwegian public health nurses with experience ranging from 0.5 to 25 years narrated about their work-related experiences. The interviews were interpreted with a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur. Four themes were identified: feeling responsible, being committed, feeling confident and feeling inadequate. These experiences were related to both work and private life and involved an emotional commitment to the well-being of children, young people and families. On the basis of the findings, it can be estimated that PHNs are committed to their work, and defending children's rights is a strong driving force. Responsibility for service users is a deciding factor that can overshadow institutional demands. It seems as if value conflicts mobilised courage which is essential in maintaining moral strength. This is in turn important for a strong professional identity and can have positive implications for the quality of public health nursing work. © 2013 Nordic College of Caring Science.

Teaching parents to look after children's teeth.

PubMed

Lloyd, S

1994-03-01

Children's toothpastes with fluoride help to prevent decay, but parents should ask their dentist before giving fluoride supplements to children. Overdosage is harmful. Sugars eaten as part of a meal do less harm to teeth than those eaten frequently as snacks. Sugar-free infant drinks and children's confectionery are now on the market and are more "tooth friendly". Look out for the "happy tooth" symbol. Babies can be registered with NHS dentists as soon as the first teeth start to come through, and should be taken regularly to the dentist throughout childhood. Under the NHS scheme, dentists are paid a capitation fee to provide continuing preventive care and treatment for children free of charge.

Inpatient Growth and Resource Use in 28 Children’s Hospitals

PubMed Central

Berry, Jay G.; Hall, Matt; Hall, David E.; Kuo, Dennis Z.; Cohen, Eyal; Agrawal, Rishi; Mandl, Kenneth D.; Clifton, Holly; Neff, John

2013-01-01

Objective To compare inpatient resource use trends for healthy children and children with chronic health conditions of varying degrees of medical complexity. Design Retrospective cohort analysis. Setting Twenty-eight US children’s hospitals. Patients A total of 1 526 051 unique patients hospitalized from January 1, 2004, through December 31, 2009, who were assigned to 1 of 5 chronic condition groups using 3M’s Clinical Risk Group software. Intervention None. Main Outcome Measures Trends in the number of patients, hospitalizations, hospital days, and charges analyzed with linear regression. Results Between 2004 and 2009, hospitals experienced a greater increase in the number of children hospitalized with vs without a chronic condition (19.2% vs 13.7% cumulative increase, P < .001). The greatest cumulative increase (32.5%) was attributable to children with a significant chronic condition affecting 2 or more body systems, who accounted for 19.2% (n=63 203) of patients, 27.2% (n=111 685) of hospital discharges, 48.9% (n=1.1 million) of hospital days, and 53.2% ($9.2 billion) of hospital charges in 2009. These children had a higher percentage of Medicaid use (56.5% vs 49.7%; P<.001) compared with children without a chronic condition. Cerebral palsy (9179 [14.6%]) and asthma (13 708 [21.8%]) were the most common primary diagnosis and comorbidity, respectively, observed among these patients. Conclusions Patients with a chronic condition increasingly used more resources in a group of children’s hospitals than patients without a chronic condition. The greatest growth was observed in hospitalized children with chronic conditions affecting 2 or more body systems. Children’s hospitals must ensure that their inpatient care systems and payment structures are equipped to meet the protean needs of this important population of children. PMID:23266509

Women convicted of a sexual offence, including child pornography production: two case reports.

PubMed

Prat, S; Bertsch, I; Chudzik, L; Réveillère, Ch

2014-03-01

All available studies addressing the clinical and legal aspects of child pornography have systematically concerned male abusers. The social lens through which women are viewed tends to play down their responsibility in the sexual abuse of children. Unlike men, women rarely abuse children outside the close or family circle. Furthermore, they have frequently been abused themselves in their childhood. To our knowledge, no cases of women charged with sex-related offences, including child pornography, have been described in the literature. The psychopathological characteristics of female sexual abusers and of the two women in our cases tend to suggest that the deliberate downloading of child pornography images by women is unusual, as their deviant behaviour is not related to paedophile sexual arousal It is hypothesized that the act enables women perpetrators to satisfy the sexual urges of their spouse. Sexual abuse by women exists, but the nature of the abuse appears to be specific to the gender of the perpetrator. We present two cases of women charged with sexual offences concerning minors, including the production of child pornography material. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

PubMed Central

Lyall, Kristen; Schweitzer, Julie B.; Schmidt, Rebecca J.; Hertz-Picciotto, Irva; Solomon, Marjorie

2017-01-01

Background Attention deficits in young children with autism spectrum disorder (ASD) are not well understood. This study sought to determine: 1) the prevalence of ADHD symptoms in young children with ASD, typical development (TD), and developmental delay (DD) and 2) the association between ADHD symptoms and cognitive and behavioral functioning in children with ASD. Method ADHD symptoms, defined according to Aberrant Behavior Checklist (ABC) hyperactivity subscale scores, were compared across children aged 2–5 from a large case-control study with ASD (n=548), TD (n=423), and DD (n=180). Inattention and hyperactivity items within this subscale were also explored. Within the ASD group, linear and logistic regression were used to examine how ADHD symptoms were associated with cognition as assessed by the Mullen Scales of Early Learning and adaptive functioning as assessed by the Vineland Adaptive Behavior Scales. Results Mean hyperactivity subscale scores were lowest in children with TD (mean=3.19), higher in children with DD (12.3), and highest in children with ASD (18.2; between-group p<0.001). Among children with ASD, significant associations were observed with higher ADHD symptoms and poorer adaptive and cognitive functioning (adjusted beta for hyperactivity score in association with: Vineland composite = −5.63, p=0.0005; Mullen visual reception scale = −2.94, p=0.02; for the highest vs. lowest quartile of hyperactivity score, odds of lowest quintile of these scores was approximately doubled). Exploratory analyses highlighted associations with inattention-related items specifically. Conclusion These results suggest ADHD symptoms may play a key role in the functioning of young children with ASD. PMID:29276530

Parents, Quality, and School Choice: Why Parents in Nairobi Choose Low-Cost Private Schools over Public Schools in Kenya's Free Primary Education Era

ERIC Educational Resources Information Center

Zuilkowski, Stephanie Simmons; Piper, Benjamin; Ong'ele, Salome; Kiminza, Onesmus

2018-01-01

Low-cost private schools (LCPS) are widespread in Kenya, particularly in urban areas. This study examines the reasons that parents send children to fee-charging schools in a context of free public primary education. Drawing on parent survey and interview data, as well as interviews with national policy makers, we found that parents who chose LCPS…

Lifetime criminal history of sex offenders seen for psychological assessment in five decades.

PubMed

Langevin, Ron; Curnoe, Suzanne

2012-10-01

A sample of 2,190 sex offenders seen between 1966 and 2009 was compared on lifetime sexual and all offending, using charges, convictions, court appearances, and self-report as criteria. Of these various criteria, between 47.4% and 81.1% reoffended. Canadian child abuse reporting laws, which came into effect in the 1980s, were associated with increased charges and convictions for offenders, who victimized children, and with a reduction in their longer term reoffense rates. Immigration and population mobility, use of aliases, study follow-up time, and self-reported undetected sex crimes influenced reoffense rates. Results indicate that sex offenders continued to have short prison sentences and/or spend little or no time incarcerated during the latter part of the 20th century.

Pediatric Spine Trauma in the United States--Analysis of the HCUP Kid'S Inpatient Database (KID) 1997-2009.

PubMed

Mendoza-Lattes, Sergio; Besomi, Javier; O'Sullivan, Cormac; Ries, Zachary; Gnanapradeep, Gnanapragasam; Nash, Rachel; Gao, Yubo; Weinstein, Stuart

2015-01-01

Few references are available describing the epidemiology of pediatric spine injuries. The purpose of this study is to examine the prevalence, risk factors and trends during the period from 1997 to 2009 of pediatric spine injuries in the United States using a large national database. Data was obtained from the Kid's Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP), for the years 1997-2009. This data includes >3 million discharges from 44 states and 4121 hospitals on children younger than 20 years. Weighted variables are provided which allow for the calculation of national prevalence rates. The Nationwide Emergency Department Sample (NEDS), HCUP. net, and National Highway Traffic Safety Administration (NHTSA) data were used for verification and comparison. A prevalence of 107.96 pmp (per million population) spine injuries in children and adolescents was found in 2009, which is increased from the 77.07 pmp observed in 1997. The group 15 to 19 years old had the highest prevalence of all age groups in (345.44 pmp). Neurological injury was present in 14.6% of the cases, for a prevalence of 15.82 pmp. The majority (86.7%) of these injuries occurred in children >15 years. Motor vehicle collisions accounted for 52.9% of all spine injuries, particularly in children >15 years. Between 1997 and 2009 the hospital length of stay decreased, but hospital charges demonstrated a significant increase. Pediatric Spine Injuries continue to be a relevant problem, with rates exceeding those of other industrialized nations. Teenagers >15 years of age were at greatest risk, and motor vehicle collisions accounted for the most common mechanism. An increase in prevalence was observed between 1997 and 2009, and this was matched by a similar increase in hospital charges. III.

Resource Utilization for Initial Hospitalization in Pediatric Heart Transplantation in the United States.

PubMed

Boucek, Dana M; Lal, Ashwin K; Eckhauser, Aaron W; Weng, Hsin-Yi Cindy; Sheng, Xiaoming; Wilkes, Jacob F; Pinto, Nelangi M; Menon, Shaji C

2018-04-15

Pediatric heart transplantation (HT) is resource intensive. Event-driven pediatric databases do not capture data on resource use. The objective of this study was to evaluate resource utilization and identify associated factors during initial hospitalization for pediatric HT. This multicenter retrospective cohort study utilized the Pediatric Health Information Systems database (43 children's hospitals in the United States) of children ≤19 years of age who underwent transplant between January 2007 and July 2013. Demographic variables including site, payer, distance and time to center, clinical pre- and post-transplant variables, mortality, cost, and charge were the data collected. Total length of stay (LOS) and charge for the initial hospitalization were used as surrogates for resource use. Charges were inflation adjusted to 2013 dollars. Of 1,629 subjects, 54% were male, and the median age at HT was 5 years (IQR [interquartile range] 0 to 13). The median total and intensive care unit LOS were 51 (IQR 23 to 98) and 23 (IQR 9 to 58) days, respectively. Total charge and cost for hospitalization were $852,713 ($464,900 to $1,609,300) and $383,600 ($214,900 to $681,000) respectively. Younger age, lower volume center, southern region, and co-morbidities before transplant were associated with higher resource use. In later years, charges increased despite shorter LOS. In conclusion, this large multicenter study provides novel insight into factors associated with resource use in pediatric patients having HT. Peritransplant morbidities are associated with increased cost and LOS. Reducing costs in line with LOS will improve health-care value. Regional and center volume differences need further investigation for optimizing value-based care and efficient use of scarce resources. Copyright © 2018 Elsevier Inc. All rights reserved.

Recidivism of child molesters: a study of victim relationship with the perpetrator.

PubMed

Greenberg, D; Bradford, J; Firestone, P; Curry, S

2000-11-01

To compare the rates among of recidivism or re-offense among convicted child molesters who offend against biological children, stepchildren, and relationships where the child is an extended family member, acquaintance or stranger to the victim. Four hundred male subjects 18 years of age or older and at least 5 years older than the victim at the time of the index offense, were convicted of a hands on sexual offense against one or more children under the age of 16. Subjects were grouped into five categories according to the type of relationship the perpetrator had with the victim. The subjects records of criminal arrests and convictions was obtained from the national Royal Canadian Mounted Police data. Subjects were then followed-up for a period of up to 15 years after conviction when they were at risk to re-offend in the community. Survival outcome data after the index sexual offense was collected for all new sexual, violent, and any criminal offenses. A larger proportion of men ( 16.2%) who sexually offended against children who were acquaintances, were charged with a new sexual offense than men who sexually offended against biological (4.8%) or their stepchildren (5.1%). The percentage of men who were subsequently charged with any type of criminal offense and who offended against their biological children (19%) was smaller than men who offended against children where the relationship is an extended family member (40%), acquaintances (35.9%) or strangers (45.2%). When comparing the different categories of relationship the victim had with the perpetrator, the category of stranger has been highlighted as a group with a higher risk for re-offense. Our results have shown that comparatively, the risk of acquaintance group is a significantly higher risk category than was previously thought. Although professionals are principally concerned with sexual recidivism, general criminality appears to present in relatively large proportions of all child molesters with the stranger group at the highest risk level. While no single factor will predict recidivism in itself, the importance of defining the relationship between the perpetrator and victim is evident from this study.

Low vaccine coverage among children born to HIV infected women in Niamey, Niger.

PubMed

Tchidjou, Hyppolite Kuekou; Vescio, Maria Fenicia; Sanou Sobze, Martin; Souleyman, Animata; Stefanelli, Paola; Mbabia, Adalbert; Moussa, Ide; Gentile, Bruno; Colizzi, Vittorio; Rezza, Giovanni

2016-01-01

The effect of mother's HIV-status on child vaccination is an important public health issue in countries with high HIV prevalence. We conducted a study in a primary healthcare center located in Niamey, the capital of Niger, which offers free of charge services to HIV positive and/or underprivileged mothers, with the aim of assessing: 1) vaccination coverage for children 0-36 months old, born to HIV-infected mothers, and 2) the impact of maternal HIV status on child vaccination. Mothers of children less than 36 months old attending the center were interviewed, to collect information on vaccines administered to their child, and family's socio-demographic characteristics. Overall, 502 children were investigated. Children of HIV-seropositive mothers were less likely to receive follow up vaccinations for Diphtheria-Tetanus-Pertussis (DTP) than those of HIV-seronegative mothers, with a prevalence ratio (PR) of 2.03 (95%CI: 1.58-2.61). Children born to HIV-seropositive mothers were less likely to miss vaccination for MMR than those born to HIV negative mothers, with a RR of 0.46 (95%CI: 0.30-0.72). Vaccine coverage among children born to HIV infected mothers was rather low. It is important to favor access to vaccination programs in this population.

Low vaccine coverage among children born to HIV infected women in Niamey, Niger

PubMed Central

Tchidjou, Hyppolite Kuekou; Vescio, Maria Fenicia; Sanou Sobze, Martin; Souleyman, Animata; Stefanelli, Paola; Mbabia, Adalbert; Moussa, Ide; Gentile, Bruno; Colizzi, Vittorio; Rezza, Giovanni

2016-01-01

Background: The effect of mother’s HIV-status on child vaccination is an important public health issue in countries with high HIV prevalence. We conducted a study in a primary healthcare center located in Niamey, the capital of Niger, which offers free of charge services to HIV positive and/or underprivileged mothers, with the aim of assessing: 1) vaccination coverage for children 0–36 months old, born to HIV-infected mothers, and 2) the impact of maternal HIV status on child vaccination. Methods: Mothers of children less than 36 months old attending the center were interviewed, to collect information on vaccines administered to their child, and family’s socio-demographic characteristics. Results: Overall, 502 children were investigated. Children of HIV-seropositive mothers were less likely to receive follow up vaccinations for Diphtheria-Tetanus-Pertussis (DTP) than those of HIV-seronegative mothers, with a prevalence ratio (PR) of 2.03 (95%CI: 1.58–2.61). Children born to HIV-seropositive mothers were less likely to miss vaccination for MMR than those born to HIV negative mothers, with a RR of 0.46 (95%CI: 0.30–0.72). Conclusions: Vaccine coverage among children born to HIV infected mothers was rather low. It is important to favor access to vaccination programs in this population. PMID:26237156

76 FR 35895 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... Administration for Children and Families (ACF), Office of Refugee Resettlement (ORR), is charged with the care... effect if OMB receives it within 30 days of publication. Written comments and recommendations for the...

Sleep Tips for Children's Mental Health

MedlinePlus

... working, using a smartphone or tablet, or playing electronic games. (Adults with consenting partners can intimacy to ... set up a family overnight charging area for electronic devices such as tablets and smartphones that is ...

Results of domestic migration on juvenile delinquency in Adana, Turkey.

PubMed

Firat, Sunay; Iltas, Yigit; Gulmen, Mete K

2017-07-01

The aim of this study is to determine the effect of migration on children in the juvenile justice system. The study takes into account whether these children arrived in the city via migration or not, the types of crimes against property and persons committed by the children brought before the Juvenile Courts, and the types, frequency, and durations of punishments and precautionary decisions they received. In addition, the study examines the children's ability to realize the meaning and consequences of their crimes and to lead their future behaviors effectively. Data gathered from children between 3 and 18 years of age who appeared before the 1, 2, and 3 numbered Juvenile Courts of Adana Courthouse after January 2004 on charges of committing a crime, and/or children who were sent to or who applied to the Provincial Directorate for National Education based on the decision of the Court has been evaluated retrospectively. Six hundred and eighty children were studied. Of these, 602 (88.5%) were male and 78 (11.5) were female. The average age of the child at the time of the commitment of the crime was 13 years and 8 months ± 2.18 years. It has been observed that there are statistically meaningful differences for children involved in delinquency between cases whether they come via migration or regardless of migration and types of crimes committed (p = 0.004). When cities faced with migration from other places and types of crime committed by children are compared, it has been observed that there are meaningful differences between the types of crimes committed by non-migrant versus migrant children (p = 0.012). It is important to state the reasons for delinquency and to obtain data to prevent future delinquency and to put forward regional and local recommendations within the scope of the data. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

PubMed

Walsh, Wendy A; Cross, Theodore P; Jones, Lisa M; Simone, Monique; Kolko, David J

2007-10-01

This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

National estimates of hospital utilization by children with gastrointestinal disorders: analysis of the 1997 kids' inpatient database.

PubMed

Guthery, Stephen L; Hutchings, Caroline; Dean, J Michael; Hoff, Charles

2004-05-01

To identify and to generate national estimates of the principal gastrointestinal (GI) diagnoses associated with hospital utilization and to describe national hospital utilization patterns associated with pediatric GI disorders. We analyzed a nationwide and stratified probability sample of 1.9 million hospital discharges from 1997 of children 18 years and younger, weighted to 6.7 million discharges nationally. Principal GI diagnoses were identified through the use of the Clinical Classification Software and Major Diagnostic Categories. In 1997 in the United States, there were 329,825 pediatric discharges associated with a principal GI diagnosis, accounting for more than 2.6 billion US dollars in hospital charges and more than 1.1 million hospital days. Appendicitis, intestinal infection, noninfectious gastroenteritis, abdominal pain, esophageal disorders, and digestive congenital anomalies combined accounted for 75.1% of GI discharge diagnoses, 64.2% of GI hospital charges, and 68.0% of GI hospital days. Excluding normal newborn infants and conditions related to pregnancy, GI disorders were the third leading cause of hospitalization. GI disorders are a leading cause of hospitalization of children. A minority of GI conditions account for the majority of measures of utilization. Children are hospitalized for GI conditions and at institutions that are distinct from adults.

Financial impact to providers using pediatric combination vaccines.

PubMed

Shen, Angela K; Sobczyk, Elizabeth; Simonsen, Lone; Khan, Farid; Esber, Allahna; Andreae, Margie C

2011-12-01

To understand the financial impact to providers for using a combination vaccine (Pediarix [GlaxoSmithKline Biologicals, King of Prussia, PA]) versus its equivalent component vaccines for children aged 1 year or younger. Using a subscription remittance billing service offered to private-practice office-based physicians, we analyzed charge and payment information submitted by providers to insurance payers from June 2007 through July 2009. We analyzed provider and payer characteristics, payer comments, and the ratio of vaccine product to immunization administration (IA) codes and computed total charges and payments to providers for both arms of the study. Most providers in our data set were pediatricians (74%), and most payers were commercial (75%), primarily managed care. The ratio of the number of vaccine products to the number of IAs was 1:1 in the majority of the claims. Twenty percent of claims were paid with no adjustment by the payer, whereas 76% of the claims were adjusted for charges that exceeded the contract arrangement or the fee schedule. Providers received $23 less from commercial payers and $13 less from Medicaid for the use of Pediarix compared with the equivalent component vaccines. The mean commercial payment was greater for age-specific Current Procedural Terminology IA codes 90465 and 90466 than for non-age-specific codes 90471 and 90472, whereas the reverse was true for Medicaid. Providers who administer vaccines to children face a reduction in payment when choosing to provide combination vaccines. The new IA codes should be monitored for correction of financial barriers to the use of combination vaccines.

Children's comprehension monitoring of multiple situational dimensions of a narrative.

PubMed

Wassenburg, Stephanie I; Beker, Katinka; van den Broek, Paul; van der Schoot, Menno

Narratives typically consist of information on multiple aspects of a situation. In order to successfully create a coherent representation of the described situation, readers are required to monitor all these situational dimensions during reading. However, little is known about whether these dimensions differ in the ease with which they can be monitored. In the present study, we examined whether children in Grades 4 and 6 monitor four different dimensions (i.e., emotion, causation, time, and space) during reading, using a self-paced reading task containing inconsistencies. Furthermore, to explore what causes failure in inconsistency detection, we differentiated between monitoring processes related to availability and validation of information by manipulating the distance between two pieces of conflicting information. The results indicated that the monitoring processes varied as a function of dimension. Children were able to validate emotional and causal information when it was still active in working memory, but this was not the case for temporal and spatial information. When context and target information were more distant from each other, only emotionally charged information remained available for further monitoring processes. These findings show that the influence of different situational dimensions should be taken into account when studying children's reading comprehension.

Hospitalized Children With Encephalitis in the United States: A Pediatric Health Information System Database Study.

PubMed

Bagdure, Dayanand; Custer, Jason W; Rao, Suchitra; Messacar, Kevin; Dominguez, Samuel; Beam, Brandon W; Bhutta, Adnan

2016-08-01

Given the paucity of data on resource utilization among children with encephalitis, the objective of this study was to describe the epidemiology and evaluate resource utilization and discharge data of children with encephalitis admitted to US hospitals from 2004 to 2013. We conducted a retrospective cohort study utilizing the Pediatric Health Information System database of children aged 0 to 18 years with the International Classification of Diseases, Ninth Revision codes for encephalitis from 2004 to 2013. Only the initial admissions were included, and the age group analyzed was 0 to 18 years. Among 7298 children with encephalitis, 2933 (40%) were admitted to a pediatric intensive care unit. The median age was nine years, the overall median length of stay was 16 days, and children requiring critical care had a median length of stay of 25 days. Children in the pediatric intensive care unit were more likely to have seizures (P <0.001) and head magnetic resonance imaging (P <0.001) than children on the floor. Similarly, children requiring critical care were more likely to have a broad diagnostic evaluation sent including cerebrospinal fluid cultures, blood bacterial and fungal cultures, western equine encephalitis antibody, St. Louis equine encephalitis antibody, varicella-zoster serology, human immunodeficiency virus 1 antibody, human immunodeficiency virus DNA polymerase chain reaction, acid-fast stain, and Lyme disease serology. Seventeen percent of children were treated with intravenous immunoglobulin, and 4% underwent plasmapheresis. There was a trend of increasing use of intravenous immunoglobulin and plasmapheresis in children with encephalitis over the study period. A total of 5944 (81%) children were discharged home, and the mortality in this cohort was 3% (230). The mean charges for hospitalization for a child with encephalitis was $64,604 and for those requiring critical care was $260,012. Encephalitis is a significant cause of morbidity and mortality in children. Children with encephalitis admitted to the pediatric intensive care unit are more likely to have seizures and to undergo a more extensive evaluation to determine the cause of encephalitis. Use of plasmapheresis and intravenous immunoglobulin is on the rise in hospitalized children. Prospective studies are necessary to better understand treatment and intervention strategies for children with encephalitis and their impact on outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Autism-specific maternal anti-fetal brain autoantibodies are associated with metabolic conditions

PubMed Central

Krakowiak, Paula; Walker, Cheryl K.; Tancredi, Daniel; Hertz-Picciotto, Irva; Van de Water, Judy

2016-01-01

Lay Abstract Approximately 23% of mothers of children with autism spectrum disorder (ASD) produce specific patterns of antibodies to fetal brain tissue that have been detected in only 1% of mothers of typically developing children. However, it is unknown what causes these ASD-specific anti-fetal antibodies to be produced. We examined the relationship between ASD-specific anti-fetal antibodies and metabolic conditions during pregnancy in 227 mothers of 2–5 year old children with ASD, enrolled in the CHARGE (Childhood Autism Risk from Genetics and the Environment) Study, and who had blood samples measured for these anti-fetal brain antibodies after study enrollment. Metabolic conditions included diabetes, hypertensive disorders, and prepregnancy obesity or overweight. The presence of ASD-specific anti-fetal brain antibody patterns was more common among mothers diagnosed with diabetes, hypertensive disorders, or overweight during pregnancy compared to healthy mothers, but these differences did not reach statistical significance. In a subset of 145 mothers whose children exhibited severe ASD symptoms, those diagnosed with type 2 or gestational diabetes were nearly 3 times more likely to have ASD-specific anti-fetal antibodies compared to healthy mothers. Further, those diagnosed with gestational diabetes specifically were over 3 times more likely to have these anti-fetal brain antibodies. In this exploratory study, mothers whose children had severe ASD and who were diagnosed with diabetes were more likely to have anti-fetal brain autoantibodies 2–5 years later. Scientific Abstract Approximately 23% of mothers of children with autism spectrum disorder (ASD) produce specific patterns of autoantibodies to fetal brain proteins that have been detected in only 1% of mothers of typically developing children. The biological mechanisms underlying the development of ASD-specific maternal autoantibodies are poorly understood. We sought to determine whether ASD-specific maternal autoantibodies identified postnatally were associated with metabolic conditions (MCs) during gestation. Participants were 227 mothers of 2–5 year old children with confirmed ASD, enrolled in CHARGE (Childhood Autism Risk from Genetics and the Environment) between January 2003 and April 2008, and from whom blood samples were collected and analyzed for anti-fetal brain autoantibodies (Ab+). MCs included diabetes, hypertensive disorders, and prepregnancy obesity or overweight, ascertained from medical records or structured telephone interviews. Log-linear regression models were performed to estimate prevalence ratios (PR) and 95% confidence intervals (CI) based on robust standard errors. Fifty-six (25%) mothers were Ab+. Ab+ prevalence was higher among mothers with diabetes, hypertensive disorders, or overweight compared to healthy mothers, but differences were not statistically significant. In a subset of 145 mothers whose children exhibited severe ASD (31 Ab+), those diagnosed with type 2 or gestational diabetes were 2.7-fold more likely to be Ab+ (95% CI 1.1, 6.6), controlling for delivery payer and smoking. Gestational diabetes specifically was associated with a 3.2-fold increased Ab+ prevalence (95% CI 1.2, 8.6). In this exploratory study, mothers whose children had severe ASD and who experienced diabetes were more likely to have anti-fetal brain autoantibodies 2–5 years later. PMID:27312731

MAOA, DBH and SLC6A4 variants in CHARGE: A case control study of autism spectrum disorders

PubMed Central

Tassone, Flora; Qi, Lihong; Zhang, Wenting; Hansen, Robin L; Pessah, Isaac N; Hertz-Picciotto, Irva

2011-01-01

Background Genetic factors are established to contribute to the development of autism. We examined three loci, serotonin transporter (SLC6A4), dopamine hydroxylase (DBH) and the variable number of tandem repeat promoter of the monoamine oxidase A (MAOA) for association with autism in participants from the CHARGE (CHildhood Autism Risks from Genetics and the Environment) Study, the first large-scale population-based case-control investigation of both environmental and genetic contributions to autism risk. Methods Among male children enrolled in the CHARGE study we tested associations between each of the three polymorphisms and autism (AU) (n=119), or a combined group of autism and other autism spectrum disorders (AU+ASD, which includes an additional n=53) as compared with typically developing controls (TD, n=137). Results The case-control association analysis showed neither SLC6A4 nor DBH to be statistically significantly associated with AU or ASD. However, the male children carrying 4 tandem repeats in the promoter region of the MAOA gene showed a 2-fold higher risk of AU (or AU+ASD) than those carrying allele 3, adjusted for confounders (OR = 2.02, 95% CI = 1.12, 3.65, p = 0.02 for AU vs. TD, and OR = 2.05, 95% CI = 1.19, 3.53, p = 0.01 for ASD vs. TD). In addition, mothers homozygous for the 4 tandem repeat allele showed at least a 3-fold higher risk of AU (or AU+ASD) than mothers homozygous for allele 3 (OR = 3.07, 95% CI = 1.19, 7.91, p = 0.02 for AU vs. TD, and OR = 3.26, 95% CI = 1.35, 7.89, p = 0.009 for AU+ASD vs. TD). Conclusions These results suggest a potential role of the functional MAOA promoter alleles in the male child, the mother, or both in autism spectrum disorders. PMID:21538940

Motor Vehicle Crashes, Medical Outcomes, and Hospital Charges Among Children Aged 1-12 Years - Crash Outcome Data Evaluation System, 11 States, 2005-2008.

PubMed

Sauber-Schatz, Erin K; Thomas, Andrea M; Cook, Lawrence J

2015-10-02

Motor vehicle crashes are a leading cause of death among children. Age- and size-appropriate restraint use is an effective way to prevent motor vehicle-related injuries and deaths. However, children are not always properly restrained while riding in a motor vehicle, and some are not restrained at all, which increases their risk for injury and death in a crash. 2005-2008. The Crash Outcome Data Evaluation System (CODES) is a multistate program facilitated by the National Highway Traffic Safety Administration to probabilistically link police crash reports and hospital databases for traffic safety analyses. Eleven participating states (Connecticut, Georgia, Kentucky, Maryland, Minnesota, Missouri, Nebraska, New York, Ohio, South Carolina, and Utah) submitted data to CODES during the reporting period. Descriptive analysis was used to describe drivers and child passengers involved in motor vehicle crashes and to summarize crash and medical outcomes. Odds ratios and 95% confidence intervals were used to compare a child passenger's likelihood of sustaining specific types of injuries by restraint status (optimal, suboptimal, or unrestrained) and seating location (front or back seat). Because of data constraints, optimal restraint use was defined as a car seat or booster seat use for children aged 1-7 years and seat belt use for children aged 8-12 years. Suboptimal restraint use was defined as seat belt use for children aged 1-7 years. Unrestrained was defined as no use of car seat, booster seat, or seat belt for children aged 1-12 years. Optimal restraint use in the back seat declined with child's age (1 year: 95.9%, 5 years: 95.4%, 7 years: 94.7%, 8 years: 77.4%, 10 years: 67.5%, 12 years: 54.7%). Child restraint use was associated with driver restraint use; 41.3% of children riding with unrestrained drivers also were unrestrained compared with 2.2% of children riding with restrained drivers. Child restraint use also was associated with impaired driving due to alcohol or drug use; 16.4% children riding with drivers suspected of alcohol or drug use were unrestrained compared with 2.9% of children riding with drivers not suspected of such use. Optimally restrained and suboptimally restrained children were less likely to sustain a traumatic brain injury than unrestrained children. The 90th percentile hospital charges for children aged 4-7 years who were in motor vehicle crashes were $1,630.00 and $1,958.00 for those optimally restrained in a back seat and front seat, respectively; $2,035.91 and $3,696.00 for those suboptimally restrained in a back seat and front seat, respectively; and $9,956.60 and $11,143.85 for those unrestrained in a back seat and front seat, respectively. Proper car seat, booster seat, and seat belt use among children in the back seat prevents injuries and deaths, as well as averts hospital charges. However, the number, severity, and cost of injuries among children in crashes who were not optimally restrained or who were seated in a front seat indicates the need for improvements in proper use of age- and size-appropriate car seats, booster seats, and seat belts in the back seat. Effective interventions for increasing proper child restraint use could be universally implemented by states and communities to prevent motor vehicle-related injuries among children and their resulting costs.

Illegal abortion in Mexico: client perceptions.

PubMed

de Weiss, S P; David, H P

1990-06-01

An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians.

Selected vitamin D metabolic gene variants and risk for autism spectrum disorder in the CHARGE Study.

PubMed

Schmidt, Rebecca J; Hansen, Robin L; Hartiala, Jaana; Allayee, Hooman; Sconberg, Jaime L; Schmidt, Linda C; Volk, Heather E; Tassone, Flora

2015-08-01

Vitamin D is essential for proper neurodevelopment and cognitive and behavioral function. We examined associations between autism spectrum disorder (ASD) and common, functional polymorphisms in vitamin D pathways. Children aged 24-60 months enrolled from 2003 to 2009 in the population-based CHARGE case-control study were evaluated clinically and confirmed to have ASD (n=474) or typical development (TD, n=281). Maternal, paternal, and child DNA samples for 384 (81%) families of children with ASD and 234 (83%) families of TD children were genotyped for: TaqI, BsmI, FokI, and Cdx2 in the vitamin D receptor (VDR) gene, and CYP27B1 rs4646536, GC rs4588, and CYP2R1 rs10741657. Case-control logistic regression, family-based log-linear, and hybrid log-linear analyses were conducted to produce risk estimates and 95% confidence intervals (CI) for each allelic variant. Paternal VDR TaqI homozygous variant genotype was significantly associated with ASD in case-control analysis (odds ratio [OR] [CI]: 6.3 [1.9-20.7]) and there was a trend towards increased risk associated with VDR BsmI (OR [CI]: 4.7 [1.6-13.4]). Log-linear triad analyses detected parental imprinting, with greater effects of paternally-derived VDR alleles. Child GC AA-genotype/A-allele was associated with ASD in log-linear and ETDT analyses. A significant association between decreased ASD risk and child CYP2R1 AA-genotype was found in hybrid log-linear analysis. There were limitations of low statistical power for less common alleles due to missing paternal genotypes. This study provides preliminary evidence that paternal and child vitamin D metabolism could play a role in the etiology of ASD; further research in larger study populations is warranted. Copyright © 2015. Published by Elsevier Ireland Ltd.

Phthalate concentrations in house dust in relation to autism spectrum disorder and developmental delay in the CHildhood Autism Risks from Genetics and the Environment (CHARGE) study.

PubMed

Philippat, Claire; Bennett, Deborah H; Krakowiak, Paula; Rose, Melissa; Hwang, Hyun-Min; Hertz-Picciotto, Irva

2015-06-26

Phthalates are endocrine-disrupting chemicals that influence thyroid hormones and sex steroids, both critical for brain development. We studied phthalate concentrations in house dust in relation to the risks of developing autism spectrum disorder (ASD) or developmental delay (DD). Participants were a subset of children from the CHARGE (CHildhood Autism Risks from Genetics and the Environment) case-control study. ASD and DD cases were identified through the California Department of Developmental Services system or referrals; general population controls were randomly sampled from state birth files and frequency-matched on age, sex, and broad geographic region to ASD cases. All children (50 ASD, 27 DD, 68 typically developing (TD)) were assessed with Mullen Scales of Early Learning, Vineland Adaptive Behavior Scales (VABS) and Aberrant Behavior Checklist. We measured 5 phthalates in dust collected in the child's home using a high volume small surface sampler. None of the phthalates measured in dust was associated with ASD. After adjustment, we observed greater di(2-ethylhexyl) phthalate (DEHP) and butylbenzyl phthalate (BBzP) concentrations in indoor dust from homes of DD children: Odds ratios (OR) were 2.10 (95% confidence interval (CI); 1.10; 4.09) and 1.40 (95% CI; 0.97; 2.04) for a one-unit increase in the ln-transformed DEHP and BBzP concentrations, respectively. Among TD children, VABS communication, daily living, and adaptive composite standard scores were lower, in association with increased diethyl phthalate (DEP) concentrations in dust. Participants with higher dibutyl phthalate (DBP) concentrations in house dust also trended toward reduced performance on these subscales. Among ASD and DD boys, higher indoor dust concentrations of DEP and DBP were associated with greater hyperactivity-impulsivity and inattention. House dust levels of phthalates were not associated with ASD. The inability to distinguish past from recent exposures in house dust and the fact that house dust does not capture exposure from all sources, limit the interpretation of both positive and null findings and further work is needed. However, the associations observed for DEP and DBP with impairments in several adaptive functions and greater hyperactivity, along with evidence for increased risk of DD raise concerns that these chemicals may affect neurodevelopment in children.

Patient cost-sharing, socioeconomic status, and children's health care utilization.

PubMed

Nilsson, Anton; Paul, Alexander

2018-05-01

This paper estimates the effect of cost-sharing on the demand for children's and adolescents' use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference-in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5-10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education. Copyright © 2018 Elsevier B.V. All rights reserved.

Generic prejudice and the presumption of guilt in sex abuse trials.

PubMed

Vidmar, N

1997-02-01

In 25 Canadian criminal trials involving charges of sexual abuse, 849 prospective jurors were asked under oath whether they could hear the evidence, follow the judge's instructions on the law, and decide the case with a fair and impartial mind. Knowing only the nature of the charges against the accused, on average 36% of the jurors stated that they could not be impartial. Some jurors explained that they themselves had been victims of abuse, others expressed fears for children, while others stated simply that they could not set aside a presumption of guilt. These findings from real trials are consistent with a body of social science literature about attitudes toward sexual abuse and sexual assault charges. The article distinguishes between prejudices arising from specific pretrial publicity and generic prejudices that cause prejudgments of the case of any defendant perceived as belonging to a general class of defendants who likely are guilty of the crime(s) charged.

Determinants of vaccine immunity in the cohort of human immunodeficiency virus-infected children living in Switzerland.

PubMed

Myers, Catherine; Posfay-Barbe, Klara M; Aebi, Christoph; Cheseaux, Jean-Jacques; Kind, Christian; Rudin, Christoph; Nadal, David; Siegrist, Claire-Anne

2009-11-01

Human immunodeficiency virus (HIV)-infected children are at increased risk of infections caused by vaccine preventable pathogens, and specific immunization recommendations have been issued. A prospective national multicenter study assessed how these recommendations are followed in Switzerland and how immunization history correlates with vaccine immunity. Among 87 HIV-infected children (mean age: 11.1 years) followed in the 5 Swiss university hospitals and 1 regional hospital, most (76%) had CD4 T cells >25%, were receiving highly active antiretroviral treatment (79%) and had undetectable viral load (60%). Immunization coverage was lower than in the general population and many lacked serum antibodies to vaccine-preventable pathogens, including measles (54%), varicella (39%), and hepatitis B (65%). The presence of vaccine antibodies correlated most significantly with having an up-to-date immunization history (P<0.05). An up-to-date immunization history was not related to age, immunologic stage, or viremia but to the referral medical center. All pediatricians in charge of HIV-infected children are urged to identify missing immunizations in this high-risk population.

Altered Gene Expression and Function of Peripheral Blood Natural Killer Cells in Children with Autism

PubMed Central

Enstrom, A M; Lit, L; Onore, C E; Gregg, J P; Hansen, R; Pessah, I N; Hertz-Picciotto, I; Van de Water, J A; Sharp, F R; Ashwood, P

2009-01-01

Immune related abnormalities have repeatedly been reported in autism spectrum disorders (ASD), including evidence of immune dysregulation and autoimmune phenomena. NK cells may play an important role in neurodevelopmental disorders such as ASD. Here we performed a gene expression screen and cellular functional analysis on peripheral blood obtained from 52 children with ASD and 27 typically developing control children enrolled in the case-control CHARGE study. RNA expression of NK cell receptors and effector molecules were significantly upregulated in ASD. Flow cytometric analysis of NK cells demonstrated increased production of perforin, granzyme B, and interferon gamma (IFNγ) under resting conditions in children with ASD (p<0.01). Following NK cell stimulation in the presence of K562 target cells, the cytotoxicity of NK cells was significantly reduced in ASD compared with controls (p<0.02). Furthermore, under similar stimulation conditions the presence of perforin, granzyme B, and IFNγ in NK cells from ASD children was significantly lower compared with controls (p<0.001). These findings suggest possible dysfunction of NK cells in children with ASD. Abnormalities in NK cells may represent a susceptibility factor in ASD and may predispose to the development of autoimmunity and/or adverse neuroimmune interactions during critical periods of development. PMID:18762240

The Modified Rambo Transcanal Approach for Cochlear Implantation in CHARGE Syndrome.

PubMed

Wick, Cameron C; Moore, Amy M; Killeen, Daniel E; Isaacson, Brandon

2017-10-01

CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. Three children with profound hearing loss secondary to CHARGE syndrome. Transcanal cochlear implantation with closure of the ear canal via a modified Rambo meatoplasty. Retrospective chart review of temporal bone anomalies associated with CHARGE syndrome, technical nuances of this transcanal approach, and cochlear implant outcomes. The mean patient age was 2.5 years (range 1.5-3.8 yr). Two were male and two were left ears. All patients had a hypoplastic mastoid, semicircular canal aplasia, and had some degree of cochlear dysplasia. A full cochlear implant insertion was achieved in all cases, even in the presence of grossly abnormal middle ear and facial nerve anatomy. There were no intraoperative or postoperative complications. The mean follow-up was 12.4 months (range, 3.9-25.2 mo). All three patients use their device daily. Their guardians report improved vocalization and environmental awareness. The modified Rambo transcanal approach provides a safe corridor for cochlear implantation in patients with CHARGE syndrome. This approach minimizes the anatomical variations associated with the syndrome and may reduce the risk of electrode extrusion. Implant outcomes in this patient population remain highly variable based on the patient's global cognitive capacity.

Hospital cost analysis of a prospective, randomized trial of early vs interval appendectomy for perforated appendicitis in children.

PubMed

Myers, Adrianne L; Williams, Regan F; Giles, Kim; Waters, Teresa M; Eubanks, James W; Hixson, S Douglas; Huang, Eunice Y; Langham, Max R; Blakely, Martin L

2012-04-01

The methods of surgical care for children with perforated appendicitis are controversial. Some surgeons prefer early appendectomy; others prefer initial nonoperative management followed by interval appendectomy. Determining which of these two therapies is most cost-effective was the goal of this study. We conducted a prospective, randomized trial in children with a preoperative diagnosis of perforated appendicitis. Patients were randomized to early or interval appendectomy. Overall hospital costs were extracted from the hospital's internal cost accounting system and the two treatment groups were compared using an intention-to-treat analysis. Nonparametric data were reported as median ± standard deviation (or range) and compared using a Wilcoxon rank sum test. One hundred thirty-one patients were randomized to either early (n = 64) or interval (n = 67) appendectomy. Hospital charges and costs were significantly lower in patients randomized to early appendectomy. Total median hospital costs were $17,450 (range $7,020 to $55,993) for patients treated with early appendectomy vs $22,518 (range $4,722 to $135,338) for those in the interval appendectomy group. Median hospital costs more than doubled in patients who experienced an adverse event ($15,245 vs $35,391, p < 0.0001). Unplanned readmissions also increased costs significantly and were more frequent in patients randomized to interval appendectomy. In a prospective randomized trial, hospital charges and costs were significantly lower for early appendectomy when compared with interval appendectomy. The increased costs were related primarily to the significant increase in adverse events, including unplanned readmissions, seen in the interval appendectomy group. Copyright © 2012. Published by Elsevier Inc.

Strengthening health system to improve immunization for migrants in China.

PubMed

Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

2017-07-01

Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

The active surface of suspended particles as a predictor of lung function and pulmonary symptoms in Austrian school children

NASA Astrophysics Data System (ADS)

Moshammer, Hanns; Neuberger, Manfred

At a central elementary school in the capital of Upper Austria children aged 7-10 years underwent repeated respiratory health checkups (questionnaires, diaries, spirometry). Between March and May 2001 the daily means of the signals of a diffusion charging sensor, measuring the "active surface" of suspended particles, and a photoelectric aerosol sensor, measuring the particle-bound polycyclic aromatic hydrocarbons, were related to spirometric results of the total 164 children examined and to the daily symptom scores of a susceptible subgroup. Significant reductions of forced vital capacity ( p=0.006) and forced expiratory volume in the first second ( p=0.001) and significant increases of wheezing ( p=0.001), shortness of breath ( p=0.041), cough in the evening ( p=0.031) and at night ( p=0.018) were found with increase of "active surface" of suspended particles measured at the adjacent outdoor monitoring station, but not with the increase of particle-bound polycyclic aromatic hydrocarbons. Monitoring "active surface" of particles with diameters of about 10 nm-1 μm by means of a diffusion charging sensor might provide additional information in surveillance of particulate matter for prevention of acute effects on respiratory health.

Neurodevelopmental Disorders and Prenatal Residential Proximity to Agricultural Pesticides: The CHARGE Study

PubMed Central

Geraghty, Estella M.; Tancredi, Daniel J.; Delwiche, Lora D.; Schmidt, Rebecca J.; Ritz, Beate; Hansen, Robin L.; Hertz-Picciotto, Irva

2014-01-01

Background: Gestational exposure to several common agricultural pesticides can induce developmental neurotoxicity in humans, and has been associated with developmental delay and autism. Objectives: We evaluated whether residential proximity to agricultural pesticides during pregnancy is associated with autism spectrum disorders (ASD) or developmental delay (DD) in the Childhood Autism Risks from Genetics and Environment (CHARGE) study. Methods: The CHARGE study is a population-based case–control study of ASD, DD, and typical development. For 970 participants, commercial pesticide application data from the California Pesticide Use Report (1997–2008) were linked to the addresses during pregnancy. Pounds of active ingredient applied for organophophates, organochlorines, pyrethroids, and carbamates were aggregated within 1.25-km, 1.5-km, and 1.75-km buffer distances from the home. Multinomial logistic regression was used to estimate the odds ratio (OR) of exposure comparing confirmed cases of ASD (n = 486) or DD (n = 168) with typically developing referents (n = 316). Results: Approximately one-third of CHARGE study mothers lived, during pregnancy, within 1.5 km (just under 1 mile) of an agricultural pesticide application. Proximity to organophosphates at some point during gestation was associated with a 60% increased risk for ASD, higher for third-trimester exposures (OR = 2.0; 95% CI: 1.1, 3.6), and second-trimester chlorpyrifos applications (OR = 3.3; 95% CI: 1.5, 7.4). Children of mothers residing near pyrethroid insecticide applications just before conception or during third trimester were at greater risk for both ASD and DD, with ORs ranging from 1.7 to 2.3. Risk for DD was increased in those near carbamate applications, but no specific vulnerable period was identified. Conclusions: This study of ASD strengthens the evidence linking neurodevelopmental disorders with gestational pesticide exposures, particularly organophosphates, and provides novel results of ASD and DD associations with, respectively, pyrethroids and carbamates. Citation: Shelton JF, Geraghty EM, Tancredi DJ, Delwiche LD, Schmidt RJ, Ritz B, Hansen RL, Hertz-Picciotto I. 2014. Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: the CHARGE study. Environ Health Perspect 122:1103–1109; http://dx.doi.org/10.1289/ehp.1307044 PMID:24954055

She's supporting them; who's supporting her? Preschool center-level social-emotional supports and teacher well-being.

PubMed

Zinsser, Katherine M; Christensen, Claire G; Torres, Luz

2016-12-01

Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting children's social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for children's SEL at the center-level are associated with teachers' psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for children's SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a high-quality early childhood workforce. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Auditory Performance and Electrical Stimulation Measures in Cochlear Implant Recipients With Auditory Neuropathy Compared With Severe to Profound Sensorineural Hearing Loss.

