Type 2B von Willebrand Disease in Pregnancy: A Systematic Literature Review.

Our objective was to review the maternal characteristics and obstetric complications in women with type 2B von Willebrand disease (VWD). A systematic literature search was conducted using PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. We included all publications that addressed type 2B VWD in pregnancy. Our primary and secondary outcomes were incidence of postpartum hemorrhage (PPH) and incidence of thrombocytopenia in pregnancy. Two reviewers independently identified eligible studies and abstracted data including maternal characteristics, hematologic characteristics, treatment, and delivery outcomes. Twenty studies met inclusion criteria. There were 27 women (32 pregnancies) with type 2B VWD. Primary PPH was reported in 9/20 women (45%) and secondary PPH was reported in 6/13 women (46%). Thrombocytopenia in pregnancy was present in 27/28 women (96%); 23/27 women (85%) had platelet count <100 × 109/L, mean 33.7 ± 22.7 × 109/L. Factor concentrate treatment was administered before delivery (n = 16) and postpartum (n = 18), some women received both. Seventeen deliveries required blood products postpartum with 13/17 (76%) platelet transfusions and 6/17 (35%) red blood cell transfusions. No maternal mortality was reported. Women with type 2B VWD have significant morbidity in pregnancy related to high incidence of severe thrombocytopenia and primary and secondary PPH.

Early Intervention Protocols: Proposing a Default Bimodal Bilingual Approach for Deaf Children.

Despite advances in hearing technology, a growing body of research, as well as early intervention protocols, deaf children largely fail to meet age-based language milestones. This gap in language acquisition points to the inconsistencies that exist between research and practice. Current research suggests that bimodal bilingual early interventions at deaf identification provide children language foundations that can lead to more effective outcomes. Recommendations that support implementing bimodal bilingualism at deaf identification include early intervention protocols, language foundations, and the development of appropriate bimodal bilingual environments. All recommendations serve as multifaceted tools in a deaf child's repertoire as language and modality preferences develop and solidify. This versatile approach allows for children to determine their own language and communication preferences.

Parent Perceptions of Pediatric Primary Care Providers' Mental Health-Related Communication and Practices.

INTRODUCTION: The pediatric primary care office is an ideal setting to address children's socioemotional-behavioral health. However, research is limited regarding parents' experiences and satisfaction in sharing mental-health concerns about their children during well-child visits. METHOD: One thousand seven hundred sixty-three parents and caregivers with children aged 3-17 years completed an online survey that addressed mental-health-related communication. RESULTS: Findings supported the key role that primary care providers play in communicating about mental-health issues; 75% of parents who had such a concern about their child raised it during the visit, although the majority desired more time devoted to discussing mental health. Parents' comfort discussing mental-health concerns was inversely related to providers' dismissing those concerns. DISCUSSION: Despite satisfaction with how providers addressed mental-health issues, results suggested that nonjudgmental, knowledgeable staff and discussion of child and parent strengths could facilitate both parental comfort and communication between parents and pediatricians.

Using a Concept Inventory to Assess the Reasoning Component of Citizen-Level Science Literacy: Results from a 17,000-Student Study.

After articulating 12 concepts for the reasoning component of citizen-level science literacy and restating these as assessable student learning outcomes (SLOs), we developed a valid and reliable assessment instrument for addressing the outcomes with a brief 25-item science literacy concept inventory (SLCI). In this paper, we report the results that we obtained from assessing the citizen-level science literacy of 17,382 undergraduate students, 149 graduate students, and 181 professors. We address only findings at or above the 99.9% confidence level. We found that general education (GE) science courses do not significantly advance understanding of science as a way of knowing. However, the understanding of science's way of knowing does increase through academic ranks, indicating that the extended overall academic experience better accounts for increasing such thinking capacity than do science courses alone. Higher mean institutional SLCI scores correlate closely with increased institutional selectivity, as measured by the institutions' higher mean SAT and ACT scores. Socioeconomic factors of a) first-generation student, b) English as a native language, and c) interest in commitment to a science major are unequally distributed across ethnic groups. These factors proved powerful in accounting for the variations in SLCI scores across ethnicities and genders.