المؤلفون: Xie, Jianling, Kuppermann, Nathan, Florin, Todd, Tancredi, Daniel, Funk, Anna, Kim, Kelly, Salvadori, Marina, Yock-Corrales, Adriana, Shah, Nipam, Breslin, Kristen, Chaudhari, Pradip, Bergmann, Kelly, Ahmad, Fahd, Nebhrajani, Jasmine, Mintegi, Santiago, Gangoiti, Iker, Plint, Amy, Avva, Usha, Gardiner, Michael, Malley, Richard, Finkelstein, Yaron, Dalziel, Stuart, Bhatt, Maala, Kannikeswaran, Nirupama, Caperell, Kerry, Campos, Carmen, Sabhaney, Vikram, Chong, Shu-Ling, Lunoe, Maren, Rogers, Alexander, Becker, Sarah, Borland, Meredith, Sartori, Laura, Pavlicich, Viviana, Rino, Pedro, Morrison, Andrea, Neuman, Mark, Poonai, Naveen, Simon, Norma-Jean, Kam, April, Kwok, Maria, Morris, Claudia, Palumbo, Laura, Ambroggio, Lilliam, Navanandan, Nidhya, Eckerle, Michelle, Klassen, Terry, Payne, Daniel, Cherry, Jonathan, Waseem, Muhammad, Dixon, Andrew, Ferre, Isabel, Freedman, Stephen

المصدر: Open Forum Infectious Diseases. 10(10)

مصطلحات موضوعية: C-reactive protein, COVID-19, SARS-CoV-2, child, lymphopenia, procalcitonin

الوصف: BACKGROUND: To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children and determined if SARS-CoV-2 test result status modified the associations. METHODS: We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up. The primary objective was to assess the associations between laboratory findings and severe outcomes. The secondary objective was to determine if the SARS-CoV-2 test result modified the associations. RESULTS: We included 1817 participants; 522 (28.7%) SARS-CoV-2 test-positive and 1295 (71.3%) test-negative. Seventy-five (14.4%) test-positive and 174 (13.4%) test-negative children experienced severe outcomes. In regression analysis, we found that among SARS-CoV-2-positive children, procalcitonin ≥0.5 ng/mL (adjusted odds ratio [aOR], 9.14; 95% CI, 2.90-28.80), ferritin >500 ng/mL (aOR, 7.95; 95% CI, 1.89-33.44), D-dimer ≥1500 ng/mL (aOR, 4.57; 95% CI, 1.12-18.68), serum glucose ≥120 mg/dL (aOR, 2.01; 95% CI, 1.06-3.81), lymphocyte count

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/7mz727pkTest

المؤلفون: Sumner, Madeleine W, Florin, Todd A, Kuppermann, Nathan, Xie, Jianling, Tancredi, Daniel J, Freedman, Stephen B, PERN, Pediatric Emergency Research Canada PERC–COVID-19 Study Teams of the Pediatric Emergency Research Network

مصطلحات موضوعية: Digestive Diseases, Infectious Diseases, Vaccine Related, Biodefense, Pediatric, Prevention, Liver Disease, Lung, Emerging Infectious Diseases, Infection, Good Health and Well Being, Humans, Child, COVID-19, SARS-CoV-2, Liver Diseases, Alanine Transaminase, Liver transaminase, Aminotransferase, Hepatotoxicity, of the Pediatric Emergency Research Network PERN, Pediatric Emergency Research Canada PERC – COVID-19 Study Teams, Medical Biochemistry and Metabolomics, Clinical Sciences, General Clinical Medicine

الوصف: ObjectiveTo evaluate the relationship between SARS-CoV-2 infection and liver injury by comparing transaminase concentrations among children tested for SARS-CoV-2 and other respiratory viruses in pediatric emergency departments.Design & methodsEligible children were

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5909q1kdTest

المؤلفون: Dotter, Dallas, Mabli, James, Carlson, Barbara, Hartnack, Julie, DeCamillis, Mason, Paxton, Nora, Defnet, Amy, Schochet, Peter, Hamilton, Gayle, Freedman, Stephen, Food and Nutrition Service (FNS) (USDA), Office of Policy Support (OPS), Mathematica

المصدر: US Department of Agriculture. 2022.