PubMed

Attias, Joseph; Greenstein, Tally; Peled, Miriam; Ulanovski, David; Wohlgelernter, Jay; Raveh, Eyal

The aim of the study was to compare auditory and speech outcomes and electrical parameters on average 8 years after cochlear implantation between children with isolated auditory neuropathy (AN) and children with sensorineural hearing loss (SNHL). The study was conducted at a tertiary, university-affiliated pediatric medical center. The cohort included 16 patients with isolated AN with current age of 5 to 12.2 years who had been using a cochlear implant for at least 3.4 years and 16 control patients with SNHL matched for duration of deafness, age at implantation, type of implant, and unilateral/bilateral implant placement. All participants had had extensive auditory rehabilitation before and after implantation, including the use of conventional hearing aids. Most patients received Cochlear Nucleus devices, and the remainder either Med-El or Advanced Bionics devices. Unaided pure-tone audiograms were evaluated before and after implantation. Implantation outcomes were assessed by auditory and speech recognition tests in quiet and in noise. Data were also collected on the educational setting at 1 year after implantation and at school age. The electrical stimulation measures were evaluated only in the Cochlear Nucleus implant recipients in the two groups. Similar mapping and electrical measurement techniques were used in the two groups. Electrical thresholds, comfortable level, dynamic range, and objective neural response telemetry threshold were measured across the 22-electrode array in each patient. Main outcome measures were between-group differences in the following parameters: (1) Auditory and speech tests. (2) Residual hearing. (3) Electrical stimulation parameters. (4) Correlations of residual hearing at low frequencies with electrical thresholds at the basal, middle, and apical electrodes. The children with isolated AN performed equally well to the children with SNHL on auditory and speech recognition tests in both quiet and noise. More children in the AN group than the SNHL group were attending mainstream educational settings at school age, but the difference was not statistically significant. Significant between-group differences were noted in electrical measurements: the AN group was characterized by a lower current charge to reach subjective electrical thresholds, lower comfortable level and dynamic range, and lower telemetric neural response threshold. Based on pure-tone audiograms, the children with AN also had more residual hearing before and after implantation. Highly positive coefficients were found on correlation analysis between T levels across the basal and midcochlear electrodes and low-frequency acoustic thresholds. Prelingual children with isolated AN who fail to show expected oral and auditory progress after extensive rehabilitation with conventional hearing aids should be considered for cochlear implantation. Children with isolated AN had similar pattern as children with SNHL on auditory performance tests after cochlear implantation. The lower current charge required to evoke subjective and objective electrical thresholds in children with AN compared with children with SNHL may be attributed to the contribution to electrophonic hearing from the remaining neurons and hair cells. In addition, it is also possible that mechanical stimulation of the basilar membrane, as in acoustic stimulation, is added to the electrical stimulation of the cochlear implant.

The financial impact of flipping the coin.

PubMed

Gonzalez, Katherine W; Reddy, Shiva R; Mundakkal, Angela A; St Peter, Shawn D

2017-01-01

Esophageal foreign body retrieval is typically performed by rigid or flexible esophagoscopy. Despite evidence supporting the efficacy and safety of balloon extraction, it is rarely performed. We sought to establish the financial benefits of this minimally invasive approach. A retrospective review of 241 children with esophageal coins between 2011 and 2013 was performed. Coins were removed via endoscopy or fluoroscopic-guided balloon retrieval. Timing, symptoms, facility cost, and patient charges were compared. Two hundred patients had attempted balloon retrieval with 80% success. Forty-one patients went directly for operative removal. Patients with respiratory difficulty (p=0.05), wheezing (p<0.01), or fever (p=0.03) were more often taken directly for endoscopic retrieval. The median cost and charges for attempted balloon extraction were $484 and $1647. The median cost and charges for primary endoscopy were $1834 and $6746. The median total cost and charges of attempted balloon extraction including ED, OR, transport, admission, and balloon retrieval were $1231 and $3539 versus $3615 and $12,204 in the primary endoscopy group (p<0.001, p<0.001). Seventeen percent of patients who underwent attempted balloon retrieval were admitted prior to removal compared to 76% who underwent primary endoscopy (p<0.001). Fluoroscopic guided balloon extraction of esophageal coins is a financially prudent choice which shortens hospital stay. III. Retrospective treatment and economic study. Copyright © 2017 Elsevier Inc. All rights reserved.

Pediatric Spine Trauma in the United States – Analysis of the HCUP Kid'S Inpatient Database (KID) 1997 – 2009

PubMed Central

Mendoza-Lattes, Sergio; Besomi, Javier; O'Sullivan, Cormac; Ries, Zachary; Gnanapradeep, Gnanapragasam; Nash, Rachel; Gao, Yubo; Weinstein, Stuart

2015-01-01

Background Few references are available describing the epidemiology of pediatric spine injuries. The purpose of this study is to examine the prevalence, risk factors and trends during the period from 1997 to 2009 of pediatric spine injuries in the United States using a large national database. Methods Data was obtained from the Kid's Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP), for the years 1997-2009. This data includes >3 million discharges from 44 states and 4121 hospitals on children younger than 20 years. Weighted variables are provided which allow for the calculation of national prevalence rates. The Nationwide Emergency Department Sample (NEDS), HCUP. net, and National Highway Traffic Safety Administration (NHTSA) data were used for verification and comparison. Results A prevalence of 107.96 pmp (per million population) spine injuries in children and adolescents was found in 2009, which is increased from the 77.07 pmp observed in 1997. The group 15 to 19 years old had the highest prevalence of all age groups in (345.44 pmp). Neurological injury was present in 14.6% of the cases, for a prevalence of 15.82 pmp. The majority (86.7%) of these injuries occurred in children >15 years. Motor vehicle collisions accounted for 52.9% of all spine injuries, particularly in children >15 years. Between 1997 and 2009 the hospital length of stay decreased, but hospital charges demonstrated a significant increase. Conclusions Pediatric Spine Injuries continue to be a relevant problem, with rates exceeding those of other industrialized nations. Teenagers >15 years of age were at greatest risk, and motor vehicle collisions accounted for the most common mechanism. An increase in prevalence was observed between 1997 and 2009, and this was matched by a similar increase in hospital charges. Level of Evidence III. PMID:26361456

Deafness and Rubella: A Challenge and a Charge to Rehabilitation.

ERIC Educational Resources Information Center

Mills, Craig

1980-01-01

Summarizing salient information from the preceding papers (EC 132 316-326), the author cites nine major issues and recommendations, including the fact that considerable underutilized legislation should be brought to bear on the needs of children and adults with rubella. (Author)

The public health impact of pediatric caustic ingestion injuries.

PubMed

Johnson, Christopher M; Brigger, Matthew T

2012-12-01

To determine the current public health burden of injuries due to caustic ingestion in children. The 2009 Kids' Inpatient Database provides data on a sample of all pediatric hospital discharges in the United States during that year. Children with caustic ingestion injuries requiring hospitalization were identified by corresponding codes from the International Classification of Diseases, Ninth Revision. Database analysis generated national estimates of summary statistics. A national database. Representative sample of all hospital discharge data on patients 18 years or younger. Public health burden related to caustic injury, including potential factors related to admission outcome, the necessity of a procedure during the admission, admission length of stay, and total charges for the admission. We estimated the prevalence of pediatric caustic ingestion injuries requiring hospitalization in the United States in 2009 to be 807 (95% CI, 731-882) children. The annual economic burden was estimated at $22 900 000 (95% CI, $15 400 000-$30 400 000) in total hospital charges. The mean charge per patient was estimated at $28 860 (95% CI, $19 799-$37 922) with a median of $9848. The mean length of admission was 4.13 (95% CI, 3.22-5.03) days with a median of 2 days. Among the 807 patients, 45.3% underwent esophagoscopy, and those admitted to teaching hospitals were more likely to undergo a procedure during their stay (P = .02). Logistic regression models suggested significant median income (P < .001) and sex (P < .001) variations. The current public health burden of pediatric caustic ingestion injuries may be less than commonly cited. This finding supports the notion that legislative efforts have been successful. Despite these successes, these injuries continue to impose a significant burden on health care resources.

45 CFR 1301.31 - Personnel policies.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... criminal arrests and charges related to child sexual abuse and their disposition; (ii) Convictions related...) Any offense, other than any offense related to child abuse and/or child sexual abuse or violent...

45 CFR 1301.31 - Personnel policies.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... criminal arrests and charges related to child sexual abuse and their disposition; (ii) Convictions related...) Any offense, other than any offense related to child abuse and/or child sexual abuse or violent...

45 CFR 1301.31 - Personnel policies.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... criminal arrests and charges related to child sexual abuse and their disposition; (ii) Convictions related...) Any offense, other than any offense related to child abuse and/or child sexual abuse or violent...

45 CFR 1301.31 - Personnel policies.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... criminal arrests and charges related to child sexual abuse and their disposition; (ii) Convictions related...) Any offense, other than any offense related to child abuse and/or child sexual abuse or violent...

Motion Simulator

NASA Technical Reports Server (NTRS)

2000-01-01

Visitors to StenniSphere can feel the motion of a ride to Mars with a ride on StenniSphere's full motion simulator. The simulator is the only attraction at StenniSphere for which there is a charge. Adult rides are $4 and children ride for $3. Group discounts are also available.

Consideration of Cost of Care in Pediatric Emergency Transfer-An Opportunity for Improvement.

PubMed

Gattu, Rajender K; De Fee, Ann-Sophie; Lichenstein, Richard; Teshome, Getachew

2017-05-01

Pediatric interhospital transfers are an economic burden to the health care, especially when deemed unnecessary. Physicians may be unaware of the cost implications of pediatric emergency transfers. A cost analysis may be relevant to reduce cost. To characterize children transferred from outlying emergency departments (EDs) to pediatric ED (PED) with a specific focus on transfers who were discharged home in 12 hours or less after transfer without intervention in PED and analyze charges associated with them. Charts of 352 patients (age, 0-18 years) transferred from 31 outlying EDs to PED during July 2009 to June 2010 were reviewed. Data were collected on the range, unit charge and volume of services provided in PED, length of stay, and final disposition. The average charge per patient transfer is calculated based on unit charge times total service units per 1000 patients per year and divided by 1000. Hospital charges were divided into fixed and variable. Of 352 patients transferred, 108 (30.7%) were admitted to pediatric inpatient service, 42 (11.9%) to intensive care; 36 (10.2%) went to the operating room, and 166 (47.2%) were discharged home. The average hospital charge per transfer was US $4843. Most (89%) of the charges were fixed, and 11% were variable. One hundred one (28.7%) patients were discharged home from PED in 12 hours or less without intervention. The hospital charges for these transfers were US $489,143. Significant number of transfers was discharged 12 hours or less without any additional intervention in PED. Fixed charges contribute to majority of total charges. Cost saving can be achieved by preventing unnecessary transfer.

Childhood Hyperactivity, Physical Aggression and Criminality: A 19-Year Prospective Population-Based Study

PubMed Central

Pingault, Jean-Baptiste; Côté, Sylvana M.; Lacourse, Eric; Galéra, Cédric; Vitaro, Frank; Tremblay, Richard E.

2013-01-01

Background Research shows that children with Attention Deficit/Hyperactivity Disorder are at elevated risk of criminality. However, several issues still need to be addressed in order to verify whether hyperactivity in itself plays a role in the prediction of criminality. In particular, co-occurrence with other behaviors as well as the internal heterogeneity in ADHD symptoms (hyperactivity and inattention) should be taken into account. The aim of this study was to assess the unique and interactive contributions of hyperactivity to the development of criminality, whilst considering inattention, physical aggression and family adversity. Methodology/Principal Findings We monitored the development of a population-based sample of kindergarten children (N = 2,741). Hyperactivity, inattention, and physical aggression were assessed annually between the ages of 6 and 12 years by mothers and teachers. Information on the presence, the age at first charge and the type of criminal charge was obtained from official records when the participants were aged 25 years. We used survival analysis models to predict the development of criminality in adolescence and adulthood: high childhood hyperactivity was highly predictive when bivariate analyses were used; however, with multivariate analyses, high hyperactivity was only marginally significant (Hazard Ratio: 1.38; 95% CI: 0.94–2.02). Sensitivity analyses revealed that hyperactivity was not a consistent predictor. High physical aggression was strongly predictive (Hazard Ratio: 3.44; 95% CI: 2.43–4.87) and its role was consistent in sensitivity analyses and for different types of crime. Inattention was not predictive of later criminality. Conclusions/Significance Although the contribution of childhood hyperactivity to criminality may be detected in large samples using multi-informant longitudinal designs, our results show that it is not a strong predictor of later criminality. Crime prevention should instead target children with the highest levels of childhood physical aggression and family adversity. PMID:23658752

Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (CHildhood Autism Risks from Genetics and Environment) case-control study123

PubMed Central

Schmidt, Rebecca J; Tancredi, Daniel J; Ozonoff, Sally; Hansen, Robin L; Hartiala, Jaana; Allayee, Hooman; Schmidt, Linda C; Tassone, Flora; Hertz-Picciotto, Irva

2012-01-01

Background: Periconceptional folate is essential for proper neurodevelopment. Objective: Maternal folic acid intake was examined in relation to the risk of autism spectrum disorder (ASD) and developmental delay (DD). Design: Families enrolled in the CHARGE (CHildhood Autism Risks from Genetics and Environment) Study from 2003 to 2009 were included if their child had a diagnosis of ASD (n = 429), DD (n = 130), or typical development (TD; n = 278) confirmed at the University of California Davis Medical Investigation of Neurodevelopmental Disorders Institute by using standardized clinical assessments. Average daily folic acid was quantified for each mother on the basis of dose, brands, and intake frequency of vitamins, supplements, and breakfast cereals reported through structured telephone interviews. Results: Mean (±SEM) folic acid intake was significantly greater for mothers of TD children than for mothers of children with ASD in the first month of pregnancy (P1; 779.0 ± 36.1 and 655.0 ± 28.7 μg, respectively; P < 0.01). A mean daily folic acid intake of ≥600 μg (compared with <600 μg) during P1 was associated with reduced ASD risk (adjusted OR: 0.62; 95% CI: 0.42, 0.92; P = 0.02), and risk estimates decreased with increased folic acid (P-trend = 0.001). The association between folic acid and reduced ASD risk was strongest for mothers and children with MTHFR 677 C>T variant genotypes. A trend toward an association between lower maternal folic acid intake during the 3 mo before pregnancy and DD was observed, but not after adjustment for confounders. Conclusions: Periconceptional folic acid may reduce ASD risk in those with inefficient folate metabolism. The replication of these findings and investigations of mechanisms involved are warranted. PMID:22648721

Why do couples discontinue unlimited free IVF treatments?

PubMed

Lande, Yechezkel; Seidman, Daniel S; Maman, Ettie; Baum, Micha; Hourvitz, Ariel

2015-03-01

Worldwide, IVF is often discontinued before a live birth is achieved due to high costs. Even when partial financial coverage is provided, often medical providers advise treatment discontinuation. In Israel, unlimited IVF is offered free of charge for a couples' first two children. Our objective was to assess the reasons couples discontinue IVF treatments before achieving two children in a completely unlimited cost-free environment. This cohort study included all primary infertile women, <35 years, referred for their first IVF cycle to Sheba IVF unit between 2001 and 2002. Patients were followed until February 2012. Those who ceased treatments for 12 months were interviewed to assess the main reason they ceased treatments. Of the 134 couples included, only 46 ceased IVF treatments without achieving two children, after performing an average of 6.2 IVF cycles to achieve their first birth. The reasons given were: lost hope of success (13), psychological burden (18), divorce (6), medical staff recommendation (5), bureaucratic difficulties (3) and general medical condition (1). The main reasons for "drop out" in our cost-free environment were as follows: psychological burden and lost hope of success. Due to high availability of treatments, medical staff recommendation was a less significant factor in our study.

Perception of Treatment Needs and Use of Dental Services for Children and Adolescents with Sickle Cell Disease.

PubMed

Luna, Ana; Gomes, Monalisa; Granville-Garcia, Ana; Menezes, Valdenice

2018-01-01

To evaluate the perception of treatment needs and the use of dental services for children/adolescents with sickle cell disease. A cross-sectional study was conducted with 250 children/adolescents with sickle cell disease at a reference center in the city of Recife, Brazil. Data on the use of dental services were collected using a 13-item questionnaire administered to parents/guardians. The examiner in charge of determining l caries and periodontal status had previously undergone a training and calibration exercise. Descriptive statistics and Poisson regression analysis were also performed (α = 5%). A total of 47.2% of the children/adolescents with sickle cell disease were diagnosed with caries and 14.0% were diagnosed with some periodontal problems. The following variables were statistically significantly associated with the perceptions of parents/guardians regarding the treatment needs of their children: caries (PR = 1.24; 95%CI: 1.09-1.42), periodontal problems (PR = 1.10; 95%CI 1.01-1.20) and history of toothache in the previous six months (PR = 1.17; 95%CI 1.06-1.29). Only a lower level of mothers' schooling (PR = 1.64; 95%CI 1.06-2.53) was statistically significantly associated with the mean number of caries among the children/adolescents with sickle cell disease. Mean dmft/DMFT indices were higher among children/adolescents who sought dental care. Based on our results, a predomination of curative treatment was found, as seeking out dental treatment was more frequent among children/adolescents with a greater number of caries.

Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection: data from the nationwide emergency department sample, 2006 to 2011.

PubMed

Sood, Akshay; Penna, Frank J; Eleswarapu, Sriram; Pucheril, Dan; Weaver, John; Abd-El-Barr, Abd-El-Rahman; Wagner, Jordan C; Lakshmanan, Yegappan; Menon, Mani; Trinh, Quoc-Dien; Sammon, Jesse D; Elder, Jack S

2015-10-01

The Emergency Department (ED) is being increasingly utilized as a pathway for management of acute conditions such as the urinary tract infections (UTIs). We sought to assess the contemporary trends in pediatric UTI associated ED visits, subsequent hospitalization, and corresponding financial expenditure, using a large nationally representative pediatric cohort. Further, we describe the predictors of admission following a UTI associated ED visit. The Nationwide Emergency Department Sample (NEDS; 2006-2011) was queried to assess temporal-trends in pediatric (age ≤17 years) ED visits for a primary diagnosis of UTI (ICD9 CM code 590.X, 595.0, and 599.0), subsequent hospital admission, and total charges. These trends were examined using the estimated annual percent change (EAPC) method. Multivariable regression models fitted with generalized estimating equations (GEE) identified the predictors of hospital admission. Of the 1,904,379 children presenting to the ED for management of UTI, 86 042 (4.7%) underwent hospital admission. Female ED visits accounted for almost 90% of visits and increased significantly (EAPC 3.28%; p = 0.003) from 709 visits per 100 000 in 2006 to 844 visits per 100 000 in 2011. Male UTI incidence remained unchanged over the study-period (p = 0.292). The overall UTI associated ED visits also increased significantly during the study-period (EAPC 3.14%; p = 0.006) because of the increase in female UTI associated ED visits. Overall hospital admissions declined significantly over the study-period (EAPC -5.59%; p = 0.021). Total associated charges increased significantly at an annual rate of 18.26%, increasing from 254 million USD in 2006 to 464 million USD in 2011 (p < 0.001; Figure). This increase in expenditure was likely driven by increased utilization of diagnostic CT scanning in these patients (EAPC 22.86%; p < 0.001). Ultrasonography (p = 0.805), X-ray (p = 0.196), and urine analysis/culture use (p = 0.121) did not change over the study-period. In multivariable analysis, the independent predictors of admission included younger age (p < 0.001), male gender (OR = 2.05, p < 0.001), higher comorbidity status (OR = 14.81, p < 0.001), pyelonephritis (OR = 4.45, p < 0.001) and concurrent hydronephrosis (OR = 49.42, p < 0.001), stone disease (OR = 6.44, p < 0.001), or sepsis (OR = 18.83, p < 0.001). We show that the incidence of ED visits for pediatric UTI is on the rise. This rise in incidence could be due to several factors, including increasing prevalence of metabolic conditions such as obesity, diabetes and metabolic syndrome in children predisposing them to infections, or could be secondary to increasing sexual activity amongst adolescents and changing patterns of contraceptive use (increased use of OCP in place of condoms), or more simply might just be a reflection of changing practice patterns. Second, we demonstrate that total charges for management of UTI in the ED setting are increasing rapidly; the increase is primarily driven by increasing utilization of diagnostic imaging in the ED setting, as has been demonstrated in other ED based studies as well. In children presenting to the ED with a primary diagnosis of UTI, total ED charges are increasing at an alarming rate not commensurate with the increase in overall ED visits. While the preponderance of children presenting to the ED for UTI are treated and discharged, 4.7% of patients were admitted to the hospital for further management. The strongest predictors of inpatient admission were pyelonephritis, younger age, male gender, higher comorbidity status, and concurrent hydronephrosis, stone disease, or sepsis. Managing these at-risk patients more aggressively in the outpatient setting may prevent unnecessary ED visits and subsequent hospitalizations, and reduce associated healthcare costs. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Transactional price of an expected child and its application in birth control.

PubMed

Li, X

1993-01-01

The theoretical presentation of the impact of the transactional price of an expected child (TPEC) on birth control led to the conclusion that successful birth control was a combination of birth utility theory and TPEC theory. In a hypothetical market, the assumption can be made that an expected price can be attached to a desired child or a transactional price can be attached for giving up the reproductive right to have an excess child. A consumer equilibrium model can characterize the changes in financial resources necessary in deciding on an appropriate number of children. In a general equilibrium model, couples would have to be compensated a certain amount as an inducement to forgo the right to have a second child. Prices of children can be determined by a distributional curve of this transactional price of expected excess children and the estimated marginal price for couples with two children. Under circumstances of limited resources, it would be cheaper to buy some couple's rights to forgo a child, and this price would vary with parity. The exact transactional price of each child by parity by each couple could be theoretically determined, if all couples told the truth about desired number of children. However, the complication is that this condition may not be possible, and couples may charge more for forgoing the right to a subsequent child that what they would actually accept. Also, the seller could ask one price and then charge more. A compromise would be to set prices only for lower parities and to set prices subject to the total funds available to the buyer. Very low prices would also decrease the effectiveness of birth control. The government could be a buyer or seller. Taxing couples for additional children would make the government a seller. When the government is the buyer, couples would be compensated for not having an additional child. Another possibility is a reward for having only a certain number of children and a tax for excess children, which would be a mixed transactional price. The transactional price must be contractual, and breach of contract would mean forfeiture of profit or required sterilization.

Drug delivery.

PubMed

Le Souëf, Peter N

2002-09-16

What we know: In preschool children, small-volume spacers perform better than large-volume spacers. Detergent is the best antistatic agent for spacers, increasing lung delivery two- to threefold, but it must not be rinsed off. A mouthpiece should be used in children aged 2-3 years or older, as lung delivery is two- to threefold higher for oral inhalation than nasal inhalation (ie, by mask). Inhaled drug doses do not generally need to be reduced in infants and young children owing to inefficiencies of delivery in younger patients. Nebulisers are "dinosaurs" and not needed for most children with asthma. What we need to know: What is the best inhalation technique for spacers? How long should children breathe, how many breaths should they take, and at what age should they breath-hold? How should children, parents and doctors be instructed to achieve optimal levels of electrostatic charge reduction for spacers? How much should inhaled steroid dose be reduced when a spacer is used optimally? What dosing instructions should be given for beta(2)-agonists delivered by spacer?

Oklahoma Nurses Association 2005 House of Delegates resolution. Dangers of leaving children unattended in and around motor vehicles.

PubMed

There is an escalation in the number of fatalities and injuries to children left unattended in and around motor vehicles. Since 1996, more than 225 children, most of them age 3 and under, have died of heat stroke after being trapped inside a parked car. In Oklahoma, SAFE KIDS Coalition has worked to educate parents and the public about leaving children in cars especially when temperatures reach 70 degrees or higher. Currently 12 states have laws that prohibit leaving children unattended in automobiles, but those states do not include Oklahoma. In states where no specific law exists, state and local prosecutors have the discretion to criminally charge adults under existing child endangerment laws. At the 2005 ANA House of Delegates a resolution to adopted so that the American Nurses Association would work with other entities to bring this issue to the public's attention to reduce and prevent future injuries and harm to children.

Most routine laboratory testing of pediatric psychiatric patients in the emergency department is not medically necessary.

PubMed

Donofrio, J Joelle; Horeczko, Timothy; Kaji, Amy; Santillanes, Genevieve; Claudius, Ilene

2015-05-01

We examined the patient characteristics and hospital charges associated with routine medical clearance laboratory screening tests in 1,082 children younger than age eighteen who were brought to the emergency department (ED) for involuntary mental health holds--that is, each patient was brought to the ED to be evaluated for being a danger to him- or herself or to others, for being gravely disabled (unable to meet his or her basic needs due to a mental disorder), or both--from July 2009 to December 2010. Testing was performed on 871 of the children; all patients also received a clinical examination. The median charge for blood and urine testing together was $1,235, and the most frequent ordering pattern was the full comprehensive panel of tests. Of the patients with a nonconcerning clinical examination, 94.3 percent also had clinically nonsignificant test results. When we extrapolated cost savings to the national level, omitting routine screening laboratory tests in the population of pediatric patients presenting to the ED on an involuntary psychiatric hold with nonconcerning clinical exams could represent up to $90 million in savings annually, without reducing the ability to screen for emergency medical conditions. Provider-initiated diagnostic testing instead of routine screening would lead to significantly lower charges to the ED and the patient. Project HOPE—The People-to-People Health Foundation, Inc.

Procreative liberty: the case for preconception sex selection.

PubMed

Dahl, Edgar

2003-01-01

Preconception sex selection for non-medical reasons raises serious moral, legal and social issues. The main concerns include the threat of a sex ratio distortion due to a common preference for boys over girls, the charge of sexism, the danger of reinforcing gender stereotypical behaviour in sex selected children, and the fear of a slippery slope towards creating designer babies. This paper endeavours to show that none of the objections to preconception sex selection is conclusive and that there is no justification for denying parents the right to choose the sex of their prospective children.

[Family and risk factors related to alcohol consumption and smoking among children and adolescents (Guayaquil-Ecuador)].

PubMed

Ramírez Ruiz, Martha; Andrade, Denise de

2005-01-01

The present investigation had as objective identifying in a family the possible factors of risk related to the use of alcohol and tobacco in the children and adolescents. It is important to emphasize that study of this nature within a social and culture perspective expresses the attempt to include/understand the factors of risk for the use of tobacco and to drink alcoholic the environmental influences in the familiar surroundings views to prevent futures cases with dependency. For the study used a sample of one hundred families, to that applied to an instrument pre to them established with the people in charge of the respective families. As result were obtained 51% of the schooling level are low, 54% has inferior wage to the basic one, 61% to drink alcoholic. To emphasize that unquestionable the reduction of the casuistry of alcoholism and/or tabaquismo to influence significantly in the quality of the individuals life.

``I Have Been Given the Power to Teach. The Children Understand Me Very Well.'' The Social and Academic Impact of Deaf Teacher Training in Kenya

NASA Astrophysics Data System (ADS)

Johnstone, Christopher; Corce, Heidi

2010-02-01

Kenya has 41 Deaf schools that serve children from Class 1 through secondary school. These schools are all characterised by the fact that they have very few teachers who are fluent in Kenyan sign language. In order to meet the needs of schools and to provide employment opportunities for Deaf Kenyan adults, a small non-governmental organisation identified Deaf secondary school students for training. They received two years of teacher training free of charge. Most have since been awarded teaching contracts by the Kenyan Teacher Service Commission or local school boards. This article reports on results from a preliminary study of the social and academic impacts of this innovation. Results indicate that Deaf teachers are inspirational in the classroom, represent a significant resource for their school communities and are preferred by Deaf students. A follow-up study on the relative learning gains of Deaf students when taught by Deaf teachers is planned once relevant data are available.

Putting the Schools in Charge

ERIC Educational Resources Information Center

Katzman, John

2012-01-01

This article shares the author's vision for a more responsive education system. States can create a more agile, more American, system of governance that eliminates impediments to improvement, empowers schools to innovate, and uses data to help families find the right schools for their children. The author presents four proposals that would move…

Stop, Look, and Listen: Children Ahead.

ERIC Educational Resources Information Center

Stirling, Nora

This play, commissioned by Project Head Start, is designed to stimulate discussion and deepen understanding of key issues surrounding the confusion and conflicts that often arise when parents and professionals become entangled in disputes over "who is in charge" of the Head Start program. Guidelines for a discussion session following presentation…

TRACKING DOWN REPRODUCTIVE HEALTH RISKS FOR HUMANS EXPOSED TO ENVIRONMENTAL CONTAMINANTS

EPA Science Inventory

Government agencies charged with protecting public health are concerned about the same things you are: being able to conceive and deliver healthy babies, and watching them grow up to be strong, disease-free adults capable of having their own children. The rules that governments p...

42 CFR 441.615 - Administration fee requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES Vaccines for Children Program § 441.615 Administration fee requirements. (a) Under the VFC Program, a provider who administers a qualified pediatric vaccine to a federally vaccine-eligible child, may not impose a charge for the cost of the vaccine. (1) A provider can impose a fee for the...

Socialization and Self- Determination in Different-Age Dyads of Students Who Are Deafblind

ERIC Educational Resources Information Center

Bruce, Susan M.; Zatta, Mary C.; Gavin, Mary; Stelzer, Sharon

2016-01-01

Introduction: Deafblindness limits access to social cues and social feedback, thus restricting the development of social skills. Many children with CHARGE syndrome, a leading cause of deafblindness, experience challenges with emotional self-regulation and anxiety that may interfere with socialization. Learning about self-determination skills such…

Parental Participation Fees in School Expenses in Israel

ERIC Educational Resources Information Center

Shaked, Haim

2016-01-01

Purpose: Many countries throughout the world provide all children with free education. However, sometimes there are user charges in publically funded schools worldwide. The purpose of this paper is to explore parental participation fees in school expenses in Israel, depicting the current situation and analyzing its implications.…

Toward Global Communication Networks: How Television is Forging New Thinking Patterns.

ERIC Educational Resources Information Center

Adams, Dennis M.; Fuchs, Mary

1986-01-01

Recent alliances between communication providers and computer manufacturers will lead to new technological combinations that will deliver visually-based ideas and information to a worldwide audience. Urges that those in charge of future video programs to consider their effects on children's language skills, thinking patterns, and intellectual…

Child abuse and neglect in Cambodian refugee families: characteristics and implications for practice.

PubMed

Chang, Janet; Rhee, Siyon; Berthold, S Megan

2008-01-01

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts.

Hospitalization Cost Model of Pediatric Surgical Treatment of Chiari Type 1 Malformation.

PubMed

Lam, Sandi K; Mayer, Rory R; Luerssen, Thomas G; Pan, I Wen

2016-12-01

To develop a cost model for hospitalization costs of surgery among children with Chiari malformation type 1 (CM-1) and to examine risk factors for increased costs. Data were extracted from the US National Healthcare Cost and Utilization Project 2009 Kids' Inpatient Database. The study cohort was comprised of patients aged 0-20 years who underwent CM-1 surgery. Patient charges were converted to costs by cost-to-charge ratios. Simple and multivariable generalized linear models were used to construct cost models and to determine factors associated with increased hospital costs of CM-1 surgery. A total of 1075 patients were included. Median age was 11 years (IQR 5-16 years). Payers included public (32.9%) and private (61.5%) insurers. Median wage-adjusted cost and length-of-stay for CM-1 surgery were US $13 598 (IQR $10 475-$18 266) and 3 days (IQR 3-4 days). Higher costs were found at freestanding children's hospitals: average incremental-increased cost (AIIC) was US $5155 (95% CI $2067-$8749). Factors most associated with increased hospitalization costs were patients with device-dependent complex chronic conditions (AIIC $20 617, 95% CI $13 721-$29 026) and medical complications (AIIC $13 632, 95% CI $7163-$21 845). Neurologic and neuromuscular, metabolic, gastrointestinal, and other congenital genetic defect complex chronic conditions were also associated with higher hospital costs. This study examined cost drivers for surgery for CM-1; the results may serve as a starting point in informing the development of financial risk models, such as bundled payments or prospective payment systems for these procedures. Beyond financial implications, the study identified specific risk factors associated with increased costs. Copyright © 2016 Elsevier Inc. All rights reserved.

[Changes in food consumption pattern among Chilean school children after the implementation of a healthy kiosk].

PubMed

Bustos, Nelly; Kain, Juliana; Leyton, Bárbara; Vio, Fernando

2011-09-01

In Chilean school there is a kiosk that sells a large number of high-calorie products. The aim of this study was to determine the barriers that children have for buying healthy food and evaluate changes in the pattern of food purchases during a school year at a school where a "Healthy Space" was created. We designed implemented and assessed changes in food purchases by developing a "Healthy Space" which included a kiosk that incorporated a range of healthy food at affordable prices. The staff in charge of the kiosk was trained and we generate communication and marketing strategies to promote the consumption of healthy food. A validated survey to determine food purchases was applied to 9-12 year-old children from both schools at baseline and follow up 8 months later. The total number of schoolchildren was 477 (291 from the intervention and 115 from the control school). There weren't significant differences in the amount of money available to buy food between children of both schools. There was a significant increase in the purchase of fruit, milk, yoghurt, soft drinks and light juices, dried seeds, healthy sandwiches and non-fat ice cream (p < 0.05) of school children from the intervention school. At the control school, no change in consumption was observed. The increase in the supply of affordable healthy food, including communication and marketing strategies, significantly increases the consumption of these products among school children.

[Evaluation of the nutritional status of children under 5 years of age: concordance between anthropometric indices in the indigenous population of Chiapas (Mexico)].

PubMed

Ochoa-Díaz López, Héctor; García-Parra, Esmeralda; Flores-Guillén, Elena; García-Miranda, Rosario; Solís-Hernández, Roberto

2017-07-28

Nutritional status is determined through various methods, including anthropometry. In children under 5 years of age indeces as weight/age (w/a), height/age (h/a), weight/height (w/h) and body mass index (BMI) are used. The purpose of this article is to analyze and compare the ability of different anthropometric indeces to identify children from marginalized communities in Chiapas (Mexico) with nutritional problems. To analyze the correlation among the different anthropometric indeces to determine the nutritional status of children under 5 years of age in poor rural areas with a background of short stature. Cross-sectional study in 1,160 children under 5 years of age in 13 high poverty communities in three regions of Chiapas. The variables studied were age, sex, weight and height. Nutritional status was determined through the indeces w/a, h/a, w/h and BMI. Field staff in charge of taking measurements of weight and height were trained and standardized. Kappa coefficients for agreement between the indeces were calculated. No correlation between BMI and w/a and h/a was found. The prevalence of malnutrition according to h/a was 64.8%. Only high concordance (0.726) between BMI and w/h was found. BMI showed a low prevalence of malnutrition and a higher prevalence of overweight and obesity rates. For a reliable and accurate diagnosis in individuals with a background of chronic malnutrition, it is recommended to use the four indeces together. Doing so it will reduce the risk of underestimating or overestimating nutritional status and will focus actions toward addressing and improving the health and nutrition of children living under extreme poverty conditions.

Screening and identification of apolipoprotein A-I as a potential hepatoblastoma biomarker in children, excluding inflammatory factors

PubMed Central

ZHAO, WEI; LI, JUAN; ZHANG, YILIN; GAO, PENGFEI; ZHANG, JUNJIE; GUO, FEI; YU, JIEKAI; ZHENG, SHU; WANG, JIAXIANG

2015-01-01

The aim of the present study was to identify a child hepatoblastoma serum biomarker that is unaffected by inflammatory factors, with the ultimate aim of finding an effective method for the early diagnosis of hepatoblastoma. The magnetic bead-based weak cation exchange chromatography technique was used to process serum harvested from 30 children with hepatoblastoma, 20 children with systemic inflammatory response syndrome (SIRS) and 20 healthy children. Proteins differentially expressed in SIRS were excluded from consideration as biomarkers for hepatoblastoma. Proteins differentially expressed in hepatoblastoma and healthy controls were screened using surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS). Target proteins were purified by SDS-PAGE, and matrix-assisted laser desorption/ionization (MALDI)-TOF-MS was used to determine their amino acid sequences. Protein matches were searched in the SwissProt database. Quantitative polymerase chain reaction (qPCR) and ELISA were employed to confirm the expression of target proteins. Following screening to exclude inflammatory factors, SELDI-TOF-MS revealed a protein with a mass-to-charge ratio of 9,348 Da that was expressed at significantly lower levels in the serum of children with hepatoblastoma compared with healthy controls (P<0.01). Sequence analysis identified this protein as apolipoprotein A-1 (Apo A-I). qPCR and ELISA confirmed that the expression of Apo A-I mRNA and protein were significantly lower in children with hepatoblastoma compared with healthy controls (P<0.05). These results indicate that Apo A-I is a non-inflammatory protein marker for hepatoblastoma with the potential for use in early diagnosis of hepatoblastoma. In addition, the present study demonstrates the feasibility of proteomic screening for the identification of proteins that can serve as markers for a specific tumor. PMID:26171005

Screening and identification of apolipoprotein A-I as a potential hepatoblastoma biomarker in children, excluding inflammatory factors.

PubMed

Zhao, Wei; Li, Juan; Zhang, Yilin; Gao, Pengfei; Zhang, Junjie; Guo, Fei; Yu, Jiekai; Zheng, Shu; Wang, Jiaxiang

2015-07-01

The aim of the present study was to identify a child hepatoblastoma serum biomarker that is unaffected by inflammatory factors, with the ultimate aim of finding an effective method for the early diagnosis of hepatoblastoma. The magnetic bead-based weak cation exchange chromatography technique was used to process serum harvested from 30 children with hepatoblastoma, 20 children with systemic inflammatory response syndrome (SIRS) and 20 healthy children. Proteins differentially expressed in SIRS were excluded from consideration as biomarkers for hepatoblastoma. Proteins differentially expressed in hepatoblastoma and healthy controls were screened using surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS). Target proteins were purified by SDS-PAGE, and matrix-assisted laser desorption/ionization (MALDI)-TOF-MS was used to determine their amino acid sequences. Protein matches were searched in the SwissProt database. Quantitative polymerase chain reaction (qPCR) and ELISA were employed to confirm the expression of target proteins. Following screening to exclude inflammatory factors, SELDI-TOF-MS revealed a protein with a mass-to-charge ratio of 9,348 Da that was expressed at significantly lower levels in the serum of children with hepatoblastoma compared with healthy controls (P<0.01). Sequence analysis identified this protein as apolipoprotein A-1 (Apo A-I). qPCR and ELISA confirmed that the expression of Apo A-I mRNA and protein were significantly lower in children with hepatoblastoma compared with healthy controls (P<0.05). These results indicate that Apo A-I is a non-inflammatory protein marker for hepatoblastoma with the potential for use in early diagnosis of hepatoblastoma. In addition, the present study demonstrates the feasibility of proteomic screening for the identification of proteins that can serve as markers for a specific tumor.

[The Spanish influence in Colombian nursing].

PubMed

Velandia, A L

1993-06-01

Four statements inferenced from: religious traditions, gender or woman status, military heritage and ethnic inheritance, and their influence in nursing, are presented in this article. The ethnic inheritance analyses the issue based upon the cultural influences of the native-indigenous groups and the spanish and mediterranean attributes in nursing development. The religious tradition began with Pedro Claver's J.C. presence between 1610 and 1617. His presence is followed by the "Hermanos Hospitalarios de San Juan de Dios" in 1768, and further with the presence of the sisters of Charity in 1873. Lastly, the article compares the Barcelona's Santa Cruz hospital organization, where at that time, seems to appear a new type of nursing arrangement; with present functions and charges, currently utilized in colombian hospitals (administrator of patient rooms, "servidor", women in charge of female patients and sick children, "ecónoma", chief in charge, and senior male nurse).

Disproportionate rise in Clostridium difficile-associated hospitalizations among US youth with inflammatory bowel disease, 1997-2011.

PubMed

Sandberg, Kelly C; Davis, Matthew M; Gebremariam, Achamyeleh; Adler, Jeremy

2015-04-01

Our aim was to characterize the temporal changes in burden that Clostridium difficile infection (CDI) added to the hospital care of children and young adults with inflammatory bowel disease (IBD) in the United States. Retrospective analysis of annual, nationally representative samples of children and young adults with IBD. There was a 5-fold increase in IBD hospitalizations with CDI from 1997 to 2011 (P for trend <0.01). During the same period, IBD hospitalizations without CDI increased 2-fold (P for trend <0.01). Mean length of stay for IBD hospitalizations with CDI was consistently longer than that for hospitalizations without CDI and did not significantly change over time (P for trend = 0.47). CDI-related total hospital days in the United States rose from 1702 to 10,194 days per million individuals per year from 1997 to 2011 (P for trend <0.01). Children and young adults hospitalized with CDI had a significantly lower odds of colectomy (0.31) compared with those without CDI. Total charges for CDI-related hospitalizations among children and young adults in the United States rose from $8.7 million in 1997 to $68.2 million in 2011. A widening gap in burden has opened between IBD hospitalizations with and without CDI during the last decade and a half. CDI-related hospitalizations are associated with disproportionately longer lengths of stay, more hospital days, and more charges than hospitalizations without CDI over time. Further work within health systems, hospitals, and practices can help us better understand this enlarging gap to improve clinical care for this vulnerable population.

Introduction to the Development of the ISPCAN Child Abuse Screening Tools

ERIC Educational Resources Information Center

Runyan, Desmond K.; Dunne, Michael P.; Zolotor, Adam J.

2009-01-01

The "World Report on Children and Violence", (Pinheiro, 2006) was produced at the request of the UN Secretary General and the UN General Assembly. This report recommended improvement in research on child abuse. ISPCAN representatives took this charge and developed 3 new instruments. We describe this background and introduce three new measures…

Supporting Refugee Students in Schools: What Constitutes Inclusive Education?

ERIC Educational Resources Information Center

Taylor, Sandra; Sidhu, Ravinder Kaur

2012-01-01

The worldwide rise in numbers of refugees and asylum seekers suggests the need to examine the practices of those institutions charged with their resettlement in host countries. In this paper, we investigate the role of one important institution--schooling--and its contribution to the successful resettlement of refugee children. We begin with an…

7 CFR 210.16 - Food service management companies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... general nature of its food service, and the prices to be charged the children for meals; (5) Retain... preparing or serving meals at a school food authority facility; (8) Establish an advisory board composed of... standard for the purpose of basing bids or estimating average cost per meal. A school food authority with...

Setting Limits: The Child Who Uses Inappropriate Language

ERIC Educational Resources Information Center

Greenberg, Polly

2004-01-01

This article discusses how to work with a child who uses inappropriate language. The words inappropriately used by young children are grouped into five categories: (1) names of body parts considered as private, and their nicknames; (2) bathroom words and body products; (3) religion-related words; (4) sexually charged words overheard when adults…

"I Don't Know What I'm Doing--They All Start with B": First Graders Negotiate Peer Reading Interactions.

ERIC Educational Resources Information Center

MacGillivray, Laurie; Hawes, Shirl

1994-01-01

Discusses the way children negotiated partner reading and the roles they assumed that determined who was in charge and how the reading would be carried out. Finds four types of role sets: coworkers, fellow artists, teacher-student, and boss-employee. (SR)

7 CFR 245.9 - Special assistance certification and reimbursement alternatives.

Code of Federal Regulations, 2014 CFR

2014-01-01

... this chapter, to all participating children at no charge. (2) Cost differential. The school food... 2 school, the actual number of all reimbursable meals served by type (free, reduced price, and paid... verification in accordance with § 245.6a. When a school elects to participate under Provision 2 or for all of...

7 CFR 245.9 - Special assistance certification and reimbursement alternatives.

Code of Federal Regulations, 2013 CFR

2013-01-01

... this chapter, to all participating children at no charge. (2) Cost differential. The school food... 2 school, the actual number of all reimbursable meals served by type (free, reduced price, and paid... verification in accordance with § 245.6a. When a school elects to participate under Provision 2 or for all of...

7 CFR 245.9 - Special assistance certification and reimbursement alternatives.

Code of Federal Regulations, 2012 CFR

2012-01-01

... this chapter, to all participating children at no charge. (2) Cost differential. The school food... 2 school, the actual number of all reimbursable meals served by type (free, reduced price, and paid... verification in accordance with § 245.6a. When a school elects to participate under Provision 2 or for all of...

Handicapped Litigation: A Review of Significant Decisions.

ERIC Educational Resources Information Center

Bowen, John W.

Since 1979 many courts have handed down rulings in favor of handicapped children under the Education of the Handicapped Act. This twentieth chapter in a book on school law summarizes these cases. In "Kruelle v. Biggs," the court ruled that a school district must provide residential placement free of charge if such placement is necessary…

Cultural Coherence and the Schooling for Identity Maintenance

ERIC Educational Resources Information Center

Merry, Michael S.

2005-01-01

An education for cultural coherence tends to the child's well-being through identity construction and maintenance. Critics charge that this sort of education will not bode well for the future autonomy of children. I will argue that culturally coherent education, provided there is no coercion, can lend itself to eventual autonomy and may assist…

Reconceptualising the "Child": Power and Resistance within Early Childhood Settings

ERIC Educational Resources Information Center

Tesar, Marek

2014-01-01

This article reconceptualises the postmodern "Child" through the lens of Havel's work on ideology, power and subject formations. Set in an any ideologically charged early childhood setting, it analyses Havel's claim that all citizens, including children, are instrumental in maintaining the ideology of the establishment, and…

The Liver, Regulator of Nutrition.

ERIC Educational Resources Information Center

Dillon, J. C.

1995-01-01

The purpose of this theme issue is to review the basic physiological, nutritional, and pathological facts pertaining to the liver. It is an educational tool through which university teachers and people in charge of training may enhance their teaching programs. The main liver diseases seen in young children and pregnant women in tropical regions is…

76 FR 23520 - Periodic Review of Existing Regulations; Retrospective Review Under E.O. 13563

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

... reviews that regulation to determine if the underlying science and policy are still valid and whether the regulations should be updated based on current science, policy, data, or technology. The third mechanism is... charged FDA with encouraging more research and development for treatments specifically for children. In...

Who's in Charge of Celebrations? A Child Centered Approach.

ERIC Educational Resources Information Center

Creaser, Barbara; Dau, Elizabeth

1994-01-01

This booklet addresses the issue of special occasions and how they are celebrated. It presents three lists of celebrations: those that focus on young children and have meaning for them; those that parents may choose and therefore are likely to acknowledge diversity among families, races, religions, classes and cultures; and those that the early…

The innocent bystander. Doxylamine/dicyclomine/pyridoxine and congenital limb defects.

PubMed

McCredie, J; Kricker, A; Elliott, J; Forrest, J

1984-04-28

The antinausea drug combination, doxylamine/dicyclomine/pyridoxine (Debendox or Bendectin [US] ), has been withdrawn from the market because of litigation based upon charges that it causes congenital limb defects. To investigate this allegation, the pregnancy histories of mothers of 155 limb-deficient children, born between 1970 and 1981, have been compared with those of mothers of 273 matched normal controls. There was no significant difference between the pregnancy histories of mothers of case children and those of mothers of control children in respect of reported frequency of morning sickness, the use of doxylamine/dicyclomine/pyridoxine, the date of commencement of its intake, the duration of intake, or its dose. The relative risk of limb deficiency in children of mothers exposed to this drug is estimated to be 1.1 with confidence limits of 0.8-1.5. No risk of congenital limb defects was found to be associated with the use of this drug.

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model.

PubMed

Lalwani, Kirk; Tomlinson, Matthew; Koh, Jeffrey; Wheeler, David

2012-01-01

Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62-100). There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient) as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

Casemix reimbursement: a Singapore Children's Hospital perspective.

PubMed

Yoong, S L

2001-07-01

Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.

Science for children and the untutored in eighteenth-century England

NASA Astrophysics Data System (ADS)

Robin, Regina Spires

The popularization of science in eighteenth-century England included books written for children and the untutored. This exploratory study examines five authors who enjoyed recognition in the world of adult literature and who sought to simplify scientific material while conserving sophisticated language and complex ideas. Francesco Algarotti popularized Newton's Opticks while John Newbery, under the pseudonym Tom Telescope, used the playthings of childhood to explore Locke's version of Newton's natural philosophy. James Ferguson, in a series of dialogues between a brother and sister, explicated astronomy for young readers. Richard Lovell Edgeworth and his daughter, Maria, regarded observation and experimentation as the primary method of teaching applied science to their young charges. Thomas Day and Edgeworth used popular heroes to explore social issues and changing values. Encouraged by members of the Lunar Society, they utilized their literary and scientific knowledge to further the cause of home schooling. They stressed industry, honesty, self-reliance and hard work as necessary corollaries to scientific exploration and, at the same time, addressed a variety of social issues including the place of women in science, the role of philanthropy, the evils of gambling and the possibilities of a plurality of worlds. This study attempts to bridge the gap between children's literature and the popularization of science.

The use and misuse of mass distributed free insecticide-treated bed nets in a semi-urban community in Rivers State, Nigeria.

