A Successful Collaboration Between an Urban School District, a Health System, and a Public Health Department to Address COVID-19 While Returning Children to the Classroom.

We sought to create and implement a set of COVID-19 mitigation processes including reliable testing to minimize in-school transmission of SARS-CoV-2. A large urban school district (> 33,000 students), a city health department, and a free-standing children's hospital partnered to implement multi-layered mitigation procedures which included access to polymerase chain reaction (PCR) testing with same day or next morning results. We tracked COVID-19 cases as well as probable/confirmed transmissions and identified needed mitigations through frequent huddles. During the 2020-2021 school year, there were 13 weeks of hybrid in person learning and 9 weeks of 5 day a week learning. Of the 1936 cases documented, only 3.2% resulted in subsequent school-related transmission. When children felt ill in the classroom, they were isolated within 10 min of reporting ill symptoms (> 90% of the time). PCR test results were routinely available to the school district by 6AM the following morning (79-99% of the time, depending on the learning model). An adaptive, fast-learning partnership across school district, public health, and a children's hospital minimized school-related transmission of COVID-19 and allowed children to safely return to the classroom.

Evaluation of Health Care Disparities for Individuals with Intellectual and Developmental Disabilities in Ohio.

The purpose of the study was to determine the acute and long term services and supports (LTSS) utilization, cost of health care and disparities in access of care for individuals with Intellectual and Developmental Disabilities (IDD). Individuals with IDD on a waiver (receiving Medicaid-funded LTSS in community settings) compared to non-IDD individuals on a waiver control group were compared using Ohio Medicaid claims data from calendar year 2013. Results found the IDD Waiver population had lower utilization rates for emergency department visits, hospital admissions, and hospital readmissions within 30 days compared to the Non-IDD Waiver population and lower PMPM expenditures across all medical service categories except pharmacy. However, the IDD Waiver population possessed greater PMPM costs for LTSS and therefore greater overall costs of care. Furthermore, 94% of IDD Waiver individuals had an episode of care for neurological conditions, with the second most frequent episode of care being for mental health services. The two most frequent episodes of care for individuals in the Non-IDD Waiver group were for conditions related to treatment (medical/surgical) and musculoskeletal conditions. The goal of this research was to investigate the health care needs of individuals with IDD that may vary from other long term care populations. The differences in health care needs for individuals with IDD require health systems and care management that is tailored to the sub-population, with an emphasis on treatment for neurological and mental health conditions. The typical focus of care management efforts on reducing unnecessary utilization of hospital services may be less relevant to the IDD Waiver population. The results of this study will be used to make recommendations regarding the unique health care needs of individuals with IDD.

Food-specific serum immunoglobulin E measurements in children presenting with food allergy.

BACKGROUND: In children with food allergy, multiple food-specific serum IgE levels to common food allergens are frequently measured. OBJECTIVE: To compare food-specific serum IgE measurements among common food allergens in children with food allergy to determine the characteristics of the measurements, their ability to discriminate between foods associated and not associated with a presenting clinical reaction, and their change over time. METHODS: A retrospective analysis was conducted of food-specific serum IgE to cow's milk, egg white and yolk, peanuts, almond, and soy, for up to 3 subsequent measurements, in 291 children with food allergy. A food-specific serum IgE level lower than 0.35 kU/L was considered a negative measurement. The correlation of IgE measurements with presenting symptoms was conducted for each food in 172 children. RESULTS: Of 1,312 food-specific serum IgE measurements, 69.8% were positive. The median (interquartile range) IgE level for foods associated with the presenting complaint was 7.3 kU/L (2.7-31) and that for foods not associated with a clinical complaint was 2.2 kU/L (0.38-13). The difference was statistically significant (P = .01) only for cow's milk. Specific IgE levels were highest for peanuts, followed by cow's milk, eggs, soy, and almonds, and trended upward over time. CONCLUSION: In children presenting with clinical symptoms of a reaction to a food allergen, measurements of food-specific serum IgE to other common food allergens are commonly positive. An increase in food-specific serum IgE occurs over time.

Not just standing there: the use of postural coordination to aid visual tasks.

Postural control is an integral part of all physical behavior. Recent research has indicated that postural control functions in a manner that facilitates other higher order (suprapostural) tasks. These studies, while showing that postural sway is modulated in a task specific manner, have not examined the form of postural coordination that allows for the achievement of these higher behavioral goals. The current study examined the relation between visual task constraints (viewing distance), environmental constraints (changes in the surface of support), and the postural coordination employed to complete the task. Thirty-one participants were asked to perform a reading task while standing on various surfaces. Postural motion was recorded from the head, cervico-thoracic spine, sacrum (hip), and ankle. It was found that body segment coordination changed as a function of surface characteristics and task constraints. Additionally, the overall pattern of postural sway (head motion) replicated that which was found by Stoffregen et al. [J. Exp. Psychol. Human Percep. Perform. 25 (6) (1999) 1641]. These findings suggest that postural adaptation involves more than basic reduction or increase of motion; it involves the functional coordination of body segments to achieve a particular goal. The data further suggest that there is a need to examine postural control in the absence of external perturbations.