تمت مراجعته من قبل الزملاء: N

Page Count: 193

الواصفات: Pilot Projects, Program Implementation, Cost Effectiveness, Barriers, Accountability, Federal Programs, Federal Legislation, Federal Aid, Food, Security (Psychology), Income, Employment, Employment Opportunities, Program Evaluation, Outcome Measures, Costs, Program Development, Surveys, Statistical Analysis, Insurance, Records (Forms), Working Hours, Comparative Analysis, Grants, Low Income Groups

مصطلحات جغرافية: California, Delaware, Georgia, Illinois, Virginia, Vermont, Washington, Kentucky, Kansas, Mississippi

مستخلص: This technical supplement to the Supplemental Nutrition Assistance Program (SNAP) Employment and Training (E&T) evaluation final reports presents details of the technical approach used for creating analysis variables and estimating impacts of treatment group services on outcomes, including employment, earnings, and SNAP participation. It also describes the statistical approach used to measure participants' receipt of services and the costs grantees incurred when planning the pilots and providing services. The supplement begins with an overview of the evaluation design and data sources. Next, it discusses imputation procedures used when constructing the analysis data files (Chapter II). It then explains the construction of analysis weights (Chapter III), followed by the approaches used to estimate statistics measuring individuals' participation in services and activities (Chapter IV). The supplement then describes the approach used to estimate impacts for all individuals enrolled in the pilot and for subgroups of individuals (Chapter V). Finally, it discusses the approach used to measure and analyze pilots' planning and implementation costs and estimating the pilot benefits relative to their costs (Chapter VI). This supplement describes the technical approach used to produce findings presented in the 10 pilot-specific final evaluation reports and cross-pilot summary report. [Title cover varies: "Expanding Opportunities & Reducing Barriers to Work: Final Report Technical Supplement. (Evaluation of USDA, Supplemental Nutrition Assistance Program (SNAP) Employment and Training Pilots)." For the Final Summary Report, see ED620374.]

Abstractor: ERIC

المؤلفون: Lirette, Marie-Pier, Kuppermann, Nathan, Finkelstein, Yaron, Zemek, Roger, Plint, Amy C, Florin, Todd Adam, Babl, Franz E, Dalziel, Stuart, Freedman, Stephen, Roland, Damian, Lyttle, Mark David, Schnadower, David, Steele, Dale, Fernandes, Ricardo M, Stephens, Derek, Kharbanda, Anupam, Johnson, David W, Macias, Charles, Benito, Javier, Schuh, Suzanne, Networks, the Pediatric Emergency Research

المصدر: BMJ Open. 12(12)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Public Health, Health Sciences, Emergency Care, Clinical Research, Respiratory, Infant, Humans, Child, Retrospective Studies, Hospitalization, Bronchodilator Agents, Bronchiolitis, Emergency Service, Hospital, Dyspnea, PAEDIATRICS, Paediatric A&E and ambulatory care, Paediatric infectious disease & immunisation, Pediatric Emergency Research Networks, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology

الوصف: ObjectivesWe aimed to evaluate the international variation in the use of evidence-based management (EBM) in bronchiolitis. We hypothesised that management consistent with full-EBM practices is associated with the research network of care, adjusted for patient-level characteristics. Secondary objectives were to determine the association between full-EBM and (1) hospitalisation and (2) emergency department (ED) revisits resulting in hospitalisation within 21 days.DesignA secondary analysis of a retrospective cohort study.Setting38 paediatric EDs belonging to the Paediatric Emergency Research Network in Canada, USA, Australia/New Zealand UK/Ireland and Spain/Portugal.PatientsOtherwise healthy infants 2-11 months old diagnosed with bronchiolitis between 1 January 2013 and 31 December, 2013.Outcome measuresPrimary outcome was management consistent with full-EBM, that is, no bronchodilators/corticosteroids/antibiotics, no chest radiography or laboratory testing. Secondary outcomes included hospitalisations during the index and subsequent ED visits.Results1137/2356 (48.3%) infants received full-EBM (ranging from 13.2% in Spain/Portugal to 72.3% in UK/Ireland). Compared with the UK/Ireland, the adjusted ORs (aOR) of full-EBM receipt were lower in Spain/Portugal (aOR 0.08, 95% CI 0.02 to 0.29), Canada (aOR 0.13 (95% CI 0.06 to 0.31) and USA (aOR 0.16 (95% CI 0.07 to 0.35). EBM was less likely in infants with dehydration (aOR 0.49 (95% CI 0.33 to 0.71)), chest retractions (aOR 0.69 (95% CI 0.52 to 0.91)) and nasal flaring (aOR 0.69 (95% CI 0.52 to 0.92)). EBM was associated with reduced odds of hospitalisation at the index visit (aOR 0.77 (95% CI 0.60 to 0.98)) but not at revisits (aOR 1.17 (95% CI 0.74 to 1.85)).ConclusionsInfants with bronchiolitis frequently do not receive full-EBM ED management, particularly those outside of the UK/Ireland. Furthermore, there is marked variation in full-EBM between paediatric emergency networks, and full-EBM delivery is associated with lower likelihood of hospitalisation. Given the global bronchiolitis burden, international ED-focused deimplementation of non-indicated interventions to enhance EBM is needed.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0hg727tcTest