PubMed

Ordinioha, Best

2012-01-01

Insecticide-treated bed net (ITN) is currently distributed free of charge to vulnerable groups in Nigeria, for malaria control. Consistent use of the nets is required for maximum effectiveness; but studies indicate that the nets are often jettisoned in periods of low mosquito activity and high night time temperature. The objective of this study has been to assess the use of mass distributed nets in a semi-urban community in Rivers State, south-south Nigeria, during the late dry season, when mosquito activity is at the lowest in the community. The study was carried out in Ishiodu - Emohua, using a cross-sectional study design. The data was collected using a structured, interviewer-administered questionnaire, administered to female head of households in the community, with under-five children. A total of 170 respondents were studied; they had an average age of 34.3 ± 7.6 years, most were married (86.5%), and had secondary school education (68.2%). All the households owned at least one ITN, and an average of 1.7 nets, with 75.3% of the households owning two or more ITNs. Almost all the nets (99.4%) were obtained free of charge. Of the 170 households that received the nets, 71.8% had hanged the nets as at the time of the survey; 83.6% of these hanged the nets over a bed, while 10.7% used the nets as window curtain. Of the 102 ITNs that were properly deployed, only 27.5% were occupied the night before the survey, by an average of 2.5 persons, mainly under-five children (37.7%). The distribution of free ITNs has resulted in universal household ownership, but the use of the nets is still very poor. Proper health education is required to encourage the consistent use of the nets, even in hot night, with low mosquito activity.

Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.

PubMed

Abdus, Salam; Hudson, Julie; Hill, Steven C; Selden, Thomas M

2014-08-01

Both Medicaid and the Children's Health Insurance Program (CHIP), which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013. Using data from the 1999-2010 Medical Expenditure Panel Surveys, we show that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. Among children with family incomes above 150 percent of the federal poverty level, a $10 increase in monthly premiums is associated with a 1.6-percentage-point reduction in Medicaid or CHIP coverage. In this income range, the increase in uninsurance may be higher among those children whose parents lack an offer of employer-sponsored insurance than among those whose parents have such an offer. Among children with family incomes of 101-150 percent of poverty, a $10 increase in monthly premiums is associated with a 6.7-percentage-point reduction in Medicaid or CHIP coverage and a 3.3-percentage-point increase in uninsurance. In this income range, the increase in uninsurance is even larger among children whose parents lack offers of employer coverage. Project HOPE—The People-to-People Health Foundation, Inc.

Pediatric sports-related lower extremity fractures: hospital length of stay and charges: what is the role of the primary payer?

PubMed

Gao, Yubo; Johnston, Richard C; Karam, Matthew

2010-01-01

The purposes of this study were (a) to evaluate the distribution by primary payer (public vs. private) of U.S. pediatric patients aged 5-18 years who were hospitalized with a sports-related lower extremity fracture and (b) to discern the adjusted mean hospital length of stay and mean charge per day by payer type. Children who were aged 5 to 18 years and had diagnoses of lower extremity fracture and sports-related injury in the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database were included. Lower extremity fractures are defined as International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under Section "Injury and Poisoning (800-999)," while sports-related external cause of injury codes (E-codes) are E886.0, E917.0, and E917.5. Differences in hospital length of stay and cost per day by payer type were assessed via adjusted least square mean analysis. The adjusted mean hospital length of stay was 20% higher for patients with a public payer (2.50 days) versus a private payer (2.08 days). The adjusted mean charge per day differed about 10% by payer type (public, US$7,900; private, US$8,794). Further research is required to identify factors that are associated with different length of stay and mean charge per day by payer type, and explore whether observed differences in hospital length of stay are the result of private payers enhancing patient care, thereby discharging patients in a more efficient manner.

Does Type of Child Risk Affect Whether Mothers Seek Assistance for Intimate Partner Violence From Civil or Criminal Court?

PubMed

Palmer, Jane E; Renner, Lynette M; Goodman, Lisa A; Dutton, Mary Ann

2016-03-01

We examined whether risks to children of intimate partner violence survivors affected the type of legal assistance accessed. We hypothesized that the level and type of perceived child risk would be associated with whether women sought a protection order in civil court or filed charges against a current or former intimate partner in criminal court. Using data from a sample of predominantly African American women (N=293), we found that some forms of child risk were positively associated with seeking a civil order of protection but negatively associated with pressing criminal charges. Implications for practice, policy, and future research are presented. © The Author(s) 2015.

Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders

PubMed Central

Walker, Cheryl K.; Bremer, Andrew A.; Baker, Alice S.; Ozonoff, Sally; Hansen, Robin L.; Hertz-Picciotto, Irva

2012-01-01

OBJECTIVE: We examined whether metabolic conditions (MCs) during pregnancy (diabetes, hypertension, and obesity) are associated with autism spectrum disorder (ASD), developmental delays (DD), or impairments in specific domains of development in the offspring. METHODS: Children aged 2 to 5 years (517 ASD, 172 DD, and 315 controls) were enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study, a population-based, case-control investigation between January 2003 and June 2010. Eligible children were born in California, had parents who spoke English or Spanish, and were living with a biological parent in selected regions of California. Children’s diagnoses were confirmed by using standardized assessments. Information regarding maternal conditions was ascertained from medical records or structured interview with the mother. RESULTS: All MCs were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD and DD relative to controls (odds ratio: 1.61 [95% confidence interval: 1.10–2.37; odds ratio: 2.35 [95% confidence interval: 1.43–3.88], respectively). Among ASD cases, children of women with diabetes had Mullen Scales of Early Learning (MSEL) expressive language scores 0.4 SD lower than children of mothers without MCs (P < .01). Among children without ASD, those exposed to any MC scored lower on all MSEL and Vineland Adaptive Behavior Scales (VABS) subscales and composites by at least 0.4 SD (P < .01 for each subscale/composite). CONCLUSIONS: Maternal MCs may be broadly associated with neurodevelopmental problems in children. With obesity rising steadily, these results appear to raise serious public health concerns. PMID:22492772

The State of Early Childhood Higher Education in New York State. Technical Report

ERIC Educational Resources Information Center

Center for the Study of Child Care Employment, University of California at Berkeley, 2015

2015-01-01

The New York State Early Childhood Advisory Council (ECAC) serves the Governor and is charged with ensuring that all of New York's young children are healthy, learning, and thriving in families that are supported by a full complement of services and resources essential for successful development. The council's Workforce Work Group is dedicated to…

The Well Being of Our Nation: An Inter-Generational Vision of Effective Mental Health Services and Supports.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This report of the National Council on Disability (NCD) examines root causes of the crisis in mental health, specifically the dysfunction of fragmented public systems charged with providing mental health services and supports for children, youth, adults, and senior citizens diagnosed with mental illnesses. Following an introductory chapter,…

Urban School Superintendents: Characteristics, Tenure, and Salary. Seventh Survey and Report. Urban Indicator, Fall 2010

ERIC Educational Resources Information Center

Council of the Great City Schools, 2010

2010-01-01

Urban school superintendents hold one of the most important and challenging jobs in America's education system. In this era of accountability and standards, superintendents are charged with making visible and rapid improvements in the academic achievement of the nation's most vulnerable children. They must break down barriers to reform and build…

34 CFR 222.161 - How is State aid treated under section 8009 of the Act?

Code of Federal Regulations, 2011 CFR

2011-07-01

... residing on Indian lands) or payments under section 8003(d) of the Act (children with disabilities... Indian lands). (D) Section 3(d)(3)(B)(ii) (increase for unusual geographical factors). (2) No State aid... definitions apply to this subpart: Current expenditures means the total charges incurred for the benefit of...

New York State School Facilities and Student Health, Achievement, and Attendance: A Data Analysis Report

ERIC Educational Resources Information Center

Boese, Stephen; Shaw, John

2005-01-01

Students who attend schools with environmental hazards that impact indoor air quality are more likely to miss class, and therefore lose learning opportunities. Yet school environmental health and safety remains largely unregulated and there is no state or federal agency in charge of protecting children's environmental health in schools. This…

26 CFR 1.1471-5 - Definitions applicable to section 1471.

Code of Federal Regulations, 2014 CFR

2014-04-01

... contract, less the sum of mortality, morbidity, and expense charges (whether or not actually imposed) for...) The mortality tables and interest rate(s)— (i) Prescribed pursuant to section 7520 and the regulations... benefit of X's children, Y and Z. X appoints Trustee A, an individual, to act as the trustee of Trust A...

K9 Buddies: A Program of Guide Dogs for the Blind

ERIC Educational Resources Information Center

Ritter, Joanne

2007-01-01

Today, exceptional dogs that have been specially bred and socialized are paired with children who are blind or visually impaired. These dogs, called "K9 Buddies," are from Guide Dogs for the Blind, a national nonprofit organization with a mission to offer skilled mobility dogs and training free-of-charge to adults with visual impairments…

Bad Signs

ERIC Educational Resources Information Center

Kohn, Alfie

2010-01-01

One can tell quite a lot about what goes on in a classroom or a school even if one visits after everyone has gone home. Just by looking at the walls--or, more precisely, what's on the walls--it's possible to get a feel for the educational priorities, the attitudes about children, even the assumptions about human nature of the people in charge. In…

Creating Connections, Building Constructions: Language, Literacy, and Play in Early Childhood.

ERIC Educational Resources Information Center

Roskos, Kathleen

In these politically charged times of early literacy initiatives, position statements, and education reform, talk about play and literacy learning seems rather awkward, if not even a bit silly. As the realities of early literacy education set in, teachers, legislators, and parents grow ever more critical of what young children are doing as…

Assessment of Cognitive Ability of Students with Severe and Low-Incidence Disabilities--Part 1

ERIC Educational Resources Information Center

Crepeau-Hobson, Franci; Vujeva, Hana

2012-01-01

Students with severe and low-incidence disabilities comprise a heterogeneous population that often presents a challenge to the professionals charged with evaluating their skills and abilities. This is especially true in conducting a valid assessment of the cognitive ability of these children. Often, school psychologists are limited to the use of…

[The use of free-of-charge prescription contraceptives among women : Results of a pilot project in the German federal state of Mecklenburg-Western Pomerania].

PubMed

Ulbricht, Sabina; Beyer, Angelika; John, Ulrich

2018-04-01

There is a connection between the receipt of unemployment benefits and the failure to use contraceptives in Germany. This study aims to understand the use of contraceptives among women entitled to unemployment benefits under the Sozialgesetzbuch II or XII (SGB II or SGB XII), prior and during an offer of contraceptives free of charge (CFOC). The criteria for the use of CFOC (pill, intrauterine device, or ring) over a 12-month period were: age between 20 and 35 years, resident in predefined urban or rural postal codes in the German federal state of Mecklenburg-Western Pomerania, and participation in a self-administered survey. Data about participants' age, education, number of children, relationship status, period of payment according to SGB II or SGB XII, the use and barriers to use of contraceptives during every occurrence of sexual intercourse, as well as the kind of contraceptives used. From a total of 418 women: 40.9% were single-mothers, 39.0% did not graduate school, 21.1% were childless, and 57.9% had received unemployment benefits for at least three years. Further, 21.1% rated their type of contraceptive as "less safe" or "unsafe." The most commonly cited reasons for nonregular use of contraceptives were: they are too expensive or their use is forgotten. A change in contraceptives was made by 30.9% due to the offer of CFOC. The change was associated with the number of children and the exclusive use of less safe contraceptives. CFOC seems to be attractive, especially for women with children and those who receive long-term unemployment benefits. Changing demands concerning the safety of birth control during the lives of women should be considered in the discussion about common rules for the access to CFOC.

Psychosocial consequences of head injury in children and adolescents: implications for rehabilitation.

PubMed

Livingston, M G; McCabe, R J

1990-01-01

Studies measuring psychosocial outcome in children and adolescents have shown that head injury leads to cognitive impairment which is directly related to the severity of injury in those with very severe head injury. Psychiatric disorders are also related to the severity of injury but here the relationship suggests that mediating factors are involved. No specific pattern of post-traumatic psychological/psychiatric dysfunction emerges from the studies, but it is clear that, as with adults, psychosocial recovery lags behind physical. Head injury affects the functioning of the young person in the family, at school, and within the wider community, often resulting in a secondary handicap of low self-esteem. The multitude of deficits which are a consequence of severe head injury present a challenge for rehabilitation specialists. A multi-disciplinary, multi-specialist, and multi-agency response is required. As a result, families are often presented with a bewildering array of treatments and programmes at different agencies. A case manager can be helpful in ensuring the appropriate use of available resources and can be the one professional in charge of a coordinating case record.

Realities and Challenges of Support for Children with Special Needs in Nursery Schools

PubMed Central

Ishiguro, Kaori; Yoshioka, Shin-ichi

2016-01-01

Background Nursery schools and kindergartens have been struggling to cope with increasing numbers of children with special needs. Hence, we conducted a study on what nursery school teachers (NSTs) will require regarding learning and societal resources for supporting such children in the future. Methods A questionnaire survey was conducted for 2,476 NSTs employed in 154 nursery schools in Shimane and Kochi Prefectures. The questionnaires were sent by post to officials at each nursery school. The completed questionnaires were collected by the school officials and returned by post. In addition to statistical processing of the survey results, the content of the free description responses was analyzed using the KJ method. Results Responses were obtained from 1,509 NSTs at 118 nursery schools. Of the respondents, 90.7% had experienced difficulties coping with children with special needs, and 83.9% were in charge of caring for such children. Such children were enrolled in every childcare facility participating in the survey. The NSTs primarily needed to learn about specific coping methods, the illness, and skills for supporting parents; concerning the societal resources, they needed the addition of assistant NSTs, the implementation of age-five check-up, and the recruitment of mentors. The free description responses were categorized into the following five categories: demand for child care administration, cooperation with professional staff, support for parents, developmental health checkups, and on-site needs for nursery childcare. One of the specific demands was to develop human resources capable of providing parents with appropriate advice. Conclusion The results have shown that all NSTs are required to deal with children with special needs. Future challenges for providing support for such children are: ⅰ) to raise awareness of such children; ⅱ) to eliminate regional disparities; ⅲ) to provide professional training for NSTs specializing in developmental disorders; ⅳ) to train and re-educate assistant NSTs and ⅴ) to enhance infant screening. PMID:27046948

Realities and Challenges of Support for Children with Special Needs in Nursery Schools.

PubMed

Ishiguro, Kaori; Yoshioka, Shin-Ichi

2016-03-01

Nursery schools and kindergartens have been struggling to cope with increasing numbers of children with special needs. Hence, we conducted a study on what nursery school teachers (NSTs) will require regarding learning and societal resources for supporting such children in the future. A questionnaire survey was conducted for 2,476 NSTs employed in 154 nursery schools in Shimane and Kochi Prefectures. The questionnaires were sent by post to officials at each nursery school. The completed questionnaires were collected by the school officials and returned by post. In addition to statistical processing of the survey results, the content of the free description responses was analyzed using the KJ method. Responses were obtained from 1,509 NSTs at 118 nursery schools. Of the respondents, 90.7% had experienced difficulties coping with children with special needs, and 83.9% were in charge of caring for such children. Such children were enrolled in every childcare facility participating in the survey. The NSTs primarily needed to learn about specific coping methods, the illness, and skills for supporting parents; concerning the societal resources, they needed the addition of assistant NSTs, the implementation of age-five check-up, and the recruitment of mentors. The free description responses were categorized into the following five categories: demand for child care administration, cooperation with professional staff, support for parents, developmental health checkups, and on-site needs for nursery childcare. One of the specific demands was to develop human resources capable of providing parents with appropriate advice. The results have shown that all NSTs are required to deal with children with special needs. Future challenges for providing support for such children are: ⅰ) to raise awareness of such children; ⅱ) to eliminate regional disparities; ⅲ) to provide professional training for NSTs specializing in developmental disorders; ⅳ) to train and re-educate assistant NSTs and ⅴ) to enhance infant screening.

A film producer focuses on issues of social justice and nurses: an interview with Richard Harding. Interviewed by Kathleen McHugh.

PubMed

Harding, Richard

2012-01-01

This case study of Richard Harding, a producer currently making a film about the Benghazi Six, includes an introductory biography, an interview with the producer, and a brief conclusion. Harding's commitments to both filmmaking and social justice issues led him to The Benghazi Six and the injustices suffered by these Bulgarian nurses, who were persecuted and imprisoned in Libya for 9 years on false charges of infecting Libyan children with HIV. The film production ran alongside of and aided international efforts to free the nurses and one physician from Libya. Copyright © 2012 Elsevier Inc. All rights reserved.

Resolution on Creating Family-Style Children's Homes, August 1988.

PubMed

1988-01-01

This Resolution approves a proposal of the V.I. Lenin Soviet Children's Fund for setting up "family-style" children's homes in the Soviet Union. Children's homes are to consist of a) children's towns--single-family, multiroom homes occupied by families raising at least ten orphaned children and children left without parental care; and b) premises of individual families raising at least five such children while occupying separate multiroom units in regular apartment buildings, specialized buildings, or groups of buildings. In addition to residential buildings, children's towns are to contain a secondary school, a sports and fitness center, preschool facilities, housekeeping and preventative health care buildings, auxiliary farming plots, and other land where children and adults can work together. Thirty homes are to be built in the period 1988-1991. The Resolution also approves proposals establishing an All-Union Wardship Council; charging public health officials with providing permanent, qualified health care, consultation, mental health care, and diagnostics to every family assuming the responsibility of raising children; setting the task of organizing expanded research on children's health and treatment; recommending that enterprises, organizations, and institutions provide transportation service to family-style children's homes and families of employees raising these children and give them passes to sanatoriums, preventoriums, recreation centers and vacation complexes; and pledging the Council of Ministers' participation in the financing, construction, outfitting, and equipping of these homes and in providing material assistance to families raising orphaned children and children left without parental care. The Council of Ministers also decided that the time foster parents spend in raising five or more such children will be added to their overall continuous work record for the purposes of pensions and benefits and to their length of service in their specialty. full text

Providing teachers with education on epilepsy increased their willingness to handle acute seizures in children from one to 10 years of age.

PubMed

Dumeier, Henriette Karoline; Neininger, Martina Patrizia; Bernhard, Matthias Karl; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid

2017-11-01

In Germany, preschool teachers supervise children up to six years of age and are also responsible for supervising older pupils after school. This study explored the impact of a teaching session on epilepsy for teachers in charge of children from 1 to 10 years of age. We evaluated the benefit of a teaching session offered to all preschool teachers in Leipzig, Germany, in 2014-2015, by asking them to complete the same questionnaire 12-24 months pre-intervention, and 12 months postintervention. Both questionnaires were completed by 123 teachers. The number of teachers who felt they were prepared to handle an acute seizure rose from 36 (29%) pre-intervention to 65 (53%) post-intervention (p < 0.001) and their willingness to administer a prescribed rescue medication rose from 66 (54%) to 93 (76%, p < 0.001). The session also increased the number of teachers who were prepared to take children with epilepsy on excursions under any circumstance from 38 (31%) to 52 (42%, p < 0.05). In addition, the number of teachers who would place a solid object in the child's mouth during an attack fell from 16 (13%) to seven (6%) (p < 0.05). Providing a teaching session on epilepsy increased the teachers' knowledge and willingness to act and reduced obsolete, counterproductive measures. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

PubMed

Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James

2017-06-01

The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the requirement to have the radiologist interpret radiographs in the pediatric orthopaedic clinic would have few clinical consequences. Level III-This is a diagnostic retrospective cohort study.

Resource utilization and national demographics of laryngotracheal trauma in children.

PubMed

McCormick, Michael E; Fissenden, Thomas M; Chun, Robert H; Lander, Lina; Shah, Rahul K

2014-09-01

Pediatric laryngotracheal trauma is rare but can carry considerable morbidity and health care resource expenditure. However, the true cost of these injuries has not been thoroughly investigated. To use a national administrative pediatric database to identify normative data on pediatric laryngotracheal trauma, specifically with regard to cost and resource utilization. Retrospective medical record review using the Kids' Inpatient Database (KID) 2009. Inclusion criteria were admissions with International Classification of Diseases, Ninth Revision, Clinical Modification, codes for fractures or open wounds of the larynx and trachea. Among many data analyzed were demographic information and admission characteristics, including length of stay, diagnoses, procedures performed, and total charges. There were 106 admissions that met inclusion criteria. Patient mean (SE) age was 15.9 (0.45) years, and 79% were males. The mean (SE) length of stay (LOS) was 8.4 (1.1) days; more than 50% of patients had a LOS longer than 4 days. The mean number of diagnoses per patient was 6.9 (0.6); other traumatic injuries included pneumothorax (n = 18). More than 75% of patients underwent more than 2 procedures during their admission; 60.2% underwent a major operative procedure. The most common procedures performed were laryngoscopy (n = 54) and operative repair of the larynx and/or trachea (n = 32). Tracheostomy was performed in only 30 patients. The mean (SE) total charge was $90,879 ($11,419), and one-third of patients had total charges more than $100,000. Pediatric laryngotracheal trauma remains a relatively rare clinical entity. These injuries primarily affect older children and are associated with long hospitalizations, multiple procedures, and high resource utilization.

Safeguarding Vulnerable Groups Act 2006: The Implications for Employers in Educational Settings

ERIC Educational Resources Information Center

Oliver, Hazel; White, Laura

2008-01-01

Vetting those who work with children and vulnerable adults is an emotive topic and one which can prove a challenging area for employers. The legitimate interest that parents, carers and employers have in screening those charged with the care of others can be in direct conflict with the most fundamental principles of economic freedom and employees'…

3 CFR 9074 - Proclamation 9074 of December 31, 2013. National Slavery and Human Trafficking Prevention Month...

Code of Federal Regulations, 2014 CFR

2014-01-01

...—children forced to take part in armed conflict or sold to brothels by their destitute families, men and... down on traffickers, charging a record number of perpetrators. We are deploying new technology in the... economies that create legitimate jobs, build a global sense of justice that says no child should ever be...

Out of Our Minds: Anti-Intellectualism and Talent Development in American Schooling. Education and Psychology of the Gifted Series.

ERIC Educational Resources Information Center

Howley, Craig B.; And Others

In interpreting the intellectual and cultural contexts of gifted education, this book considers how and why U.S. schooling fails to care for intellect and to develop the talents of all children. Rather than acting as stewards charged with nurturing intellectual development, schools concertedly devalue intellect, and this shortcoming is most…

The Myth of Free and Barrier-Free Access: India's Right to Education Act--Private Schooling Costs and Household Experiences

ERIC Educational Resources Information Center

Srivastava, Prachi; Noronha, Claire

2016-01-01

We examine relative household costs and experiences of accessing private and government schooling under India's "Right of Children to Free and Compulsory Education Act, 2009" in the early implementation phase. The Act deems that no child should incur any fee, charges, or expenses in accessing schooling. Private schools are mandated to…

[Family pharmacy: survey of a sample of patients in Midi-Pyrénées].

PubMed

Bismuth, Michel; Oustric, Stéphane; Boyer, Pierre; Escourrou, Brigitte; Brillac, Thierry; Mesthe, Pierre; Boutin, Aurélie; Arlet, Philippe; Montastruc, Jean-Louis

2011-01-01

Possession of drugs at home in the family pharmacy and self-medication are at risk. Appraisal based upon an analysis of 247 questionnaires completed by patients and 116 questionnaires completed by general practitioners in the French department of Haute Garonne (Southwestern, France). Two hundred and forty-four patients were involved in the study. In 80% of cases, women were in charge of family pharmacy who was located in 66% of cases in a unsecurise room and could be reached by children in 17% of cases. Drugs most frequently found: antiseptics (97%), paracetamol (91%), anti-inflammatory drugs (68%), anti-diarrhea (60%). For the physicians 52 useable questionnaires, 80% of physician were confronted with one of three risks: self-medication, drug autolysis, poisoning in children. Women are the referent of the family pharmacy. The doctors seem best placed to a message of prevention through minimal advice. © 2011 Société Française de Pharmacologie et de Thérapeutique.

Jamaican child-rearing practices: the role of corporal punishment.

PubMed

Smith, Delores E; Mosby, Gail

2003-01-01

The family is the most prominent social group that exists. It prepares its members for the various roles they will perform in society. Yet, the literature has unequivocally singled out the family as the most violent social group, with parental violence against children being the most prevalent type of family violence. While societies like the United States, Japan, and Sweden have taken a hard line on physical punishment and shifted to a gentler approach to discipline, harsh disciplining of children persists elsewhere. In the Caribbean, and Jamaica in particular, child-rearing and disciplinary practices that would warrant child abuse charges in other Western societies are rampant. This article examines the child-rearing techniques of Jamaican adults and their assumed effects on child outcomes. It also examines the plausibility of the assumption that the harsh physical punishment meted out to children is partially responsible for the current social problems of that island nation. We recommend approaches to tackle the broad goals of addressing familial and societal practices that compromise children's development and well-being.

The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children.

PubMed

Smith, G A; Knapp, J F; Barnett, T M; Shields, B J

1996-07-01

To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large urban children's hospital. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparkler-related injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 < OR < 29.24). Permanent sequelae were more common for eye injuries caused by rockets than eye injuries caused by other types of fireworks (Fisher's exact test, P = .03; OR = 6.72, 95% confidence interval 1.18 < OR < 38.18). Charges for medical care of a fireworks-related injury averaged $1385 per patient (range, $44 to $15 071). Fireworks are associated with serious injuries. Findings of this large consecutive series describe the epidemiology of these injuries. Children and their families should be encouraged to enjoy fireworks at public fireworks displays conducted by professionals. Fireworks for individual private use should be banned.

[Alessandro Laurinsich, the key player in the progress of paediatrics in the 20(th) century].

PubMed

Farnetani, I; Farnetani, F

2007-02-01

Alessandro Laurinsich was one of the greatest Italian paediatricians of the 20(th) century. He was born in Monfalcone (it was the province of Trieste, but now it belongs to Gorizia) on 29(th) May 1899. After having completed secondary school in Trieste, he obtained a medical degree with honours in 1922 at the University of Naples and entered the paediatric clinic run by Rocco Jemma. Laurinsich was in charge of teaching at the clinic of infectious diseases from 1937 to 1940. During this period he focused on the study of tuberculosis in children, the first applications of pnemoencephalography in Italy, but also studied different malignant tumors of the kidney, neurological and psychological disorders in children, as well as educational problems. In 1940 he had a teaching post in the peadiatric clinic at the University of Siena and remained until 1945 when he moved to Parma. He worked with illegitimate children as well as evacuees. During the 1945-46 academic year, Alessandro Laurinsich was called to direct the paediatric clinic of Parma University where he created a series of paediatric centres and took many initiatives in the area. In 1961 he was offered the paediatric teaching post at the University of Milan, but inexplicably refused it. He was Dean of the faculty of Medicine from 1956 to 1968. He passed away on 2(nd) February 1969 in Parma.

Epidemiology of pediatric ocular trauma in the Chaoshan Region, China, 2001-2010.

PubMed

Cao, He; Li, Liping; Zhang, Mingzhi; Li, Hongni

2013-01-01

Ocular trauma is the leading cause of monocular visual disability and noncongenital unilateral blindness in children. This study describes the epidemiology and medical care associated with nonfatal pediatric (≤ 17 years of age) eye injury-related hospitalization in the largest industrial base for plastic toy production in China. A population-based retrospective study of patients hospitalized for ocular and orbital trauma in the ophthalmology departments of 3 major tertiary hospitals from 1st January 2001 to 31st December 2010 was performed. The study included 1035 injured eyes from 1018 patients over a 10-year period: 560 (54.1%) eyes exhibited open globe injuries, 402 (38.8%) eyes suffered closed globe injuries, 10 (1.0%) eyes suffered chemical injuries and 8 (0.8%) eyes exhibited thermal injuries, representing an average annual hospitalization rate of 0.37 per 10,000 (95% confidence interval [CI], 0.36-0.38) due to pediatric eye injury in the Chaoshan region. The mean patient age was 9.2 ± 4.4 years with a male-to-female ratio of 3.3:1 (P = 0.007). Children aged 6 to 11 years accounted for the highest percentage (40.8%, 416/1018) of hospitalization, 56.7% (236/416) of whom were hospitalized for open globe wounds. Injury occurred most frequently at home (73.1%). Open globe wounds cost the single most expensive financial burden (60.8%) of total charges with $998 ± 702 mean charges per hospitalization. Open globe wounds occurred at home are earmarked for the priorities to prevention strategies. Higher public awareness of protecting primary schoolchildren from home-related eye injuries should be strengthened urgently by legislation or regulation since the traditional industrial mode seems to remain the pattern for the foreseeable future. Further research that provide detailed information on the specific inciting agents of pediatric eye injuries are recommended for facilitating the development and targeting of appropriate injury prevention initiatives.

Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

PubMed Central

Cao, He; Li, Liping; Zhang, Mingzhi; Li, Hongni

2013-01-01

Background Ocular trauma is the leading cause of monocular visual disability and noncongenital unilateral blindness in children. This study describes the epidemiology and medical care associated with nonfatal pediatric (≤17 years of age) eye injury-related hospitalization in the largest industrial base for plastic toy production in China. Methods A population-based retrospective study of patients hospitalized for ocular and orbital trauma in the ophthalmology departments of 3 major tertiary hospitals from 1st January 2001 to 31st December 2010 was performed. Results The study included 1035 injured eyes from 1018 patients over a 10-year period: 560 (54.1%) eyes exhibited open globe injuries, 402 (38.8%) eyes suffered closed globe injuries, 10 (1.0%) eyes suffered chemical injuries and 8 (0.8%) eyes exhibited thermal injuries, representing an average annual hospitalization rate of 0.37 per 10,000 (95% confidence interval [CI], 0.36–0.38) due to pediatric eye injury in the Chaoshan region. The mean patient age was 9.2±4.4 years with a male-to-female ratio of 3.3∶1 (P = 0.007). Children aged 6 to 11 years accounted for the highest percentage (40.8%, 416/1018) of hospitalization, 56.7% (236/416) of whom were hospitalized for open globe wounds. Injury occurred most frequently at home (73.1%). Open globe wounds cost the single most expensive financial burden (60.8%) of total charges with $998±702 mean charges per hospitalization. Conclusions Open globe wounds occurred at home are earmarked for the priorities to prevention strategies. Higher public awareness of protecting primary schoolchildren from home-related eye injuries should be strengthened urgently by legislation or regulation since the traditional industrial mode seems to remain the pattern for the foreseeable future. Further research that provide detailed information on the specific inciting agents of pediatric eye injuries are recommended for facilitating the development and targeting of appropriate injury prevention initiatives. PMID:23593323

Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism

PubMed Central

Schmidt, Rebecca J.; Hansen, Robin L.; Hartiala, Jaana; Allayee, Hooman; Schmidt, Linda C.; Tancredi, Daniel J.; Tassone, Flora; Hertz-Picciotto, Irva

2011-01-01

Background Causes of autism are unknown. Associations with maternal nutritional factors and their interactions with gene variants have not been reported. Methods Northern California families were enrolled from 2003–2009 in the CHARGE (CHildhood Autism Risks from Genetics and Environment) population-based case-control study. Children aged 24–60 months were evaluated and confirmed to have autism (n = 288), autism spectrum disorder (n = 141), or typical development (n = 278) at the University of California–Davis Medical Investigation of Neurodevelopmental Disorders Institute using standardized clinical assessments. We calculated adjusted odds ratios (ORs) for associations between autism and retrospectively collected maternal vitamin intake before and during pregnancy. We explored interaction effects with functional genetic variants involved in one-carbon metabolism (MTHFR, COMT, MTRR, BHMT, FOLR2, CBS, and TCN2) as carried by the mother or child. Results Mothers of children with autism were less likely than those of typically developing children to report having taken prenatal vitamins during the three months before pregnancy or the first month of pregnancy (OR = 0.62 [95% confidence interval = 0.42–0.93]). Significant interaction effects were observed for maternal MTHFR 677 TT, CBS rs234715 GT+TT, and child COMT 472 AA genotypes, with greater risk for autism when mothers did not report taking prenatal vitamins periconceptionally (4.5 [1.4–14.6]; 2.6 [1.2–5.4]; and 7.2 [2.3–22.4], respectively). Greater risk was also observed for children whose mothers had other one-carbon metabolism pathway gene variants and reported no maternal prenatal vitamin intake. Conclusions Periconceptional use of prenatal vitamins may reduce the risk of having children with autism, especially for genetically susceptible mothers and children. Replication and mechanistic investigations are warranted. PMID:21610500

Combining global positioning system and accelerometer data to determine the locations of physical activity in children.

PubMed

Oreskovic, Nicolas M; Blossom, Jeff; Field, Alison E; Chiang, Sylvia R; Winickoff, Jonathan P; Kleinman, Ronald E

2012-05-01

National trends indicate that children and adolescents are not achieving sufficient levels of physical activity. Combining global positioning system (GPS) technology with accelerometers has the potential to provide an objective determination in locations where youth engage in physical activity. The aim of this study was to identify the optimal methods for collecting combined accelerometer and GPS data in youth, to best locate where children spend time and are physically active. A convenience sample of 24 mid-school children in Massachusetts was included. Accelerometers and GPS units were used to quantify and locate childhood physical activity over 5 weekdays and 2 weekend days. Accelerometer and GPS data were joined by time and mapped with a geographical information system (GIS) using ArcGIS software. Data were collected in winter, spring, summer in 2009-2010, collecting a total of 26,406 matched datapoints overall. Matched data yield was low (19.1% total), regardless of season (winter, 12.8%; spring, 30.1%; summer, 14.3%). Teacher-provided, pre-charged equipment yielded the most matched (30.1%; range: 10.1-52.3%) and greatest average days (6.1 days) of data. Across all seasons, children spent most of their time at home. Outdoor use patterns appeared to vary by season, with street use increasing in spring, and park and playground use increasing in summer. Children spent equal amounts of physical activity time at home and walking in the streets. Overall, the various methods for combining GPS and accelerometer data provided similarly low amounts of combined data. No combined GPS and accelerometer data collection method proved superior in every data return category, but use of GIS to map joined accelerometer and GPS data can demarcate childhood physical activity locations.

Using Novel Technology within a School-Based Setting to Increase Physical Activity: A Pilot Study in School-Age Children from a Low-Income, Urban Community.

PubMed

Evans, E Whitney; Abrantes, Ana M; Chen, Eva; Jelalian, Elissa

2017-01-01

Less than half of American children meet national physical activity (PA) recommendations. This study tested the feasibility, acceptability, and preliminary effectiveness of using wearable PA monitors to increase PA in school-age children. In Phase 1 of this study, conducted in 2014, 32 fifth-grade students enrolled in a low-resource middle school were given a waist-worn Fitbit Zip monitor for 4 weeks to test its feasibility (adherence) and acceptability. Adherence, wear time of ≥8 hours per day, was examined. Feedback was solicited from parents through structured interviews. In Phase 2 , conducted in 2015, 42 sixth-grade students were assigned, by classroom, to one of three conditions (Fitbit + goal and incentive-based intervention, Fitbit only, or control) to test the feasibility of the wrist-worn Fitbit Charge and its preliminary effectiveness in increasing PA over 6 weeks. In Phase 1 , average adherence was 64.1%. In Phase 2 , it was 73.4% and 80.2% for participants in the Fitbit + intervention and Fitbit only groups, respectively ( p = .07). After controlling for baseline values, weight status, and sex, there were no significant group differences in changes in MVPA or steps from baseline to follow-up. While moderately acceptable, wearable PA monitors did not increase PA levels in this sample. They may be more effective within a coordinated school-based physical activity program.

[The role of pediatric polyclinics in social and legal work concerning maternal and child health].

PubMed

Grebesheva, I I; Chicherin, L P; Esikov, M S

1990-01-01

Approaches to protection of mother and child health in the USSR are outlined with special emphasis on the role of children's polyclinics. The law on childhood protection is based on 10 principles of Declaration on Children Rights adopted by the UN General Assembly in 1959. Current legislation provides for an increase in the duration of paid leave to care for the sick child up to 14 years of age, an increase in the monthly stipends to the children of military personnel, and free drug prescriptions for children up to 3 years of age treated as outpatients. From September 1, 1990, the duration of paid maternity leave for working women is 70 days. In light of a general legal reform currently conducted in the USSR, children's polyclinics as the primary link in the health care system are charged with protection of legal rights of mothers and children. Presently, 1.4% of all marriages in the USSR end up in divorce, so that every year 700,000 children younger the 18 years old are brought up in a single-parent family. Almost 85% of children in orphanages have live parents. Almost 200,000 children have criminal record, and 14,000 children are diagnosed to have sexually transmitted diseases annually. The legal work of children's polyclinics should be based on the evaluation of social risk factors. Following risk factors are identified: families with single mothers; families with 3 children; low-income families; families of the military personnel; families living in poor conditions; families with a history of death of a child 1 year old; disabled mothers; children of migrants or refugees; families in which one or both parent avoid the parental responsibilities or abuse their children.

[Effects of self-adapting G-DRG system 2004 to 2006 on in-patient services payment in pediatric hematology and oncology patients of a university hospital].

PubMed

Christaras, A; Schaper, J; Strelow, H; Laws, H-J; Göbel, U

2006-01-01

Reimbursement of inpatient treatment by daily constant charges is replaced by diagnosis- and procedure-related group system (G-DRG) in German acute care hospitals excerpt for psychiatry since 2004. Re-designs of G-DRG system were undertaken in 2005 and 2006. Parallel to implementation requirement- and resource-based self-adjustment of this new reimbursement system has been established by law. Adjustments performed in 2005 and 2006 are examined with respect to their effect on reimbursements in treatments of children with oncological, hematological, and immunological diseases. An unchanged population of 349 patients associated with 1,731 inpatient stays of a Clinic of Pediatric Oncology, Hematology, and Immunology in 2004 was analyzed by methods and means of G-DRG systems 2004, 2005, and 2006. DRGs and additional payments for drugs and procedures eligible for all and/or individual hospitals were calculated. G-DRG system 2005 resulted in overall reimbursement loss of 3.77 % compared to G-DRG 2004. G-DRG 2006 leads to slightly improved overall reimbursements compared to G-DRG 2005 by increasing DRG-based revenues. G-DRG 2006 effects 2.40 % reduction in overall reimbursement compared to G-DRG 2004. This loss includes ameliorating effects of additional payments for drugs and blood products already. Despite introduction of additional payments especially designed for children and teenagers in 2006, additional payment volume is decreased by 21.71 % from 2005 to 2006. G-DRG 2006 yields over-all reimbursement losses of 1.45 % in comparison to G-DRG 2004. Overall reimbursements include introduced additional payments for drugs and blood products. (Reimbursements resulting out of DRG payment alone drop by 14.73 % from 2004 to 2005, and increase by 3.26 % from 2005 to 2006 (2004 vs. 2006 11.95 %). Introduction of additional payments for drugs and blood products on a Germany-wide basis introduced in 2005 dampens DRG-based reimbursement losses. Despite introduction of dosage intervals specifically designed for children and adolescents in 2006, reimbursement of additional payments for drugs and blood products decrease by 21.71 % from 2005 to 2006. An important revenue-balancing function is attributed to additional charges individual for each hospital according to Par. 6 Section 2 (New diagnostic and therapeutic methods) and Section 2 a KHEntgG (German Hospital Reimbursement Law) with respect to financing tertiary care focusses. If possible to attain, those charges may partially equalize losses. Including these additional charges per individual hospital balance of summarized additional charges is -3.89 % from 2005 to 2006. However, fraction of additional payments on total reimbursements increases from 0.64 % in 2004 to 11.98 % in 2005, and 11.24 % in 2006, respectively. The G-DRG system in its versions 2005 and 2006 results in lowering overall reimbursements of a pediatric hematology, oncology, and immunology department compared to initial status in 2004. The growing chargeability of additional payments ameliorate this effect.

An Easy Guide to Developing an Emergency Child Care System (Free Child Care in the Aftermath of Major Disasters).

ERIC Educational Resources Information Center

Bozeman, Karl

A program and related materials for providing child care free of charge in the aftermath of widespread disaster to children ranging in age from infancy through second grade are described in this guidebook. In Section I, the Temporary Emergency Child Care (TECC) program is discussed. In particular, the nature of TECC services is indicated, the…

The Legal Rights of Secondary School Children Charged with an Act of Delinquency or Violation of School Laws.

ERIC Educational Resources Information Center

Piersma, Paul

This report is divided into two parts. Part I discusses school roles, regulations, and disciplinary policies. An outline is presented of the development of the law concerning the authority of local boards of education, the reasonableness of specific rules and regulations, the exercise of suspension and expulsion, and the need for schools to adopt…

Indian Education Is "Sui Generis": Of It's Own Kind. The Sixth Annual Report to the Congress of the United States.

ERIC Educational Resources Information Center

National Advisory Council on Indian Education, Washington, DC.

Appointed by the President, the fifteen Indian and Alaska Native members of the National Advisory Council on Indian Education (NACIE) are charged by law to advise the Congress and the Commissioner of Education in a number of areas concerning the administration of programs in which Indian children and adults participate and to submit an Annual…

Use of iron supplements in children aged 1-2 years with iron deficiency anemia: A cross-sectional study

PubMed Central

Sezik, Handan Atsiz; Can, Huseyin; Kurnaz, Mehmet Ali; Tuna, Mine; Ay, Zeynep

2015-01-01

Objectives: Iron deficiency (ID) is the most common nutritional problem in the world and is the most common cause of childhood anemia. In this study, our aim was to find out about the state of usage of iron preparation, which is distributed free of charge by the Ministry of Health, for the infants between 4-12 months in our country, as well as detecting the awareness degree of families those who are informed about iron-deficiency anemia (IDA), prophylaxis of the drug and to determine the drug’s effectiveness. Methods: It was a cross-sectional survey. The laboratory values from the files of the children aged 1-2 those who visited our hospital’s department of pediatrics, between January 2010 to August 2013, were collected. The survey included families who have children diagnosed with IDA. Questions included about families’ sociodemographic characteristics, the state of the usage of the iron drug, how much information received in terms of the side effects- consumption period and dosage. Results: A total of 139 children were enrolled in our study. While 77.7% of the families who participated stated that (n = 108) iron medicine was prescribed other 43.2% of families stated (n = 60) was prescribed and they were informed about iron pills and IDA. 25.9% of families had received information about drug’s side effects, 74.8% of them had information about period of consumption and 77.7% said they were given information about the drug dose. The average duration of use of iron medicine was 6.98±4.52 (min: 1, max: 24) months. It has been noted that; parent’s education level, mother’s occupation, child’s gender, how the child was born and receiving information about how to use the medicine had no effects on usage of the drug in children. Nevertheless, it has been noticed that, when the families were given proper information the drug use increased and the patients compliance with medications also increased. Conclusion: We believe that, due to frequent diagnosis of anemia in children, prophylaxis iron supplementation should be continued for up to the age of two years. PMID:26649019

Street children turn to sex-work to survive.

PubMed

1995-08-01

The Kenyan government currently deports tourists who are caught with child prostitutes and charges the children with prostitution. A harder treatment of foreigners caught with child prostitutes may soon emerge. The Undugu Society in Kenya, an organization working with street children, welcomes such changes. It teaches children practical skills, e.g., tailoring and carpentry. The Society has four schools and sponsors 1000 children to attend school or workshops. It sends social workers into the slums to counsel and gain the trust of street children as well as to encourage them to attend workshops. The Society has workshops on HIV transmission and emphasizes behavior change rather than condom use. Kenyan law prohibits adults from having sex with a child less than 18 years old. Juvenile courts deal with children caught engaging in solicitation of customers and/or prostitution. Children found guilty go to children's homes for rehabilitation into mainstream society. More and more countries of sex-tourists are punishing tourists who engage in sexual intercourse with minors in Kenya. Fear that high-profile cases will harm the multi-million-dollar tourist industry as well as lack of state resources makes Kenya reluctant to prosecute tourists. In 1994, most of Nairobi's 40,000 street children were engaged in prostitution. The leading centers of child prostitution are all tourist areas: Nairobi, Mombasa, Malindi, Lamu, and Diani. 80% of pornographic material in Kenya features children. Kenyan taxi drivers, tour guides, and hotel workers serve as middlemen in child prostitution. Urban poverty forces many children on to the streets. Rural children sent to urban areas to work as maids or servants in a rich house are often sexually abused. They then escape to the streets. Many child prostitutes come from poor families and have low literacy and no practical skills. AIDS orphans also become prostitutes to survive.

Psychohistory and Family Among Antebellum Slaveholders.

PubMed

Adams, Kenneth Alan

2016-01-01

This article examines the macroscopic reasons for maternal rage and its injection into slaveholder children in the antebellum South. It is argued that the misogyny that infected antebellum life metastasized in southern mistresses and affected the way they felt about themselves and their children. As mothers, they were casual parents, concerned with molding the character of their charges, rearing warriors and proper ladies, but uninterested in caring for them and helping them realize their own aspirations. It is argued that the misanthropic rage that they injected into their children constituted the poison that each generation of slaveholders had to ventilate into poison containers, slaves, as a homeostatic means of psycho-emotional survival. This intergenerational process of poison injection--from father to mother, from mother to child, from child to slave, constituted the process that insured the perpetuation of the psychic structure necessary for the continuation of slavery from generation to generation.

Seeing the Invisible: Educating the Public on Planetary Magnetic Fields and How they Affect Atmospheres

NASA Astrophysics Data System (ADS)

Fillingim, M. O.; Brain, D. A.; Peticolas, L. M.; Schultz, G.; Yan, D.; Guevara, S.; Randol, S.

2010-08-01

Magnetic fields and charged particles are difficult for school children, the general public, and scientists alike to visualize. But studies of planetary magnetospheres and ionospheres have broad implications for planetary evolution, from the deep interior to the ancient climate, that are important to communicate to each of these audiences. This presentation will highlight the visualization materials that we are developing to educate audiences on the magnetic fields of planets and how they affect the atmosphere. The visualization materials that we are developing consist of simplified data sets that can be displayed on spherical projection systems and portable 3-D rigid models of planetary magnetic fields.

High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa.

PubMed

Kluge, Wolfram H; Bauer, Heike I

2002-01-01

BACKGROUND: Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. DISCUSSION: The Zambian-Italian Orthopaedic Hospital in Lusaka is a well organized small unit providing free treatment of physically disabled children. The running costs are met from the fees charged for private consultations, supplemented by donations. State of the art surgical techniques are being used for congenital and acquired musculo-skeletal abnormalities. Last year 513 patients were operated upon free of charge and 320 operations were performed on private patients.

[Genetic analysis of two children patients affected with CHARGE syndrome].

PubMed

Li, Guoqiang; Li, Niu; Xu, Yufei; Li, Juan; Ding, Yu; Shen, Yiping; Wang, Xiumin; Wang, Jian

2018-04-10

To analyze two Chinese pediatric patients with multiple malformations and growth and development delay. Both patients were subjected to targeted gene sequencing, and the results were analyzed with Ingenuity Variant Analysis software. Suspected pathogenic variations were verified by Sanger sequencing. High-throughput sequencing showed that both patients have carried heterozygous variants of the CHD7 gene. Patient 1 carried a nonsense mutation in exon 36 (c.7957C>T, p.Arg2653*), while patient 2 carried a nonsense mutation of exon 2 (c.718C>T, p.Gln240*). Sanger sequencing confirmed the above mutations in both patients, while their parents were of wild-type for the corresponding sites, indicating that the two mutations have happened de novo. Two patients were diagnosed with CHARGE syndrome by high-throughput sequencing.

The Public Health Impact of Pediatric Deep Neck Space Infections.

PubMed

Adil, Eelam; Tarshish, Yael; Roberson, David; Jang, Jisun; Licameli, Greg; Kenna, Margaret

2015-12-01

There is little consensus about the best management of pediatric deep neck space infections (DNSIs) and limited information about the national disease burden. The purpose of this study is to examine the health care burden, management, and complications of DNSIs from a national perspective. Retrospective administrative data set review. National pediatric admission database. Pediatric patients diagnosed with a parapharyngeal space and/or retropharyngeal abscess were identified from the 2009 KIDS' Inpatient Database. Patient demographic, hospital, and clinical characteristics were compared between patients who received surgical and nonsurgical management. All results for the analyses were weighted, clustered, and stratified appropriately according to the sampling design of the KIDS' Inpatient Database. The prevalence of DNSIs was 3444 in 2009, and the estimated incidence was 4.6 per 100,000 children. The total hospital charges were >$75 million. The patients who were drained surgically had a 22% longer length of stay (mean = 4.19 days) than that of those who were managed without surgery (mean = 3.44 days). Mean hospital charges for patients who were drained surgically were almost twice those of patients who were managed medically ($28,969 vs $17,022); 165 patients (4.8%) had a complication. There are >3400 admissions for pediatric DNSIs annually, and they account for a significant number of inpatient days and hospital charges. A randomized controlled trial of management may be indicated from a public health perspective. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

PubMed Central

Waguespack, Steven G.; Bauer, Andrew J.; Angelos, Peter; Benvenga, Salvatore; Cerutti, Janete M.; Dinauer, Catherine A.; Hamilton, Jill; Hay, Ian D.; Luster, Markus; Parisi, Marguerite T.; Rachmiel, Marianna; Thompson, Geoffrey B.; Yamashita, Shunichi

2015-01-01

Background: Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. Methods: A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects ≤18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. Results: These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided. Conclusions: In response to our charge as an independent task force appointed by the ATA, we developed recommendations based on scientific evidence and expert opinion for the management of thyroid nodules and DTC in children and adolescents. In our opinion, these represent the current optimal care for children and adolescents with these conditions. PMID:25900731

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer.