المؤلفون: Freedman, Stephen B, Kuppermann, Nathan, Funk, Anna L, Kim, Kelly, Xie, Jianling, Tancredi, Daniel, Dalziel, Stuart R, Neuman, Mark I, Mintegi, Santiago, Plint, Amy C, Gómez-Vargas, Jessica, Finkelstein, Yaron, Ambroggio, Lilliam, Klassen, Terry P, Salvadori, Marina, Malley, Richard, Payne, Daniel C, Florin, Todd A, Pediatric Emergency Research Network-COVID-19 Study Team

المصدر: Academic pediatrics. 22(7)

مصطلحات موضوعية: Pediatric Emergency Research Network-COVID-19 Study Team, Humans, Adrenal Cortex Hormones, Nucleic Acids, Cross-Sectional Studies, Adolescent, Child, Emergency Service, Hospital, SARS-CoV-2, COVID-19 Drug Treatment, COVID-19, adrenal cortex hormones, child, hospitalized, emergency service, hospital, Emerging Infectious Diseases, Pediatric, Vaccine Related, Prevention, Clinical Trials and Supportive Activities, Biodefense, Clinical Research, Lung, Infectious Diseases, Respiratory, child, hospitalized, emergency service, hospital, Paediatrics and Reproductive Medicine, Pediatrics

الوصف: ObjectiveWe sought to determine if corticosteroid administration is associated with a SARS-CoV-2 nucleic acid test-positive result and to describe therapies administered to SARS-CoV-2 infected children.MethodsWe collected cross-sectional data from participants recruited in 41 pediatric emergency departments (ED) in 10 countries between March 2020 and June 2021. Participants were

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2250c54dTest

المؤلفون: Freedman, Stephen B, Finkelstein, Yaron, Pang, Xiao Li, Chui, Linda, Tarr, Phillip I, VanBuren, John M, Olsen, Cody, Lee, Bonita E, Hall-Moore, Carla A, Sapien, Robert, O'Connell, Karen, Levine, Adam C, Poonai, Naveen, Roskind, Cindy, Schuh, Suzanne, Rogers, Alexander, Bhatt, Seema, Gouin, Serge, Mahajan, Prashant, Vance, Cheryl, Hurley, Katrina, Powell, Elizabeth C, Farion, Ken J, Schnadower, David

المصدر: Clinical Infectious Diseases. 75(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Emerging Infectious Diseases, Complementary and Integrative Health, Clinical Trials and Supportive Activities, Foodborne Illness, Prevention, Pediatric, Infectious Diseases, Clinical Research, Nutrition, Biotechnology, Digestive Diseases, Infection, Good Health and Well Being, Canada, Child, Diarrhea, Double-Blind Method, Emergency Medical Services, Gastroenteritis, Humans, Infant, Lactobacillus helveticus, Lacticaseibacillus rhamnosus, Probiotics, child, probiotic, gastroenteritis, diarrhea, emergency service, hospital, Biological Sciences, Medical and Health Sciences, Microbiology, Clinical sciences

الوصف: BackgroundIt is unknown if probiotics exert pathogen-specific effects in children with diarrhea secondary to acute gastroenteritis.MethodsAnalysis of patient-level data from 2 multicenter randomized, placebo controlled trials conducted in pediatric emergency departments in Canada and the United States. Participants were 3-48 months with >3 diarrheal episodes in the preceding 24 hours and were symptomatic for

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9t80q1rwTest

المؤلفون: Dotter, Dallas, Mabli, James, Carlson, Barbara, Hartnack, Julie, DeCamillis, Mason, Paxton, Nora, Defnet, Amy, Schochet, Peter, Hamilton, Gayle, Freedman, Stephen, Food and Nutrition Service (FNS) (USDA), Mathematica, MDRC

المصدر: US Department of Agriculture. 2021.

تمت مراجعته من قبل الزملاء: N

Page Count: 98

الواصفات: Federal Legislation, Federal Programs, Grants, Barriers, Job Training, Employment, Employment Opportunities, Food, Low Income Groups, Security (Psychology), Pilot Projects, Program Evaluation, Accountability, Federal Aid, Outcome Measures, Measurement Techniques, State Government, Income, Cost Effectiveness, Program Implementation

مصطلحات جغرافية: California, Delaware, Illinois, Mississippi, Vermont, Virginia, Washington, Georgia, Kansas, Kentucky

مستخلص: This technical supplement to the SNAP Employment and Training (SNAP E&T) evaluation interim reports presents details of the authors' technical approach for creating analysis variables and estimating impacts of treatment group services on outcomes, including employment, earnings, and SNAP participation. It also describes the statistical approach for measuring participants' receipt of services and the costs grantees incurred when planning the pilots and providing services. The supplement begins with an overview of the evaluation design and data sources. Next, it discusses imputation procedures used when constructing the analysis data files (Chapter II). It then explains the construction of analysis weights (Chapter III), followed by the approaches used to estimate statistics measuring individuals' participation in services and activities (Chapter IV). The supplement then describes the approach used to estimate impacts for all individuals enrolled in the pilot and for subgroups of individuals (Chapter V). Finally, it discusses the approach used to measure and analyze pilots' planning and implementation costs (Chapter VI). This supplement describes the technical approach used to produce findings presented in the 10 pilot-specific interim evaluation reports and cross-pilot summary report. [For the Interim Summary Report, see ED620376.]

Abstractor: ERIC

المؤلفون: Chun, Thomas H, Schnadower, David, Casper, T Charles, Sapién, Robert, Tarr, Phillip I, O'Connell, Karen, Roskind, Cindy, Rogers, Alexander, Bhatt, Seema, Mahajan, Prashant, Vance, Cheryl, Olsen, Cody S, Powell, Elizabeth C, Freedman, Stephen B, Network, Pediatric Emergency Care Applied Research

المصدر: Academic Pediatrics. 22(4)

مصطلحات موضوعية: Paediatrics, Biomedical and Clinical Sciences, Health Services, Pediatric, Clinical Research, Good Health and Well Being, Child, Child, Preschool, Cohort Studies, Emergency Service, Hospital, Fluid Therapy, Gastroenteritis, Humans, Infant, Severity of Illness Index, child, emergency service, gastroenteritis, hospital, income, poverty, Pediatric Emergency Care Applied Research Network, Paediatrics and Reproductive Medicine, Pediatrics

الوصف: ObjectiveTo determine if low household income is associated with disease severity following emergency department (ED) discharge in children with acute gastroenteritis (AGE).MethodsWe conducted a secondary analysis employing data collected in 10 US-based tertiary-care, pediatric EDs between 2014 and 2017. Participants were aged 3 to 48 months and presented for care due to AGE. Income status was defined based on 1) home ZIP Code median annual home income and 2) percentage of home ZIP Code households below the poverty threshold. The primary outcome was moderate-to-severe AGE, defined by a post-ED visit Modified Vesikari Scale (MVS) score ≥9. Secondary outcomes included in-person revisits, revisits with intravenous rehydration, hospitalization, and etiologic pathogens.ResultsAbout 943 (97%) participants with a median age of 17 months (interquartile range 10, 28) completed follow-up. Post-ED visit MVS scores were lower for the lowest household income group (adjusted: -0.60; 95% confidence interval [CI]: -1.13, -0.07). Odds of experiencing an MVS score ≥9 did not differ between groups (adjusted odds ratio: 0.91; 95% CI: 0.54, 1.52). No difference in the post-ED visit MVS score or the proportion of participants with scores ≥9 was observed using the national poverty threshold definition. For both income definitions, there were no differences in terms of revisits following discharge, hospitalizations, and intravenous rehydration. Bacterial enteropathogens were more commonly identified in the lowest socioeconomic group using both definitions.ConclusionsLower household income was not associated with increased disease severity or resource use. Economic disparities do not appear to result in differences in the disease course of children with AGE seeking ED care.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6m59z3tqTest

المؤلفون: Levine, Adam C, O’Connell, Karen J, Schnadower, David, VanBuren, T John M, Mahajan, Prashant, Hurley, Katrina F, Tarr, Phillip, Olsen, Cody S, Poonai, Naveen, Schuh, Suzanne, Powell, Elizabeth C, Farion, Ken J, Sapien, Robert E, Roskind, Cindy G, Rogers, Alexander J, Bhatt, Seema, Gouin, Serge, Vance, Cheryl, Freedman, Stephen B