PubMed

Francis, Gary L; Waguespack, Steven G; Bauer, Andrew J; Angelos, Peter; Benvenga, Salvatore; Cerutti, Janete M; Dinauer, Catherine A; Hamilton, Jill; Hay, Ian D; Luster, Markus; Parisi, Marguerite T; Rachmiel, Marianna; Thompson, Geoffrey B; Yamashita, Shunichi

2015-07-01

Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects ≤18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided. In response to our charge as an independent task force appointed by the ATA, we developed recommendations based on scientific evidence and expert opinion for the management of thyroid nodules and DTC in children and adolescents. In our opinion, these represent the current optimal care for children and adolescents with these conditions.

Computerized pediatric telephone triage and advice programs at children's hospitals: operating and financial characteristics.

PubMed

Melzer, S M; Poole, S R

1999-08-01

To describe the operating characteristics, financial performance, and perceived value of computerized children's hospital-based telephone triage and advice (TTA) programs. A written survey of all 32 children's hospital-based TTA programs in the United States that used the same proprietary pediatric TTA software product for at least 6 months. The expense, revenues, and perceived value of children's hospital-based TTA programs. Of 30 programs (94%) responding, 27 (90%) were eligible for the study and reported on their experience with nearly 1.3 million TTA calls over a 12-month period. Programs provided pediatric TTA services for 1560 physicians, serving an average of 82 physicians (range, 10-340 physicians) and answering 38880 calls (range, 8500-140000 calls) annually. The mean call duration was 11.3 minutes and the estimated mean total expense per call was $12.45. Of programs charging fees for TTA services, 16 (59%) used a per-call fee and 7 (26%) used a monthly service fee. All respondents indicated that fees did not cover all associated costs. Telephone triage and advice programs, when examined on a stand-alone basis, were all operating with annual deficits (mean, $447000; median, $325000; range, $74000-$1.3 million), supported by the sponsoring children's hospitals and their companion programs. Using a 3-point Likert scale, the TTA program managers rated the value of the TTA program very highly as a mechanism for marketing to physicians (2.85) and increasing physician (2.92) and patient (2.80) satisfaction. Children's hospital-based TTA programs operate at substantial financial deficits. Ongoing support of these programs may derive from the perception that they are a valuable mechanism for marketing and increase patient and physician satisfaction. Children's hospitals should develop strategies to ensure the long-term financial viability of TTA programs or they may have to discontinue these services.

Vending machine policies and practices in Delaware.

PubMed

Gemmill, Erin; Cotugna, Nancy

2005-04-01

Overweight has reached alarming proportions among America's youth. Although the cause of the rise in overweight rates in children and adolescents is certainly the result of the interaction of a variety of factors, the presence of vending machines in schools is one issue that has recently come to the forefront. Many states have passed or proposed legislation that limits student access to vending machines in schools or require that vending machines in schools offer healthier choices. The purposes of this study were (a) to assess the food and beverage vending machine offerings in the public school districts in the state of Delaware and (b) to determine whether there are any district vending policies in place other than the current U.S. Department of Agriculture regulations. The results of this study indicate the most commonly sold food and drink items in school vending machines are of minimal nutritional value. School administrators are most frequently in charge of the vending contract, as well as setting and enforcing vending machine policies. Suggestions are offered to assist school nurses, often the only health professional in the school, in becoming advocates for changes in school vending practices and policies that promote the health and well-being of children and adolescents.

Association of Income Inequality With Pediatric Hospitalizations for Ambulatory Care-Sensitive Conditions.

PubMed

Bettenhausen, Jessica L; Colvin, Jeffrey D; Berry, Jay G; Puls, Henry T; Markham, Jessica L; Plencner, Laura M; Krager, Molly K; Johnson, Matthew B; Queen, Mary Ann; Walker, Jacqueline M; Latta, Grant M; Riss, Robert R; Hall, Matt

2017-06-05

The level of income inequality (ie, the variation in median household income among households within a geographic area), in addition to family-level income, is associated with worsened health outcomes in children. To determine the influence of income inequality on pediatric hospitalization rates for ambulatory care-sensitive conditions (ACSCs) and whether income inequality affects use of resources per hospitalization for ACSCs. This retrospective, cross-sectional analysis used the 2014 State Inpatient Databases of the Healthcare Cost and Utilization Project of 14 states to evaluate all hospital discharges for patients aged 0 to 17 years (hereafter referred to as children) from January 1 through December 31, 2014. Using the 2014 American Community Survey (US Census), income inequality (Gini index; range, 0 [perfect equality] to 1.00 [perfect inequality]), median household income, and total population of children aged 0 to 17 years for each zip code in the 14 states were measured. The Gini index for zip codes was divided into quartiles for low, low-middle, high-middle, and high income inequality. Rate, length of stay, and charges for pediatric hospitalizations for ACSCs. A total of 79 275 hospitalizations for ACSCs occurred among the 21 737 661 children living in the 8375 zip codes in the 14 included states. After adjustment for median household income and state of residence, ACSC hospitalization rates per 10 000 children increased significantly as income inequality increased from low (27.2; 95% CI, 26.5-27.9) to low-middle (27.9; 95% CI, 27.4-28.5), high-middle (29.2; 95% CI, 28.6-29.7), and high (31.8; 95% CI, 31.2-32.3) categories (P < .001). A significant, clinically unimportant longer length of stay was found for high inequality (2.5 days; 95% CI, 2.4-2.5 days) compared with low inequality (2.4 days; 95% CI, 2.4-2.5 days; P < .001) zip codes and between charges ($765 difference among groups; P < .001). Children living in areas of high income inequality have higher rates of hospitalizations for ACSCs. Consideration of income inequality, in addition to income level, may provide a better understanding of the complex relationship between socioeconomic status and pediatric health outcomes for ACSCs. Efforts aimed at reducing rates of hospitalizations for ACSCs should consider focusing on areas with high income inequality.

Review of intellectual assessment measures for children who are deaf or hard of hearing.

PubMed

Reesman, Jennifer H; Day, Lori A; Szymanski, Christen A; Hughes-Wheatland, Roxanne; Witkin, Gregory A; Kalback, Shawn R; Brice, Patrick J

2014-02-01

Intellectual assessment of children who are deaf or hard of hearing presents unique challenges to the clinician charged with attempting to obtain an accurate representation of the child's skills. Selection of appropriate intellectual assessment instruments requires a working knowledge of the strengths and weaknesses of the measure and what changes in standardized administration might be necessary to accommodate for the needs of children who are deaf or hard of hearing. In the case of some available instruments, there is limited guidance and objective research available examining the performance of children who are deaf or hard of hearing. This review summarizes available information on widely used and most recent editions of intellectual assessment measures with special attention to guidance on accommodations, score interpretation, subtest selection and other test-specific considerations when assessing children who are deaf or hard of hearing. There is much opportunity for further inquiry in the field of intellectual assessment as it applies to children who are deaf or hard of hearing, as many measures have not been closely scrutinized for their appropriate use with this population. Clinicians must recognize inherent difficulties with intellectual assessment measures with children who are deaf or hard of hearing and issues in providing for an accessible and accurate administration of test items. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Modeling the Partial Atomic Charges in Inorganometallic Molecules and Solids and Charge Redistribution in Lithium-Ion Cathodes

DOE PAGES

Wang, Bo; Li, Shaohong L.; Truhlar, Donald G.

2014-10-30

Partial atomic charges are widely used for the description of charge distributions of molecules and solids. These charges are useful to indicate the extent of charge transfer and charge flow during chemical reactions in batteries, fuel cells, and catalysts and to characterize charge distributions in capacitors, liquid-phase electrolytes, and solids and at electrochemical interfaces. However, partial atomic charges given by various charge models differ significantly, especially for systems containing metal atoms. In the present study, we have compared various charge models on both molecular systems and extended systems, including Hirshfeld, CM5, MK, ChElPG, Mulliken, MBS, NPA, DDEC, LoProp, and Badermore » charges. Their merits and drawbacks are compared. The CM5 charge model is found to perform well on the molecular systems, with a mean unsigned percentage deviation of only 9% for the dipole moments. We therefore formulated it for extended systems and applied it to study charge flow during the delithiation process in lithium-containing oxides used as cathodes. Our calculations show that the charges given by the CM5 charge model are reasonable and that during the delithiation process, the charge flow can occur not only on the transition metal but also on the anions. The oxygen atoms can lose a significant density of electrons, especially for deeply delithiated materials. We also discuss other methods in current use to analyze the charge transfer and charge flow in batteries, in particular the use of formal charge, spin density, and orbital occupancy. Here, we conclude that CM5 charges provide useful information in describing charge distributions in various materials and are very promising for the study of charge transfer and charge flows in both molecules and solids.« less

Modeling the Partial Atomic Charges in Inorganometallic Molecules and Solids and Charge Redistribution in Lithium-Ion Cathodes.

PubMed

Wang, Bo; Li, Shaohong L; Truhlar, Donald G

2014-12-09

Partial atomic charges are widely used for the description of charge distributions of molecules and solids. These charges are useful to indicate the extent of charge transfer and charge flow during chemical reactions in batteries, fuel cells, and catalysts and to characterize charge distributions in capacitors, liquid-phase electrolytes, and solids and at electrochemical interfaces. However, partial atomic charges given by various charge models differ significantly, especially for systems containing metal atoms. In the present study, we have compared various charge models on both molecular systems and extended systems, including Hirshfeld, CM5, MK, ChElPG, Mulliken, MBS, NPA, DDEC, LoProp, and Bader charges. Their merits and drawbacks are compared. The CM5 charge model is found to perform well on the molecular systems, with a mean unsigned percentage deviation of only 9% for the dipole moments. We therefore formulated it for extended systems and applied it to study charge flow during the delithiation process in lithium-containing oxides used as cathodes. Our calculations show that the charges given by the CM5 charge model are reasonable and that during the delithiation process, the charge flow can occur not only on the transition metal but also on the anions. The oxygen atoms can lose a significant density of electrons, especially for deeply delithiated materials. We also discuss other methods in current use to analyze the charge transfer and charge flow in batteries, in particular the use of formal charge, spin density, and orbital occupancy. We conclude that CM5 charges provide useful information in describing charge distributions in various materials and are very promising for the study of charge transfer and charge flows in both molecules and solids.

Pediatric reduction mammaplasty: A retrospective analysis of the Kids' Inpatient Database (KID).

PubMed

Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hadad, Ivan; Socas, Juan; Flores, Roberto L; Tholpady, Sunil S

2015-09-01

Pediatric breast reduction mammaplasty is a procedure commonly performed in children suffering from excess breast tissue, back pain, and social anxiety. Minimal information exists regarding demographics, epidemiology, and complications in adolescents. As health care reform progresses, investigating the socioeconomic and patient-related factors affecting cost and operative outcomes is essential. The Kids' Inpatient Database (KID) was used from 2000 to 2009. Patients with an International Classification of Diseases, 9th Revision code of macromastia and procedure code of reduction mammaplasty 20 and less were included. Demographic data, including age, sex, payer mix, and location, were collected. Significant independent variables associated with complications and duration of stay were identified with bivariate and multiple regression analysis. A total of 1,345 patients between the ages 12 and 20 were evaluated. The majority of patients were white (64%), from a zip code with greatest income (36%), and had private insurance (75%). Overall comorbidity and complication rates were 30% and 3.2%, respectively. Duration of stay was associated with race, income quartile, insurance type, having complications, and hospital type. African-American race, Medicaid, lower income, and private-investor owned hospitals were predictive of greater hospital charges. In this large retrospective database analysis, pediatric reduction mammaplasty had a relatively low early complication rate and short duration of stay. Complications, total charges, and duration of stay discrepancies were associated with race, location, and socioeconomic status. Although demonstrably safe, this is the first study demonstrating the negative effect of race and socioeconomic status on a completely elective procedure involving children. These results demonstrate the intricate association between socioeconomic and patient-related factors influencing overall outcomes in the pediatric population. Copyright © 2015 Elsevier Inc. All rights reserved.

Control of malaria: a successful experience from Viet Nam.

PubMed Central

Hung, Le Q.; Vries, Peter J. de; Giao, Phan T.; Nam, Nguyen V.; Binh, Tran Q.; Chong, M. T.; Quoc, N. T. T. A.; Thanh, T. N.; Hung, L. N.; Kager, P. A.

2002-01-01

OBJECTIVE: To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. METHODS: From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. FINDINGS: The baseline survey in 1994 recorded 716 inhabitants. Of the children under 2 years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P.falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. CONCLUSIONS: A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria. PMID:12219158

Burden of Obesity on Pediatric Inpatients with Acute Asthma Exacerbation in the United States.

PubMed

Okubo, Yusuke; Nochioka, Kotaro; Hataya, Hiroshi; Sakakibara, Hiroshi; Terakawa, Toshiro; Testa, Marcia

Obesity and asthma are common health problems in the United States. The objective of this study was to evaluate the clinical and economic burdens of obesity on hospitalized children with acute asthma exacerbation in 2012. Hospital discharge records of patients aged 2 to 18 years with a diagnosis of asthma were obtained from the 2012 Kids' Inpatient Database, wherein the data were compiled by the Agency for Healthcare Research and Quality. The discharge records were weighted to estimate the number of hospitalizations because of asthma exacerbations in the United States. To classify whether the patient was obese or not, we used the International Classification of Diseases, Ninth Revision, Clinical Modification code 278.0x. We compared the odds of using noninvasive or invasive mechanical ventilation, mean total charges for inpatient service, and length of hospital stay between obese and nonobese patients. A total of 74,338 patient discharges were extracted. Of these, 3,494 discharges were excluded because of chronic medical conditions. Using discharge weight variables, we estimated a total of 100,157 hospitalizations with asthma exacerbations among children aged between 2 and 18 years in 2012. Obesity was significantly associated with higher odds of using mechanical ventilation (odds ratio 1.59, 95% CI 1.28-1.99), higher mean total hospital charges (adjusted difference: $1588, 95% CI $802-$2529), and longer mean length of hospital stay (0.24 days, 95% CI 0.17-0.32 days) compared with nonobesity. These findings suggest that obesity is a significant risk factor of severe asthma exacerbation that requires mechanical ventilation, and obesity is an economically complicating factor. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Education of the Deaf; The Challenge and the Charge. A Report of the National Conference on Education of the Deaf (Colorado Springs, Colorado, April 12-15, 1967).

ERIC Educational Resources Information Center

Department of Health, Education, and Welfare, Washington, DC.

Conference keynote addresses present the views of a non-professional on deaf education, a plea for a global approach to the child with auditory problems, a psychiatric approach to the problems of deaf children, and legislation affecting deaf education. Discussions and recommendations are summarized concerning the medical-psychological,…

What Makes a Good Children's Book? The Art of the Word: Significance in Stories for Young People.

ERIC Educational Resources Information Center

Neumeyer, Peter

A "good" book may be defined as a book that is rich and dense in texture and that draws on many authorial resources. This paper demonstrates the way in which richness in word usage contributes to making books good. It discusses the way in which words are emotionally charged and then analyzes the use of individual words in a brief portion…

Daddy's Girl: Kurt Kondrich Gave Up His Career as a Police Officer to Fight for Children with Disabilities

ERIC Educational Resources Information Center

Henderson, Nancy

2010-01-01

A take-charge "people person," Kurt Kondrich began his career in law enforcement in 1985, when he graduated with a criminology degree and landed a job with the Atlanta Police Department. Six years later, he became deputy sheriff in Fort Meyers, Florida, but missed his family in Pittsburgh. So in 1993, when he heard that his hometown police…

The chiropractic care of children.

PubMed

Alcantara, Joel; Ohm, Jeanne; Kunz, Derek

2010-06-01

The objective of this study was to characterize the practice of pediatric chiropractic. The study design was a cross-sectional descriptive survey. The settings were private practices throughout the United States, Canada, and Europe. The participants were 548 chiropractors, the majority of whom are practicing in the United States, Canada, and Europe. Practitioner demographics (i.e., gender, years in practice, and chiropractic alma mater), practice characteristics (i.e., patient visits per week, practice income reimbursement), and chiropractic technique were surveyed. The practitioners were also asked to indicate common indicators for pediatric presentation, their practice activities (i.e., use of herbal remedies, exercise and rehabilitation, prayer healing, etc.), and referral patterns. A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (<18 years of age). Practice income was derived primarily from out-of-pocket reimbursement with charges of an average of $127 and $42 for the first and subsequent visits, respectively. These visits were reimbursed to address common conditions of childhood (i.e., asthma, ear infections, etc.). Approach to patient care was spinal manipulative therapy (SMT) augmented with herbal remedies, exercises, rehabilitation, and so on. Wellness care also figured prominently as a motivator for chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician. The chiropractic care of children is a significant aspect of the practice of chiropractic. Further research is warranted to examine the safety and effectiveness of this popular nonallopathic approach to children's health.

Psychostimulants: Concerns over Long-Term Adverse Side Effects.

PubMed

Adams, James Gray

2015-11-01

The personal rewards are substantial for the healthcare provider who can make teachers and parents happy. There are evolving, alternative methods of dealing with ADHD, but PS are relatively cheap and quick when they work (roughly 70% of the time) and readily accessible. We have no social or educational structures currently to deal with the extreme ADHD cases. In cases of less dramatic, attention problems, poor grades, where PS boost attention, physicians are unlikely to abandon their patients willingly, unless compelled to sacrifice short-term goals over the unanswered questions about what is best in the long run. How can we know if it's the child and not the educational system that needs diagnosis and treatment? Psychiatric literature consistently suggests the prevalence of attention deficit in children is roughly 5% of the child population. Do 5% of our children need to take PS? This is where risks versus benefits enters the decision making process, and this is where this article aims to intentionally plant a healthy dose of scientific scrutiny. Ultimately, the doctor in charge makes a decision ... sometimes based on intangibles that cannot be legislated or defined by even the best scientific studies. It is not clear or scientifically established that the use of PS, especially in young, developing minds of children, is safe or meaningfully beneficial in the long run. There is much information in human and animal studies to question the wishful thinking that using mind altering drugs in children is the right thing to do. There are risks, and there are benefits. In this case, the risks are less obvious, cloaked in the inadequacy of our current state of knowledge, potentially threatening the quality of the lives we seek to enhance.

Interaction between electrically charged droplets in microgravity

NASA Astrophysics Data System (ADS)

Brandenbourger, Martin; Caps, Herve; Hardouin, Jerome; Vitry, Youen; Boigelot, Bernard; Dorbolo, Stephane; Grasp Team; Beams Collaboration

2015-11-01

The past ten years, electrically charged droplets have been studied tremendously for their applications in industry (electrospray, electrowetting,...). However, charged droplets are also present in nature. Indeed, it has been shown that the droplets falling from thunderclouds possess an excess of electric charges. Moreover, some research groups try to use the electrical interaction between drops in order to control the coalescence between cloud droplets and control rain generation. The common way to study this kind of system is to make hypothesis on the interaction between two charged drops. Then, these hypothesis are extended to a system of thousands of charged droplets. Thanks to microgravity conditions, we were able to study the interaction between two electrically charged droplets. In practice, the charged droplets were propelled one in front of the other at low speed (less than 1 m/s). The droplets trajectory is studied for various charges and volumes. The repulsion between two charged drops is correctly fitted by a simple Coulomb repulsion law. In the case of attractive interactions, we discuss the collisions observed as a function of the droplets speed, volume and electric charges. Thanks to FNRS for financial support.

Does sharing the cost of a bicycle helmet help promote helmet use?

PubMed Central

Kim, A. N.; Rivara, F. P.; Koepsell, T. D.

1997-01-01

OBJECTIVE: To determine whether asking for a $5.00 donation for bicycle helmets, compared with distribution free of charge, would affect helmet use among children receiving helmets and an educational intervention from public health clinics. SETTING: Six public health clinic sites in King County, Washington. METHODS: Six participating clinic sites were randomly assigned to either free helmet distribution or to a $5.00 suggested donation for the helmets, stratified by whether a helmet law was in place. Three sites were assigned to each arm. Children who were between 6 and 12 years of age and who reported riding bicycles, but having no bicycle helmets, were eligible. Clinicians distributed helmets and delivered an educational intervention to 506 eligible children, or siblings of children seen at the clinic between March and July 1993. Parents were contacted after helmet distribution to ascertain helmet use. RESULTS: 82% of children whose parents were asked for a copayment and 77% of children who received free helmets were reported to wear their helmets every time they rode their bicycles (p=0.20). The adjusted odds ratio for the association between copayment compared with free helmets and helmet use was 1.66 (95% confidence interval 0.94 to 2.92). CONCLUSIONS: Helmet use was not significantly different among children whose parents were asked for a small copayment, compared with those who received helmets free. Use of copayments can increase helmet use by increasing the number of helmets given to low income children. PMID:9113846

Web-Based Intervention for Nutritional Management in Cystic Fibrosis: Development, Usability, and Pilot Trial.

PubMed

Stark, Lori J; Opipari-Arrigan, Lisa; Filigno, Stephanie S; Simon, Stacey L; Leonard, Amanda; Mogayzel, Peter J; Rausch, Joseph; Zion, Cynthia; Powers, Scott W

2016-06-01

Usability and pilot testing of a web intervention (BeInCharge.org [BIC]) of behavior plus nutrition intervention for children with cystic fibrosis (CF) ages 4-9 years. Think Aloud methodology was used with five mothers to assess usability and refine the intervention. A pilot trial was then conducted with 10 mothers of children with CF ages 4-9 years randomized to the web-based BIC or a Standard Care Control (STC). Change in weight gain for each group was compared in a pre-to-post design. Mothers rated the usability and clarity of BIC highly. The pilot trial showed children of mothers who received BIC had a significant change in weight pre-to-post-treatment (0.67 kg, p = .04). Change for the STC was not significant (0.41 kg, p = .10). A web-based behavior plus nutrition intervention appears promising in increasing weight gain in children with CF. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The practice report of a cooperation teaching with an aquarium and an elementary school

NASA Astrophysics Data System (ADS)

Kureha, R.; Matsumoto, I.

2013-12-01

In Japan, recognition that cooperation with an eco-museum, a science-museum, an aquarium, a zoo, etc. is important in the science education in a school is spreading. Simultaneously with it, the institution of each museum which offer the learning program to the children of a school has increased. In this presentation, we introduce some of program for which an aquarium provides schools with the aquarium "AQUAS" of Shimane prefecture. Moreover, we arrange also about a viewpoint when making these programs. In addition, in these programs, the role of the teacher of a school serves as an important very much for a child's study. That is, since study before and after study in an aquarium is performed in the classroom of a school, it is important how we assemble a prior preparation and subsequent review. Here, the teacher of the school divided the type of educational support into three kinds from the position of the teacher when participating in programs of aquarium. That is, they are a type with which the staff of an aquarium take charge of all the teaching, a type with which the staff of an aquarium mainly take charge of a lesson and a teacher offers the teaching support, and a type with which the school teacher mainly takes charge of a lesson, and the staff of an aquarium offer teaching support. It being an important is that the teacher of a school leaves not all study to the staff of an aquarium in an aquarium. That is, a teacher needs to offer lesson support according to a situation, or to make an effort to promote a teaching activity. Moreover, the teacher needs to perform a prior meeting so that common recognition may be shared about the main point which should be taught to a student using a school textbook of science with the staff of an aquarium.

Patients' willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation.

PubMed

Puteh, Sharifa Ezat Wan; Ahmad, Siti Nurul Akma; Aizuddin, Azimatun Noor; Zainal, Ramli; Ismail, Ruhaini

2017-01-01

Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population. A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses. Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant ( p  = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP. The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.

Predictive study of charge transport in disordered semiconducting polymers.

PubMed

Athanasopoulos, Stavros; Kirkpatrick, James; Martínez, Diego; Frost, Jarvist M; Foden, Clare M; Walker, Alison B; Nelson, Jenny

2007-06-01

We present a theoretical study of charge transport in disordered semiconducting polymers that relates the charge mobility to the chemical structure and the physical morphology in a novel multiscale approach. Our studies, focusing on poly(9,9-dioctylfluorene) (PFO), show that the charge mobility is dominated by pathways with the highest interchain charge-transfer rates. We also find that disorder is not always detrimental to charge transport. We find good agreement with experimental time-of-flight mobility data in highly aligned PFO films.

The emergence, structure and development of ethnic identity during childhood: the case of Roma identity.

PubMed

Pnevmatikos, Dimitris; Geka, Maria; Divane, Maria

2010-12-01

This study investigates the emergence, development and structure of ethnic identity during childhood. Forty Roma children living in Greece aged between 2.8 and 11.9 years answered questions about their awareness/recognition of four aspects of their ethnic identity-namely place of habitation, traditional costumes, the Roma language, and early betrothal of children-their identity and their sense of stability and constancy. The study also investigates how the children feel about the abandonment of those four aspects. The evidence from the current data supports the hypothesis that awareness of ethnic identity emerges before the age of 4. Moreover, this study offers direct empirical evidence of the multidimensionality of ethnic identity. A model of three concentric rings is proposed, extending from a core containing the most highly valued aspects of ethnic identity to the outer annulus that comprises the nonpermanent and nonstable aspects of ethnic identity. The aspects in each annulus differ in terms of the development of the sense of stability and constancy and the feelings associated with loss of the aspects in question. Even the youngest participants considered the aspects in the core to be stable and constant as well as emotionally charged; and even the 11-year-olds did not consider the aspects contained in the outer, more fluid annulus as stable and constant aspects of their ethnic identity. The development of an aspect is determined by what the majority of adults in a society, at a particular time in history, consider to be most important.

[Implementation of vaccinations in Chechen refugees' children in Poland].

PubMed

Hartmann, Piotr; Jackowska, Teresa

2010-01-01

Poland is a destination country or temporary living place for many refugees from Chechnya. Refugees are provided with full, free of charge, health care including the vaccination programme according to the present National Vaccination Programme (NVP). To assess the implementation of vaccinations in Chechen refugees' children in Poland. The group comprised 310 children from the Centre for Foreigners in Warsaw-Bielany. The mean age of the examined children was 7.5 years. The investigations were performed three times during the study--the first was conducted in a group of 220 children in June, the second one in 303 children in August and the third in 310 children in October 2008 (the differences in the numbers resulted from the changes in the size of the Chechen population living in the Centre). The vaccination records were assessed paying special attention to the implementation of vaccinations. During the consecutive two examinations the implementation of vaccination recommendations was analyzed as well as the availability of this information in the records. At every visit the history was obtained on the reasons for not having the vaccination programme implemented. The information on vaccination programme implementation was available in 19, 30 and 45%, of analyzed records from the Centre at the first, second and third visit, respectively. The majority of the obtained data regarded the implementation of vaccinations in children in the first year of life (85%), while the least data was on vaccinations in children over 12 years of age (30%). Similar results were obtained when analyzing a group of 168 children at the all three visits (18, 32 and 48%, respectively). The reasons for non-implementation of vaccinations were as follows: (a) low parents' awareness of the necessity of vaccinations; (b) lack of self-discipline (every other child did not report for a scheduled appointment); (c) relocation of refugees to other Centres; (d) exceedingly frequent postponing of vaccinations (in every fourth child). Substantially better implementation of vaccinations was found in refugees' children born in Poland. On account of the differences in the Polish and Chechen vaccination programmes and the low awareness among the Chechen parents' regarding the need of vaccinations, implementation of health care programmes and monitoring of the sanitary-epidemiologic situation in the Centres for Foreigners is necessary in order to prevent local outbreaks of an epidemic.

Infant welfare, philanthropy and entrepreneurship in Glasgow: Sister Laura's Infant Food Company.

PubMed

Weaver, L T

2008-06-01

Laura Smith was sister-in-charge of the Children's Dispensary in Glasgow from 1897 to 1922. In 1911 she established Sister Laura's Infant Food Company to market a special milk formula of her own invention.The directors of the Dispensary were not amused. As the 'outdoor' department of the Royal Hospital for Sick Children (Yorkhill), the Dispensary was at the forefront of efforts to combat child ill health and malnutrition. This paper considers Laura Smith's initiative within the context of the health and care of infants of the time - high infant mortality, public and professional concerns for infant welfare, technological advances in food science, changing recommendations and practices of infant feeding and ambiguous relations between medicine and commerce.

Recommended minimal emergency equipment and resources for schools: national consensus group report.

PubMed

Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

2003-06-01

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.

Cleft Lip and Palate in CHARGE Syndrome: Phenotypic Features That Influence Management.

PubMed

Isaac, Kathryn V; Ganske, Ingrid M; Rottgers, Stephen A; Lim, So Young; Mulliken, John B

2018-03-01

Infants with syndromic cleft lip and/or cleft palate (CL/P) often require more complex care than their nonsyndromic counterparts. Our purpose was to (1) determine the prevalence of CL/P in patients with CHARGE syndrome and (2) highlight factors that affect management in this subset of children. This is a retrospective review from 1998 to 2016. Patients with CHARGE syndrome were diagnosed clinically and genetically. Prevalence of CL/P was determined and clinical details tabulated: phenotypic anomalies, cleft types, operative treatment, and results of repair. CHARGE syndrome was confirmed in 44 patients: 11 (25%) had cleft lip and palate and 1 had cleft palate only. Surgical treatment followed our usual protocols. Two patients with cardiac anomalies had prolonged recovery following surgical correction, necessitating palatal closure prior to nasolabial repair. One of these patients was too old for dentofacial orthopedics and underwent combined premaxillary setback and palatoplasty, prior to labial closure. Velopharyngeal insufficiency was frequent (n = 3/7). All patients had feeding difficulty and required a gastrostomy tube. All patients had neurosensory hearing loss; anomalies of the semicircular canals were frequent (n = 3/4). External auricular anomalies, colobomas, and cardiovascular anomalies were also common (n = 8/11). Other associated anomalies were choanal atresia (n = 4/11) and tracheoesophageal fistula (n = 2/11). CHARGE syndrome is an under-recognized genetic cause of cleft lip and palate. Hearing loss and speech and feeding difficulties often occur in these infants. Diagnosis can be delayed if the child presents with covert phenotypic features, such as chorioretinal colobomas, semicircular canal hypoplasia, and unilateral choanal atresia.

A Study on Wireless Charging for Prolonging the Lifetime of Wireless Sensor Networks.

PubMed

Tu, Weijian; Xu, Xianghua; Ye, Tingcong; Cheng, Zongmao

2017-07-04

Wireless charging is an important issue in wireless sensor networks, since it can provide an emerging and effective solution in the absence of other power supplies. The state-of-the-art methods employ a mobile car and a predefined moving path to charge the sensor nodes in the network. Previous studies only consider a factor of the network (i.e., residual energy of sensor node) as a constraint to design the wireless charging strategy. However, other factors, such as the travelled distance of the mobile car, can also affect the effectiveness of wireless charging strategy. In this work, we study wireless charging strategy based on the analysis of a combination of two factors, including the residual energy of sensor nodes and the travelled distance of the charging car. Firstly, we theoretically analyze the limited size of the sensor network to match the capability of a charging car. Then, the networked factors are selected as the weights of traveling salesman problem (TSP) to design the moving path of the charging car. Thirdly, the charging time of each sensor node is computed based on the linear programming problem for the charging car. Finally, a charging period for the network is studied. The experimental results show that the proposed approach can significantly maximize the lifetime of the wireless sensor network.

Taking Charge and Letting Go: Exploring the Ways a Transition to Adulthood Project for Teenagers with Duchenne Muscular Dystrophy Has Supported Parents to Prepare for the Future

ERIC Educational Resources Information Center

Hoskin, Janet

2017-01-01

The new Special Educational Needs and Disability legislation in the Children and Families Act 2014 intends to raise the aspirations of young people with special educational needs and their families, and improve their life outcomes. But what do raised aspirations and better outcomes look like for young people who have a life-limiting impairment?…

[Prevalence of obesity in children: study in the primary public Parisian schools].

PubMed

Barthel, B; Cariou, C; Lebas-Saison, E; Momas, I

2001-03-01

Obesity is an important risk factor in public health. In Paris, few statistical data are available in this area. The purpose of the present study is to evaluate the prevalence of overweight and obesity in 10 years-old children attending Paris elementary schools (cours moyen deuxième année--CM2--last level of the elementary school). 148 classes were randomly selected, gathering 3,621 schoolchildren 10 years 6 months old. 66 doctors in charge of health at school participated in the study, doing the measurements of weight, size and collecting also the weight and size at birth and at the "grande section-GS-level" (last level of the infant school, 5 years-old children) from the individual health file of the schoolchildren. The statistical analysis was based on the study of distributions of the observed Quetelet index (Q0) at the different ages, compared to French reference curves. A logistic regression analysis was performed to determine whether birth weight and GS weight predict obesity in CM2. In GS and in CM2, observed Quetelet indices are over expected values: in CM2, 22.8% of boys and 25.6% of girls exceed the reference value Q90; the prevalence of obesity (Q0 > or = Q97) is 13.4% in boys and 13.5% in girls. Among the variables "term", "weight at birth", weight in GS level and "gender", the weight in GS level is the only predictive factor of obesity in CM2 level. The situation in Paris appears to be serious. Preventive actions are needed at early stages to try to stop and, if possible, to reverse the present increase of overweight. In this context, school doctors have to play a prominent role.

Penetration and release studies of positively and negatively charged nanoemulsions--is there a benefit of the positive charge?

PubMed

Baspinar, Yücel; Borchert, Hans-Hubert

2012-07-01

The surface of all tissues, including the stratum corneum, carries a negative charge. Following that fact it is assumed that a positively charged topical formulation could lead to an enhanced penetration because of an increased interaction with the negative charge of the membrane. The intention of this study is to prove an enhanced penetration of a positively charged nanoemulsion compared to a negatively charged nanoemulsion, both containing prednicarbate. The release and penetration of these nanoemulsions, produced with the high pressure homogenization method, were investigated. Regarding these results reveals that the release of the negatively charged formulation is higher compared to the positively charged nanoemulsion, while the penetration of the positively charged nanoemulsion is enhanced compared to the negatively charged formulation. The results of the investigated positively charged nanoemulsion containing prednicarbate show that its topical use could be advantageous for the therapy of atopic dermatitis, especially regarding phytosphingosine, which was responsible for the positive charge. Copyright © 2012 Elsevier B.V. All rights reserved.

Economic Analysis of Cleft Palate Repair in International Adoptees.

PubMed

Tomlinson-Hansen, Sandra; Paliga, J Thomas; Tahiri, Youssef; Paine, Kaitlyn M; Bartlett, Scott P; Taylor, Jesse A

2016-09-01

Retrospective cohort study. Major international tertiary care referral center for cleft palate repair. One hundred thirty-eight patients at the Children's Hospital of Philadelphia who had palate repair performed between 2010 and 2013, excluding syndromic patients, patients undergoing palate revision, and patients with incomplete payment information. None. Fees and charges for procedures. Surgeon payment was significantly higher for international adoptees (Δ = $2047.51 [$128.35 to $3966.66], P = .038). Medicaid-adjusted surgeon payments averaged $1006 more for adoptees ([-$394.19 to $2406.98], P = .158). Hospital and anesthesiology costs for adoptee palate repair were highly variable but did not differ significantly from those for nonadoptees. Partly due to payer mix, surgeon reimbursement was somewhat higher for international adoptees. No difference in total payment was found.

Solar Array and Auroral Charging Studies of DMSP Spacecraft

NASA Technical Reports Server (NTRS)

Matias, Kelwin

2013-01-01

The SSJ electrostatic analyzers and the SSIES plasma instruments on the DMSP spacecraft in low Earth polar orbit can be used to conduct case studies of auroral and solar array charging. We will use a program written in the Interactive Data Language (IDL) to evaluate questionable charging events in the SSJ records by comparing charging signatures in SSJ and SSIES data. In addition, we will assemble a number of case studies of solar array charging showing the signatures from the SSJ data and compare to the SSIES charging signatures. In addition we will use Satellite Tool Kit (STK) to propagate orbits, obtain solar intensity, and use to verify onset of charging with sunrise.

Controlling charge on levitating drops.

PubMed

Hilger, Ryan T; Westphall, Michael S; Smith, Lloyd M

2007-08-01

Levitation technologies are used in containerless processing of materials, as microscale manipulators and reactors, and in the study of single drops and particles. Presented here is a method for controlling the amount and polarity of charge on a levitating drop. The method uses single-axis acoustic levitation to trap and levitate a single, initially neutral drop with a diameter between 400 microm and 2 mm. This drop is then charged in a controllable manner using discrete packets of charge in the form of charged drops produced by a piezoelectric drop-on-demand dispenser equipped with a charging electrode. The magnitude of the charge on the dispensed drops can be adjusted by varying the voltage applied to the charging electrode. The polarity of the charge on the added drops can be changed allowing removal of charge from the trapped drop (by neutralization) and polarity reversal. The maximum amount of added charge is limited by repulsion of like charges between the drops in the trap. This charging scheme can aid in micromanipulation and the study of charged drops and particles using levitation.

Children with suspected craniosynostosis: a cost-effectiveness analysis of diagnostic strategies.

PubMed

Medina, L Santiago; Richardson, Randy R; Crone, Kerry

2002-07-01

Our purpose was to evaluate the clinical and economic impact of three evaluation strategies in children at different risks of craniosynostosis. A decision-analytic and cost-effectiveness model was constructed to compare three evaluation in strategies in children with suspected synostosis: no imaging, radiography (if abnormal, followed by three-dimensional CT [3D CT]), and 3D CT. Three risk groups were analyzed on the basis of the prevalence (pretest probability) of disease: low (completly healthy children; prevalence, 34/100,000), intermediate (healthy children with head deformity; prevalence, 1/115), and high risk (children with syndromic craniofacial disorders [i.e., Crouzon's syndrome or Apert's syndrome]; prevalence, 9-10/10). Test performance (sensitivity and specificity) of the evaluation strategies was obtained from the literature. Costs (not charge) estimates were obtained from the hospital cost-accounting database and from the Medicaid fee schedule. In the low-risk group, the radiographic and 3D CT strategies resulted in a cost per quality-adjusted life year (QALY) gained of more than $560,000. In the intermediate-risk group, the radiographic strategy resulted in a cost per QALY gained of $54,600. Three-dimensional CT was more effective than the two other strategies but at a higher cost-hence, with a cost per QALY gained of $374,200. In the high-risk group, 3D CT was the most effective strategy with a cost per QALY gained of $33,800. Less experienced radiologists and poor-quality studies increased the evaluation cost per QALY gained for all of the risk groups because of decreased effectiveness. Radiologic screening of completely healthy children (low risk) for synostosis is not warranted because of the high cost per QALY gained of the radiographic and 3D CT strategies. In healthy children with head deformity (intermediate risk), the radiographic strategy had a reasonable cost per QALY gained. Three-dimensional CT was more effective but had a high cost per QALY gained. In children with syndromic craniofacial disorders (high risk), 3D CT was the most effective strategy and had a reasonable cost per QALY gained. Selection of children with suspected craniosynostosis based on their risk group and use of the most appropriate evaluation strategy could maximize clinical and economic outcomes for these patients.

A Study on Wireless Charging for Prolonging the Lifetime of Wireless Sensor Networks

PubMed Central

Tu, Weijian; Xu, Xianghua; Ye, Tingcong; Cheng, Zongmao

2017-01-01

Wireless charging is an important issue in wireless sensor networks, since it can provide an emerging and effective solution in the absence of other power supplies. The state-of-the-art methods employ a mobile car and a predefined moving path to charge the sensor nodes in the network. Previous studies only consider a factor of the network (i.e., residual energy of sensor node) as a constraint to design the wireless charging strategy. However, other factors, such as the travelled distance of the mobile car, can also affect the effectiveness of wireless charging strategy. In this work, we study wireless charging strategy based on the analysis of a combination of two factors, including the residual energy of sensor nodes and the travelled distance of the charging car. Firstly, we theoretically analyze the limited size of the sensor network to match the capability of a charging car. Then, the networked factors are selected as the weights of traveling salesman problem (TSP) to design the moving path of the charging car. Thirdly, the charging time of each sensor node is computed based on the linear programming problem for the charging car. Finally, a charging period for the network is studied. The experimental results show that the proposed approach can significantly maximize the lifetime of the wireless sensor network. PMID:28677639

Dimensions of the local health care environment and use of care by uninsured children in rural and urban areas.

PubMed

Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, José J

2006-03-01

Despite concerted policy efforts, a sizeable percentage of children lack health insurance coverage. This article examines the impact of the health care safety net and health care market structure on the use of health care by uninsured children. We used the Medical Expenditure Panel Survey linked with data from multiple sources to analyze health care utilization among uninsured children. We ran analyses separately for children who lived in rural and urban areas and assessed the effects on utilization of the availability of safety net providers, safety net funding, supply of primary care physicians, health maintenance organization penetration, and the percentage of people who are uninsured, controlling for other factors that influence use. Fewer than half of uninsured children had office-based visits to health care providers during the year, 8% of rural and 10% of urban children visited the emergency department at least once, and just over half of children had medical expenditures or charges during the year. Among uninsured children in rural areas, living closer to a safety net provider and living in an area with a higher supply of primary care physicians were positively associated with higher use and medical expenditures. In urban areas, the supply of primary care physicians and the level of safety net funding were positively associated with uninsured children's medical expenditures, whereas the percentage of the population that was uninsured was negatively associated with use of the emergency department. Uninsured children had low levels of utilization over a range of different health care provider types and settings. The availability of safety net providers in the local area and the safety net's capacity to serve the uninsured influence access to care among children. Possible measures for ensuring access to health care among uninsured children include increasing the density of safety net providers in rural areas, enhancing funding for the safety net, and policies to increase primary care physician supply.

Design and implementation of a physical activity intervention to enhance children's use of the built environment (the CUBE study).

PubMed

Oreskovic, Nicolas M; Goodman, Elizabeth; Park, Elyse R; Robinson, Alyssa I; Winickoff, Jonathan P

2015-01-01

Adequate physical activity promotes physical and mental health and decreases obesity risk. However, most adolescents do not attain recommended physical activity levels and effective interventions are lacking. Physical activity trials rarely incorporate built environment use patterns. This paper describes the design and rationale of the Children's Use of the Built Environment (CUBE) Study, an office-based intervention designed to teach youth how to use their surrounding built environment to increase physical activity. CUBE is a 6-month intervention trial among 60 overweight and obese 10-16 year old adolescents from a community health center in Massachusetts. The study began in the winter of 2013. Patients are sequentially assigned to either the intervention or control group. Baseline physical activity by accelerometry and location by GPS, along with measured height, weight, and blood pressure are collected. Control subjects receive standard of care lifestyle counseling. Intervention subjects receive tailored recommendations on how to increase their physical activity based on their accelerometer and GPS data. Data collections are repeated at end-of-treatment, and again 3 months later. The findings from this study should help guide future efforts to design interventions aimed at increasing adolescent physical activity as well as to inform design professionals and government officials charged with creating outdoor spaces where adolescents spend time. Copyright © 2014 Elsevier Inc. All rights reserved.

A changing child welfare workforce: What worker characteristics are valued in child welfare?

PubMed

Lwin, Kristen; Fallon, Barbara; Trocmé, Nico; Fluke, John; Mishna, Faye

2018-05-07

A child welfare system is responsible for making difficult decisions. Child welfare workers are charged with assessing and determining when a child is in need of protection, including when it is necessary to intervene on behalf of children when their caregivers' abilities and/or situation is deemed to put them at risk of abuse or neglect. Although the child welfare workforce in Ontario attended to an estimated 125,281 child maltreatment investigations in 2013, little is known about the skills, education, and experiences of these investigating workers. Notwithstanding assumptions about the qualifications and characteristics necessary for effective child welfare practice, few studies explicitly link the specific characteristics of workers to children, youth, and families achieving positive case outcomes. These assumptions have been shaped by a multitude of factors including knowledge of human resources, professional standards, and educational requriements. This study examined data from five cycles over twenty years of Ontario Incidence Studies (-1993, -1998, -2003, -2008, -2013) to provide a profile of child welfare workers. This is the first study to examine the changing profile of child welfare workers in any province in Canada and provides a foundation for developing effective recruitment and professional development strategies, and promoting a positive work environment. Policy and practice implications for the changing needs of these families are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Origins of institutional Pediatrics: Maternity and Childhood Hospital of Mexico City in the nineteenth century].

PubMed

Baeza Bacab, Manuel Antonio

In June of 1866, the empress Carlota founded the Maternity House in the Department of Secret Births at the Hospice of the Poor. Upon the reinstatement of a republican government, Dr. Ramon Pacheco was appointed director of the Maternity House. Shortly after, in February of 1868, Dr. Luis Fernandez Gallardo established a pavilion for sick children in the Hospital of San Andres. After realizing this pavilion didn't have the adequate conditions to operate properly, and in the need of a children's hospital in Mexico City, Dr. Pacheco merged both institutions in April 2, 1869 -with the help of Ms. Luciana Arrazola- and founded the Maternity and Childhood Hospital, the first institution for the care of ill children in the independent Mexico. Ever since it was founded, Dr. Eduardo Liceaga was in charge of the children's health. Later, with the help of the presidents Juarez, Lerdo de Tejada and Díaz, he was able to consolidate the hospital in academic and health services aspects. This noble institution closed its doors on February 5, 1905, upon its incorporation to the General Hospital of Mexico, after 36 years of working for the welfare of Mexican children. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

What's parenting got to do with it: emotional autonomy and brain and behavioral responses to emotional conflict in children and adolescents.

PubMed

Marusak, Hilary A; Thomason, Moriah E; Sala-Hamrick, Kelsey; Crespo, Laura; Rabinak, Christine A

2017-09-15

Healthy parenting may be protective against the development of emotional psychopathology, particularly for children reared in stressful environments. Little is known, however, about the brain and behavioral mechanisms underlying this association, particularly during childhood and adolescence, when emotional disorders frequently emerge. Here, we demonstrate that psychological control, a parenting strategy known to limit socioemotional development in children, is associated with altered brain and behavioral responses to emotional conflict in 27 at-risk (urban, lower income) youth, ages 9-16. In particular, youth reporting higher parental psychological control demonstrated lower activity in the left anterior insula, a brain area involved in emotion conflict processing, and submitted faster but less accurate behavioral responses-possibly reflecting an avoidant pattern. Effects were not replicated for parental care, and did not generalize to an analogous nonemotional conflict task. We also find evidence that behavioral responses to emotional conflict bridge the previously reported link between parental overcontrol and anxiety in children. Effects of psychological control may reflect a parenting style that limits opportunities to practice self-regulation when faced with emotionally charged situations. Results support the notion that parenting strategies that facilitate appropriate amounts of socioemotional competence and autonomy in children may be protective against social and emotional difficulties. © 2017 John Wiley & Sons Ltd.

Rotavirus vaccines in Israel: Uptake and impact.

PubMed

Muhsen, Khitam; Cohen, Daniel

2017-07-03

We present an overview of the impact of universal rotavirus immunization with the pentavalent vaccine, RotaTeq, which was introduced in Israel in 2010. The vaccine is given free of charge at age 2, 4 and 6 months, with an 80% coverage that was shortly achieved during the universal immunization period. Compared to pre-universal immunization years (2008-2010), a reduction of 66-68% in the incidence of rotavirus gastroenteritis (RVGE) hospitalizations was observed in 2011-2015 among children aged 0-23 months in central and northern Israel. In southern Israel a reduction of 80-88% in RVGE hospital visit rate was found among Jewish children aged 0-23 months in 2011-2013. Among Bedouins, the respective decline was 62-75%. A significant reduction of 59% was also observed in RVGE clinic visits, presumably representing less severe illness. Indirect benefit was evident in children aged 24-59 months who were ineligible for universal immunization. Vaccine effectiveness against RVGE hospitalization was estimated at 86% in children aged 6-23 months. Changes in the circulating rotavirus genotypes occurred but the contribution of vaccine induced immune pressure is unclear. Universal rotavirus immunization was followed by an impressive decrease in the burden of RVGE in young children in Israel, likely attributed to good vaccine coverage and effectiveness.

Getting It Right for Every Child: A National Policy Framework to Promote Children's Well-being in Scotland, United Kingdom.

PubMed

Coles, Emma; Cheyne, Helen; Rankin, Jean; Daniel, Brigid

2016-06-01

Getting It Right for Every Child (GIRFEC), a landmark policy framework for improving children's well-being in Scotland, United Kingdom, is a practice initiative signifying a distinct way of thinking, an agenda for change, and the future direction of child welfare policy. GIRFEC represents a unique case study of national transformative change within the contexts of children's well-being and universal services and is of relevance to other jurisdictions. Implementation is under way, with an understanding of well-being and the requirement for information sharing enshrined in law. Yet there is scope for interpretation within the legislation and associated guidance. Inherent tensions around intrusion, data gathering, professional roles, and balancing well-being against child protection threaten the effectiveness of the policy if not resolved. Despite persistent health inequalities and intergenerational deprivation, the Scottish government aspires for Scotland to be the best country for children to grow up in. Getting It Right for Every Child (GIRFEC) is a landmark children's policy framework to improve children's well-being via early intervention, universal service provision, and multiagency coordination across organizational boundaries. Placing the child and family "at the center," this approach marks a shift from welfare to well-being, yet there is still a general lack of consensus over how well-being is defined and measured. As an umbrella policy framework with broad reach, GIRFEC represents the current and future direction of children's/family policy in Scotland, yet large-scale practice change is required for successful implementation. This article explores the origins and emergence of GIRFEC and presents a critical analysis of its incremental design, development, and implementation. There is considerable scope for interpretation within the GIRFEC legislation and guidance, most notably around assessment of well-being and the role and remit of those charged with implementation. Tensions have arisen around issues such as professional roles; intrusion, data sharing, and confidentiality; and the balance between supporting well-being and protecting children. Despite the policy's intentions for integration, the service landscape for children and families still remains relatively fragmented. Although the policy has groundbreaking potential, inherent tensions must be resolved and the processes of change carefully managed in order for GIRFEC to be effective. It remains to be seen whether GIRFEC can fulfil the Scottish government's aspirations to reduce inequalities and improve lifelong outcomes for Scotland's children and young people. In terms of both a national children's well-being framework within a universal public service context and a distinct style of policymaking and implementation, the Scottish experience represents a unique case study of whole-country, transformational change and is of relevance to other jurisdictions. © 2016 Milbank Memorial Fund.

Getting It Right for Every Child: A National Policy Framework to Promote Children's Well‐being in Scotland, United Kingdom

PubMed Central

CHEYNE, HELEN; RANKIN, JEAN; DANIEL, BRIGID

2016-01-01

Policy Points: Getting It Right for Every Child (GIRFEC), a landmark policy framework for improving children's well‐being in Scotland, United Kingdom, is a practice initiative signifying a distinct way of thinking, an agenda for change, and the future direction of child welfare policy.GIRFEC represents a unique case study of national transformative change within the contexts of children's well‐being and universal services and is of relevance to other jurisdictions.Implementation is under way, with an understanding of well‐being and the requirement for information sharing enshrined in law. Yet there is scope for interpretation within the legislation and associated guidance.Inherent tensions around intrusion, data gathering, professional roles, and balancing well‐being against child protection threaten the effectiveness of the policy if not resolved. Context Despite persistent health inequalities and intergenerational deprivation, the Scottish government aspires for Scotland to be the best country for children to grow up in. Getting It Right for Every Child (GIRFEC) is a landmark children's policy framework to improve children's well‐being via early intervention, universal service provision, and multiagency coordination across organizational boundaries. Placing the child and family “at the center,” this approach marks a shift from welfare to well‐being, yet there is still a general lack of consensus over how well‐being is defined and measured. As an umbrella policy framework with broad reach, GIRFEC represents the current and future direction of children's/family policy in Scotland, yet large‐scale practice change is required for successful implementation. Methods This article explores the origins and emergence of GIRFEC and presents a critical analysis of its incremental design, development, and implementation. Findings There is considerable scope for interpretation within the GIRFEC legislation and guidance, most notably around assessment of well‐being and the role and remit of those charged with implementation. Tensions have arisen around issues such as professional roles; intrusion, data sharing, and confidentiality; and the balance between supporting well‐being and protecting children. Despite the policy's intentions for integration, the service landscape for children and families still remains relatively fragmented. Conclusions Although the policy has groundbreaking potential, inherent tensions must be resolved and the processes of change carefully managed in order for GIRFEC to be effective. It remains to be seen whether GIRFEC can fulfil the Scottish government's aspirations to reduce inequalities and improve lifelong outcomes for Scotland's children and young people. In terms of both a national children's well‐being framework within a universal public service context and a distinct style of policymaking and implementation, the Scottish experience represents a unique case study of whole‐country, transformational change and is of relevance to other jurisdictions. PMID:27265560

[IMPLEMENTATION OF THE RIGHT FOR HEALTH CARE FOR CHILDREN - INTERNALLY DISPLACED PERSONS (CERTAIN ASPECTS)].

PubMed

Buletsa, S; Lazur, Y; Mendzhul, M; Pushkarenko, О

2017-12-01

The aim of the article is to do a research on selected issues related to realizing the right for health сare for the children - internally dislocated persons. In order to achieve the given aim statistical data of the quantity of involuntarily dislocated persons including children and also the quantity of children registered with the health-care authority as well as the quantity of their requests for medical care have been analized. It has been determined that in case of involuntary dislocation children are more often exposed to trauma than adults which leads to different emotional disorders. The concepts of «the right for health care» in international legal acts, national legislation of Ukraine and scientific works have been analized. There have been defined three levels of the provision of the right for health care of internally dislocated persons. It has been substantiated that the fact that a child has not been registered with the health-care authority as IRP can't be a ground for limitations in realization of his right on health care. During the research process it has been defined that children IRP need medical care more often than other internally dislocated persons and in realization of the right for health care they come across a number of problems that need urgent solution, including access to free of charge professional medical care, regardless of the fact of medical registration of a child IRP, insufficient funding for provision of the needs of children IRP with medications, absence of obligatory primary medical examination of children IRP, etc.

Home safety: development and validation of one component of an ecobehavioral treatment program for abused and neglected children.

PubMed Central

Tertinger, D A; Greene, B F; Lutzker, J R

1984-01-01

Parents may be charged with child abuse or neglect or both on the basis of a variety of circumstances. Child neglect, for example, is often documented when caseworkers observe that the family's home itself is so poorly kept that it presents an environment in which young children have ready access to lethal hazards such as poisons, uncovered wall outlets, and firearms. In this study, we describe the development of a Home Accident Prevention Inventory (HAPI) which was validated and used to assess hazards in the homes of several families under state protective service for child abuse and neglect. The HAPI included five categories of hazards: fire and electrical, mechanical-suffocation, ingested object suffocation, firearms, and solid/liquid poisons. Following the collection of baseline data, parents were presented with a treatment package that included instructions and demonstrations on making hazards inaccessible to children, plus feedback regarding the number and location of hazards in the home. The multiple-baseline design across hazardous categories in each family's home showed that the package resulted in decreases in the number of these accessible hazards. These improvements were maintained over an extended period of unannounced follow-up checks. This research provides a model for the development and assessment of an area previously unexamined in the child abuse and neglect literature. PMID:6735949

Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review

PubMed Central

Hone, Thomas; Lee, John Tayu; Majeed, Azeem; Conteh, Lesong; Millett, Christopher

2017-01-01

Abstract Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients. PMID:28453713

A Laboratory Study of the Charging/Discharging Mechanisms of a Dust Particle Exposed to an Electron Beam

NASA Technical Reports Server (NTRS)

Venturini, C. C.; Spann, J. F.; Comfort, R. H.

1999-01-01

The interaction of micron sized particles or "dust particles" with different space and planetary environments has become an important area of research. One particular area of interest is how dust particles interact with plasmas. Studies have shown that charged dust particles immersed in plasmas can alter plasma characteristics, while ions and electrons in plasmas can affect a particle's potential and thereby, its interaction with other particles. The basis for understanding these phenomena is the charging mechanisms of the dust particle, specifically, how the particle's charge and characteristics are affected when exposed to ions and electrons. At NASA Marshall Space Flight Center, a laboratory experiment has been developed to study the interaction of dust particles with electrons. Using a unique laboratory technique known as electrodynamic suspension, a single charged particle is suspended in a modified quadrupole trap. Once suspended, the particle is then exposed to an electron beam to study the charging/discharging mechanisms due to collisions of energetic electrons. The change in the particle's charge, approximations of the charging/discharging currents, and the charging/discharging yield are calculated.

Melissa Rowland and the rights of pregnant women.

PubMed

Minkoff, Howard; Paltrow, Lynn M

2004-12-01

On March 11, 2004, the State of Utah charged Melissa Rowland with the murder of her stillborn fetus, claiming that the death resulted from her rejection of the advice of her physicians to have a cesarean delivery. Although Ms. Rowland avoided the homicide charge by pleading guilty to lesser child endangerment charges, the approach taken by the State raises important and troubling issues regarding the autonomy rights of pregnant women, as well as their right to speak on behalf their unborn children. We use this case to review relevant ethical principals and legal precedents. We conclude that if Ms. Rowland is to be judged legally culpable for the death of her fetus, then the courts must first create a new and significant exception to the doctrine of informed consent and the common law and constitutional principles upon which it is based. Such a precedent could introduce a substantial disparity between the rights of pregnant women and those of all other persons. We would argue that a better means of assuring the health interests of the pregnant woman and the fetus in similar circumstances is through advocacy by obstetricians for pregnant women's fully realized rights, including the right to informed consent.

The effect of transfers between health care facilities on costs and length of stay for pediatric burn patients.

PubMed

Myers, John; Smith, Michael; Woods, Charles; Espinosa, Claudia; Lehna, Carlee

2015-01-01

Hospitals vary widely in the services they offer to care for pediatric burn patients. When a hospital does not have the ability or capacity to handle a pediatric burn, the decision often is made to transfer the patient to another short-term hospital. Transfers may be based on available specialty coverage for children; which adult and non-teaching hospitals may not have available. The effect these transfers have on costs and length of stay (LOS) has on pediatric burn patients is not well established and is warranted given the prominent view that pediatric hospitals are inefficient or more costly. The authors examined inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. ICD-9-CM codes 940 to 947 were used to define burn injury. The authors tested if transfer status was associated with LOS and total charges for pediatric burn patients, while adjusting for traditional risk factors (eg, age, TBSA, insurance status, type of hospital [pediatric vs adult; teaching vs nonteaching]) by using generalized linear mixed-effects modeling. A total of n = 28,777 children had a burn injury. Transfer status (P < .001) and TBSA (P < .001) was independently associated with LOS, while age, insurance status, and type of hospital were not associated with LOS. Similarly, transfer status (P < .001) and TBSA (P < .001) was independently associated with total charges, while age, insurance status, and type of hospital were not associated with total charges. In addition, the data suggest that the more severe pediatric burn patients are being transferred from adult and non-teaching hospitals to pediatric and teaching hospitals, which may explain the increased costs and LOS seen at pediatric hospitals. Larger more severe burns are being transferred to pediatric hospitals with the ability or capacity to handle these conditions in the pediatric population, which has a dramatic impact on costs and LOS. As a result, unadjusted, pediatric hospitals are seen as being inefficient in treating pediatric burns. However, since pediatric hospitals see more severe cases, after adjustment, type of hospital did not influence costs and LOS. TBSA and transfer status were the predictors studied that independently affect costs and LOS.

The attitudes of mental health professionals towards patients’ desire for children

PubMed Central

2014-01-01

Background When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues. Methods Seven focus groups with a total of 49 participants from all professional groups active in mental health (nurses, psychologists, social workers and psychiatrists) were conducted in a 330-bed psychiatric hospital. Group discussions were transcribed verbatim and analysed by the documentary method described by Bohnsack. Results Mental health professionals did not feel that their patients’ desire for children was as important in daily practice as were parenting issues. When discussing the desire for children on the part of patients, the following themes emerged: “the patient’s own decision”, “neutrality”, “the patient’s well-being”, “issues affecting the children of mentally ill parents” and “appropriate parenthood”. In order to cope with what they perceived as conflicting norms, mental health professionals developed the following (discursive) strategies: "subordination of child welfare", "de-professionalisation", "giving rational advice" and "resignation". Conclusions The theme of “reproductive autonomy” dominated mental health professionals’ discourse on the desire for children among psychiatric patients. “Reproductive autonomy” stood in conflict with another important theme (patient’s children). Treating reproductive issues as taboo is the result of the gap between MHPs’ perceptions of (conflicting) norms when dealing with a patient’s desire for children and the limited opportunities to cope with them appropriately. In order to support both patients with a desire for children and mental health professionals who are charged with providing counselling for such patients, there is a need to encourage ethical reflection and to focus on clinical recommendations in this important area. PMID:24580889

The attitudes of mental health professionals towards patients' desire for children.

PubMed

Krumm, Silvia; Checchia, Carmen; Badura-Lotter, Gisela; Kilian, Reinhold; Becker, Thomas

2014-03-02

When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues. Seven focus groups with a total of 49 participants from all professional groups active in mental health (nurses, psychologists, social workers and psychiatrists) were conducted in a 330-bed psychiatric hospital. Group discussions were transcribed verbatim and analysed by the documentary method described by Bohnsack. Mental health professionals did not feel that their patients' desire for children was as important in daily practice as were parenting issues. When discussing the desire for children on the part of patients, the following themes emerged: "the patient's own decision", "neutrality", "the patient's well-being", "issues affecting the children of mentally ill parents" and "appropriate parenthood". In order to cope with what they perceived as conflicting norms, mental health professionals developed the following (discursive) strategies: "subordination of child welfare", "de-professionalisation", "giving rational advice" and "resignation". The theme of "reproductive autonomy" dominated mental health professionals' discourse on the desire for children among psychiatric patients. "Reproductive autonomy" stood in conflict with another important theme (patient's children). Treating reproductive issues as taboo is the result of the gap between MHPs' perceptions of (conflicting) norms when dealing with a patient's desire for children and the limited opportunities to cope with them appropriately.In order to support both patients with a desire for children and mental health professionals who are charged with providing counselling for such patients, there is a need to encourage ethical reflection and to focus on clinical recommendations in this important area.

Food Assistance: Efforts To Control Fraud and Abuse in the Child and Adult Care Food Program Should Be Strengthened. United States General Accounting Office Report to Congressional Committees.

ERIC Educational Resources Information Center

Robertson, Robert E.

The Child and Adult Care Food Program provides over $1.5 billion in benefits annually to children and adults in day care. In order to address the longstanding problems of fraud and abuse present in the program, state agencies have been charged with the responsibility for implementing Food and Nutrition Service's (FNS) regulations to prevent and…

Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review.

PubMed

Hone, Thomas; Lee, John Tayu; Majeed, Azeem; Conteh, Lesong; Millett, Christopher

2017-06-01

Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Amendments to Provincial Regulations on Protecting the Legal Rights and Interests of Women and Children, November 1989.

PubMed

1989-01-01

In early November 1989 the government of Fujian, China made the following amendments to its Provincial Regulations on Protecting the Legal Rights and Interests of Women and Children: "a) if state policy on the recruitment of students and workers is violated, and if the law is broken through the imposition of restrictions on women seeking education and jobs, the party concerned or his guardian may file a complaint with the department in charge of recruitment of students or workers within 30 days after learning about the matter; the latter should handle the case within 30 days after receiving the complaint. b) when handling divorce cases the People's Court should follow the law and divide up the property jointly owned by the two sides when the husband- wife relationship still existed; the court is forbidden from increasing the unreasonable economic burden of the wife simply because it was the wife that asked for the divorce. c) in proceedings relating to saving women and children who have been abducted for purposes of selling later, it is necessary to respect the will of the abducted women; no one is allowed to demand compensation from the victimized women, children, or their families."

Promoting Children's Social-Emotional Skills in Preschool Can Enhance Academic and Behavioral Functioning in Kindergarten: Findings from Head Start REDI

PubMed Central

Nix, Robert L.; Bierman, Karen L.; Domitrovich, Celene E.; Gill, Sukhdeep

2013-01-01

This study examined processes of change associated with the positive preschool and kindergarten outcomes of children who received the Head Start REDI intervention, compared to “usual practice” Head Start. In a large-scale randomized-controlled trial (N = 356 children, 42% African American or Latino, all from low-income families), this study tests the logic model that improving preschool social-emotional skills (e.g., emotion understanding, social problem solving, and positive social behavior) as well as language/emergent literacy skills will promote cross-domain academic and behavioral adjustment after children transition into kindergarten. Validating this logic model, the present study finds that intervention effects on three important kindergarten outcomes (e.g., reading achievement, learning engagement, and positive social behavior) were mediated by preschool gains in the proximal social-emotional and language/emergent literacy skills targeted by the REDI intervention. Importantly, preschool gains in social-emotional skills made unique contributions to kindergarten outcomes in reading achievement and learning engagement, even after accounting for the concurrent preschool gains in vocabulary and emergent literacy skills. These findings highlight the importance of fostering at-risk children's social-emotional skills during preschool as a means of promoting school readiness. The REDI (Research-Based, Developmentally-Informed) enrichment intervention was designed to complement and strengthen the impact of existing Head Start programs in the dual domains of language/emergent literacy skills and social-emotional competencies. REDI was one of several projects funded by the Interagency School Readiness Consortium, a partnership of four federal agencies (the National Institute of Child Health and Human Development, the Administration for Children and Families, the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services, and the Office of Special Education and Rehabilitation Services in the Department of Education). The projects funded through this partnership were designed to assess how integrative early interventions for at-risk children could promote learning and development across multiple domains of functioning. In addition, the projects were charged with examining processes of change and identifying mechanisms of action by which the early childhood interventions fostered later school adjustment and academic achievement. This study examined such processes of change, with the goal of documenting hypothesized cross-domain influences on kindergarten outcomes. In particular, this study tested whether gains in the proximal language/emergent literacy and social-emotional competencies targeted during Head Start would mediate the REDI intervention effects on kindergarten academic and behavioral outcomes. In addition, it tested the hypothesis that gains in social-emotional competencies during preschool would make unique contributions to intervention effects on both academic and behavioral outcomes, even after accounting for the effects of preschool gains in language and emergent literacy skills. PMID:24311939

Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay

PubMed Central

Lee, Li-Ching; Crum, Rosa M.; Zimmerman, Andrew W.; Hertz-Picciotto, Irva

2014-01-01

OBJECTIVE: To examine associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the odds of autism spectrum disorders (ASDs) and other developmental delays (DDs). METHODS: A total of 966 mother-child pairs were evaluated (492 ASD, 154 DD, 320 typical development [TD]) from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a population-based case-control study. Standardized measures confirmed developmental status. Interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information. RESULTS: Overall, prevalence of prenatal SSRI exposure was lowest in TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with ASD relative to TD (adjusted odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.07–7.93); the strongest association occurred with first-trimester exposure (OR: 3.22; 95% CI: 1.17–8.84). Exposure was also elevated among boys with DD (OR: 3.39; 95% CI: 0.98–11.75) and was strongest in the third trimester (OR: 4.98; 95% CI: 1.20–20.62). Findings were similar among mothers with an anxiety or mood disorder history. CONCLUSIONS: In boys, prenatal exposure to SSRIs may increase susceptibility to ASD or DD. Findings from published studies on SSRIs and ASD continues to be inconsistent. Potential recall bias and residual confounding by indication are concerns. Larger samples are needed to replicate DD results. Because maternal depression itself carries risks for the fetus, the benefits of prenatal SSRI use should be carefully weighed against potential harms. PMID:24733881

Dual structure in the charge excitation spectrum of electron-doped cuprates

NASA Astrophysics Data System (ADS)

Bejas, Matías; Yamase, Hiroyuki; Greco, Andrés

2017-12-01

Motivated by the recent resonant x-ray scattering (RXS) and resonant inelastic x-ray scattering (RIXS) experiments for electron-doped cuprates, we study the charge excitation spectrum in a layered t -J model with the long-range Coulomb interaction. We show that the spectrum is not dominated by a specific type of charge excitations, but by different kinds of charge fluctuations, and is characterized by a dual structure in the energy space. Low-energy charge excitations correspond to various types of bond-charge fluctuations driven by the exchange term (J term), whereas high-energy charge excitations are due to usual on-site charge fluctuations and correspond to plasmon excitations above the particle-hole continuum. The interlayer coupling, which is frequently neglected in many theoretical studies, is particularly important to the high-energy charge excitations.

Airblast Simulator Studies.

DTIC Science & Technology

1984-02-01

RAREFACTION WAVE ELIMINATOR CONSIDERATIONS 110 5.1 FLIP CALCULATIONS 110 5.2 A PASSIVE/ACTIVE RWE 118 6 DISTRIBUTED FUEL AIR EXPLOSIVES 120 REFERENCES 123 TA...conventional and distributed-charge fuel- air explosive charges used in a study of the utility of distributed charge FAE systems for blast simulation. The...limited investigation of distributed charge fuel air explosive configurations for blast simulator applications. During the course of this study

Problem Gambling Associated with Violent and Criminal Behaviour: A Danish Population-Based Survey and Register Study.

PubMed

Laursen, Bjarne; Plauborg, Rikke; Ekholm, Ola; Larsen, Christina Viskum Lytken; Juel, Knud

2016-03-01

This study compares the number of criminal charges among problem gamblers (N = 384) and non-problem gamblers including non-gamblers (N = 18,241) and examines whether problem gambling is more strongly associated with income-generating crimes like theft, fraud and forgery than other types of crimes such as violent crimes. A cohort study was carried out, based on data from the Danish Health and Morbidity Surveys in 2005 and 2010, which were linked at the individual level with data from The Danish National Criminal Register. Multiple logistic regression analyses were used to determine the association between problem gambling and charges for different categories of crime. We found that problem gamblers had significantly higher odds of being charged than non-problem gamblers (adjusted odds ratio 1.5; 95 % confidence interval 1.1-1.9). The odds ratio for economic crime charges was 2.6 (1.5-4.5), for violence charges 2.2 (1.1-4.5), and for drug charges 3.7 (1.7-8.0). For road traffic charges the odds ratio was 1.3 (1.0-1.8). Hence, there was a strong association between problem gambling and being charged except for road traffic charges; however the association was not stronger for economic charges than for violence and drug charges.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samedov, V. V., E-mail: v-samedov@yandex.ru

Fluctuations of charge induced by charge carriers on the detector electrodes make a significant contribution to the energy resolution of ionization detectors, namely, semiconductor detectors and gas and liquid ionization chambers. These fluctuations are determined by the capture of charge carriers, as they drift in the bulk of the detector under the action of an electric field, by traps. In this study, we give a correct mathematical description of charge induction on electrodes of an ionization detector for an arbitrary electric field distribution in the detector with consideration of charge carrier capture by traps. The characteristic function obtained in thismore » study yields the general expression for the distribution function of the charge induced on the detector electrodes. The formulas obtained in this study are useful for analysis of the influence of charge carrier transport on energy resolution of ionization detectors.« less

Charge breeding simulations for radioactive ion beam production

DOE Office of Scientific and Technical Information (OSTI.GOV)

Variale, V.; Raino, A. C.; Clauser, T.

2012-02-15

The charge breeding technique is used for radioactive ion beam (RIB) production in order of optimizing the re-acceleration of the radioactive element ions produced by a primary beam in a thick target. Charge breeding is achieved by means of a device capable of increasing the ion charge state from 1+ to a desired value n+. In order to get high intensity RIB, experiments with charge breeding of very high efficiency could be required. To reach this goal, the charge breeding simulation could help to optimize the high charge state production efficiency by finding more proper parameters for the radioactive 1+more » ions. In this paper a device based on an electron beam ion source (EBIS) is considered. In order to study that problem, a code already developed for studying the ion selective containment in an EBIS with RF quadrupoles, BRICTEST, has been modified to simulate the ion charge state breeding rate for different 1+ ion injection conditions. Particularly, the charge breeding simulations for an EBIS with a hollow electron beam have been studied.« less

Gender and morals in Spanish Catholic youth culture: a case study of the Marian Congregations 1930-1936.

PubMed

Vincent, M

2001-01-01

Jesuit-run Marian Congregations proliferated in 1930s Spain. Drawing on literature produced for their members, this article demonstrates how gendered understandings were fundamental to the congregations' symbolic delineation of an uncontaminated Catholic space. Visions of an incorrupt male elite abound, reinforcing the Jesuits' educational mission among future leaders and opinion-formers. In contrast, the purity of women and children was seen as a sign of society's moral health. Modesty was the quintessential female virtue. Yet, the cult of the Virgin Mary suggested that the virginal female body was both tool and symbol in the struggle against a fallen world. Girls were, therefore, charged with the task of moral guardianship. Such campaigns were emblematic of Spanish Catholicism's tendency to proffer religious solutions to social problems.

Study on Impact of Electric Vehicles Charging Models on Power Load

NASA Astrophysics Data System (ADS)

Cheng, Chen; Hui-mei, Yuan

2017-05-01

With the rapid increase in the number of electric vehicles, which will lead the power load on grid increased and have an adversely affect. This paper gives a detailed analysis of the following factors, such as scale of the electric cars, charging mode, initial charging time, initial state of charge, charging power and other factors. Monte Carlo simulation method is used to compare the two charging modes, which are conventional charging and fast charging, and MATLAB is used to model and simulate the electric vehicle charging load. The results show that compared with the conventional charging mode, fast charging mode can meet the requirements of fast charging, but also bring great load to the distribution network which will affect the reliability of power grid.

Epidemiology of bronchiolitis: a description of emergency department visits and hospitalizations in Puerto Rico, 2010-2014.

PubMed

Rivera-Sepulveda, Andrea; Garcia-Rivera, Enid J

2017-01-01

Little is known about the epidemiology of bronchiolitis as a clinical diagnosis and its impact on emergency department visits and hospitalizations in tropical and semitropical regions. We described the epidemiology of bronchiolitis emergency visits and hospitalizations, its temporal trend and geographic distribution in Puerto Rico between 2010 and 2014. We performed a retrospective descriptive analysis of a representative sample of privately insured children with bronchiolitis from January 2010 to December 2014. Data was provided by the largest private health insurer in Puerto Rico and identified children < 24 months of age with bronchiolitis by International Classification of Diseases, Ninth Revision code 466, 466.11, and 466.19. Chi-square and one-way ANOVA compared sex, age, diagnosis, and severity across the years. Joinpoint Poisson regression analysis evaluated the temporal trend distribution of bronchiolitis hospitalizations per calendar year. A P value less than 0.05 was statistically significant. During the study period, the annual proportion of emergency department visits and hospitalizations due to bronchiolitis increased from 3 to 5%, and 26 to 38%, respectively. The annual incidence rate of hospitalizations was 3.2 per 1000 privately insured children < 24 months. Non-RSV bronchiolitis was the most frequent diagnosis (51%). Hospitalizations occurred year-round, but increased significantly from August through December. Most children hospitalized resided in the metropolitan San Juan (35%) and surrounding urban areas. Total hospital charges decreased from $3.78 to $3.74 million, with an average cost per hospitalization of $4320.12 (11.3% increase; P  = 0.0015). This is the first study that evaluates the epidemiological characteristics of bronchiolitis in a primarily Hispanic population, living in a tropical country, and using data from a privately insured population. We found a small but significant increase in proportion of emergency visits and hospitalizations. Temporal trend shows year-round hospitalizations with an earlier seasonal peak and longer duration, consistent with Puerto Rico's seasonal rainfall throughout the study period. Further studies are needed to elucidate whether this epidemiologic pattern can also be seen in publicly insured children and whether Hispanic ethnicity is a risk factor for increased hospitalizations or is related to health disparities in the US healthcare system.

Black Flags of Their Fathers: The Islamic States Returning Foreign Fighter Youths and the Implications for U.S. Domestic Security

DTIC Science & Technology

2017-12-01

headquarters Services , Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the...indoctrination and training that give them the tools to plan, organize, and execute terrorist attacks. These children also have the motive, means, and...Tani Jr. Assistant to the Special Agent in Charge, U.S. Secret Service B.A., University of Mary Washington, 1998 Submitted in partial fulfillment of

A Retrospective Inquiry into the Operation of Service Custom under the American Military General Articles.

DTIC Science & Technology

1982-05-23

of women and children . Levy was convicted by a general court-martial of making a disloyal statement, in violation of Article 134, and of conduct...domination of the court-martial process, ineffective and inhibited defense counsel services, and discrimination against enlisted men in charging decisions ... sexual acts with a chicken.14 It is not surprising, then, that the antecedents of Article 134 have been referred to by soldiers as "the 15Devil’s Article

Home accidents to children under 15 years: survey of 910 cases.

PubMed

Murdock, R; Eva, J

1974-07-13

Out of 910 accidents sustained by children under 15 seen at the casualty department of a local hospital 678 (74.5%) were to children under 5 years of age. Boys were more prone to accidents than girls, and in preschool children the highest incidence of accidents was among the 2-to 3-year-olds of both sexes. Social class had no significant bearing on the accident rate. The fact that the average size of families with children under 5 was higher among families living in council houses than among those living in private houses appeared to have some bearing on the higher incidence of accidents among children under 5 living in council houses. There appeared to be no peak month when accidents were more frequent and the incidence of accidents was not significantly high on any particular weekday. In 95% of the cases one or both parents were in charge of the child at the time of the accident.Cuts were the most common types of accident followed by falls and poisoning. Among other accidents crushed fingers were as frequent as burns. A total of 62 patients (6.8% of all cases) were admitted as inpatients. Of the actual causes of the cuts and falls playing, fighting, and misbehaving were the most common followed by falling from beds, chairs, etc. While there is a need for health education programmes to draw attention to the specific dangers evidenced there clearly will always be home accidents.

Home Accidents to Children under 15 Years: Survey of 910 Cases

PubMed Central

Murdock, R.; Eva, Joyce

1974-01-01

Out of 910 accidents sustained by children under 15 seen at the casualty department of a local hospital 678 (74·5%) were to children under 5 years of age. Boys were more prone to accidents than girls, and in preschool children the highest incidence of accidents was among the 2-to 3-year-olds of both sexes. Social class had no significant bearing on the accident rate. The fact that the average size of families with children under 5 was higher among families living in council houses than among those living in private houses appeared to have some bearing on the higher incidence of accidents among children under 5 living in council houses. There appeared to be no peak month when accidents were more frequent and the incidence of accidents was not significantly high on any particular weekday. In 95% of the cases one or both parents were in charge of the child at the time of the accident. Cuts were the most common types of accident followed by falls and poisoning. Among other accidents crushed fingers were as frequent as burns. A total of 62 patients (6·8% of all cases) were admitted as inpatients. Of the actual causes of the cuts and falls playing, fighting, and misbehaving were the most common followed by falling from beds, chairs, etc. While there is a need for health education programmes to draw attention to the specific dangers evidenced there clearly will always be home accidents. PMID:4852285

Electrification of particulate entrained fluid flows-Mechanisms, applications, and numerical methodology

NASA Astrophysics Data System (ADS)

Wei, Wei; Gu, Zhaolin

2015-10-01

Particulates in natural and industrial flows have two basic forms: liquid (droplet) and solid (particle). Droplets would be charged in the presence of the applied electric field (e.g. electrospray). Similar to the droplet charging, particles can also be charged under the external electric field (e.g. electrostatic precipitator), while in the absence of external electric field, tribo-electrostatic charging is almost unavoidable in gas-solid two-phase flows due to the consecutive particle contacts (e.g. electrostatic in fluidized bed or wind-blown sand). The particle charging may be beneficial, or detrimental. Although electrostatics in particulate entrained fluid flow systems have been so widely used and concerned, the mechanisms of particulate charging are still lack of a thorough understanding. The motivation of this review is to explore a clear understanding of particulate charging and movement of charged particulate in two-phase flows, by summarizing the electrification mechanisms, physical models of particulate charging, and methods of charging/charged particulate entrained fluid flow simulations. Two effective methods can make droplets charged in industrial applications: corona charging and induction charging. The droplet charge to mass ratio by corona charging is more than induction discharge. The particle charging through collisions could be attributed to electron transfer, ion transfer, material transfer, and/or aqueous ion shift on particle surfaces. The charges on charged particulate surface can be measured, nevertheless, the charging process in nature or industry is difficult to monitor. The simulation method might build a bridge of investigating from the charging process to finally charged state on particulate surface in particulate entrained fluid flows. The methodology combining the interface tracking under the action of the applied electric with the fluid flow governing equations is applicable to the study of electrohydrodynamics problems. The charge distribution and mechanical behaviors of liquid surface can be predicted by using this method. The methodology combining particle charging model with Computational Fluid Dynamics (CFD) and Discrete element method (DEM) is applicable to study the particle charging/charged processes in gas-solid two phase flows, the influence factors of particle charging, such as gas-particle interaction, contact force, contact area, and various velocities, are described systematically. This review would explore a clear understanding of the particulate charging and provide theoretical references to control and utilize the charging/charged particulate entrained fluid system.

Shuttle user analysis (study 2.2). Volume 2: User charge analysis. Part 1: Summary

NASA Technical Reports Server (NTRS)

1974-01-01

Alternative candidate STS flight charge approaches which will provide a basis for NASA's determination of an STS flight charge policy were analyzed. The analysis used STS transportation costs furnished by NASA. The STS User Charge Analysis was accomplished by (1) generating criteria for evaluation of alternative flight charge approaches, (2) defining alternative flight charge approaches, (3) computing flight charges for selected missions, (4) evaluating results using the criteria generated under (1), and (5) recommending flight charge approaches to be used as a basis for the formulation of a STS user flight charge policy.

Regional Charging Infrastructure for Plug-In Electric Vehicles: A Case Study of Massachusetts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, Eric; Raghavan, Sesha; Rames, Clement

Given the complex issues associated with plug-in electric vehicle (PEV) charging and options in deploying charging infrastructure, there is interest in exploring scenarios of future charging infrastructure deployment to provide insight and guidance to national and regional stakeholders. The complexity and cost of PEV charging infrastructure pose challenges to decision makers, including individuals, communities, and companies considering infrastructure installations. The value of PEVs to consumers and fleet operators can be increased with well-planned and cost-effective deployment of charging infrastructure. This will increase the number of miles driven electrically and accelerate PEV market penetration, increasing the shared value of charging networksmore » to an expanding consumer base. Given these complexities and challenges, the objective of the present study is to provide additional insight into the role of charging infrastructure in accelerating PEV market growth. To that end, existing studies on PEV infrastructure are summarized in a literature review. Next, an analysis of current markets is conducted with a focus on correlations between PEV adoption and public charging availability. A forward-looking case study is then conducted focused on supporting 300,000 PEVs by 2025 in Massachusetts. The report concludes with a discussion of potential methodology for estimating economic impacts of PEV infrastructure growth.« less

Role of protein surface charge in monellin sweetness.

PubMed

Xue, Wei-Feng; Szczepankiewicz, Olga; Thulin, Eva; Linse, Sara; Carey, Jannette

2009-03-01

A small number of proteins have the unusual property of tasting intensely sweet. Despite many studies aimed at identifying their sweet taste determinants, the molecular basis of protein sweetness is not fully understood. Recent mutational studies of monellin have implicated positively charged residues in sweetness. In the present work, the effect of overall net charge was investigated using the complementary approach of negative charge alterations. Multiple substitutions of Asp/Asn and Glu/Gln residues radically altered the surface charge of single-chain monellin by removing six negative charges or adding four negative charges. Biophysical characterization using circular dichroism, fluorescence, and two-dimensional NMR demonstrates that the native fold of monellin is preserved in the variant proteins under physiological solution conditions although their stability toward chemical denaturation is altered. A human taste test was employed to determine the sweetness detection threshold of the variants. Removal of negative charges preserves monellin sweetness, whereas added negative charge has a large negative impact on sweetness. Meta-analysis of published charge variants of monellin and other sweet proteins reveals a general trend toward increasing sweetness with increasing positive net charge. Structural mapping of monellin variants identifies a hydrophobic surface predicted to face the receptor where introduced positive or negative charge reduces sweetness, and a polar surface where charges modulate long-range electrostatic complementarity.

Taking care of you and care for others: an analysis of the activity of the work of technical and nursing assistants of a psychiatric institution for children and adolescents.

PubMed

Mendes, Davidson Passos; Moraes, Geraldo Fabiano de Souza; Mendes, Juliana Cristina de Lima

2012-01-01

Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.

Analysis of Electric Vehicle Charging Impact on the Electric Power Grid

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, Zeming; Tian, Hao; Beshir, Mohammed J.

2016-09-24

In order to evaluate the impact of electric vehicles (EVs) on the distribution grid and assess their potential benefits to the future smart grid, it is crucial to study the EV charging patterns and the usage charging station. Though EVs are not yet widely adopted nationwide, a valuable methodology to conduct such studies is the statistical analysis of real-world charging data. This paper presents actual EV charging behavior of 64 EVs (5 brands, 8 models) from EV users and charging stations at Los Angeles Department of Water and Power for more than one year. Twenty-four-hour EV charging load curves havemore » been generated and studied for various load periods: daily, monthly, seasonally and yearly. Finally, the effect and impact of EV load on the California distribution network are evaluated at different EV penetration rates.« less

Abnormal Multiple Charge Memory States in Exfoliated Few-Layer WSe2 Transistors.

PubMed

Chen, Mikai; Wang, Yifan; Shepherd, Nathan; Huard, Chad; Zhou, Jiantao; Guo, L J; Lu, Wei; Liang, Xiaogan

2017-01-24

To construct reliable nanoelectronic devices based on emerging 2D layered semiconductors, we need to understand the charge-trapping processes in such devices. Additionally, the identified charge-trapping schemes in such layered materials could be further exploited to make multibit (or highly desirable analog-tunable) memory devices. Here, we present a study on the abnormal charge-trapping or memory characteristics of few-layer WSe 2 transistors. This work shows that multiple charge-trapping states with large extrema spacing, long retention time, and analog tunability can be excited in the transistors made from mechanically exfoliated few-layer WSe 2 flakes, whereas they cannot be generated in widely studied few-layer MoS 2 transistors. Such charge-trapping characteristics of WSe 2 transistors are attributed to the exfoliation-induced interlayer deformation on the cleaved surfaces of few-layer WSe 2 flakes, which can spontaneously form ambipolar charge-trapping sites. Our additional results from surface characterization, charge-retention characterization at different temperatures, and density functional theory computation strongly support this explanation. Furthermore, our research also demonstrates that the charge-trapping states excited in multiple transistors can be calibrated into consistent multibit data storage levels. This work advances the understanding of the charge memory mechanisms in layered semiconductors, and the observed charge-trapping states could be further studied for enabling ultralow-cost multibit analog memory devices.

Nanoparticle coagulation in fractionally charged and charge fluctuating dusty plasmas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nunomura, Shota; Kondo, Michio; Shiratani, Masaharu

2008-08-15

The kinetics of nanoparticle coagulation has been studied in fractionally charged and charge fluctuating dusty plasmas. The coagulation occurs when the mutual collision frequency among nanoparticles exceeds their charging and decharging/neutralization frequency. Interestingly, the coagulation is suppressed while a fraction (several percent) of nanoparticles are negatively charged in a plasma, in which stochastic charging plays an important role. A model is developed to predict a phase diagram of the coagulation and its suppression.

Ion-ion charge exchange processes. Final technical report, June 1, 1977-May 31, 1978

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poe, R.T.; Choi, B.H.

Under the auspices of ERDA, we have undertaken a vigorous study of ion-ion charge exchange process pertinent to the storage-ring configurations in the heavy-ion fusion program. One particular reaction, singly charged helium charge exchange, was investigated in detail. General trend of the singly charged heavy-ion charge exchange reaction can be inferred from the present study. Some of our results were presented at Proceedings of the Heavy-Ion Fusion Workshop, Argonne National Laboratory (September 1978) as a paper entitled Charge Exchange Between Singly Ionized Helium Ions, by B.H. Choi, R.T. Poe and K.T. Tang. Here, we briefly describe our method and reportmore » the results.« less

A MASSive Laboratory Tour. An Interactive Mass Spectrometry Outreach Activity for Children

NASA Astrophysics Data System (ADS)

Jungmann, Julia H.; Mascini, Nadine E.; Kiss, Andras; Smith, Donald F.; Klinkert, Ivo; Eijkel, Gert B.; Duursma, Marc C.; Cillero Pastor, Berta; Chughtai, Kamila; Chughtai, Sanaullah; Heeren, Ron M. A.

2013-07-01

It is imperative to fascinate young children at an early stage in their education for the analytical sciences. The exposure of the public to mass spectrometry presently increases rapidly through the common media. Outreach activities can take advantage of this exposure and employ mass spectrometry as an exquisite example of an analytical science in which children can be fascinated. The presented teaching modules introduce children to mass spectrometry and give them the opportunity to experience a modern research laboratory. The modules are highly adaptable and can be applied to young children from the age of 6 to 14 y. In an interactive tour, the students explore three major scientific concepts related to mass spectrometry; the building blocks of matter, charged particle manipulation by electrostatic fields, and analyte identification by mass analysis. Also, the students carry out a mass spectrometry experiment and learn to interpret the resulting mass spectra. The multistage, inquiry-based tour contains flexible methods, which teach the students current-day research techniques and possible applications to real research topics. Besides the scientific concepts, laboratory safety and hygiene are stressed and the students are enthused for the analytical sciences by participating in "hands-on" work. The presented modules have repeatedly been successfully employed during laboratory open days. They are also found to be extremely suitable for (early) high school science classes during laboratory visit-focused field trips.

Rotavirus vaccines in Israel: Uptake and impact

PubMed Central

Muhsen, Khitam; Cohen, Daniel

2017-01-01

ABSTRACT We present an overview of the impact of universal rotavirus immunization with the pentavalent vaccine, RotaTeq, which was introduced in Israel in 2010. The vaccine is given free of charge at age 2, 4 and 6 months, with an 80% coverage that was shortly achieved during the universal immunization period. Compared to pre-universal immunization years (2008–2010), a reduction of 66–68% in the incidence of rotavirus gastroenteritis (RVGE) hospitalizations was observed in 2011–2015 among children aged 0–23 months in central and northern Israel. In southern Israel a reduction of 80–88% in RVGE hospital visit rate was found among Jewish children aged 0–23 months in 2011–2013. Among Bedouins, the respective decline was 62–75%. A significant reduction of 59% was also observed in RVGE clinic visits, presumably representing less severe illness. Indirect benefit was evident in children aged 24–59 months who were ineligible for universal immunization. Vaccine effectiveness against RVGE hospitalization was estimated at 86% in children aged 6–23 months. Changes in the circulating rotavirus genotypes occurred but the contribution of vaccine induced immune pressure is unclear. Universal rotavirus immunization was followed by an impressive decrease in the burden of RVGE in young children in Israel, likely attributed to good vaccine coverage and effectiveness. PMID:28281866

The charging security study of electric vehicle charging spot based on automatic testing platform

NASA Astrophysics Data System (ADS)

Li, Yulan; Yang, Zhangli; Zhu, Bin; Ran, Shengyi

2018-03-01

With the increasing of charging spots, the testing of charging security and interoperability becomes more and more urgent and important. In this paper, an interface simulator for ac charging test is designed, the automatic testing platform for electric vehicle charging spots is set up and used to test and analyze the abnormal state during the charging process. On the platform, the charging security and interoperability of ac charging spots and IC-CPD can be checked efficiently, the test report can be generated automatically with No artificial reading error. From the test results, the main reason why the charging spot is not qualified is that the power supply cannot be cut off in the prescribed time when the charging anomaly occurs.

Fever and neutropenia hospital discharges in children with cancer: A 2012 update.

PubMed

Mueller, Emily L; Croop, James; Carroll, Aaron E

2016-02-01

Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors' previous analysis from 2009. Data were analyzed from the Kids' Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a "short length of stay" (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8% of pediatric hospital discharges (n = 120,675), with 12.2% (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6%) or upper respiratory infection (9.6%). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10-1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09-2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden.

The elimination of healthcare user fees for children under five substantially alleviates the burden on household expenses in Burkina Faso.

PubMed

Abdou Illou, Mahaman Mourtala; Haddad, Slim; Agier, Isabelle; Ridde, Valéry

2015-08-08

Since September 2008, an intervention has made it possible to provide free care to children under five in public health facilities in two districts of Burkina Faso. This study evaluated the intervention's impact on household expenses incurred for services (consultations and medications) to the children targeted. The study is based on a survey of a representative panel of 1,260 households encountered in two waves, one month before and 12 months after the introduction of the intervention. The questions explored the illness episodes of all children under five in the 30 days before each wave. The analysis of health expenses incurred during an illness episode distinguished between total expenses and those incurred in public health facilities (charges for services and medications). Analyses based on multilevel simultaneous equation models were used to estimate the probability of spending and the amount spent, in a context where a large number of observations returned a count of zero. The burden on household expenses was greatly alleviated under the intervention. Average expenditure dropped from US$11 per episode of care to less than US$2 after the intervention was implemented. The risk of incurring an expense at a public health facility was reduced by two-thirds. The facility users' savings were primarily related to medication purchases. In rural areas, where barriers to access health services are more acute, both poor and non-poor families benefited from the intervention. The probability of spending on medications dropped dramatically for both the poor and the non-poor under the exemption (-75% vs.-77%), and the reduction in expenses for medications generated by the intervention was comparable for both groups in relative values (-86% vs.-89%). User fees abolition at the point of service substantially alleviated the burden on household expenses. The intervention benefited both poor and non-poor families and provided financial protection.

New aspect of critical nonlinearly charged black hole

NASA Astrophysics Data System (ADS)

Hendi, S. H.; Taghadomi, Z. S.; Corda, C.

2018-04-01

The motion of a point charged particle moving in the background of the critical power Maxwell charged AdS black holes in a probe approximation is studied. The extended phase space, where the cosmological constant appears as a pressure, is regarded and the effective potential is investigated. At last, the mass-to-charge ratio and the large q limit are studied.

PSO Based PI Controller Design for a Solar Charger System

PubMed Central

Yau, Her-Terng; Lin, Chih-Jer; Liang, Qin-Cheng

2013-01-01

Due to global energy crisis and severe environmental pollution, the photovoltaic (PV) system has become one of the most important renewable energy sources. Many previous studies on solar charger integrated system only focus on load charge control or switching Maximum Power Point Tracking (MPPT) and charge control modes. This study used two-stage system, which allows the overall portable solar energy charging system to implement MPPT and optimal charge control of Li-ion battery simultaneously. First, this study designs a DC/DC boost converter of solar power generation, which uses variable step size incremental conductance method (VSINC) to enable the solar cell to track the maximum power point at any time. The voltage was exported from the DC/DC boost converter to the DC/DC buck converter, so that the voltage dropped to proper voltage for charging the battery. The charging system uses constant current/constant voltage (CC/CV) method to charge the lithium battery. In order to obtain the optimum PI charge controller parameters, this study used intelligent algorithm to determine the optimum parameters. According to the simulation and experimental results, the control parameters resulted from PSO have better performance than genetic algorithms (GAs). PMID:23766713

PSO based PI controller design for a solar charger system.

PubMed

Yau, Her-Terng; Lin, Chih-Jer; Liang, Qin-Cheng

2013-01-01

Due to global energy crisis and severe environmental pollution, the photovoltaic (PV) system has become one of the most important renewable energy sources. Many previous studies on solar charger integrated system only focus on load charge control or switching Maximum Power Point Tracking (MPPT) and charge control modes. This study used two-stage system, which allows the overall portable solar energy charging system to implement MPPT and optimal charge control of Li-ion battery simultaneously. First, this study designs a DC/DC boost converter of solar power generation, which uses variable step size incremental conductance method (VSINC) to enable the solar cell to track the maximum power point at any time. The voltage was exported from the DC/DC boost converter to the DC/DC buck converter, so that the voltage dropped to proper voltage for charging the battery. The charging system uses constant current/constant voltage (CC/CV) method to charge the lithium battery. In order to obtain the optimum PI charge controller parameters, this study used intelligent algorithm to determine the optimum parameters. According to the simulation and experimental results, the control parameters resulted from PSO have better performance than genetic algorithms (GAs).