المصدر: Journal of Pediatric Gastroenterology and Nutrition. 74(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Digestive Diseases, Patient Safety, Biodefense, Vaccine Related, Prevention, Emergency Care, Clinical Research, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Good Health and Well Being, Child, Emergency Service, Hospital, Fluid Therapy, Gastroenteritis, Hospitalization, Humans, Infant, Risk Factors, children, diarrhea, emergency department, prognosis, Pediatric Emergency Research Canada (PERC) the Pediatric Emergency Care Applied Research Network, Medical and Health Sciences, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics, Paediatrics

الوصف: ObjectivesAlthough most acute gastroenteritis (AGE) episodes in children rapidly self-resolve, some children go on to experience more significant and prolonged illness. We sought to develop a prognostic score to identify children at risk of experiencing moderate-to-severe disease after an index emergency department (ED) visit.MethodsData were collected from a cohort of children 3 to 48 months of age diagnosed with AGE in 16 North American pediatric EDs. Moderate-to-severe AGE was defined as a Modified Vesikari Scale (MVS) score ≥9 during the 14-day post-ED visit. A clinical prognostic model was derived using multivariable logistic regression and converted into a simple risk score. The model's accuracy was assessed for moderate-to-severe AGE and several secondary outcomes.ResultsAfter their index ED visit, 19% (336/1770) of participants developed moderate-to-severe AGE. Patient age, number of vomiting episodes, dehydration status, prior ED visits, and intravenous rehydration were associated with MVS ≥9 in multivariable regression. Calibration of the prognostic model was strong with a P value of 0.77 by the Hosmer-Lemenshow goodness-of-fit test, and discrimination was moderate with an area under the receiver operator characteristic curve of 0.68 (95% confidence interval [CI] 0.65-0.72). Similarly, the model was shown to have good calibration when fit to the secondary outcomes of subsequent ED revisit, intravenous rehydration, or hospitalization within 72 hours after the index visit.ConclusionsAfter external validation, this new risk score may provide clinicians with accurate prognostic insight into the likely disease course of children with AGE, informing disposition decisions, anticipatory guidance, and follow-up care.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/4kc2h00cTest

المؤلفون: La, Parker L., Walker, Robyn, Bell, Tiffany K., Craig, William, Doan, Quynh, Beauchamp, Miriam H., Zemek, Roger, Yeates, Keith Owen, Harris, Ashley D., Bjornson, Bruce H., Gravel, Jocelyn, Mikrogianakis, Angelo, Goodyear, Bradley, Abdeen, Nishard, Beaulieu, Christian, Dehaes, Mathieu, Deschenes, Sylvain, Lebel, Catherine, Lamont, Ryan, Williamson, Tyler, Barlow, Karen Maria, Bernier, Francois, Brooks, Brian L., Emery, Carolyn, Freedman, Stephen B., Kowalski, Kristina, Mrklas, Kelly, Tomfohr-Madsen, Lianne, Schneider, Kathryn J.

المساهمون: Alberta Children's Hospital Research Institute, Canadian Institutes of Health Research, Hotchkiss Brain Institute, University of Calgary, Canadian Foundation for Innovation and John Evans Leaders Fund, Canada Research Chair in Magnetic Resonance Spectroscopy in Brain Injury

المصدر: Scientific Reports ; volume 14, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Concussion is commonly characterized by a cascade of neurometabolic changes following injury. Magnetic Resonance Spectroscopy (MRS) can be used to quantify neurometabolites non-invasively. Longitudinal changes in neurometabolites have rarely been studied in pediatric concussion, and fewer studies consider symptoms. This study examines longitudinal changes of neurometabolites in pediatric concussion and associations between neurometabolites and symptom burden. Participants who presented with concussion or orthopedic injury (OI, comparison group) were recruited. The first timepoint for MRS data collection was at a mean of 12 days post-injury (n = 545). Participants were then randomized to 3 (n = 243) or 6 (n = 215) months for MRS follow-up. Parents completed symptom questionnaires to quantify somatic and cognitive symptoms at multiple timepoints following injury. There were no significant changes in neurometabolites over time in the concussion group and neurometabolite trajectories did not differ between asymptomatic concussion, symptomatic concussion, and OI groups. Cross-sectionally, Choline was significantly lower in those with persistent somatic symptoms compared to OI controls at 3 months post-injury. Lower Choline was also significantly associated with higher somatic symptoms. Although overall neurometabolites do not change over time, choline differences that appear at 3 months and is related to somatic symptoms.

الإتاحة: https://doi.org/10.1038/s41598-024-52744-7Test
https://www.nature.com/articles/s41598-024-52744-7.pdfTest
https://www.nature.com/articles/s41598-024-52744-7Test