A charging study of ACTS using NASCAP

NASA Technical Reports Server (NTRS)

Herr, Joel L.

1991-01-01

The NASA Charging Analyzer Program (NASCAP) computer code is a three dimensional finite element charging code designed to analyze spacecraft charging in the magnetosphere. Because of the characteristics of this problem, NASCAP can use an quasi-static approach to provide a spacecraft designer with an understanding of how a specific spacecraft will interact with a geomagnetic substorm. The results of the simulation can help designers evaluate the probability and location of arc discharges of charged surfaces on the spacecraft. A charging study of NASA's Advanced Communication Technology Satellite (ACTS) using NASCAP is reported. The results show that the ACTS metalized multilayer insulating blanket design should provide good electrostatic discharge control.

Studies of Surface Charging of Polymers by Indirect Triboelectrification

NASA Astrophysics Data System (ADS)

Mantovani, James; Calle, Carlos; Groop, Ellen; Buehler, Martin

2001-03-01

Charge is known to develop on the surface of an insulating polymer by frictional charging through direct physical contact with another material. We will present results of recent triboelectrification studies of polymer surfaces that utilized an indirect method of frictional charging. This method first involves placing a grounded thin metal foil in stationary contact over the polymer surface. The exposed metal foil is then rubbed with the surface of the material that generates the triboelectric charge. Data is presented for five types of polymers: fiberglass/epoxy, polycarbonate (Lexan), polytetraflouroethylene (Teflon), Rulon J, and polymethylmethacrylate (PMMA, Lucite). The amount of charge that develops on an insulator's surface is measured using the MECA Electrometer, which was developed jointly by NASA Kennedy Space Center and the Jet Propulsion Laboratory to study the electrostatic properties of soil on the surface of Mars. Even though the insulator's surface is electrically shielded from the rubbing material by the grounded metal foil, charge measurements obtained by the MECA Electrometer after the metal foil is separated from the insulator's surface reveal that the insulator's surface does accumulate charge by indirect frictional charging. A possible explanation of the observations will be presented based on a simple contact barrier model.

Ionization efficiency studies with charge breeder and conventional electron cyclotron resonance ion source

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koivisto, H., E-mail: hannu.koivisto@phys.jyu.fi; Tarvainen, O.; Toivanen, V.

2014-02-15

Radioactive Ion Beams play an increasingly important role in several European research facility programs such as SPES, SPIRAL1 Upgrade, and SPIRAL2, but even more for those such as EURISOL. Although remarkable advances of ECRIS charge breeders (CBs) have been achieved, further studies are needed to gain insight on the physics of the charge breeding process. The fundamental plasma processes of charge breeders are studied in the frame of the European collaboration project, EMILIE, for optimizing the charge breeding. Important information on the charge breeding can be obtained by conducting similar experiments using the gas mixing and 2-frequency heating techniques withmore » a conventional JYFL 14 GHz ECRIS and the LPSC-PHOENIX charge breeder. The first experiments were carried out with noble gases and they revealed, for example, that the effects of the gas mixing and 2-frequency heating on the production of high charge states appear to be additive for the conventional ECRIS. The results also indicate that at least in the case of noble gases the differences between the conventional ECRIS and the charge breeder cause only minor impact on the production efficiency of ion beams.« less

Naval Justice School Procedure Study Guide. Revision

DTIC Science & Technology

1990-01-01

preferring charges. The preferral of charges is accomplished by the signing and swearing to charges in Block 11 on page 1 of the charge sheet (DD Form 458...by the Naval Investigative Service (NIS) or similar agency; or upon receipt of signed and sworn charges (i.e., preferred charges on DD Form 458). 2-1 4...imcludiag. if loppropriatte in tkv astolrsoa# of joistiro sod 4.. ap4.e. the preferring of such charges alt app..? to yes to be mssimed by expected

A Novel Methodology for Charging Station Deployment

NASA Astrophysics Data System (ADS)

Sun, Zhonghao; Zhao, Yunwei; He, Yueying; Li, Mingzhe

2018-02-01

Lack of charging stations has been a main obstacle to the promotion of electric vehicles. This paper studies deploying charging stations in traffic networks considering grid constraints to balance the charging demand and grid stability. First, we propose a statistical model for charging demand. Then we combine the charging demand model with power grid constraints and give the formulation of the charging station deployment problem. Finally, we propose a theoretical solution for the problem by transforming it to a Markov Decision Process.

A Study of the Nature and Origins of Pyroelectricity and Piezoelectricity in Polyvinylidenefluoride and Its Co-Polymers.

DTIC Science & Technology

1980-01-01

OF THIS PAOE(3tn Dea afm 20. Contd. It is possible that space charges are also present in the’film. However, the distribution of space charges in the...the discontinuities so that space charge effects may cause field perturbations. On the other hand, the corona charging procedure may drive ions into...trapped space charge effects; (iv) tunnelling of charge from the electrodes to empty traps; (v) hopping of charge carriers through localized states. The

Charged polymers in high dimensions

NASA Technical Reports Server (NTRS)

Kantor, Yacov

1990-01-01

A Monte Carlo study of charged polymers with either homogeneously distributed frozen charges or with mobile charges has been performed in four and five space dimensions. The results are consistent with the renormalization-group predictions and contradict the predictions of Flory-type theory. Introduction of charge mobility does not modify the behavior of the polymers.

Longitudinal charge nurse leadership development and evaluation.

PubMed

Krugman, Mary; Heggem, Laura; Kinney, Lisa Judd; Frueh, Margaret

2013-09-01

The study's aim was to examine longitudinal outcomes of a leadership program for permanent and relief charge nurse from 1996 to 2012 using action research and Kouzes and Posner's The Leadership Challenge conceptual frameworks. Charge nurses hold significant oversight of patient safety, quality, and team functioning. This study contributes knowledge regarding charge nurse leadership and organization outcomes associated with these essential roles over time. Data were collected over 6 time periods using Kouzes and Posner's The Leadership Practices Inventory (LPI) and internally developed action research tools. Surveys were aligned with leadership and work environment changes to examine outcomes. Charge nurse leadership LPI mean ratings improved. Relief charge nurses reached similar LPI outcomes by 2012, with no statistical differences in mean or domain scores. Action research methods facilitated executive decision making during change processes. Demographics shifted with younger charge nurses with less practice experience serving as charge nurses in the most recent years. Charge nurse leadership reported significant gains despite institutional changes and uneven delivery of educational interventions.

Cu nuclear magnetic resonance study of charge and spin stripe order in La 1.875 Ba 0.125 CuO 4

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pelc, D.; Grafe, H. -J.; Gu, G. D.

In this paper, we present a Cu nuclear magnetic/quadrupole resonance study of the charge stripe ordered phase of LBCO, with detection of previously unobserved (“wiped-out”) signal. We show that spin-spin and spin-lattice relaxation rates are strongly enhanced in the charge ordered phase, explaining the apparent signal decrease in earlier investigations. The enhancement is caused by magnetic, rather than charge fluctuations, conclusively confirming the long-suspected assumption that spin fluctuations are responsible for the wipeout effect. Observation of the full Cu signal enables insight into the spin and charge dynamics of the stripe-ordered phase, and measurements in external magnetic fields provide informationmore » on the nature and suppression of spin fluctuations associated with charge order. Lastly, we find glassy spin dynamics, in agreement with previous work, and incommensurate static charge order with charge modulation amplitude similar to other cuprate compounds, suggesting that the amplitude of charge stripes is universal in the cuprates.« less

Cu nuclear magnetic resonance study of charge and spin stripe order in La 1.875 Ba 0.125 CuO 4

DOE PAGES

Pelc, D.; Grafe, H. -J.; Gu, G. D.; ...

2017-02-15

In this paper, we present a Cu nuclear magnetic/quadrupole resonance study of the charge stripe ordered phase of LBCO, with detection of previously unobserved (“wiped-out”) signal. We show that spin-spin and spin-lattice relaxation rates are strongly enhanced in the charge ordered phase, explaining the apparent signal decrease in earlier investigations. The enhancement is caused by magnetic, rather than charge fluctuations, conclusively confirming the long-suspected assumption that spin fluctuations are responsible for the wipeout effect. Observation of the full Cu signal enables insight into the spin and charge dynamics of the stripe-ordered phase, and measurements in external magnetic fields provide informationmore » on the nature and suppression of spin fluctuations associated with charge order. Lastly, we find glassy spin dynamics, in agreement with previous work, and incommensurate static charge order with charge modulation amplitude similar to other cuprate compounds, suggesting that the amplitude of charge stripes is universal in the cuprates.« less

Charge Transfer from n-Doped Nanocrystals: Mimicking Intermediate Events in Multielectron Photocatalysis.

PubMed

Wang, Junhui; Ding, Tao; Wu, Kaifeng

2018-06-12

In multielectron photocatalytic reactions, an absorbed photon triggers charge transfer from the light-harvester to the attached catalyst, leaving behind a charge of the opposite sign in the light-harvester. If this charge is not scavenged before the absorption of the following photons, photoexcitation generates not neutral but charged excitons from which the extraction of charges should become more difficult. This is potentially an efficiency-limiting intermediate event in multielectron photocatalysis. To study the charge dynamics in this event, we doped CdS nanocrystal quantum dots (QDs) with an extra electron and measured hole transfer from n-doped QDs to attached acceptors. We find that the Auger decay of charged excitons lowers the charge separation yield to 68.6% from 98.4% for neutral excitons. In addition, the hole transfer rate in the presence of two electrons (1290 ps) is slower than that in the presence one electron (776 ps), and the recombination rate of charge separated states is about 2 times faster in the former case. This model study provides important insights into possible efficiency-limiting intermediate events involved in photocatalysis.

Exploring Demand Charge Savings from Commercial Solar

DOE Office of Scientific and Technical Information (OSTI.GOV)

Darghouth, Naim; Barbose, Galen; Mills, Andrew

Commercial retail electricity rates commonly include a demand charge component, based on some measure of the customer’s peak demand. Customer-sited solar PV can potentially reduce demand charges, but the magnitude of these savings can be difficult to predict, given variations in demand charge designs, customer loads, and PV generation profiles. Moreover, depending on the circumstances, demand charges from solar may or may not align well with associated utility cost savings. Lawrence Berkeley National Laboratory (Berkeley Lab) and the National Renewable Energy Laboratory (NREL) are collaborating in a series of studies to understand how solar PV can reduce demand charge levelsmore » for a variety of customer types and demand charges designs. Previous work focused on residential customs with solar. This study, instead, focuses on commercial customers and seeks to understand the extent and conditions under which rooftop can solar reduce commercial demand charges. To answer these questions, we simulate demand charge savings for a broad range of commercial customer types, demand charge designs, locations, and PV system characteristics. This particular analysis does not include storage, but a subsequent analysis in this series will evaluate demand charge savings for commercial customers with solar and storage.« less

Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gagnon, Pieter J.; Govindarajan, Anand; Bird, Lori A.

We study the synergies between behind-the-meter solar and storage in reducing commercial-customer demand charges. This follows two previous studies that examined demand charge savings for stand-alone solar in both the residential and commercial sectors. In this study we show that solar and storage show consistent synergies for demand charge management, that the magnitude of reductions are highly customer-specific, and that the magnitude of savings is influenced by the design of the electricity tariff.

INFANT FEEDING IN THE FIRST TWO YEARS OF LIFE.

PubMed

Lopes, Wanessa Casteluber; Marques, Fúlvia Karine Santos; Oliveira, Camila Ferreira de; Rodrigues, Jéssica Alkmim; Silveira, Marise Fagundes; Caldeira, Antônio Prates; Pinho, Lucinéia de

2018-01-01

To analyze the prevalence of breastfeeding and the introduction of complementary food for zero to 24-month-old infants. This is a population-based cross-sectional study of children aged less than 24 months in Montes Claros, Minas Gerais, Brazil. Data were collected in 2015, by interviews with people in charge of infant care in the house. The questionnaire administered assessed the sociodemographic status of the family, maternal and infant characteristics and food consumption habits. Survival analysis was used to calculate median prevalence and duration of breastfeeding and the introduction of complementary feeding. With 180 days of life, 4.0% of the children were exclusively breastfed, 22.4% were mostly breastfed and 43.4% were fed breast milk as complementary food. In the third month of life, children were consuming water (56.8%), fruit juice or formula (15.5%) and cow's milk (10.6%). At the age of 12 months, 31.1% were consuming artificial juice and 50.0% were eating candies. Before the age of 1 year, 25.0% of them had already eaten instant noodles. The introduction of drinks, honey, sugar and candies as complementary food was found to be premature; and solid and semi-solid foods were almost appropriate. The habits described can directly affect the success of breastfeeding. Given that the inadequate eating practices identified can compromise the infant's health, actions that promote breastfeeding and provide guidance on the introduction of complementary foods are important.

Medical center staff attitudes about spanking.

PubMed

Gershoff, Elizabeth T; Font, Sarah A; Taylor, Catherine A; Foster, Rebecca H; Garza, Ann Budzak; Olson-Dorff, Denyse; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa

2016-11-01

Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and staff who do not (e.g., receptionists, lab technicians). Less than half (44% and 46%) of staff at each medical center agreed that spanking is harmful to children, although almost all (85% and 88%) acknowledged that spanking can lead to injury. Men, staff who report being religious, and staff who held non-direct care positions at the medical center reported stronger endorsement of spanking and perceived their co-workers to be more strongly in favor of spanking. Non-direct care staff were more supportive of spanking compared with direct care staff on every item assessed. All staff underestimated the extent to which their co-workers held negative views of spanking. If medical centers and other medical settings are to lead the charge in informing the community about the harms of spanking, comprehensive staff education about spanking is indicated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Benchmark Airport Charges

NASA Technical Reports Server (NTRS)

deWit, A.; Cohn, N.

1999-01-01

The Netherlands Directorate General of Civil Aviation (DGCA) commissioned Hague Consulting Group (HCG) to complete a benchmark study of airport charges at twenty eight airports in Europe and around the world, based on 1996 charges. This study followed previous DGCA research on the topic but included more airports in much more detail. The main purpose of this new benchmark study was to provide insight into the levels and types of airport charges worldwide and into recent changes in airport charge policy and structure, This paper describes the 1996 analysis. It is intended that this work be repeated every year in order to follow developing trends and provide the most up-to-date information possible.

Benchmark Airport Charges

NASA Technical Reports Server (NTRS)

de Wit, A.; Cohn, N.

1999-01-01

The Netherlands Directorate General of Civil Aviation (DGCA) commissioned Hague Consulting Group (HCG) to complete a benchmark study of airport charges at twenty eight airports in Europe and around the world, based on 1996 charges. This study followed previous DGCA research on the topic but included more airports in much more detail. The main purpose of this new benchmark study was to provide insight into the levels and types of airport charges worldwide and into recent changes in airport charge policy and structure. This paper describes the 1996 analysis. It is intended that this work be repeated every year in order to follow developing trends and provide the most up-to-date information possible.

Procedure Study Guide

DTIC Science & Technology

1998-08-01

differentiate between initiating a complaint and preferring charges. The preferral of charges is accomplished by the signing and swearing to charges in Block...Criminal Investigative Service (NCIS) or similar agency; or upon receipt of signed and sworn charges (i.e., preferred charges on DD Form 458). 4. Duty to...including, if appropriate in the interest of justice and discipline, the preferring of such charges as appear to you to be sustained by expected

In situ X-ray near-edge absorption spectroscopy investigation of the state of charge of all-vanadium redox flow batteries.

PubMed

Jia, Chuankun; Liu, Qi; Sun, Cheng-Jun; Yang, Fan; Ren, Yang; Heald, Steve M; Liu, Yadong; Li, Zhe-Fei; Lu, Wenquan; Xie, Jian

2014-10-22

Synchrotron-based in situ X-ray near-edge absorption spectroscopy (XANES) has been used to study the valence state evolution of the vanadium ion for both the catholyte and anolyte in all-vanadium redox flow batteries (VRB) under realistic cycling conditions. The results indicate that, when using the widely used charge-discharge profile during the first charge process (charging the VRB cell to 1.65 V under a constant current mode), the vanadium ion valence did not reach V(V) in the catholyte and did not reach V(II) in the anolyte. Consequently, the state of charge (SOC) for the VRB cell was only 82%, far below the desired 100% SOC. Thus, such incompletely charged mix electrolytes results in not only wasting the electrolytes but also decreasing the cell performance in the following cycles. On the basis of our study, we proposed a new charge-discharge profile (first charged at a constant current mode up to 1.65 V and then continuously charged at a constant voltage mode until the capacity was close to the theoretical value) for the first charge process that achieved 100% SOC after the initial charge process. Utilizing this new charge-discharge profile, the theoretical charge capacity and the full utilization of electrolytes has been achieved, thus having a significant impact on the cost reduction of the electrolytes in VRB.

A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.

PubMed

Gordon, John B; Colby, Holly H; Bartelt, Tera; Jablonski, Debra; Krauthoefer, Mary L; Havens, Peter

2007-10-01

To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes. Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005. A tertiary care center pediatric hospital and medical school serving urban and rural patients. A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program. Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician. Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments. A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000. This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support.

Analytical characterization of ch14.18

PubMed Central

Kallarakal, Abraham T; Michiel, Dennis; Yang, Xiaoyi; Saptharishi, Nirmala; Jiang, Hengguang; Giardina, Steve; Gilly, John; Mitra, George

2012-01-01

Ch14.18 is a mouse-human chimeric monoclonal antibody to the disialoganglioside (GD2) glycolipid. In the clinic, this antibody has been shown to be effective in the treatment of children with high-risk neuroblastoma, either alone or in combination therapy. Extensive product characterization is a prerequisite to addressing the potential issues of product variability associated with process changes and manufacturing scale-up. Charge heterogeneity, glycosylation profile, molecular state and aggregation, interaction (affinity) with Fcγ receptors and functional or biological activities are a few of the critical characterization assays for assessing product comparability for this antibody. In this article, we describe the in-house development and qualification of imaged capillary isoelectric focusing to assess charge heterogeneity, analytical size exclusion chromatography with online static and dynamic light scattering (DLS), batch mode DLS for aggregate detection, biosensor (surface plasmon resonance)-based Fcγ receptor antibody interaction kinetics, N-glycoprofiling with PNGase F digestion, 2-aminobenzoic acid labeling and high performance liquid chromatography and N-glycan analysis using capillary electrophoresis. In addition, we studied selected biological activity assays, such as complement-dependent cytotoxicity. The consistency and reproducibility of the assays are established by comparing the intra-day and inter-day assay results. Applications of the methodologies to address stability or changes in product characteristics are also reported. The study results reveal that the ch14.18 clinical product formulated in phosphate-buffered saline at a concentration of 5 mg/ml and stored at 2–8°C is stable for more than five years. PMID:22327432

A Charge Separation Study to Enable the Design of a Complete Muon Cooling Channel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoshikawa, C.; Ankenbrandt, Charles M.; Johnson, Rolland P.

2013-12-01

The most promising designs for 6D muon cooling channels operate on a specific sign of electric charge. In particular, the Helical Cooling Channel (HCC) and Rectilinear RFOFO designs are the leading candidates to become the baseline 6D cooling channel in the Muon Accelerator Program (MAP). Time constraints prevented the design of a realistic charge separator, so a simplified study was performed to emulate the effects of charge separation on muons exiting the front end of a muon collider. The output of the study provides particle distributions that the competing designs will use as input into their cooling channels. We reportmore » here on the study of the charge separator that created the simulated particles.« less

[Development, implementation, and analysis of a "collaborative decision-making for reasonable care" document in pediatric palliative care].

PubMed

Paoletti, M; Litnhouvongs, M-N; Tandonnet, J

2015-05-01

In France, a legal framework and guidelines state that decisions to limit treatments (DLT) require a collaborative decision meeting and a transcription of decisions in the patient's file. The do-not-attempt-resuscitation order involves the same decision-making process for children in palliative care. To fulfill the law's requirements and encourage communication within the teams, the Resource Team in Pediatric Palliative Care in Aquitaine created a document shared by all children's hospital units, tracing the decision-making process. This study analyzed the decision-making process, quality of information transmission, and most particularly the relevance of this new "collaborative decision-making for reasonable care" card. Retrospective study evaluating the implementation of a traceable document relating the DLT process. All the data sheets collected between January and December 2013 were analyzed. A total of 58 data sheets were completed between January and December 2013. We chose to collect the most relevant data to evaluate the relevance of the items to be completed and the transmission of the document, to draw up the patients' profile, and the contents of discussions with families. Of the 58 children for whom DLT was discussed, 41 data sheets were drawn up in the pediatric intensive care unit, seven in the oncology and hematology unit, five in the neonatology unit, four in the neurology unit, and one in the pneumology unit. For 30 children, one sheet was created, for 11 children, two sheets and for two children, three sheets were filled out. Thirty-nine decisions were made for withholding lifesaving treatment, 11 withdrawing treatment, and for five children, no limitation was set. Nine children survived after DLT. Of the 58 data sheets, only 31 discussions with families were related to the content of the data sheet. Of the 14 children transferred out of the unit with a completed data sheet, it was transmitted to the new unit for 11 children (79%). The number of data sheets collected in 1 year shows the value of this document. The participation of several pediatric specialities' referents in its creation, then its progressive presentation in the children's hospital units, were essential steps in introducing and establishing its use. Items describing the situation, management proposals, and adaptation of the children's supportive care were completed in the majority of cases. They correspond to a clinical description, the object of the discussion, and the daily caregiver's practices, respectively. On the other hand, discussions with families were related to the card's contents in only 53% of the cases. This can be explained by the time required to complete the DLT process. It is difficult for referring doctors to systematically, faithfully, and objectively transcribe discussions with parents. Although this process has been used for a long time in intensive care units, this document made possible an indispensable formalisation in the decision-making process. In other pediatric specialities, the sheet allowed introducing the palliative approach and was a starter and a tool for reflection on the do-not-attempt-resuscitation order, thus suggesting the need for anticipation in these situations. With the implementation of this new document, the DLT, data transmission, and continuity of care conditions were improved in the children's hospital units. Sharing this sheet with all professionals in charge of these children would support homogeneity and quality of management and care for children and their parents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

On cracking of charged anisotropic polytropes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Azam, M.; Mardan, S.A., E-mail: azam.math@ue.edu.pk, E-mail: syedalimardanazmi@yahoo.com

2017-01-01

Recently in [1], the role of electromagnetic field on the cracking of spherical polytropes has been investigated without perturbing charge parameter explicitly. In this study, we have examined the occurrence of cracking of anisotropic spherical polytropes through perturbing parameters like anisotropic pressure, energy density and charge. We consider two different types of polytropes in this study. We discuss the occurrence of cracking in two different ways ( i ) by perturbing polytropic constant, anisotropy and charge parameter ( ii ) by perturbing polytropic index, anisotropy and charge parameter for each case. We conclude that cracking appears for a wide rangemore » of parameters in both cases. Also, our results are reduced to [2] in the absence of charge.« less

Quantum and classical dissipation of charged particles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ibarra-Sierra, V.G.; Anzaldo-Meneses, A.; Cardoso, J.L.

2013-08-15

A Hamiltonian approach is presented to study the two dimensional motion of damped electric charges in time dependent electromagnetic fields. The classical and the corresponding quantum mechanical problems are solved for particular cases using canonical transformations applied to Hamiltonians for a particle with variable mass. Green’s function is constructed and, from it, the motion of a Gaussian wave packet is studied in detail. -- Highlights: •Hamiltonian of a damped charged particle in time dependent electromagnetic fields. •Exact Green’s function of a charged particle in time dependent electromagnetic fields. •Time evolution of a Gaussian wave packet of a damped charged particle.more » •Classical and quantum dynamics of a damped electric charge.« less

A Different Approach to Studying the Charge and Discharge of a Capacitor without an Oscilloscope

ERIC Educational Resources Information Center

Ladino, L. A.

2013-01-01

A different method to study the charging and discharging processes of a capacitor is presented. The method only requires a high impedance voltmeter. The charging and discharging processes of a capacitor are usually studied experimentally using an oscilloscope and, therefore, both processes are studied as a function of time. The approach presented…

Formation of charged nanoparticles in hydrocarbon flames: principal mechanisms

NASA Astrophysics Data System (ADS)

Starik, A. M.; Savel'ev, A. M.; Titova, N. S.

2008-11-01

The processes of charged gaseous and particulate species formation in sooting hydrocarbon/air flame are studied. The original kinetic model, comprising the chemistry of neutral and charged gaseous species, generation of primary clusters, which then undergo charging due to attachment of ions and electrons to clusters and via thermoemission, and coagulation of charged-charged, charged-neutral and neutral-neutral particles, is reported. The analysis shows that the principal mechanisms of charged particle origin in hydrocarbon flames are associated with the attachment of ions and electrons produced in the course of chemoionization reactions to primary small clusters and particles and coagulation via charged-charged and charged-neutral particle interaction. Thermal ionization of particles does not play a significant role in the particle charging. This paper was presented at the Third International Symposium on Nonequilibrium Process, combustion, and Atmospheric Phenomena (Dagomys, Sochi, Russia, 25-29 June 2007).

Surgical Treatment of Pediatric Craniofacial Fractures: A National Perspective.

PubMed

Massenburg, Benjamin B; Sanati-Mehrizy, Paymon; Taub, Peter J

2015-11-01

Head trauma is the most common cause of death because of injury in children, and trauma alone is the leading cause of morbidity and mortality in pediatrics. This study aimed to characterize the demographics and economic burden associated with the surgical and nonsurgical repair of craniofacial fractures in the pediatric inpatient population in the United States. A retrospective cohort study was performed using the 2012 Kids' Inpatient Database which identified 20,070 patients who had a skull or facial fracture, of whom 6395 (31.9%) were treated surgically. Epidemiologic patient and hospital data were analyzed as potential determinants of surgical treatment, prolonged hospitalizations, and higher charges. Pediatric craniofacial fractures are estimated to represent $1.2 billion of national healthcare expenditures annually. The average patient charge for surgical treatment of a craniofacial fracture in the pediatric population is $84,849 compared with $52,490 for nonsurgical management (P < 0.001), and the average length of stay was longer for surgical repair when compared with nonsurgical management for craniofacial fractures (5.3 days versus 4.6 days, P < 0.001). Patients who were older, African American, had nonprivate insurance, whose fracture was caused by external trauma, and who were treated in an urban hospital had an independently increased likelihood of surgical repair of craniofacial fractures. Patients who were older, female, insured, of lower income brackets, whose fracture was caused by a motor vehicle accident, who had surgical treatment of their craniofacial fracture, and who were treated in hospitals in the South, Midwest, or West, teaching hospitals, and government-owned hospitals had an independent risk for a prolonged hospitalization. Patients who were older, Caucasian, insured, whose fracture was caused by a motor vehicle accident, and who were treated in hospitals in the South, teaching hospitals, pediatric hospitals, larger hospitals, and government-owned hospitals had an independent risk for increased patient charges. Craniofacial fractures in the pediatric population represent a large economic burden to the patient and family, as well as the healthcare system as a whole. The identified patient and hospital demographics that are associated with prolonged hospital stays and higher patient charges may represent potential barriers to care, and additional research to elucidate these factors is warranted.

"Hope for the best, prepare for the worst": A qualitative interview study on parents' needs and fears in pediatric advance care planning.

PubMed

Lotz, Julia Desiree; Daxer, Marion; Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika

2017-09-01

Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. We aimed to investigate parents' views and needs regarding pediatric advance care planning. We performed a qualitative interview study with parents of children who had died from a severe illness. The interviews were analyzed by descriptive and evaluation coding according to Saldaña. We conducted semi-structured interviews with 11 parents of 9 children. Maximum variation was sought regarding the child's illness, age at death, care setting, and parent gender. Parents find it difficult to engage in pediatric advance care planning but consider it important. They argue for a sensitive, individualized, and gradual approach. Hope and quality of life issues are primary. Parents have many non-medical concerns that they want to discuss. Written advance directives are considered less important, but medical emergency plans are viewed as necessary in particular cases. Continuity of care and information should be improved through regular pediatric advance care planning meetings with the various care providers. Parents emphasize the importance of a continuous contact person to facilitate pediatric advance care planning. Despite a need for pediatric advance care planning, it is perceived as challenging. Needs-adjusted content and process and continuity of communication should be a main focus in pediatric advance care planning. Future research should focus on strategies that facilitate parent engagement in pediatric advance care planning to increase the benefit for the families.

Cross-Sectional Study of Malnutrition and Associated Factors among School Aged Children in Rural and Urban Settings of Fogera and Libo Kemkem Districts, Ethiopia

PubMed Central

Herrador, Zaida; Sordo, Luis; Gadisa, Endalamaw; Moreno, Javier; Nieto, Javier; Benito, Agustín; Aseffa, Abraham; Cañavate, Carmen; Custodio, Estefania

2014-01-01

Introduction Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas. Methods In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities. Results The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23–2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29–0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27–0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09–10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79–0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03–1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41–0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10–0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09–0.65) in the urban setting. Conclusion The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of malnutrition, and varied by type of setting. To effectively tackle malnutrition, nutritional programs should be oriented to local needs. PMID:25265481

Cross-sectional study of malnutrition and associated factors among school aged children in rural and urban settings of Fogera and Libo Kemkem districts, Ethiopia.

PubMed

Herrador, Zaida; Sordo, Luis; Gadisa, Endalamaw; Moreno, Javier; Nieto, Javier; Benito, Agustín; Aseffa, Abraham; Cañavate, Carmen; Custodio, Estefania

2014-01-01

Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas. In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities. The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23-2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29-0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27-0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09-10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79-0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03-1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41-0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10-0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09-0.65) in the urban setting. The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of malnutrition, and varied by type of setting. To effectively tackle malnutrition, nutritional programs should be oriented to local needs.

Elimination of the Out-of-Pocket Charge for Children's Primary Care Visits: An Application of Value-Based Insurance Design.

PubMed

Sepúlveda, Martín-J; Roebuck, M Christopher; Fronstin, Paul; Vidales-Calderon, Pablo; Parikh, Ashish; Rhee, Kyu

2016-08-01

To evaluate the impact of a value-based insurance design for primary care among children. A retrospective analysis of health care claims data on 25 950 children (<18 years of age) was conducted. Individuals were enrolled in a large employer's health plans when zero out-of-pocket cost for primary care physician visits was implemented. A rigorous propensity score matching process was used to generate a control group of equal size from a database of other employer-sponsored insurees. Multivariate difference-in-differences models estimated the effect of zero out-of-pocket cost on 21 health services and cost outcomes 24 months after intervention. Zero out-of-pocket cost for primary care was associated with significant increases (P < .01) in primary care physician visits (+32 per 100 children), as well as decreases in emergency department (-5 per 100 children) and specialist physician visits (-12 per 100 children). The number of prescription drug fills also declined (-20 per 100 children), yet medication adherence for 3 chronic conditions was unaffected. The receipt of well child visits and 4 recommended vaccinations were all significantly (P < .05) greater under the new plan design feature. Employer costs for primary care increased significantly (P < .01) in association with greater utilization ($29 per child), but specialist visit costs declined (-$12 per child) and total health care costs per child did not exhibit a statistically significant increase. This novel application of value-based insurance design warrants broader deployment and assessment of its longer term outcomes. As with recommended preventive services, policymakers should consider exempting primary care from health insurance cost-sharing. Copyright © 2016 Elsevier Inc. All rights reserved.

Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children

PubMed Central

Lardelli, Patrizia; Frech-Dörfler, Martina; Holland-Cunz, Stefan; Mayr, Johannes

2016-01-01

Abstract Stabilization of diaphyseal long-bone fractures using elastic stable intramedullary nails (ESIN) in children promises early mobilization and rapid resumption of full weight bearing. We evaluated the duration of postoperative functional rehabilitation after ESIN, measured by the time from stabilization until first partial weight bearing, full weight bearing, and resumption of school sports. Fifty children with unstable, displaced fractures of the femur or lower leg treated with ESIN between 2002 and 2012 were included in this retrospective analysis. We classified fractures according to the pediatric comprehensive classification of fractures (PCCF). Thirty-five children sustained a femur fracture, and 15 children had a fracture of the lower leg or tibia. The surgeons in charge applied an additional plaster cast in 7 of 15 children who suffered a lower leg fracture. The postoperative time interval until full weight bearing in the group of children who had suffered transverse or short oblique femur fractures was significantly shorter (median: 4.4 weeks; range: 0.1–9.1 weeks) than that in the group who had sustained more complex fracture patterns (median: 6.8 weeks; range: 2.9–13.9 weeks; P = 0.04). Similarly, transverse and short oblique lower leg and tibia fractures required less time until full weight bearing (median: 4.1 weeks; range 2.7–6.0 weeks) than complex lower leg fractures (median: 6.1 weeks; range: 1.3–12.9 weeks; P = 0.04). ESIN proved fairly effective in restoring full weight bearing in transverse or short oblique fractures of the lower extremities but was less effective in complex fractures. PMID:26986106

Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children.

PubMed

Lardelli, Patrizia; Frech-Dörfler, Martina; Holland-Cunz, Stefan; Mayr, Johannes

2016-03-01

Stabilization of diaphyseal long-bone fractures using elastic stable intramedullary nails (ESIN) in children promises early mobilization and rapid resumption of full weight bearing. We evaluated the duration of postoperative functional rehabilitation after ESIN, measured by the time from stabilization until first partial weight bearing, full weight bearing, and resumption of school sports. Fifty children with unstable, displaced fractures of the femur or lower leg treated with ESIN between 2002 and 2012 were included in this retrospective analysis. We classified fractures according to the pediatric comprehensive classification of fractures (PCCF). Thirty-five children sustained a femur fracture, and 15 children had a fracture of the lower leg or tibia. The surgeons in charge applied an additional plaster cast in 7 of 15 children who suffered a lower leg fracture. The postoperative time interval until full weight bearing in the group of children who had suffered transverse or short oblique femur fractures was significantly shorter (median: 4.4 weeks; range: 0.1-9.1 weeks) than that in the group who had sustained more complex fracture patterns (median: 6.8 weeks; range: 2.9-13.9 weeks; P = 0.04). Similarly, transverse and short oblique lower leg and tibia fractures required less time until full weight bearing (median: 4.1 weeks; range 2.7-6.0 weeks) than complex lower leg fractures (median: 6.1 weeks; range: 1.3-12.9 weeks; P = 0.04). ESIN proved fairly effective in restoring full weight bearing in transverse or short oblique fractures of the lower extremities but was less effective in complex fractures.

Polyelectrolyte adsorption onto like-charged surfaces mediated by trivalent counterions: A Monte Carlo simulation study

NASA Astrophysics Data System (ADS)

Luque-Caballero, Germán; Martín-Molina, Alberto; Quesada-Pérez, Manuel

2014-05-01

Both experiments and theory have evidenced that multivalent cations can mediate the interaction between negatively charged polyelectrolytes and like-charged objects, such as anionic lipoplexes (DNA-cation-anionic liposome complexes). In this paper, we use Monte Carlo simulations to study the electrostatic interaction responsible for the trivalent-counterion-mediated adsorption of polyelectrolytes onto a like-charged planar surface. The evaluation of the Helmholtz free energy allows us to characterize both the magnitude and the range of the interaction as a function of the polyelectrolyte charge, surface charge density, [3:1] electrolyte concentration, and cation size. Both polyelectrolyte and surface charge favor the adsorption. It should be stressed, however, that the adsorption will be negligible if the surface charge density does not exceed a threshold value. The effect of the [3:1] electrolyte concentration has also been analyzed. In certain range of concentrations, the counterion-mediated attraction seems to be independent of this parameter, whereas very high concentrations of salt weaken the adsorption. If the trivalent cation diameter is doubled the adsorption moderates due to the excluded volume effects. The analysis of the integrated charge density and ionic distributions suggests that a delicate balance between charge inversion and screening effects governs the polyelectrolyte adsorption onto like-charged surfaces mediated by trivalent cations.

The load shift potential of plug-in electric vehicles with different amounts of charging infrastructure

NASA Astrophysics Data System (ADS)

Gnann, Till; Klingler, Anna-Lena; Kühnbach, Matthias

2018-06-01

Plug-in electric vehicles are the currently favoured option to decarbonize the passenger car sector. However, a decarbonisation is only possible with electricity from renewable energies and plug-in electric vehicles might cause peak loads if they started to charge at the same time. Both these issues could be solved with coordinated load shifting (demand response). Previous studies analyzed this research question by focusing on private vehicles with domestic and work charging infrastructure. This study additionally includes the important early adopter group of commercial fleet vehicles and reflects the impact of domestic, commercial, work and public charging. For this purpose, two models are combined. In a comparison of three scenarios, we find that charging of commercial vehicles does not inflict evening load peaks in the same magnitude as purely domestic charging of private cars does. Also for private cars, charging at work occurs during the day and may reduce the necessity of load shifting while public charging plays a less important role in total charging demand as well as load shifting potential. Nonetheless, demand response reduces the system load by about 2.2 GW or 2.8% when domestic and work charging are considered compared to a scenario with only domestic charging.

Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gagnon, P.; Govindarajan, A.; Bird, L.

Demand charges, which are based on a customer’s maximum demand in kilowatts (kW), are a common element of electricity rate structures for commercial customers. Customer-sited solar photovoltaic (PV) systems can potentially reduce demand charges, but the level of savings is difficult to predict, given variations in demand charge designs, customer loads, and PV generation profiles. Lawrence Berkeley National Laboratory (Berkeley Lab) and the National Renewable Energy Laboratory (NREL) are collaborating on a series of studies to understand how solar PV can impact demand charges. Prior studies in the series examined demand charge reductions from solar on a stand-alone basis formore » residential and commercial customers. Those earlier analyses found that solar, alone, has limited ability to reduce demand charges depending on the specific design of the demand charge and on the shape of the customer’s load profile. This latest analysis estimates demand charge savings from solar in commercial buildings when co-deployed with behind-the-meter storage, highlighting the complementary roles of the two technologies. The analysis is based on simulated loads, solar generation, and storage dispatch across a wide variety of building types, locations, system configurations, and demand charge designs.« less

Effect of pulsed current charging on the performance of nickel-cadium cells

NASA Technical Reports Server (NTRS)

Bedrossian, A. A.; Cheh, H. Y.

1977-01-01

The effect of pulsed current charging on the charge acceptance of NiCd cells in terms of mass transfer, kinetic, and structural considerations was investigated. A systemic investigation on the performance of Ni-Cd cells by pulsed current charging was conducted under a variety of well-defined charge-discharge conditions. Experiments were carried out with half cells and film electrodes. The system behavior was studied by charge acceptance, mechanistic, and structural measurements.

Improving Charging-Breeding Simulations with Space-Charge Effects

NASA Astrophysics Data System (ADS)

Bilek, Ryan; Kwiatkowski, Ania; Steinbrügge, René

2016-09-01

Rare-isotope-beam facilities use Highly Charged Ions (HCI) for accelerators accelerating heavy ions and to improve measurement precision and resolving power of certain experiments. An Electron Beam Ion Trap (EBIT) is able to create HCI through successive electron impact, charge breeding trapped ions into higher charge states. CBSIM was created to calculate successive charge breeding with an EBIT. It was augmented by transferring it into an object-oriented programming language, including additional elements, improving ion-ion collision factors, and exploring the overlap of the electron beam with the ions. The calculation is enhanced with the effects of residual background gas by computing the space charge due to charge breeding. The program assimilates background species, ionizes and charge breeds them alongside the element being studied, and allows them to interact with the desired species through charge exchange, giving fairer overview of realistic charge breeding. Calculations of charge breeding will be shown for realistic experimental conditions. We reexamined the implementation of ionization energies, cross sections, and ion-ion interactions when charge breeding.

Fast charge implications: Pack and cell analysis and comparison

NASA Astrophysics Data System (ADS)

Tanim, Tanvir R.; Shirk, Matthew G.; Bewley, Randy L.; Dufek, Eric J.; Liaw, Bor Yann

2018-03-01

This study investigates the effect of 50-kW (about 2C) direct current fast charging on a full-size battery electric vehicle's battery pack in comparison to a pack exclusively charged at 3.3 kW, which is the common alternating current Level 2 charging power level. Comparable scaled charging protocols are also independently applied to individual cells at three different temperatures, 20 °C, 30 °C, and 40 °C, to perform a comparative analysis with the packs. Dominant cell-level aging modes were identified through incremental capacity analysis and compared with full packs to gain a clear understanding of additional key factors that affect pack aging. While the cell-level study showed a minor impact on performance due to direct current fast charging, the packs showed a significantly higher rate of capacity fade under similar charging protocols. This indicates that pack-level aging cannot be directly extrapolated from cell evaluation. Delayed fast charging, completing shortly before discharge, was found to have less of an impact on battery degradation than conventional alternating current Level 2 charging.

Hospital charges associated with motorcycle crash factors: a quantile regression analysis.

PubMed

Olsen, Cody S; Thomas, Andrea M; Cook, Lawrence J

2014-08-01

Previous studies of motorcycle crash (MC) related hospital charges use trauma registries and hospital records, and do not adjust for the number of motorcyclists not requiring medical attention. This may lead to conservative estimates of helmet use effectiveness. MC records were probabilistically linked with emergency department and hospital records to obtain total hospital charges. Missing data were imputed. Multivariable quantile regression estimated reductions in hospital charges associated with helmet use and other crash factors. Motorcycle helmets were associated with reduced median hospital charges of $256 (42% reduction) and reduced 98th percentile of $32,390 (33% reduction). After adjusting for other factors, helmets were associated with reductions in charges in all upper percentiles studied. Quantile regression models described homogenous and heterogeneous associations between other crash factors and charges. Quantile regression comprehensively describes associations between crash factors and hospital charges. Helmet use among motorcyclists is associated with decreased hospital charges. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Charge-transfer modified embedded atom method dynamic charge potential for Li-Co-O system

NASA Astrophysics Data System (ADS)

Kong, Fantai; Longo, Roberto C.; Liang, Chaoping; Nie, Yifan; Zheng, Yongping; Zhang, Chenxi; Cho, Kyeongjae

2017-11-01

To overcome the limitation of conventional fixed charge potential methods for the study of Li-ion battery cathode materials, a dynamic charge potential method, charge-transfer modified embedded atom method (CT-MEAM), has been developed and applied to the Li-Co-O ternary system. The accuracy of the potential has been tested and validated by reproducing a variety of structural and electrochemical properties of LiCoO2. A detailed analysis on the local charge distribution confirmed the capability of this potential for dynamic charge modeling. The transferability of the potential is also demonstrated by its reliability in describing Li-rich Li2CoO2 and Li-deficient LiCo2O4 compounds, including their phase stability, equilibrium volume, charge states and cathode voltages. These results demonstrate that the CT-MEAM dynamic charge potential could help to overcome the challenge of modeling complex ternary transition metal oxides. This work can promote molecular dynamics studies of Li ion cathode materials and other important transition metal oxides systems that involve complex electrochemical and catalytic reactions.

Charge-transfer modified embedded atom method dynamic charge potential for Li-Co-O system.

PubMed

Kong, Fantai; Longo, Roberto C; Liang, Chaoping; Nie, Yifan; Zheng, Yongping; Zhang, Chenxi; Cho, Kyeongjae

2017-11-29

To overcome the limitation of conventional fixed charge potential methods for the study of Li-ion battery cathode materials, a dynamic charge potential method, charge-transfer modified embedded atom method (CT-MEAM), has been developed and applied to the Li-Co-O ternary system. The accuracy of the potential has been tested and validated by reproducing a variety of structural and electrochemical properties of LiCoO 2 . A detailed analysis on the local charge distribution confirmed the capability of this potential for dynamic charge modeling. The transferability of the potential is also demonstrated by its reliability in describing Li-rich Li 2 CoO 2 and Li-deficient LiCo 2 O 4 compounds, including their phase stability, equilibrium volume, charge states and cathode voltages. These results demonstrate that the CT-MEAM dynamic charge potential could help to overcome the challenge of modeling complex ternary transition metal oxides. This work can promote molecular dynamics studies of Li ion cathode materials and other important transition metal oxides systems that involve complex electrochemical and catalytic reactions.

Filicide, attempted filicide, and psychotic disorders.

PubMed

Valença, Alexandre M; Mendlowicz, Mauro V; Nascimento, Isabella; Nardi, Antonio E

2011-03-01

The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention. © 2011 American Academy of Forensic Sciences.

Seeing the Invisible: Educating the Public on Planetary Magnetic Fields and How they Affect Atmospheres

NASA Astrophysics Data System (ADS)

Fillingim, M. O.; Brain, D. A.; Peticolas, L. M.; Schultz, G.; Yan, D.; Guevara, S.; Randol, S.

2009-12-01

Magnetic fields and charged particles are difficult for school children, the general public, and scientists alike to visualize. But studies of planetary magnetospheres and ionospheres have broad implications for planetary evolution, from the deep interior to the ancient climate, that are important to communicate to each of these audiences. This presentation will highlight the visualization materials that we are developing to educate audiences on the magnetic fields of planets and how they affect atmospheres. The visualization materials that we are developing consist of simplified data sets that can be displayed on spherical projection systems and portable 3-D rigid models of planetary magnetic fields.We are developing presentations for science museums and classrooms that relate fundamental information about the Martian magnetic field, how it differs from Earth’s, and why the differences are significant.

Lead and uranium group abundances in cosmic rays

NASA Technical Reports Server (NTRS)

Yadav, J. S.; Perelygin, V. P.

1985-01-01

The importance of Lead and Uranium group abundances in cosmic rays is discussed in understanding their evolution and propagation. The electronic detectors can provide good charge resolution but poor data statistics. The plastic detectors can provide somewhat better statistics but charge resolution deteriorates. The extraterrestrial crystals can provide good statistics but with poor charge resolution. Recent studies of extraterrestrial crystals regarding their calibration to accelerated uranium ion beam and track etch kinetics are discussed. It is hoped that a charge resolution of two charge units can be achieved provided an additional parameter is taken into account. The prospects to study abundances of Lead group, Uranium group and superheavy element in extraterrestrial crystals are discussed, and usefulness of these studies in the light of studies with electronic and plastic detectors is assessed.

Charging of interplanetary grains

NASA Technical Reports Server (NTRS)

Baragiola, R. A.; Johnson, R. E.; Newcomb, John L.

1995-01-01

The objective of this program is to quantify, by laboratory experiments, the charging of ices and other insulators subject to irradiation with electrons, ions and ultraviolet photons and to model special conditions based on the data. The system and conditions to be studied are those relevant for charging of dust in magnetospheric plasmas. The measurements are supplemented by computer simulations of charging or grains under a variety of conditions. Our work for this period involved experiments on water ice, improved models of charging of ice grains for Saturn's E-ring, and the construction of apparatus for electron impact studies and measurements of electron energy distributions.

Study of charged hadron multiplicities in charged-current neutrino-lead interactions in the OPERA detector

NASA Astrophysics Data System (ADS)

Agafonova, N.; Aleksandrov, A.; Anokhina, A.; Aoki, S.; Ariga, A.; Ariga, T.; Bertolin, A.; Bodnarchuk, I.; Bozza, C.; Brugnera, R.; Buonaura, A.; Buontempo, S.; Chernyavskiy, M.; Chukanov, A.; Consiglio, L.; D'Ambrosio, N.; De Lellis, G.; De Serio, M.; del Amo Sanchez, P.; Di Crescenzo, A.; Di Ferdinando, D.; Di Marco, N.; Dmitrievski, S.; Dracos, M.; Duchesneau, D.; Dusini, S.; Dzhatdoev, T.; Ebert, J.; Ereditato, A.; Fini, R. A.; Fornari, F.; Fukuda, T.; Galati, G.; Garfagnini, A.; Gentile, V.; Goldberg, J.; Gornushkin, Y.; Gorbunov, S.; Grella, G.; Guler, A. M.; Gustavino, C.; Hagner, C.; Hara, T.; Hayakawa, T.; Hollnagel, A.; Hosseini, B.; Ishiguro, K.; Jakovcic, K.; Jollet, C.; Kamiscioglu, C.; Kamiscioglu, M.; Kim, S. H.; Kitagawa, N.; Klicek, B.; Kodama, K.; Komatsu, M.; Kose, U.; Kreslo, I.; Laudisio, F.; Lauria, A.; Ljubicic, A.; Longhin, A.; Loverre, P.; Malgin, A.; Malenica, M.; Mandrioli, G.; Matsuo, T.; Matveev, V.; Mauri, N.; Medinaceli, E.; Meregaglia, A.; Mikado, S.; Miyanishi, M.; Mizutani, F.; Monacelli, P.; Montesi, M. C.; Morishima, K.; Muciaccia, M. T.; Naganawa, N.; Naka, T.; Nakamura, M.; Nakano, T.; Niwa, K.; Okateva, N.; Ogawa, S.; Ozaki, K.; Paoloni, A.; Paparella, L.; Park, B. D.; Pasqualini, L.; Pastore, A.; Patrizii, L.; Pessard, H.; Podgrudkov, D.; Polukhina, N.; Pozzato, M.; Pupilli, F.; Roda, M.; Roganova, T.; Rokujo, H.; Rosa, G.; Ryazhskaya, O.; Sato, O.; Schembri, A.; Shakirianova, I.; Shchedrina, T.; Shibuya, H.; Shibayama, E.; Shiraishi, T.; Simone, S.; Sirignano, C.; Sirri, G.; Sotnikov, A.; Spinetti, M.; Stanco, L.; Starkov, N.; Stellacci, S. M.; Stipcevic, M.; Strolin, P.; Takahashi, S.; Tenti, M.; Terranova, F.; Tioukov, V.; Vasina, S.; Vilain, P.; Voevodina, E.; Votano, L.; Vuilleumier, J. L.; Wilquet, G.; Wonsak, B.; Yoon, C. S.

2018-01-01

The OPERA experiment was designed to search for ν _{μ } → ν _{τ } oscillations in appearance mode through the direct observation of tau neutrinos in the CNGS neutrino beam. In this paper, we report a study of the multiplicity of charged particles produced in charged-current neutrino interactions in lead. We present charged hadron average multiplicities, their dispersion and investigate the KNO scaling in different kinematical regions. The results are presented in detail in the form of tables that can be used in the validation of Monte Carlo generators of neutrino-lead interactions.

Application of the bounds-analysis approach to arsenic and gallium antisite defects in gallium arsenide

DOE PAGES

Wright, A. F.; Modine, N. A.

2015-01-23

The As antisite in GaAs (AsGa) has been the subject of numerous experimental and theoretical studies. Recent density-functional-theory (DFT) studies report results in good agreement with experimental data for the +2, +1, and 0 charge states of the stable EL2 structure, the 0 charge state of the metastable EL2* structure, and the activation energy to transform from EL2* to EL2 in the 0 charge state. However, these studies did not report results for EL2* in the -1 charge state. In this paper, we report new DFT results for the +2, +1, 0, and -1 charge states of AsGa, obtained usingmore » a semilocal exchange-correlation functional and interpreted using a bounds-analysis approach. In good agreement with experimental data, we find a -1/0 EL2* level 0.06 eV below the conduction-band edge and an activation energy of 0.05 eV to transform from EL2* to EL2 in the -1 charge state. While the Ga antisite in GaAs (GaAs) has not been studied as extensively as AsGa, experimental studies report three charge states (-2, -1, 0) and two levels (-2/-1, -1/0) close to the valence-band edge. Recent DFT studies report the same charge states, but the levels are found to be well-separated from the valence-band edge. To resolve this disagreement, we performed new DFT calculations for GaAs and interpreted them using a bounds analysis. The analysis identified the -1 and 0 charge states as hole states weakly bound to a highly-localized -2 charge state. Moreover, the -2/-1, -1/0 levels were found to be near the valence-band edge, in good agreement with the experimental data.« less

Effect of the surface charge discretization on electric double layers: a Monte Carlo simulation study.

PubMed

Madurga, Sergio; Martín-Molina, Alberto; Vilaseca, Eudald; Mas, Francesc; Quesada-Pérez, Manuel

2007-06-21

The structure of the electric double layer in contact with discrete and continuously charged planar surfaces is studied within the framework of the primitive model through Monte Carlo simulations. Three different discretization models are considered together with the case of uniform distribution. The effect of discreteness is analyzed in terms of charge density profiles. For point surface groups, a complete equivalence with the situation of uniformly distributed charge is found if profiles are exclusively analyzed as a function of the distance to the charged surface. However, some differences are observed moving parallel to the surface. Significant discrepancies with approaches that do not account for discreteness are reported if charge sites of finite size placed on the surface are considered.

Pediatric deep space neck infections in U.S. children, 2000-2009.

PubMed

Novis, Sarah J; Pritchett, Cedric V; Thorne, Marc C; Sun, Gordon H

2014-05-01

Deep space neck infections (DNI) are common pediatric illnesses, which can lead to significant morbidity and healthcare expenditures. Recent studies suggest that the incidence of pediatric DNI in the United States is increasing, but no nationally representative studies exist. This study sought to characterize pediatric DNI at the national level over the past decade and to determine whether U.S. incidence of pediatric DNI and associated resource utilization changed from 2000 to 2009. The Kids' Inpatient Database (KID) was used to evaluate pediatric DNI incidence, demographics, and outcomes from 2000 to 2009. Cases were identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic codes for peritonsillar abscess (475), parapharyngeal abscess (478.22), and retropharyngeal abscess (478.24). Regression analyses within each year and across the entire study period were performed on variables of interest including performance of imaging studies, operative intervention, length of hospital stay and total hospital charges. The incidence of retropharyngeal abscess increased significantly from 0.10 cases per 10,000 in 2000 to 0.22 in 2009 (p=0.02). There was no significant change during this time period in the incidence of combined DNI (1.07-1.37 cases per 10,000, p=0.07), peritonsillar abscess (0.82-0.94 cases per 10,000, p=0.12) or parapharyngeal abscess (0.08-0.14 cases per 10,000, p=0.13). The percentage of retropharyngeal abscess patients managed surgically decreased (48-38%, p=0.04) and the average length of hospital stay also decreased during this time (4.6-3.9 days, p=0.03). There was a marked increase in the total inflation-corrected hospital charges per case for all DNI ($9,486-16,348, p=0.005). The incidence of pediatric retropharyngeal abscess has increased significantly from 2000 to 2009, without concurrent increases in the incidence of combined DNI, peritonsillar, or parapharyngeal abscesses. There has been a change in management of retropharyngeal abscesses during this time with a decrease in operative intervention and a decrease in the length of hospital stay. Hospital charges associated with all pediatric DNI have nearly doubled during this timeframe, warranting future epidemiologic resource utilization studies in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Charge renormalization and inversion of a highly charged lipid bilayer: effects of dielectric discontinuities and charge correlations.

PubMed

Taheri-Araghi, Sattar; Ha, Bae-Yeun

2005-08-01

We reexamine the problem of charge renormalization and inversion of a highly charged surface of a low dielectric constant immersed in ionic solutions. To be specific, we consider an asymmetrically charged lipid bilayer, in which only one layer is negatively charged. In particular, we study how dielectric discontinuities and charge correlations (among lipid charges and condensed counterions) influence the effective charge of the surface. When counterions are monovalent (e.g., Na+), our mean-field approach implies that dielectric discontinuities can enhance counterion condensation. A simple scaling picture shows how the effects of dielectric discontinuities and surface-charge distributions are intertwined: Dielectric discontinuities diminish condensation if the backbone charge is uniformly smeared out while counterions are localized in space; they can, however, enhance condensation when the backbone charge is discrete. In the presence of asymmetric salts such as CaCl2 , we find that the correlation effect, treated at the Gaussian level, is more pronounced when the surface has a lower dielectric constant, inverting the sign of the charge at a smaller value of Ca2+ concentration.

Interactions between charged residues in the transmembrane segments of the voltage-sensing domain in the hERG channel.

PubMed

Zhang, M; Liu, J; Jiang, M; Wu, D-M; Sonawane, K; Guy, H R; Tseng, G-N

2005-10-01

Studies on voltage-gated K channels such as Shaker have shown that positive charges in the voltage-sensor (S4) can form salt bridges with negative charges in the surrounding transmembrane segments in a state-dependent manner, and different charge pairings can stabilize the channels in closed or open states. The goal of this study is to identify such charge interactions in the hERG channel. This knowledge can provide constraints on the spatial relationship among transmembrane segments in the channel's voltage-sensing domain, which are necessary for modeling its structure. We first study the effects of reversing S4's positive charges on channel activation. Reversing positive charges at the outer (K525D) and inner (K538D) ends of S4 markedly accelerates hERG activation, whereas reversing the 4 positive charges in between either has no effect or slows activation. We then use the 'mutant cycle analysis' to test whether D456 (outer end of S2) and D411 (inner end of S1) can pair with K525 and K538, respectively. Other positive charges predicted to be able, or unable, to interact with D456 or D411 are also included in the analysis. The results are consistent with predictions based on the distribution of these charged residues, and confirm that there is functional coupling between D456 and K525 and between D411 and K538.

Precision Blasting Techniques For Avalanche Control

NASA Astrophysics Data System (ADS)

Powell, Kevin M.

Experimental firings sponsored by the Center For Snow Science at Alta, Utah have demonstrated the potential of a unique prototype shaped charge device designed to stimulate snow pack and ice. These studies, conducted against stable snow pack, demonstrated a fourfold increase in crater volume yield and introduced a novel application of Shock Tube technology to facilitate position control, detonation and dud recovery of manually deployed charges. The extraordinary penetration capability of the shaped charge mechanism has been exploited in many non-military applications to meet a wide range of rapidpiercing and/or cutting requirements. The broader exploitation of the potential of the shaped charge mechanism has nevertheless remained confined to defence based applications. In the studies reported in this paper, the inimitable ability of the shaped charge mechanism to project shock energy, or a liner material, into a highly focussed energetic stream has been applied uniquely to the stimulation of snow pack. Recent research and development work, conducted within the UK, has resulted in the integration of shaped charge technology into a common Avalauncher and hand charge device. The potential of the common charge configuration and spooled Shock Tube fire and control system to improve the safety and cost effectiveness of explosives used in avalanche control operations was successfully demonstrated at Alta in March 2001. Future programmes of study will include focussed shock/blast mechanisms for suspended wire traverse techniques, application of the shaped charge mechanism to helibombing, and the desig n and development of non-fragmenting shaped charge ammunition formilitary artillery gun systems.

Pediatric Chiropractic Care: The Subluxation Question And Referral Risk.

PubMed

Homola, Samuel

2016-02-01

Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice. © 2016 John Wiley & Sons Ltd.

The Education of Learners with CHARGE Syndrome

ERIC Educational Resources Information Center

Deuce, Gail

2017-01-01

CHARGE syndrome, although a low incidence condition, is now recognised as a leading cause of congenital deafblindness among genetic conditions. Anecdotal reporting has suggested that learners with CHARGE syndrome are distinct from the wider deafblind population. This study investigates the education of learners with CHARGE syndrome, while also…

Charge transport and recombination in bulk heterojunction solar cells studied by the photoinduced charge extraction in linearly increasing voltage technique

NASA Astrophysics Data System (ADS)

Mozer, A. J.; Sariciftci, N. S.; Lutsen, L.; Vanderzande, D.; Österbacka, R.; Westerling, M.; Juška, G.

2005-03-01

Charge carrier mobility and recombination in a bulk heterojunction solar cell based on the mixture of poly[2-methoxy-5-(3,7-dimethyloctyloxy)-phenylene vinylene] (MDMO-PPV) and 1-(3-methoxycarbonyl)propyl-1-phenyl-(6,6)-C61 (PCBM) has been studied using the novel technique of photoinduced charge carrier extraction in a linearly increasing voltage (Photo-CELIV). In this technique, charge carriers are photogenerated by a short laser flash, and extracted under a reverse bias voltage ramp after an adjustable delay time (tdel). The Photo-CELIV mobility at room temperature is found to be μ =2×10-4cm2V-1s-1, which is almost independent on charge carrier density, but slightly dependent on tdel. Furthermore, determination of charge carrier lifetime and demonstration of an electric field dependent mobility is presented.

Surface charge effects in protein adsorption on nanodiamonds

NASA Astrophysics Data System (ADS)

Aramesh, M.; Shimoni, O.; Ostrikov, K.; Prawer, S.; Cervenka, J.

2015-03-01

Understanding the interaction of proteins with charged diamond nanoparticles is of fundamental importance for diverse biomedical applications. Here we present a thorough study of protein binding, adsorption kinetics and structure on strongly positively (hydrogen-terminated) and negatively (oxygen-terminated) charged nanodiamond particles using a quartz crystal microbalance by dissipation and infrared spectroscopy. By using two model proteins (bovine serum albumin and lysozyme) of different properties (charge, molecular weight and rigidity), the main driving mechanism responsible for the protein binding to the charged nanoparticles was identified. Electrostatic interactions were found to dominate the protein adsorption dynamics, attachment and conformation. We developed a simple electrostatic model that can qualitatively explain the observed adsorption behaviour based on charge-induced pH modifications near the charged nanoparticle surfaces. Under neutral conditions, the local pH around the positively and negatively charged nanodiamonds becomes very high (11-12) and low (1-3) respectively, which has a profound impact on the protein charge, hydration and affinity to the nanodiamonds. Small proteins (lysozyme) were found to form multilayers with significant conformational changes to screen the surface charge, while larger proteins (albumin) formed monolayers with minor conformational changes. The findings of this study provide a step forward toward understanding and eventually predicting nanoparticle interactions with biofluids.Understanding the interaction of proteins with charged diamond nanoparticles is of fundamental importance for diverse biomedical applications. Here we present a thorough study of protein binding, adsorption kinetics and structure on strongly positively (hydrogen-terminated) and negatively (oxygen-terminated) charged nanodiamond particles using a quartz crystal microbalance by dissipation and infrared spectroscopy. By using two model proteins (bovine serum albumin and lysozyme) of different properties (charge, molecular weight and rigidity), the main driving mechanism responsible for the protein binding to the charged nanoparticles was identified. Electrostatic interactions were found to dominate the protein adsorption dynamics, attachment and conformation. We developed a simple electrostatic model that can qualitatively explain the observed adsorption behaviour based on charge-induced pH modifications near the charged nanoparticle surfaces. Under neutral conditions, the local pH around the positively and negatively charged nanodiamonds becomes very high (11-12) and low (1-3) respectively, which has a profound impact on the protein charge, hydration and affinity to the nanodiamonds. Small proteins (lysozyme) were found to form multilayers with significant conformational changes to screen the surface charge, while larger proteins (albumin) formed monolayers with minor conformational changes. The findings of this study provide a step forward toward understanding and eventually predicting nanoparticle interactions with biofluids. Electronic supplementary information (ESI) available: The FTIR spectrum of nanodiamonds, QCM-D profiles of 50 nm nanodiamond adsorption on silica surfaces, QCM-D profiles of protein desorption after rinsing with water (rinsing experiment) and the full FTIR spectrum of proteins before and after adsorption on ND particles. See DOI: 10.1039/c5nr00250h

ELECTROSTATIC EFFECTS IN FABRIC FILTRATION: VOLUME I. FIELDS, FABRICS, AND PARTICLES. (ANNOTATED DATA)

EPA Science Inventory

The report examines the effect of particle charge and electric fields on the filtration of dust by fabrics. Both frictional charging and charging by corona are studied. Charged particles and an electric field driving particles toward the fabric can greatly reduce the initial pres...

Predictions of nuclear charge radii

NASA Astrophysics Data System (ADS)

Bao, M.; Lu, Y.; Zhao, Y. M.; Arima, A.

2016-12-01

The nuclear charge radius is a fundamental property of an atomic nucleus. In this article we study the predictive power of empirical relations for experimental nuclear charge radii of neighboring nuclei and predict the unknown charge radii of 1085 nuclei based on the experimental CR2013 database within an uncertainty of 0.03 fm.

General Purpose Electronegativity Relaxation Charge Models Applied to CoMFA and CoMSIA Study of GSK-3 Inhibitors.

PubMed

Tsareva, Daria A; Osolodkin, Dmitry I; Shulga, Dmitry A; Oliferenko, Alexander A; Pisarev, Sergey A; Palyulin, Vladimir A; Zefirov, Nikolay S

2011-03-14

Two fast empirical charge models, Kirchhoff Charge Model (KCM) and Dynamic Electronegativity Relaxation (DENR), had been developed in our laboratory previously for widespread use in drug design research. Both models are based on the electronegativity relaxation principle (Adv. Quantum Chem. 2006, 51, 139-156) and parameterized against ab initio dipole/quadrupole moments and molecular electrostatic potentials, respectively. As 3D QSAR studies comprise one of the most important fields of applied molecular modeling, they naturally have become the first topic to test our charges and thus, indirectly, the assumptions laid down to the charge model theories in a case study. Here these charge models are used in CoMFA and CoMSIA methods and tested on five glycogen synthase kinase 3 (GSK-3) inhibitor datasets, relevant to our current studies, and one steroid dataset. For comparison, eight other different charge models, ab initio through semiempirical and empirical, were tested on the same datasets. The complex analysis including correlation and cross-validation, charges robustness and predictability, as well as visual interpretability of 3D contour maps generated was carried out. As a result, our new electronegativity relaxation-based models both have shown stable results, which in conjunction with other benefits discussed render them suitable for building reliable 3D QSAR models. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Intracellular sorting of differently charged chitosan derivatives and chitosan-based nanoparticles

NASA Astrophysics Data System (ADS)

Zubareva, A. A.; Shcherbinina, T. S.; Varlamov, V. P.; Svirshchevskaya, E. V.

2015-04-01

Chitosan (Chi) is a biodegradable nontoxic polycation with multiple reactive groups that is easily used to obtain derivatives with a desired charge and hydrophobic properties. The aim of this work was to study the intracellular traffic of positively charged hexanoyl-chitosan (HC) or HC-based nanoparticles (HCNPs) and negatively charged succinoyl-chitosan (SC) and SCNPs in epithelial and macrophage cell lines. By using flow cytometry we demonstrated that positively charged HC adhered to cell membranes quicker and more efficiently than negatively charged SC or NPs. However confocal studies showed that SC and SCNPs penetrated cells much more efficiently than HC while HCNPs did not enter the epithelial cells. Macrophages also phagocyted better negatively charged material but were able to engulf both HC and HCNPs. Upon entering the cells, SC and SCNPs were co-localized with endosomes and lysosomes while HC was found in mitochondria and, to a lesser extent, in lysosomes of epithelial cells. Macrophages, RAW264.7, more efficiently transported all Chi samples to the lysosomal compartment while some positively charged material was still found in mitochondria. Incubation of Chi derivatives and ChiNPs at pH specific to mitochondria (8.0) and lysosomes (4.5) demonstrated the neutralization of Chi charge. We concluded that epithelial cells and, to a lesser extent, macrophages sort charged material to the organelles neutralizing Chi charge.

The charged black-hole bomb: A lower bound on the charge-to-mass ratio of the explosive scalar field

NASA Astrophysics Data System (ADS)

Hod, Shahar

2016-04-01

The well-known superradiant amplification mechanism allows a charged scalar field of proper mass μ and electric charge q to extract the Coulomb energy of a charged Reissner-Nordström black hole. The rate of energy extraction can grow exponentially in time if the system is placed inside a reflecting cavity which prevents the charged scalar field from escaping to infinity. This composed black-hole-charged-scalar-field-mirror system is known as the charged black-hole bomb. Previous numerical studies of this composed physical system have shown that, in the linearized regime, the inequality q / μ > 1 provides a necessary condition for the development of the superradiant instability. In the present paper we use analytical techniques to study the instability properties of the charged black-hole bomb in the regime of linearized scalar fields. In particular, we prove that the lower bound q/μ>√{rm /r- - 1/ rm /r+ - 1 } provides a necessary condition for the development of the superradiant instability in this composed physical system (here r± are the horizon radii of the charged Reissner-Nordström black hole and rm is the radius of the confining mirror). This analytically derived lower bound on the superradiant instability regime of the composed black-hole-charged-scalar-field-mirror system is shown to agree with direct numerical computations of the instability spectrum.

Studying Spacecraft Charging via Numerical Simulations

NASA Astrophysics Data System (ADS)

Delzanno, G. L.; Moulton, D.; Meierbachtol, C.; Svyatskiy, D.; Vernon, L.

2015-12-01

The electrical charging of spacecraft due to bombarding charged particles can affect their performance and operation. We study this charging using CPIC; a particle-in-cell code specifically designed for studying plasma-material interactions [1]. CPIC is based on multi-block curvilinear meshes, resulting in near-optimal computational performance while maintaining geometric accuracy. Relevant plasma parameters are imported from the SHIELDS framework (currently under development at LANL), which simulates geomagnetic storms and substorms in the Earth's magnetosphere. Simulated spacecraft charging results of representative Van Allen Probe geometries using these plasma parameters will be presented, along with an overview of the code. [1] G.L. Delzanno, E. Camporeale, J.D. Moulton, J.E. Borovsky, E.A. MacDonald, and M.F. Thomsen, "CPIC: A Curvilinear Particle-In-Cell Code for Plasma-Material Interaction Studies," IEEE Trans. Plas. Sci., 41 (12), 3577 (2013).

Simulation study of spheroidal dust gains charging: Applicable to dust grain alignment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zahed, H.; Sobhanian, S.; Mahmoodi, J.

2006-09-15

The charging process of nonspherical dust grains in an unmagnetized plasma as well as in the presence of a magnetic field is studied. It is shown that unlike the spherical dust grain, due to nonhomogeneity of charge distribution on the spheroidal dust surface, the resultant electric forces on electrons and ions are different. This process produces some surface charge density gradient on the nonspherical grain surface. Effects of a magnetic field and other plasma parameters on the properties of the dust particulate are studied. It has been shown that the alignment direction could be changed or even reversed with themore » magnetic field and plasma parameters. Finally, the charge distribution on the spheroidal grain surface is studied for different ambient parameters including plasma temperature, neutral collision frequency, and the magnitude of the magnetic field.« less

Naval Justice Procedure Study Guide. Revised

DTIC Science & Technology

1994-05-01

differentiate between initiating a complaint and preferring charges. The preferral of charges is accomplished by the signing and swearing to charges...Investigative Service (NCIS) or similar agency; or upon receipt of signed and sworn charges (i.e., preferred charges on DD Form 458). 4. Duty to report...will suffer no serious injury and that the place of confinement will not be injurious to the accused. Diminished rations is a restricted diet of 2100

Dynamics of glycoprotein charge in the evolutionary history of human influenza.

PubMed

Arinaminpathy, Nimalan; Grenfell, Bryan

2010-12-30

Influenza viruses show a significant capacity to evade host immunity; this is manifest both as large occasional jumps in the antigenic phenotype of viral surface molecules and in gradual antigenic changes leading to annual influenza epidemics in humans. Recent mouse studies show that avidity for host cells can play an important role in polyclonal antibody escape, and further that electrostatic charge of the hemagglutinin glycoprotein can contribute to such avidity. We test the role of glycoprotein charge on sequence data from the three major subtypes of influenza A in humans, using a simple method of calculating net glycoprotein charge. Of all subtypes, H3N2 in humans shows a striking pattern of increasing positive charge since its introduction in 1968. Notably, this trend applies to both hemagglutinin and neuraminidase glycoproteins. In the late 1980s hemagglutinin charge reached a plateau, while neuraminidase charge started to decline. We identify key groups of amino acid sites involved in this charge trend. To our knowledge these are the first indications that, for human H3N2, net glycoprotein charge covaries strongly with antigenic drift on a global scale. Further work is needed to elucidate how such charge interacts with other immune escape mechanisms, such as glycosylation, and we discuss important questions arising for future study.

Surface charge effects in protein adsorption on nanodiamonds.

PubMed

Aramesh, M; Shimoni, O; Ostrikov, K; Prawer, S; Cervenka, J

2015-03-19

Understanding the interaction of proteins with charged diamond nanoparticles is of fundamental importance for diverse biomedical applications. Here we present a thorough study of protein binding, adsorption kinetics and structure on strongly positively (hydrogen-terminated) and negatively (oxygen-terminated) charged nanodiamond particles using a quartz crystal microbalance by dissipation and infrared spectroscopy. By using two model proteins (bovine serum albumin and lysozyme) of different properties (charge, molecular weight and rigidity), the main driving mechanism responsible for the protein binding to the charged nanoparticles was identified. Electrostatic interactions were found to dominate the protein adsorption dynamics, attachment and conformation. We developed a simple electrostatic model that can qualitatively explain the observed adsorption behaviour based on charge-induced pH modifications near the charged nanoparticle surfaces. Under neutral conditions, the local pH around the positively and negatively charged nanodiamonds becomes very high (11-12) and low (1-3) respectively, which has a profound impact on the protein charge, hydration and affinity to the nanodiamonds. Small proteins (lysozyme) were found to form multilayers with significant conformational changes to screen the surface charge, while larger proteins (albumin) formed monolayers with minor conformational changes. The findings of this study provide a step forward toward understanding and eventually predicting nanoparticle interactions with biofluids.

A quantum mechanical-Poisson-Boltzmann equation approach for studying charge flow between ions and a dielectric continuum

NASA Astrophysics Data System (ADS)

Gogonea, Valentin; Merz, Kenneth M.

2000-02-01

This paper presents a theoretical model for the investigation of charge transfer between ions and a solvent treated as a dielectric continuum media. The method is a combination of a semiempirical effective Hamiltonian with a modified Poisson-Boltzmann equation which includes charge transfer in the form of a surface charge density positioned at the dielectric interface. The new Poisson-Boltzmann equation together with new boundary conditions results in a new set of equations for the electrostatic potential (or polarization charge densities). Charge transfer adds a new free energy component to the solvation free energy term, which accounts for all interactions between the transferred charge at the dielectric interface, the solute wave function and the solvent polarization charges. Practical calculations on a set of 19 anions and 17 cations demonstrate that charge exchange with a dielectric is present and it is in the range of 0.06-0.4 eu. Furthermore, the pattern of the magnitudes of charge transfer can be related to the acid-base properties of the ions in many cases, but exceptions are also found. Finally, we show that the method leads to an energy decomposition scheme of the total electrostatic energy, which can be used in mechanistic studies on protein and DNA interaction with water.

Meeting the Grand Challenge of Protecting Astronauts Health: Electrostatic Active Space Radiation Shielding for Deep Space Missions

NASA Technical Reports Server (NTRS)

Tripathi, Ram K.

2016-01-01

This report describes the research completed during 2011 for the NASA Innovative Advanced Concepts (NIAC) project. The research is motivated by the desire to safely send humans in deep space missions and to keep radiation exposures within permitted limits. To this end current material shielding, developed for low earth orbit missions, is not a viable option due to payload and cost penalties. The active radiation shielding is the path forward for such missions. To achieve active space radiation shielding innovative large lightweight gossamer space structures are used. The goal is to deflect enough positive ions without attracting negatively charged plasma and to investigate if a charged Gossamer structure can perform charge deflections without significant structural instabilities occurring. In this study different innovative configurations are explored to design an optimum active shielding. In addition, to establish technological feasibility experiments are performed with up to 10kV of membrane charging, and an electron flux source with up to 5keV of energy and 5mA of current. While these charge flux energy levels are much less than those encountered in space, the fundamental coupled interaction of charged Gossamer structures with the ambient charge flux can be experimentally investigated. Of interest are, will the EIMS remain inflated during the charge deflections, and are there visible charge flux interactions. Aluminum coated Mylar membrane prototype structures are created to test their inflation capability using electrostatic charging. To simulate the charge flux, a 5keV electron emitter is utilized. The remaining charge flux at the end of the test chamber is measured with a Faraday cup mounted on a movable boom. A range of experiments with this electron emitter and detector were performed within a 30x60cm vacuum chamber with vacuum environment capability of 10-7 Torr. Experiments are performed with the charge flux aimed at the electrostatically inflated membrane structure (EIMS) in both charged and uncharged configurations. The amount of charge shielding behind and around the EIMS was studied for different combinations of membrane structure voltages and electron energies. Both passive and active shielding were observed, with active shielding capable of deflecting nearly all incoming electrons. The pattern of charge distribution around the structure was studied as well as the stability of the structures in the charge flow. The charge deflection experiments illustrate that the EIMS remain inflated during charge deflection, but will experience small amplitude oscillations. Investigations were performed to determine a potential cause of the vibrations. It is postulated these vibrations are due to the charge flux causing local membrane charge distribution changes. As the membrane structure inflation pressure is changed, the shape responds, and causes the observed sustained vibration. Having identified this phenomenon is important when considering electrostatically inflated membrane structures (EIMS) in a space environment. Additionally, this project included a study of membrane material impacts, specifically the impact of membrane thickness. Extremely thin materials presented new challenges with vacuum preparation techniques and rapid charging. The thinner and lighter membrane materials were successfully inflated using electrostatic forces in a vacuum chamber. However, care must be taken when varying the potentials of such lighter structures as the currents can cause local heating and melting of the very thin membranes. Lastly, a preliminary analysis is performed to study rough order of magnitude power requirements for using EIMS for radiation shielding. The EIMS power requirement becomes increasingly more challenging as the spacecraft voltage is increased. As a result, the emphasis is on the deflection of charges away from the spacecraft rather than totally stopping them. This significantly alleviates the initial power requirements. With modest technological development(s) active shielding is emerging to be a viable option.

Impact of charge-transfer excitons in regioregular polythiophene on the charge separation at polythiophene-fullerene heterojunctions

NASA Astrophysics Data System (ADS)

Polkehn, M.; Tamura, H.; Burghardt, I.

2018-01-01

This study addresses the mechanism of ultrafast charge separation in regioregular oligothiophene-fullerene assemblies representative of poly-3-hexylthiophene (P3HT)-[6,6]-phenyl-C61 butyric acid methyl ester (PCBM) heterojunctions, with special emphasis on the inclusion of charge transfer excitons in the oligothiophene phase. The formation of polaronic inter-chain charge separated species in highly ordered oligothiophene has been demonstrated in recent experiments and could have a significant impact on the net charge transfer to the fullerene acceptor. The present approach combines a first-principles parametrized multi-site Hamiltonian, based on time-dependent density functional theory calculations, with accurate quantum dynamics simulations using the multi-layer multi-configuration time-dependent Hartree method. Quantum dynamical studies are carried out for up to 182 electronic states and 112 phonon modes. The present analysis follows up on our previous study of (Huix-Rotllant et al 2015 J. Phys. Chem. Lett. 6 1702) and significantly expands the scope of this analysis by including the dynamical role of charge transfer excitons. Our investigation highlights the pronounced mixing of photogenerated Frenkel excitons with charge transfer excitons in the oligothiophene domain, and the opening of new transfer channels due the creation of such charge-separated species. As a result, it turns out that the interfacial donor/acceptor charge transfer state can be largely circumvented due to the presence of charge transfer excitons. However, the latter states in turn act as a trap, such that the free carrier yield observed on ultrafast time scales is tangibly reduced. The present analysis underscores the complexity of the transfer pathways at P3HT-PCBM type junctions.

Intelligent electric vehicle charging: Rethinking the valley-fill

NASA Astrophysics Data System (ADS)

Valentine, Keenan; Temple, William G.; Zhang, K. Max

This study proposes an intelligent PEV charging scheme that significantly reduces power system cost while maintaining reliability compared to the widely discussed valley-fill method of aggregated charging in the early morning. This study considers optimal PEV integration into the New York Independent System Operator's (NYISO) day-ahead and real-time wholesale energy markets for 21 days in June, July, and August of 2006, a record-setting summer for peak load. NYISO market and load data is used to develop a statistical Locational Marginal Price (LMP) and wholesale energy cost model. This model considers the high cost of ramping generators at peak-load and the traditional cost of steady-state operation, resulting in a framework with two competing cost objectives. Results show that intelligent charging assigns roughly 80% of PEV load to valley hours to take advantage of low steady-state cost, while placing the remaining 20% equally at shoulder and peak hours to reduce ramping cost. Compared to unregulated PEV charging, intelligent charging reduces system cost by 5-16%; a 4-9% improvement over the flat valley-fill approach. Moreover, a Charge Flexibility Constraint (CFC), independent of market modeling, is constructed from a vehicle-at-home profile and the mixture of Level 1 and Level 2 charging infrastructure. The CFC is found to severely restrict the ability to charge vehicles during the morning load valley. This study further shows that adding more Level 2 chargers without regulating PEV charging will significantly increase wholesale energy cost. Utilizing the proposed intelligent PEV charging method, there is a noticeable reduction in system cost if the penetration of Level 2 chargers is increased from 70/30 to 50/50 (Level 1/Level 2). However, the system benefit is drastically diminished for higher penetrations of Level 2 chargers.

Space and surface charge behavior analysis of charge-eliminated polymer films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oda, Tetsuji; Takashima, Kazunori; Ichiyama, Shinichiro

1995-12-31

Charge behavior of corona-charged or charge eliminated polymer films being dipped in the city water were studied. They were polytetrafluoroethylene (PTFE teflon{trademark}), polypropylene (PP), low density or high density polyethylene (LDPE or HDPE) thin films which are as grown (native) or plasma-processed. The plasma processing at low pressure was tested as antistatic processing. Charge elimination was done by being dipped in alcohol or city water. TSDC analysis and surface charge profile measurement were done for both charged and charge eliminated polymer films. Surface charge density of plasma processed polymer films just after corona charging is roughly the same as thatmore » of an original film. There is little difference between surface charge density profile of a native film and that of a plasma processed film. A large hetero current peak of TSDC was observed at room temperature for a processed film. It was found that the hetero peak disappears after charge elimination process. A pressure pulse wave method by using a pulse-driven piezoelectric PVDF polymer film as a piezoelectric actuator was newly developed to observe real space charge distribution. A little difference of internal space charge distribution between the plasma processed film and the native one after corona charging is found.« less

Model improvements to simulate charging in SEM

NASA Astrophysics Data System (ADS)

Arat, K. T.; Klimpel, T.; Hagen, C. W.

2018-03-01

Charging of insulators is a complex phenomenon to simulate since the accuracy of the simulations is very sensitive to the interaction of electrons with matter and electric fields. In this study, we report model improvements for a previously developed Monte-Carlo simulator to more accurately simulate samples that charge. The improvements include both modelling of low energy electron scattering and charging of insulators. The new first-principle scattering models provide a more realistic charge distribution cloud in the material, and a better match between non-charging simulations and experimental results. Improvements on charging models mainly focus on redistribution of the charge carriers in the material with an induced conductivity (EBIC) and a breakdown model, leading to a smoother distribution of the charges. Combined with a more accurate tracing of low energy electrons in the electric field, we managed to reproduce the dynamically changing charging contrast due to an induced positive surface potential.

Experimental validation of calculated atomic charges in ionic liquids

NASA Astrophysics Data System (ADS)

Fogarty, Richard M.; Matthews, Richard P.; Ashworth, Claire R.; Brandt-Talbot, Agnieszka; Palgrave, Robert G.; Bourne, Richard A.; Vander Hoogerstraete, Tom; Hunt, Patricia A.; Lovelock, Kevin R. J.

2018-05-01

A combination of X-ray photoelectron spectroscopy and near edge X-ray absorption fine structure spectroscopy has been used to provide an experimental measure of nitrogen atomic charges in nine ionic liquids (ILs). These experimental results are used to validate charges calculated with three computational methods: charges from electrostatic potentials using a grid-based method (ChelpG), natural bond orbital population analysis, and the atoms in molecules approach. By combining these results with those from a previous study on sulfur, we find that ChelpG charges provide the best description of the charge distribution in ILs. However, we find that ChelpG charges can lead to significant conformational dependence and therefore advise that small differences in ChelpG charges (<0.3 e) should be interpreted with care. We use these validated charges to provide physical insight into nitrogen atomic charges for the ILs probed.

Characterizing the surface charge of synthetic nanomembranes by the streaming potential method

PubMed Central

Datta, Subhra; Conlisk, A. T.; Kanani, Dharmesh M.; Zydney, Andrew L.; Fissell, William H.; Roy, Shuvo

2010-01-01

The inference of the surface charge of polyethylene glycol (PEG)-coated and uncoated silicon membranes with nanoscale pore sizes from streaming potential measurements in the presence of finite electric double layer (EDL) effects is studied theoretically and experimentally. The developed theoretical model for inferring the pore wall surface charge density from streaming potential measurements is applicable to arbitrary pore cross-sectional shapes and accounts for the effect of finite salt concentration on the ionic mobilities and the thickness of the deposited layer of PEG. Theoretical interpretation of the streaming potential data collected from silicon membranes having nanoscale pore sizes, with/without pore wall surface modification with PEG, indicates that finite electric double layer (EDL) effects in the pore-confined electrolyte significantly affect the interpretation of the membrane charge and that surface modification with PEG leads to a reduction in the pore wall surface charge density. The theoretical model is also used to study the relative significance of the following uniquely nanoscale factors affecting the interpretation of streaming potential in moderate to strongly charged pores: altered net charge convection by applied pressure differentials, surface-charge effects on ionic conduction, and electroosmotic convection of charges. PMID:20462592

Spacecraft surface charging within geosynchronous orbit observed by the Van Allen Probes

DOE PAGES

Sarno-Smith, Lois K.; Larsen, Brian A.; Skoug, Ruth M.; ...

2016-02-27

Using the Helium Oxygen Proton Electron (HOPE) and Electric Field and Waves (EFW) instruments from the Van Allen Probes, we explored the relationship between electron energy fluxes in the eV and keV ranges and spacecraft surface charging. We present statistical results on spacecraft charging within geosynchronous orbit by L and MLT. An algorithm to extract the H+ charging line in the HOPE instrument data was developed to better explore intense charging events. Also, this study explored how spacecraft potential relates to electron number density, electron pressure, electron temperature, thermal electron current, and low-energy ion density between 1 and 210 eV.more » It is demonstrated that it is imperative to use both EFW potential measurements and the HOPE instrument ion charging line for examining times of extreme spacecraft charging of the Van Allen Probes. The results of this study show that elevated electron energy fluxes and high-electron pressures are present during times of spacecraft charging but these same conditions may also occur during noncharging times. Furthermore, we also show noneclipse significant negative charging events on the Van Allen Probes.« less

The Flexible Faraday Cage

NASA Astrophysics Data System (ADS)

Gluck, Paul

2004-03-01

The Faraday ice-pail experiment is performed when studying the distribution of charges in conductors: Inside a hollow conductor the net charge is zero, and any excess charge resides on the outside surface.

Load shift potential of electric vehicles in Europe

NASA Astrophysics Data System (ADS)

Babrowski, Sonja; Heinrichs, Heidi; Jochem, Patrick; Fichtner, Wolf

2014-06-01

Many governments highly encourage electric mobility today, aiming at a high market penetration. This development would bring forth an impact on the energy system, which strongly depends on the driving and charging behavior of the users. While an uncontrolled immediate charging might strain the local grid and/or higher peak loads, there are benefits to be gained by a controlled charging. We examine six European mobility studies in order to display the effects of controlled and uncontrolled unidirectional charging. Taking into account country-specific driving patterns, we generate for each country a charging load curve corresponding to uncontrolled charging and consider the corresponding parking time at charging facilities in order to identify load shift potentials. The main results are that besides the charging power of the vehicles, the possibility to charge at the work place has a significant influence on the uncontrolled charging curve. Neither national nor regional differences are as significant. When charging is only possible at home, the vehicle availability at charging facilities during the day for all countries is at least 24%. With the additional possibility to charge at work, at least 45% are constantly available. Accordingly, we identified a big potential for load shifting through controlled charging.

Full counting statistics of a charge pump in the Coulomb blockade regime

NASA Astrophysics Data System (ADS)

Andreev, A. V.; Mishchenko, E. G.

2001-12-01

We study full charge counting statistics (FCCS) of a charge pump based on a nearly open single electron transistor. The problem is mapped onto an exactly soluble problem of a nonequilibrium g=1/2 Luttinger liquid with an impurity. We obtain an analytic expression for the generating function of the transmitted charge for an arbitrary pumping strength. Although this model contains fractionally charged excitations only integer transmitted charges can be observed. In the weak pumping limit FCCS correspond to a Poissonian transmission of particles with charge e*=e/2 from which all events with odd numbers of transferred particles are excluded.

Quantifying the energy-storage benefits of controlled plug-in electric vehicle charging

DOE PAGES

Xi, Xiaomin; Sioshansi, Ramteen

2016-01-01

Flexibility in plug-in electric vehicle (PEV) charging can reduce PEV charging costs. Moreover, controlled PEV charging can be viewed as a limited form of energy storage, insomuch as charging loads are shifted from high-cost periods to lower-cost ones. Energy storage that is used for generation shifting is used in much the same manner. In this paper, we study these benefits of PEV charging, demonstrating that controlled PEV charging can reduce generation costs. As a result, we also determine how much energy storage would be needed to provide the same cost-reduction benefits that the PEV fleet does.

Quantifying the energy-storage benefits of controlled plug-in electric vehicle charging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xi, Xiaomin; Sioshansi, Ramteen

Flexibility in plug-in electric vehicle (PEV) charging can reduce PEV charging costs. Moreover, controlled PEV charging can be viewed as a limited form of energy storage, insomuch as charging loads are shifted from high-cost periods to lower-cost ones. Energy storage that is used for generation shifting is used in much the same manner. In this paper, we study these benefits of PEV charging, demonstrating that controlled PEV charging can reduce generation costs. As a result, we also determine how much energy storage would be needed to provide the same cost-reduction benefits that the PEV fleet does.

Charging and Transport Dynamics of a Flow-Through Electrode Capacitive Deionization System.

PubMed

Qu, Yatian; Campbell, Patrick G; Hemmatifar, Ali; Knipe, Jennifer M; Loeb, Colin K; Reidy, John J; Hubert, Mckenzie A; Stadermann, Michael; Santiago, Juan G

2018-01-11

We present a study of the interplay among electric charging rate, capacitance, salt removal, and mass transport in "flow-through electrode" capacitive deionization (CDI) systems. We develop two models describing coupled transport and electro-adsorption/desorption which capture salt removal dynamics. The first model is a simplified, unsteady zero-dimensional volume-averaged model which identifies dimensionless parameters and figures of merits associated with cell performance. The second model is a higher fidelity area-averaged model which captures both spatial and temporal responses of charging. We further conducted an experimental study of these dynamics and considered two salt transport regimes: (1) advection-limited regime and (2) dispersion-limited regime. We use these data to validate models. The study shows that, in the advection-limited regime, differential charge efficiency determines the salt adsorption at the early stage of the deionization process. Subsequently, charging transitions to a quasi-steady state where salt removal rate is proportional to applied current scaled by the inlet flow rate. In the dispersion-dominated regime, differential charge efficiency, cell volume, and diffusion rates govern adsorption dynamics and flow rate has little effect. In both regimes, the interplay among mass transport rate, differential charge efficiency, cell capacitance, and (electric) charging current governs salt removal in flow-through electrode CDI.

Trapping-charging ability and electrical properties study of amorphous insulator by dielectric spectroscopy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mekni, Omar, E-mail: omarmekni-lmop@yahoo.fr; Arifa, Hakim; Askri, Besma

2014-09-14

Usually, the trapping phenomenon in insulating materials is studied by injecting charges using a Scanning Electron Microscope. In this work, we use the dielectric spectroscopy technique for showing a correlation between the dielectric properties and the trapping-charging ability of insulating materials. The evolution of the complex permittivity (real and imaginary parts) as a function of frequency and temperature reveals different types of relaxation according to the trapping ability of the material. We found that the space charge relaxation at low frequencies affects the real part of the complex permittivity ε{sup ´} and the dissipation factor Tan(δ). We prove that themore » evolution of the imaginary part of the complex permittivity against temperature ε{sup ′′}=f(T) reflects the phenomenon of charge trapping and detrapping as well as trapped charge evolution Q{sub p}(T). We also use the electric modulus formalism to better identify the space charge relaxation. The investigation of trapping or conductive nature of insulating materials was mainly made by studying the activation energy and conductivity. The conduction and trapping parameters are determined using the Correlated Barrier Hopping (CBH) model in order to confirm the relation between electrical properties and charge trapping ability.« less

Attraction of likely charged nano-sized grains in dust-electron plasmas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vishnyakov, Vladimir I., E-mail: eksvar@ukr.net

2016-01-15

Dust-electron plasma, which contains only the dust grains and electrons, emitted by them, is studied. Assumption of almost uniform spatial electrons distribution, which deviates from the uniformity only near the dust grains, leads to the grain charge division into two parts: first part is the individual for each grain “visible” charge and the second part is the common charge of the neutralized background. The visible grain charge can be both negative and positive, while the total grain charge is only positive. The attraction of likely charged grains is possible, because the grain interaction is determined by the visible charges. Themore » equilibrium state between attraction and repulsion of grains is demonstrated.« less

Optimal Coordinated EV Charging with Reactive Power Support in Constrained Distribution Grids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paudyal, Sumit; Ceylan, Oğuzhan; Bhattarai, Bishnu P.

Electric vehicle (EV) charging/discharging can take place in any P-Q quadrants, which means EVs could support reactive power to the grid while charging the battery. In controlled charging schemes, distribution system operator (DSO) coordinates with the charging of EV fleets to ensure grid’s operating constraints are not violated. In fact, this refers to DSO setting upper bounds on power limits for EV charging. In this work, we demonstrate that if EVs inject reactive power into the grid while charging, DSO could issue higher upper bounds on the active power limits for the EVs for the same set of grid constraints.more » We demonstrate the concept in an 33-node test feeder with 1,500 EVs. Case studies show that in constrained distribution grids in coordinated charging, average costs of EV charging could be reduced if the charging takes place in the fourth P-Q quadrant compared to charging with unity power factor.« less

Charged black rings at large D

NASA Astrophysics Data System (ADS)

Chen, Bin; Li, Peng-Cheng; Wang, Zi-zhi

2017-04-01

We study the charged slowly rotating black holes in the Einstein-Maxwell theory in the large dimensions ( D). By using the 1 /D expansion in the near regions of the black holes we obtain the effective equations for the charged slowly rotating black holes. The effective equations capture the dynamics of various stationary solutions, including the charged black ring, the charged slowly rotating Myers-Perry black hole and the charged slowly boosted black string. Via different embeddings we construct these stationary solutions explicitly. For the charged black ring at large D, we find that the charge lowers the angular momentum due to the regularity condition on the solution. By performing the perturbation analysis of the effective equations, we obtain the quasinormal modes of the charge perturbation and the gravitational perturbation analytically. Like the neutral case the charged thin black ring suffers from the Gregory-Laflamme-like instability under the non-axisymmetric perturbations, but the charge weakens the instability. Besides, we find that the large D analysis always respects the cosmic censorship.

Energy use behaviour: A window of opportunity

NASA Astrophysics Data System (ADS)

Roy, Deborah

2017-06-01

The environmental impact of electric vehicles depends on the kind of energy used to charge them. They are typically charged at peak times, when extra fossil fuels are needed to meet energy demands. A study shows that e-mails targeting electric vehicle charging for new owners can be effective for promoting greener charging behaviours.

Charge Control Investigation of Rechargeable Lithium Cells

NASA Technical Reports Server (NTRS)

Otzinger, B.; Somoano, R.

1984-01-01

An ambient temperature rechargeable Li-TiS2 cell was cycled under conditions which simulate aerospace applications. A novel charge/discharge state-of-charge control scheme was used, together with tapered current charging, to overcome deleterious effects associated with end-of-charge and end-of-discharge voltages. The study indicates that Li-TiS2 cells hold promise for eventual synchronous satellite-type applications. Problem areas associated with performance degradation and reconditioning effects are identified.

In situ measurements and radar observations of a severe storm - Electricity, kinematics, and precipitation

NASA Technical Reports Server (NTRS)

Byrne, G. J.; Few, A. A.; Stewart, M. F.; Conrad, A. C.; Torczon, R. L.

1987-01-01

Electric field measurements made inside a multicell severe storm in Oklahoma in 1983 with a balloon-borne instrument are presented. The properties of the electric charge regions, such as altitude, thickness, and charge concentrations, are studied. These measurements are analzyed with meteorological measurements of temperature and humidity, and balloon tracking and radar observations. The relation between the electric charge structure and the precipitation and kinematic features of the storm is examined. The data reveal that the cell exhibits a bipolar charge structure with negative charge below positive charge. The average charge concentrations of the two regions are estimated as -1.2 and 0.15 nC/cu m, respectively; the upper positive charge is about 6 km in vertical extent, and the lower negative charge is less than 1 km in vertical extent.

Breastfeeding. COTALMA: training health professionals.

PubMed

Casanovas, M C

1994-01-01

The Comite Tecnico de Apoyo a la Lactancia Materna (COTALMA), the Technical Breastfeeding Support Committee, was founded in Bolivia in 1989. It is financed by the United States Agency for International Development (USAID) and the United Nations Children's Fund (UNICEF). It is administered in coordination with the Ministry of Health (MOH). MOH and UNICEF choose the hospitals, who send teams that include a pediatrician, a gynecologist, a nurse, and a nutritionist. The first phase of the course (5.5 days) covers the scientific background of breastfeeding. A baseline study is then planned and conducted at each hospital. 2 to 3 months later, the second phase takes place during which data is presented and breast feeding programs are developed for each hospital. Communication, training, counseling, and planning and evaluation are covered. Practicums are conducted at hospitals. Trainers are usually members of COTALMA. The person in charge of maternal and child health services at MOH lectures on national health policies concerning mothers and children. Training includes use of the national health card, breastfeeding and child survival, and breastfeeding as a family planning method. Culturally appropriate course materials, which are in Spanish, are adapted from those developed by Wellstart International. Articles by COTALMA members and others are added. Participants are encouraged to train all staff at their institutions.

What's the fuss about? Parent presentations of fussy eating to a parenting support helpline.

PubMed

Harris, Holly A; Ria-Searle, Bonnie; Jansen, Elena; Thorpe, Karen

2018-06-01

To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline. Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions. Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim. From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6-48 months. Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13-48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child's eating behaviour as a battle (conflict), in which their children's agency over limited intake and variety of foods (child control) was constructed as 'bad' or 'wrong'. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred. Real-time descriptions of young children's fussy eating at a time of crisis that initiated parents' call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child's emerging assertion of food autonomy can escalate parents' emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.

Numerical Simulations of Spacecraft Charging: Selected Applications

NASA Astrophysics Data System (ADS)

Moulton, J. D.; Delzanno, G. L.; Meierbachtol, C.; Svyatskiy, D.; Vernon, L.; Borovsky, J.; Thomsen, M. F.

2016-12-01

The electrical charging of spacecraft due to bombarding charged particles affects their performance and operation. We study this charging using CPIC, a particle-in-cell code specifically designed for studying plasma-material interactions. CPIC is based on multi-block curvilinear meshes, resulting in near-optimal computational performance while maintaining geometric accuracy. It is interfaced to a mesh generator that creates a computational mesh conforming to complex objects like a spacecraft. Relevant plasma parameters can be imported from the SHIELDS framework (currently under development at LANL), which simulates geomagnetic storms and substorms in the Earth's magnetosphere. Selected physics results will be presented, together with an overview of the code. The physics results include spacecraft-charging simulations with geometry representative of the Van Allen Probes spacecraft, focusing on the conditions that can lead to significant spacecraft charging events. Second, results from a recent study that investigates the conditions for which a high-power (>keV) electron beam could be emitted from a magnetospheric spacecraft will be presented. The latter study proposes a spacecraft-charging mitigation strategy based on the plasma contactor technology that might allow beam experiments to operate in the low-density magnetosphere. High-power electron beams could be used for instance to establish magnetic-field-line connectivity between ionosphere and magnetosphere and help solving long-standing questions in ionospheric/magnetospheric physics.

Neutrino Mass Generation at TeV Scale and New Physics Signatures from Charged Higgs at the LHC for Photon Initiated Processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghosh, Kirtiman; Homi Bhabha National Institute, Mumbai; Jana, Sudip

We consider the collider phenomenology of a simple extension of the Standard Model (SM), which consists of an EW isospinmore » $3/2$ scalar, $$\\Delta$$ and a pair of EW isospin $1$ vector like fermions, $$\\Sigma$$ and $$\\bar{\\Sigma}$$, responsible for generating tiny neutrino mass via the effective dimension seven operator. This scalar quadruplet with hypercharge Y = 3 has a plethora of implications at the collider experiments. Its signatures at TeV scale colliders are expected to be seen, if the quadruplet masses are not too far above the electroweak symmetry breaking scale. In this article, we study the phenomenology of multi-charged quadruplet scalars. In particular, we study the multi-lepton signatures at the Large Hadron Collider (LHC) experiment, arising from the production and decays of triply and doubly charged scalars. We studied Drell-Yan (DY) pair production as well as pair production of the charged scalars via photon-photon fusion. For doubly and triply charged scalars, photon fusion contributes significantly for large scalar masses. We also studied LHC constraints on the masses of doubly charged scalars in this model. We derive a lower mass limit of 725 GeV on doubly charged quadruplet scalar.« less

Neutrino Mass Generation at TeV Scale and New Physics Signatures from Charged Higgs at the LHC for Photon Initiated Processes

DOE PAGES

Ghosh, Kirtiman; Homi Bhabha National Institute, Mumbai; Jana, Sudip; ...

2018-03-29

We consider the collider phenomenology of a simple extension of the Standard Model (SM), which consists of an EW isospinmore » $3/2$ scalar, $$\\Delta$$ and a pair of EW isospin $1$ vector like fermions, $$\\Sigma$$ and $$\\bar{\\Sigma}$$, responsible for generating tiny neutrino mass via the effective dimension seven operator. This scalar quadruplet with hypercharge Y = 3 has a plethora of implications at the collider experiments. Its signatures at TeV scale colliders are expected to be seen, if the quadruplet masses are not too far above the electroweak symmetry breaking scale. In this article, we study the phenomenology of multi-charged quadruplet scalars. In particular, we study the multi-lepton signatures at the Large Hadron Collider (LHC) experiment, arising from the production and decays of triply and doubly charged scalars. We studied Drell-Yan (DY) pair production as well as pair production of the charged scalars via photon-photon fusion. For doubly and triply charged scalars, photon fusion contributes significantly for large scalar masses. We also studied LHC constraints on the masses of doubly charged scalars in this model. We derive a lower mass limit of 725 GeV on doubly charged quadruplet scalar.« less

A review of studies on ion thruster beam and charge-exchange plasmas

NASA Technical Reports Server (NTRS)

Carruth, M. R., Jr.

1982-01-01

Various experimental and analytical studies of the primary beam and charge-exchange plasmas of ion thrusters are reviewed. The history of plasma beam research is recounted, emphasizing experiments on beam neutralization, expansion of the beam, and determination of beam parameters such as electron temperature, plasma density, and plasma potential. The development of modern electron bombardment ion thrusters is treated, detailing experimental results. Studies on charge-exchange plasma are discussed, showing results such as the relationship between neutralizer emission current and plasma beam potential, ion energies as a function of neutralizer bias, charge-exchange ion current collected by an axially moving Faraday cup-RPA for 8-cm and 30-cm ion thrusters, beam density and potential data from a 15-cm ion thruster, and charge-exchange ion flow around a 30-cm thruster. A 20-cm thruster electrical configuration is depicted and facility effects are discussed. Finally, plasma modeling is covered in detail for plasma beam and charge-exchange plasma.

A comparative study of charge movement in rat and frog skeletal muscle fibres.

PubMed

Hollingworth, S; Marshall, M W

1981-12-01

1. The middle of the fibre voltage--clamp technique (Adrian & Marshall, 1977), modified where necessary for electrically short muscle fibres, has been used to measure non-linear charge movements in mammalian fast twitch (rat extensor digitorum longus), mammalian slow twitch (rat soleus) and frog (sartorius) muscles. 2. The maximum amount of charge moved in mammalian fast twitch muscle at 2 degrees C in hypertonic solution, was 3--5 times greater than in slow twitch muscle. The voltage distribution of fast twitch charge was 10--15 mV more positive when compared to slow twitch. 3. In both mammalian muscle types hypertonic Ringer solution negatively shifted the voltage distribution of charge some 6 mV. The steepness of charge moved around mechanical threshold was unaffected by hypertonicity. 4. The amount of charge in frog sartorius fibres at 2 degrees C in hypertonic solution was about half of that in rat fast twitch muscle; the voltage distribution of the frog charge was similar to rat soleus muscle. 5. Warming between 2 and 15 degrees C had no effect on either the amount of steady-state distribution of charge in mammalian or frog muscles. 6. At 2 degrees C, the kinetics of charge movement in fast and slow twitch mammalian muscles were similar and 2--3 times faster than frog muscle at the same temperature. In fast and slow mammalian fibres at 2 degrees C similar times were taken to shift the same fractions of the total amount of charge. The Q10 of charge movement kinetics was between 1.2 and 2.0 in the three muscles studied.

Comparison of In-Patient Costs for Children Treated on the AAML0531 Clinical Trial: A Report From the Children’s Oncology Group

PubMed Central

Getz, Kelly D.; Li, Yimei; Alonzo, Todd A.; Hall, Matthew; Gerbing, Robert B.; Sung, Lillian; Huang, Yuan-Shung; Arnold, Staci; Seif, Alix E.; Miller, Tamara P.; Bagatell, Rochelle; Fisher, Brian T.; Adamson, Peter C.; Gamis, Alan; Keren, Ron; Aplenc, Richard

2015-01-01

Background A better understanding of drivers of treatment costs may help identify effective cost containment strategies and prioritize resources. We aimed to develop a method for estimating inpatient costs for pediatric patients with acute myeloid leukemia (AML) enrolled on NCI-funded Phase III trials, compare costs between AAML0531 treatment arms (standard chemotherapy ± gemtuzumab ozogamicin (GMTZ)), and evaluate primary drivers of costs for newly diagnosed pediatric AML. Procedure Patients from the AAML0531 trial were matched on hospital, sex, and dates of birth and diagnosis to the Pediatric Health Information Systems (PHIS) database to obtain daily billing data. Inpatient treatment costs were calculated as adjusted charges multiplied by hospital-specific cost-to-charge ratios. Generalized linear models were used to compare costs between treatment arms and courses, and by patient characteristics. Results Inpatient costs did not differ by randomized treatment arm. Costs varied by course with stem cell transplant being most expensive, followed by Intensification II (cytarabine/mitoxantrone) and Induction I (cytarabine/daunorubicin/etoposide). Room/board and pharmacy were the largest contributors to inpatient treatment cost, representing 74% of the total cost. Higher AML risk group (P = 0.0003) and older age (P < 0.0001) were associated with significantly higher daily inpatient cost. Conclusions Costs from external data sources can be successfully integrated into NCI-funded Phase III clinical trials. Inpatient treatment costs did not differ by GMTZ exposure but varied by chemotherapy course. Variation in cost by course was driven by differences in duration of hospitalization through room/board charges as well as increased clinical and pharmacy charges in specific courses. Pediatr Blood Cancer PMID:25946708

Factors affecting compliance with measles vaccination in Lao PDR.

PubMed

Phimmasane, Maniphet; Douangmala, Somthana; Koffi, Paulin; Reinharz, Daniel; Buisson, Yves

2010-09-24

In line with WHO objectives, the Lao Government is committed to eliminate measles by 2012. Yet from 1992 to 2007, the annual incidence of measles remained high while the vaccination coverage showed a wide diversity across provinces. A descriptive study was performed to determine factors affecting compliance with vaccination against measles, which included qualitative and quantitative components. The qualitative study used a convenience sample of 13 persons in charge of the vaccination program, consisting of officials from different levels of the health care structure and members of vaccination teams. The quantitative study performed on the target population consisted of a matched, case-control survey conducted on a stratified random sample of parents of children aged 9-23 months. Overall, 584 individuals (292 cases and 292 controls) were interviewed in the three provinces selected because of low vaccination coverage. On the provision of services side (supply), the main problems identified were a lack of vaccine supply and diluent, a difficulty in maintaining the cold chain, a lack of availability and competence among health workers, a lack of coordination and a limited capacity to assess needs and make coherent decisions. In the side of the consumer (demand), major obstacles identified were poor knowledge about measles immunization and difficulties in accessing vaccination centers because of distance and cost. In multivariate analysis, a low education level of the father was a factor of non-immunization while the factors of good compliance were high incomes, spacing of pregnancies, a feeling that children must be vaccinated, knowledge about immunization age, presenting oneself to the hospital rather than expecting the mobile vaccination teams and last, immunization of other family members or friends' children. The main factors affecting the compliance with vaccination against measles in Laos involve both the supply side and the demand side. Obtaining an effective coverage requires upgrading and training the Expanded Programme on Immunization (EPI) staff and a reinforcement of health education for target populations in all provinces. Copyright © 2010 Elsevier Ltd. All rights reserved.

High Pressure Optical Studies of the Thallous Halides and of Charge-Transfer Complexes

NASA Astrophysics Data System (ADS)

Jurgensen, Charles Willard

High pressure was used to study the insulator -to-metal transition in sulfur and the thallous halides and to study the intermolecular interactions in charge -transfer complexes. The approach to the band overlap insulator -to-metal transition was studied in three thallous halides and sulfur by optical absorption measurements of the band gap as a function of pressure. The band gap of sulfur continuously decreases with pressure up to the insulator -to-metal transition which occurs between 450 and 485 kbars. The results on the thallous halides indicate that the indirect gap decreases more rapidly than the direct gap; the closing of the indirect gap is responsible for the observed insulator -to-metal transitions. High pressure electronic and vibrational spectroscopic measurements on the solid-state complexes of HMB-TCNE were used to study the intermolecular interactions of charge -transfer complexes. The vibrational frequency shifts indicate that the degree of charge transfer increases with pressure which is independently confirmed by an increase in the molar absorptivity of the electronic charge-transfer peak. Induction and dispersion forces contribute towards a red shift of the charge-transfer peak; however, charge-transfer resonance contributes toward a blue shift and this effect is dominant for the HMB-TCNE complexes. High pressure electronic spectra were used to study the effect of intermolecular interactions on the electronic states of TCNQ and its complexes. The red shifts with pressure of the electronic spectra of TCNQ and (TCNQ)(' -) in polymer media and of crystalline TCNQ can be understood in terms of Van der Waals interactions. None of the calculations which considered intradimer distance obtained the proper behavior for either the charge-transfer of the locally excited states of the complexes. The qualitative behavior of both states can be interpreted as the effect of increased mixing of the locally excited and charge transfer states.

Mechanism of the free charge carrier generation in the dielectric breakdown

NASA Astrophysics Data System (ADS)

Rahim, N. A. A.; Ranom, R.; Zainuddin, H.

2017-12-01

Many studies have been conducted to investigate the effect of environmental, mechanical and electrical stresses on insulator. However, studies on physical process of discharge phenomenon, leading to the breakdown of the insulator surface are lacking and difficult to comprehend. Therefore, this paper analysed charge carrier generation mechanism that can cause free charge carrier generation, leading toward surface discharge development. Besides, this paper developed a model of surface discharge based on the charge generation mechanism on the outdoor insulator. Nernst’s Planck theory was used in order to model the behaviour of the charge carriers while Poisson’s equation was used to determine the distribution of electric field on insulator surface. In the modelling of surface discharge on the outdoor insulator, electric field dependent molecular ionization was used as the charge generation mechanism. A mathematical model of the surface discharge was solved using method of line technique (MOL). The result from the mathematical model showed that the behaviour of net space charge density was correlated with the electric field distribution.

A comprehensive study of charge trapping in organic field-effect devices with promising semiconductors and different contact metals by displacement current measurements

NASA Astrophysics Data System (ADS)

Bisoyi, Sibani; Rödel, Reinhold; Zschieschang, Ute; Kang, Myeong Jin; Takimiya, Kazuo; Klauk, Hagen; Tiwari, Shree Prakash

2016-02-01

A systematic and comprehensive study on the charge-carrier injection and trapping behavior was performed using displacement current measurements in long-channel capacitors based on four promising small-molecule organic semiconductors (pentacene, DNTT, C10-DNTT and DPh-DNTT). In thin-film transistors, these semiconductors showed charge-carrier mobilities ranging from 1.0 to 7.8 cm2 V-1 s-1. The number of charges injected into and extracted from the semiconductor and the density of charges trapped in the device during each measurement were calculated from the displacement current characteristics and it was found that the density of trapped charges is very similar in all devices and of the order 1012 cm-2, despite the fact that the four semiconductors show significantly different charge-carrier mobilities. The choice of the contact metal (Au, Ag, Cu, Pd) was also found to have no significant effect on the trapping behavior.

Interplay between efficiency and device architecture for small molecule organic solar cells.

PubMed

Williams, Graeme; Sutty, Sibi; Aziz, Hany

2014-06-21

Small molecule organic solar cells (OSCs) have experienced a resurgence of interest over their polymer solar cell counterparts, owing to their improved batch-to-batch (thus, cell-to-cell) reliability. In this systematic study on OSC device architecture, we investigate five different small molecule OSC structures, including the simple planar heterojunction (PHJ) and bulk heterojunction (BHJ), as well as several planar-mixed structures. The different OSC structures are studied over a wide range of donor:acceptor mixing concentrations to gain a comprehensive understanding of their charge transport behavior. Transient photocurrent decay measurements provide crucial information regarding the interplay between charge sweep-out and charge recombination, and ultimately hint toward space charge effects in planar-mixed structures. Results show that the BHJ/acceptor architecture, comprising a BHJ layer with high C60 acceptor content, generates OSCs with the highest performance by balancing charge generation with charge collection. The performance of other device architectures is largely limited by hole transport, with associated hole accumulation and space charge effects.

Laboratory Studies of Thermal Energy Charge Transfer of Silicon and Iron Ions in Astrophysical Plasmas

NASA Technical Reports Server (NTRS)

Kwong, Victor H. S.

1996-01-01

Charge transfer at electron-volt energies between multiply charged atomic ions and neutral atoms and molecules is of considerable importance in astrophysics, plasma physics, and in particular, fusion plasmas. In the year covered by this report, several major tasks were completed. These include: (1) the re-calibration of the ion gauge to measure the absolute particle densities of H2, He, N2, and CO for our current measurements; (2) the analysis of data for charge transfer reactions of N(exp 2 plus) ion and He, H2, N2, and CO; (3) measurement and data analysis of the charge transfer reaction of (Fe(exp 2 plus) ion and H2; (4) charge transfer measurement of Fe(exp 2 plus) ion and H2; and (5) redesign and modification of the ion detection and data acquisition system for the low energy beam facility (reflection time of flight mass spectrometer) dedicated to the study of state select charge transfer.

Microelectrophoretic study of calcium oxalate monohydrate in macromolecular solutions

NASA Technical Reports Server (NTRS)

Curreri, P. A.; Onoda, G. Y., Jr.; Finlayson, B.

1987-01-01

Electrophoretic mobilities were measured for calcium oxalate monohydrate (COM) in solutions containing macromolecules. Two mucopolysaccharides (sodium heparin and chondroitin sulfate) and two proteins (positively charged lysozyme and negatively charged bovine serum albumin) were studied as adsorbates. The effects of pH, calcium oxalate surface charge (varied by calcium or oxalate ion activity), and citrate concentration were investigated. All four macromolecules showed evidence for adsorption. The macromolecule concentrations needed for reversing the surface charge indicated that the mucopolysaccharides have greater affinity for the COM surface than the proteins. Citrate ions at high concentrations appear to compete effectively with the negative protein for surface sites but show no evidence for competing with the positively charged protein.

On Born's Conjecture about Optimal Distribution of Charges for an Infinite Ionic Crystal

NASA Astrophysics Data System (ADS)

Bétermin, Laurent; Knüpfer, Hans

2018-04-01

We study the problem for the optimal charge distribution on the sites of a fixed Bravais lattice. In particular, we prove Born's conjecture about the optimality of the rock salt alternate distribution of charges on a cubic lattice (and more generally on a d-dimensional orthorhombic lattice). Furthermore, we study this problem on the two-dimensional triangular lattice and we prove the optimality of a two-component honeycomb distribution of charges. The results hold for a class of completely monotone interaction potentials which includes Coulomb-type interactions for d≥3 . In a more general setting, we derive a connection between the optimal charge problem and a minimization problem for the translated lattice theta function.

An empirical study of estimating vehicle emissions under cordon and distance based road user charging in Leeds, UK.

PubMed

Namdeo, Anil; Mitchell, Gordon

2008-01-01

This paper presents the impact of road user charging (RUC) on vehicle emissions through application of traffic assignment and pollutant emission models. It presents results of an analysis of five RUC schemes on vehicle emissions in Leeds, UK for 2005. The schemes were: a 3 pound sterling inner ring road cordon charge; a double cordon with a 2 pound sterling inner ring road and a 1 pound sterling outer ring road charge; and distance charges of 2, 10 and 20 p/km levied for travel within the outer cordon. Schemes were compared to a no charge option and results presented here. Emissions are significantly reduced within the inner cordon, whilst beyond the cordon, localised increases and decreases occur. The double cordon exhibits a similar but less marked pattern. Distance charging reduces city-wide emissions by 10% under a 2 p/km charge, 42-49% under a 10 p/km charge and 52-59% under a 20 p/km charge. The higher distance charges reduce emissions within the charge zone, and are also associated with elevated emissions outside the zone, but to a lesser extent than that observed for cordon charging.

Single charging events on colloidal particles in a nonpolar liquid with surfactant

NASA Astrophysics Data System (ADS)

Schreuer, Caspar; Vandewiele, Stijn; Brans, Toon; Strubbe, Filip; Neyts, Kristiaan; Beunis, Filip

2018-01-01

Electrical charging of colloidal particles in nonpolar liquids due to surfactant additives is investigated intensively, motivated by its importance in a variety of applications. Most methods rely on average electrophoretic mobility measurements of many particles, which provide only indirect information on the charging mechanism. In the present work, we present a method that allows us to obtain direct information on the charging mechanism, by measuring the charge fluctuations on individual particles with a precision higher than the elementary charge using optical trapping electrophoresis. We demonstrate the capabilities of the method by studying the influence of added surfactant OLOA 11000 on the charging of single colloidal PMMA particles in dodecane. The particle charge and the frequency of charging events are investigated both below and above the critical micelle concentration (CMC) and with or without applying a DC offset voltage. It is found that at least two separate charging mechanisms are present below the critical micelle concentration. One mechanism is a process where the particle is stripped from negatively charged ionic molecules. An increase in the charging frequency with increased surfactant concentration suggests a second mechanism that involves single surfactant molecules. Above the CMC, neutral inverse micelles can also be involved in the charging process.

The influence of charge and the distribution of charge in the polar region of phospholipids on the activity of UDP-glucuronosyltransferase.

PubMed

Zakim, D; Eibl, H

1992-07-05

Studies of the mechanism of lipid-induced regulation of the microsomal enzyme UDP-glucuronosyltransferase have been extended by examining the influence of charge within the polar region on the ability of lipids to activate delipidated pure enzyme. The effects of net negative charge, of charge separation in phosphocholine, and of the distribution of charge in the polar region of lipids were studied using the GT2p isoform isolated from pig liver. Prior experiments have shown that lipids with net negative charge inhibit the enzyme (Zakim, D., Cantor, M., and Eibl, H. (1988) J. Biol. Chem. 263, 5164-5169). The current experiments show that the extent of inhibition on a molar basis increases as the net negative charge increases from -1 to -2. The inhibitory effect of negatively charged lipids is on the functional state of the enzyme and is not due to electrostatic repulsion of negatively charged substrates of the enzyme. Although the inhibitory effect of net negative charge is removed when negative charge is balanced by a positive charge due to a quaternary nitrogen, neutrality of the polar region is not a sufficient condition for activation of the enzyme. In addition to a balance of charge between Pi and the quaternary nitrogen, the distance between the negative and positive charges and the orientation of the dipole created by them are critical for activation of GT2p. The negative and positive charges must be separated by the equivalent of three -CH2- groups for optimal activation by a lipid. Shortening this distance by one -CH2- unit leads to a lipid that is ineffective in activating the enzyme. Reversal of the orientation of the dipole in which the negative charge is on the polymethylene side of the lipid-water interface and the positive charge extends into water also produces a lipid that is not effective for activating GT2p. On the other hand, lipids with phosphoserine as the polar region, which has the "normal" P-N distance but carries a net negative charge, do not inhibit GT2p. This result again illustrates the importance of the dipole of phosphocholine for modulating the functional state of GT2p.

Header: Do adult DTC programs prevent child maltreatment? Parental criminal justice involvement and children’s involvement with child protective services: Do adult drug treatment courts prevent child maltreatment?

PubMed Central

Eldred, Lindsey M.; Sloan, Frank A.; Evans, Kelly E.

2016-01-01

Background In light of evidence showing reduced criminal recidivism and cost savings, adult drug treatment courts have grown in popularity. However, the potential spillover benefits to family members are understudied. Objectives To examine: 1) the overlap between parents who were convicted of a substance-related offense and their children’s involvement with child protective services (CPS); and 2) whether parental participation in an adult drug treatment court program reduces children’s risk for CPS involvement. Methods Administrative data from North Carolina courts, birth records, and social services were linked at the child level. First, children of parents convicted of a substance-related offense were matched to (a) children of parents convicted of a non-substance-related offense and (b) those not convicted of any offense. Second, we compared children of parents who completed a DTC program with children of parents who were referred but did not enroll, who enrolled for <90 days but did not complete, and who enrolled for 90+ days but did not complete. Multivariate logistic regression was used to model group differences in the odds of being reported to CPS in the one to three years following parental criminal conviction or, alternatively, being referred to a DTC program. Results Children of parents convicted of a substance-related offense were at greater risk of CPS involvement than children whose parents were not convicted of any charge, but DTC participation did not mitigate this risk. Conclusion/Importance The role of specialty courts as a strategy for reducing children’s risk of maltreatment should be further explored. PMID:26789656

Impact of spot charge inaccuracies in IMPT treatments.

PubMed

Kraan, Aafke C; Depauw, Nicolas; Clasie, Ben; Giunta, Marina; Madden, Tom; Kooy, Hanne M

2017-08-01

Spot charge is one parameter of pencil-beam scanning dose delivery system whose accuracy is typically high but whose required value has not been investigated. In this work we quantify the dose impact of spot charge inaccuracies on the dose distribution in patients. Knowing the effect of charge errors is relevant for conventional proton machines, as well as for new generation proton machines, where ensuring accurate charge may be challenging. Through perturbation of spot charge in treatment plans for seven patients and a phantom, we evaluated the dose impact of absolute (up to 5× 10 6 protons) and relative (up to 30%) charge errors. We investigated the dependence on beam width by studying scenarios with small, medium and large beam sizes. Treatment plan statistics included the Γ passing rate, dose-volume-histograms and dose differences. The allowable absolute charge error for small spot plans was about 2× 10 6 protons. Larger limits would be allowed if larger spots were used. For relative errors, the maximum allowable error size for small, medium and large spots was about 13%, 8% and 6% for small, medium and large spots, respectively. Dose distributions turned out to be surprisingly robust against random spot charge perturbation. Our study suggests that ensuring spot charge errors as small as 1-2% as is commonly aimed at in conventional proton therapy machines, is clinically not strictly needed. © 2017 American Association of Physicists in Medicine.

Experimental evidence of space charge driven resonances in high intensity linear accelerators

DOE PAGES

Jeon, Dong -O

2016-01-12

In the construction of high intensity accelerators, it is the utmost goal to minimize the beam loss by avoiding or minimizing contributions of various halo formation mechanisms. As a halo formation mechanism, space charge driven resonances are well known for circular accelerators. However, the recent finding showed that even in linear accelerators the space charge potential can excite the 4σ = 360° fourth order resonance [D. Jeon et al., Phys. Rev. ST Accel. Beams 12, 054204 (2009)]. This study increased the interests in space charge driven resonances of linear accelerators. Experimental studies of the space charge driven resonances of highmore » intensity linear accelerators are rare as opposed to the multitude of simulation studies. This paper presents an experimental evidence of the space charge driven 4σ ¼ 360° resonance and the 2σ x(y) – 2σ z = 0 resonance of a high intensity linear accelerator through beam profile measurements from multiple wire-scanners. Moreover, measured beam profiles agree well with the characteristics of the space charge driven 4σ = 360° resonance and the 2σ x(y) – 2σ z = 0 resonance that are predicted by the simulation.« less

Analytical characterization of ch14.18: a mouse-human chimeric disialoganglioside-specific therapeutic antibody.

PubMed

Soman, Gopalan; Kallarakal, Abraham T; Michiel, Dennis; Yang, Xiaoyi; Saptharish, Nirmala; Jiang, Hengguang; Giardina, Steve; Gilly, John; Mitra, George

2012-01-01

Ch14.18 is a mouse-human chimeric monoclonal antibody to the disialoganglioside (GD2) glycolipid. In the clinic, this antibody has been shown to be effective in the treatment of children with high-risk neuroblastoma, either alone or in combination therapy. Extensive product characterization is a prerequisite to addressing the potential issues of product variability associated with process changes and manufacturing scale-up. Charge heterogeneity, glycosylation profile, molecular state and aggregation, interaction (affinity) with Fcγ receptors and functional or biological activities are a few of the critical characterization assays for assessing product comparability for this antibody. In this article, we describe the in-house development and qualification of imaged capillary isoelectric focusing to assess charge heterogeneity, analytical size exclusion chromatography with online static and dynamic light scattering (DLS), batch mode DLS for aggregate detection, biosensor (surface plasmon resonance)-based Fcγ receptor antibody interaction kinetics, N-glycoprofiling with PNGase F digestion, 2-aminobenzoic acid labeling and high performance liquid chromatography and N-glycan analysis using capillary electrophoresis. In addition, we studied selected biological activity assays, such as complement-dependent cytotoxicity. The consistency and reproducibility of the assays are established by comparing the intra-day and inter-day assay results. Applications of the methodologies to address stability or changes in product characteristics are also reported. The study results reveal that the ch14.18 clinical product formulated in phosphate-buffered saline at a concentration of 5 mg/ml and stored at 2-8°C is stable for more than five years.

Search for free fractional electric charge elementary particles using an automated millikan oil drop technique

PubMed

Halyo; Kim; Lee; Lee; Loomba; Perl

2000-03-20

We have carried out a direct search in bulk matter for free fractional electric charge elementary particles using the largest mass single sample ever studied-about 17.4 mg of silicone oil. The search used an improved and highly automated Millikan oil drop technique. No evidence for fractional charge particles was found. The concentration of particles with fractional charge more than 0. 16e ( e being the magnitude of the electron charge) from the nearest integer charge is less than 4.71x10(-22) particles per nucleon with 95% confidence.

Effects of non-Hermitian perturbations on Weyl Hamiltonians with arbitrary topological charges

NASA Astrophysics Data System (ADS)

Cerjan, Alexander; Xiao, Meng; Yuan, Luqi; Fan, Shanhui

2018-02-01

We provide a systematic study of non-Hermitian topologically charged systems. Starting from a Hermitian Hamiltonian supporting Weyl points with arbitrary topological charge, adding a non-Hermitian perturbation transforms the Weyl points to one-dimensional exceptional contours. We analytically prove that the topological charge is preserved on the exceptional contours. In contrast to Hermitian systems, the addition of gain and loss allows for a new class of topological phase transition: when two oppositely charged exceptional contours touch, the topological charge can dissipate without opening a gap. These effects can be demonstrated in realistic photonics and acoustics systems.

Photoinduced ultrafast charge-order melting: Charge-order inversion and nonthermal effects

DOE Office of Scientific and Technical Information (OSTI.GOV)

van Veenendaal, Michel

2016-09-01

The effect of photoexcitation is studied for a system with checkerboard charge order induced by displacements of ligands around a metal site. The motion of the ligands is treated classically and the electronic charges are simplified to two-level molecular bond charges. The calculations are done for a checkerboard charge-ordered system with about 100 000 ligand oscillators coupled to a fixed-temperature bath. The initial photoexcitation is followed by a rapid decrease in the charge-order parameter within 50–100 femtoseconds while leaving the correlation length almost unchanged. Depending on the fluence, a complete melting of the charge order occurs in less than amore » picosecond. While for low fluences, the system returns to its original state, for full melting, it recovers to its broken-symmetry state leading to an inversion of the charge order. For small long-range interactions, recovery can be slow due to domain formation.« less

Photoinduced ultrafast charge-order melting: Charge-order inversion and nonthermal effects

DOE PAGES

van Veenendaal, Michel

2016-09-01

The effect of photoexcitation is studied for a system with checkerboard charge order induced by displacements of ligands around a metal site. The motion of the ligands is treated classically and the electronic charges are simplified to two-level molecular bond charges. The calculations are done for a checkerboard charge-ordered system with about 100 000 ligand oscillators coupled to a fixed-temperature bath. The initial photoexcitation is followed by a rapid decrease in the charge-order parameter within 50–100 femtoseconds while leaving the correlation length almost unchanged. Depending on the fluence, a complete melting of the charge order occurs in less than amore » picosecond. While for low fluences, the system returns to its original state, for full melting, it recovers to its broken-symmetry state leading to an inversion of the charge order. Finally, for small long-range interactions, recovery can be slow due to domain formation.« less

Two particle model for studying the effects of space-charge force on strong head-tail instabilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chin, Yong Ho; Chao, Alexander Wu; Blaskiewicz, Michael M.

In this paper, we present a new two particle model for studying the strong head-tail instabilities in the presence of the space-charge force. It is a simple expansion of the well-known two particle model for strong head-tail instability and is still analytically solvable. No chromaticity effect is included. It leads to a formula for the growth rate as a function of the two dimensionless parameters: the space-charge tune shift parameter (normalized by the synchrotron tune) and the wakefield strength, Upsilon. The three-dimensional contour plot of the growth rate as a function of those two dimensionless parameters reveals stopband structures. Manymore » simulation results generally indicate that a strong head-tail instability can be damped by a weak space-charge force, but the beam becomes unstable again when the space-charge force is further increased. The new two particle model indicates a similar behavior. In weak space-charge regions, additional tune shifts by the space-charge force dissolve the mode coupling. As the space-charge force is increased, they conversely restore the mode coupling, but then a further increase of the space-charge force decouples the modes again. Lastly, this mode coupling/decoupling behavior creates the stopband structures.« less

Two particle model for studying the effects of space-charge force on strong head-tail instabilities

DOE PAGES

Chin, Yong Ho; Chao, Alexander Wu; Blaskiewicz, Michael M.

2016-01-19

In this paper, we present a new two particle model for studying the strong head-tail instabilities in the presence of the space-charge force. It is a simple expansion of the well-known two particle model for strong head-tail instability and is still analytically solvable. No chromaticity effect is included. It leads to a formula for the growth rate as a function of the two dimensionless parameters: the space-charge tune shift parameter (normalized by the synchrotron tune) and the wakefield strength, Upsilon. The three-dimensional contour plot of the growth rate as a function of those two dimensionless parameters reveals stopband structures. Manymore » simulation results generally indicate that a strong head-tail instability can be damped by a weak space-charge force, but the beam becomes unstable again when the space-charge force is further increased. The new two particle model indicates a similar behavior. In weak space-charge regions, additional tune shifts by the space-charge force dissolve the mode coupling. As the space-charge force is increased, they conversely restore the mode coupling, but then a further increase of the space-charge force decouples the modes again. Lastly, this mode coupling/decoupling behavior creates the stopband structures.« less

Study of Velocity and Materials on Tribocharging of Polymer Powders for Powder Coating Applications

NASA Technical Reports Server (NTRS)

Biris, Alex S.; Trigwell, Steve; Sims, Robert A.; Mazumder, Malay K.

2005-01-01

Electrostatic powder deposition is widely used in a plethora of industrial-applications ranging from the pharmaceutical and food.industries, to farm equipment and automotive applications. The disadvantages of this technique are possible back corona (pin-like formations) onset and the Faraday penetration limitation (when the powder does not penetrate in some recessed areas). A possible solution to overcome these problems is to use tribochargers to electrostatically charge the powder. Tribocharging, or contact charging while two materials are in contact, is related to the work function difference between the contacting materials and generates bipolarly charged particles. The generation of an ion-free powder cloud by tribocharging with high bipolar charge and an overall charge density of almost zero, provides a better coverage of the recessed areas. In this study, acrylic and epoxy powders were fluidized and charged by passing through stainless steel, copper, aluminum, and polycarbonate static mixers, respectively. The particle velocity was varied to determine its effect on the net charge-to-mass ratio (QIM) acquired by the powders. In general, the Q/M increases rapidly when the velocity was increased from 1.5 to 2.5 m/s, remaining almost constant for higher velocities. Charge separation experiments showed bipolar charging for all chargers.

Method for Estimating the Charge Density Distribution on a Dielectric Surface.

PubMed

Nakashima, Takuya; Suhara, Hiroyuki; Murata, Hidekazu; Shimoyama, Hiroshi

2017-06-01

High-quality color output from digital photocopiers and laser printers is in strong demand, motivating attempts to achieve fine dot reproducibility and stability. The resolution of a digital photocopier depends on the charge density distribution on the organic photoconductor surface; however, directly measuring the charge density distribution is impossible. In this study, we propose a new electron optical instrument that can rapidly measure the electrostatic latent image on an organic photoconductor surface, which is a dielectric surface, as well as a novel method to quantitatively estimate the charge density distribution on a dielectric surface by combining experimental data obtained from the apparatus via a computer simulation. In the computer simulation, an improved three-dimensional boundary charge density method (BCM) is used for electric field analysis in the vicinity of the dielectric material with a charge density distribution. This method enables us to estimate the profile and quantity of the charge density distribution on a dielectric surface with a resolution of the order of microns. Furthermore, the surface potential on the dielectric surface can be immediately calculated using the obtained charge density. This method enables the relation between the charge pattern on the organic photoconductor surface and toner particle behavior to be studied; an understanding regarding the same may lead to the development of a new generation of higher resolution photocopiers.

[Autism after an earthquake: the experience of L'Aquila (Central Italy) as a basis for an operative guideline].

PubMed

Valenti, Marco; Di Giovanni, Chiara; Mariano, Melania; Pino, Maria Chiara; Sconci, Vittorio; Mazza, Monica

2016-01-01

People with autism, their families, and their specialised caregivers are a social group at high health risk after a disruptive earthquake. They need emergency assistance and immediate structured support according to definite protocols and quality standards. We recommend to establish national guidelines for taking-in-charge people with autism after an earthquake. The adaptive behaviour of participants with autism declined dramatically in the first months after the earthquake in all the dimensions examined (i.e., communication, daily living, socialisation, and motor skills). After relatively stable conditions returned and with immediate and intensive post-disaster intervention, children and adolescents with autism showed a trend towards partial recovery of adaptive functioning. As to the impact on services, this study indicates the need for supporting exposed caregivers at high risk of burnout over the first two years after the disaster and for an immediate reorganisation of person-tailored services.

Assessment of parental awareness about malocclusion in Shiraz, Islamic Republic of Iran.

PubMed

Danaei, S Momeni; Oshagh, M; Pajuhi, N; Ghahremani, Y; Bushehri, Ghodsi S

2011-07-01

Information empowers people to take charge of their health. The aim of this study in Shiraz, Islamic Republic of Iran was to evaluate parents' knowledge about dental malocclusion, referral routes and information sources. A random sample of 1000 7-9-year-old schoolchildren were given a questionnaire to complete at home. Questionnaires were completed by 795 parents. Knowledge about malocclusion was significantly greater in families with higher levels of education and income. Most respondents (83.5%) were aware of the importance of maintaining primary teeth to prevent malocclusion, and 25.1% thought that carious primary teeth must be extracted. Half of the parents (50.6%) did not know that spaces between primary teeth are normal. Only 28.8% of the children visited dentists for annual routine check-ups. Television (43.3%) was the most common source of dental information. The level of general public awareness about malocclusion needs to be improved.

Study of Charge Transport in Vertically Aligned Nitride Nanowire Based Core Shell P-I-N Junctions

DTIC Science & Technology

2016-07-01

Vertically- Aligned Nitride Nanowire Based Core Shell P-I-N Junctions Distribution Statement A. Approved for public release; distribution is...Study of Charge Transport in Vertically- Aligned Nitride Nanowire Based Core Shell P-I-N Junctions Grant Number: HDTRA1-14-1-0003 Principal...Investigator: Abhishek Motayed University of Maryland DISTRIBUTION A: Public Release Study of Charge Transport in Vertically-Aligned Nitride Nanowire

Tribo-charging properties of waste plastic granules in process of tribo-electrostatic separation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Jia, E-mail: weee@sjtu.edu.cn; Wu, Guiqing; Xu, Zhenming

Highlights: • The cyclone charging was more effective and stable than vibrating charging. • The small particle size was better changed than large ones and was more suitable recycled by TES. • The drying pretreatment is good for improving the short-term charging effect. - Abstract: Plastic products can be found everywhere in people’s daily life. With the consistent growth of plastic consumption, more and more plastic waste is generated. Considering the stable chemical and physics characteristics of plastic, regular waste management methods are not suitable for recycling economic strategy of each government, which has become a serious environmental problem. Recyclingmore » plastic waste is considered to be the best way to treat it, because it cannot only deduce the waste but also save the energy to produce new virgin plastic. Tribo-electrostatic separation is strongly recommended for plastic separation as it can preserve the original properties of plastic and has little additional pollution. In this study, plastic granules are generated by crushing plastic waste in waste electric and electronic equipment. The tribo-charging properties of plastic waste were studied by vibrating tribo-charging and cyclone tribo-charging. The triboelectric series obtained by vibrating was: (−)-PE–PS–PC–PVC–ABS–PP-(+), while the triboelectric series obtained by cyclone was (−)-PE–PS–PC–PVC–ABS–PP-(+). Further, the cyclone charging was more effective and stable than vibrating charging. The impact factors experiments showed that small particle size was better changed than large ones and were more suitable recycled by tribo-electrostatic separation. High relative humidity was identified as impede charging effect. The results of this study will help defining the operating parameters of subsequent separator.« less

Surface charge accumulation of particles containing radionuclides in open air

DOE PAGES

Kim, Yong-ha; Yiacoumi, Sotira; Tsouris, Costas

2015-05-01

Radioactivity can induce charge accumulation on radioactive particles. But, electrostatic interactions caused by radioactivity are typically neglected in transport modeling of radioactive plumes because it is assumed that ionizing radiation leads to charge neutralization. The assumption that electrostatic interactions caused by radioactivity are negligible is evaluated here by examining charge accumulation and neutralization on particles containing radionuclides in open air. Moreover, a charge-balance model is employed to predict charge accumulation on radioactive particles. It is shown that particles containing short-lived radionuclides can be charged with multiple elementary charges through radioactive decay. The presence of radioactive particles can significantly modify themore » particle charge distribution in open air and yield an asymmetric bimodal charge distribution, suggesting that strong electrostatic particle interactions may occur during short- and long-range transport of radioactive particles. Possible effects of transported radioactive particles on electrical properties of the local atmosphere are reported. Our study offers insight into transport characteristics of airborne radionuclides. Results are useful in atmospheric transport modeling of radioactive plumes.« less

Reply to Comment on X-ray resonant scattering studies of orbital and charge ordering in Pr[sub 1-x]Ca[sub x]MnO[sub 3].

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zimmermann, M. V.; Grenier, S.; Nelson, C. S.

2003-09-01

The interpretation given in our recent x-ray scattering study of Pr{sub 1-x}Ca{sub x}MnO{sub 3} in terms of charge and orbital ordering is questioned in the preceding Comment by Garcia and Subias. They argue that anisotropy of the charge distribution induced by local distortions gives rise to the so-called charge order reflections. In this Reply we suggest that the two different pictures are reconcilable.

Increasing Coverage and Decreasing Inequity in Insecticide-Treated Bed Net Use among Rural Kenyan Children

PubMed Central

Noor, Abdisalan M; Amin, Abdinasir A; Akhwale, Willis S; Snow, Robert W

2007-01-01

Background Inexpensive and efficacious interventions that avert childhood deaths in sub-Saharan Africa have failed to reach effective coverage, especially among the poorest rural sectors. One particular example is insecticide-treated bed nets (ITNs). In this study, we present repeat observations of ITN coverage among rural Kenyan homesteads exposed at different times to a range of delivery models, and assess changes in coverage across socioeconomic groups. Methods and Findings We undertook a study of annual changes in ITN coverage among a cohort of 3,700 children aged 0–4 y in four districts of Kenya (Bondo, Greater Kisii, Kwale, and Makueni) annually between 2004 and 2006. Cross-sectional surveys of ITN coverage were undertaken coincidentally with the incremental availability of commercial sector nets (2004), the introduction of heavily subsidized nets through clinics (2005), and the introduction of free mass distributed ITNs (2006). The changing prevalence of ITN coverage was examined with special reference to the degree of equity in each delivery approach. ITN coverage was only 7.1% in 2004 when the predominant source of nets was the commercial retail sector. By the end of 2005, following the expansion of heavily subsidized clinic distribution system, ITN coverage rose to 23.5%. In 2006 a large-scale mass distribution of ITNs was mounted providing nets free of charge to children, resulting in a dramatic increase in ITN coverage to 67.3%. With each subsequent survey socioeconomic inequity in net coverage sequentially decreased: 2004 (most poor [2.9%] versus least poor [15.6%]; concentration index 0.281); 2005 (most poor [17.5%] versus least poor [37.9%]; concentration index 0.131), and 2006 with near-perfect equality (most poor [66.3%] versus least poor [66.6%]; concentration index 0.000). The free mass distribution method achieved highest coverage among the poorest children, the highly subsidised clinic nets programme was marginally in favour of the least poor, and the commercial social marketing favoured the least poor. Conclusions Rapid scaling up of ITN coverage among Africa's poorest rural children can be achieved through mass distribution campaigns. These efforts must form an important adjunct to regular, routine access to ITNs through clinics, and each complimentary approach should aim to make this intervention free to clients to ensure equitable access among those least able to afford even the cost of a heavily subsidized net. PMID:17713981

Coulombic charge ice

NASA Astrophysics Data System (ADS)

McClarty, P. A.; O'Brien, A.; Pollmann, F.

2014-05-01

We consider a classical model of charges ±q on a pyrochlore lattice in the presence of long-range Coulomb interactions. This model first appeared in the early literature on charge order in magnetite [P. W. Anderson, Phys. Rev. 102, 1008 (1956), 10.1103/PhysRev.102.1008]. In the limit where the interactions become short ranged, the model has a ground state with an extensive entropy and dipolar charge-charge correlations. When long-range interactions are introduced, the exact degeneracy is broken. We study the thermodynamics of the model and show the presence of a correlated charge liquid within a temperature window in which the physics is well described as a liquid of screened charged defects. The structure factor in this phase, which has smeared pinch points at the reciprocal lattice points, may be used to detect charge ice experimentally. In addition, the model exhibits fractionally charged excitations ±q/2 which are shown to interact via a 1/r potential. At lower temperatures, the model exhibits a transition to a long-range ordered phase. We are able to treat the Coulombic charge ice model and the dipolar spin ice model on an equal footing by mapping both to a constrained charge model on the diamond lattice. We find that states of the two ice models are related by a staggering field which is reflected in the energetics of these two models. From this perspective, we can understand the origin of the spin ice and charge ice ground states as coming from a dipolar model on a diamond lattice. We study the properties of charge ice in an external electric field, finding that the correlated liquid is robust to the presence of a field in contrast to the case of spin ice in a magnetic field. Finally, we comment on the transport properties of Coulombic charge ice in the correlated liquid phase.

The influence of space charge shielding on dielectric multipactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, C.; Liu, G. Z.; Tang, C. X.

2009-05-15

A model of space charge influenced by multipactor electrons and plasma has been established. The positive space charge potential/field for vacuum dielectric multipactor is analytically studied. After considering the plasma, the positive space charge field is further shielded, and multipactor saturates at higher surface accumulated field, compared with that for only considering multipactor electrons. The negative space charge potential/field for dielectric breakdown at high pressure is analyzed. It is found that the negative potential can be nonmonotonously varied, forming a minimum potential well.

A Cost-Effective Electric Vehicle Charging Method Designed For Residential Homes with Renewable Energy

NASA Astrophysics Data System (ADS)

Lie, T. T.; Liang, Xiuli; Haque, M. H.

2015-03-01

Most of the electrical infrastructure in use around the world today is decades old, and may be illsuited to widespread proliferation of personal Electric Vehicles (EVs) whose charging requirements will place increasing strain on grid demand. In order to reduce the pressure on the grid and taking benefits of off peak charging, this paper presents a smart and cost effective EV charging methodology for residential homes equipped with renewable energy resources such as Photovoltaic (PV) panels and battery. The proposed method ensures slower battery degradation and prevents overcharging. The performance of the proposed algorithm is verified by conducting simulation studies utilizing running data of Nissan Altra. From the simulation study results, the algorithm is shown to be effective and feasible which minimizes not only the charging cost but also can shift the charging time from peak value to off-peak time.