Carbapenem-Resistant Enterobacteriaceae in Children,United States, 1999–2012

The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections is increasing in the United States. However, few studies have addressed their epidemiology in children. To phenotypically identify CRE isolates cultured from patients 1–17 years of age, we used antimicrobial susceptibilities of Enterobacteriaceae reported to 300 laboratories participating in The Surveillance Network–USA database during January 1999–July 2012. Of 316,253 isolates analyzed, 266 (0.08%) were identified as CRE. CRE infection rate increases were highest for Enterobacter species, blood culture isolates, and isolates from intensive care units, increasing from 0.0% in 1999–2000 to 5.2%, 4.5%, and 3.2%, respectively, in 2011–2012. CRE occurrence in children is increasing but remains low and is less common than that for extended-spectrum β-lactamase–producing Enterobacteriaceae. The molecular characterization of CRE isolates from children and clinical epidemiology of infection are essential for development of effective prevention strategies.     

Disentangling Family Life and Hair Pulling: Trichotillomania and Relatedness

ABSTRACT

Trichotillomania (hair pulling) remains a relatively unknown form of body-focused repetitive behavior (BFRB). Sufferers tend to conceal both the action and its effects from others because of stigmatization, which is strong in both public and domestic spheres. Negative responses from close family members can add significantly to the suffering. Based on fieldwork in the United Kingdom and United States, we explore how hair pulling troubles ties even among close family members. We show why ethnographic methods reveal impacts of hair pulling that structured assessments do not yet capture and argue for a more nuanced study of BFRBs through anthropologies of relatedness.     

The care of VIPs in the emergency department: Triage,treatment and ethics

People identified as Very Important Persons (VIPs) often present or are referred to the Emergency Department (ED). Celebrities are a small subset of this group, but many others are included. Triage of these patients, including occasional prioritization, creates practical and ethical challenges. Treatment also provides challenges with the risks of over testing, overtreatment, over consultation, and over or under admission to the hospital. This article presents a practical and ethical framework for addressing the care of VIPs in the ED.     

A national UK census of Applied Behavior Analysis school provision for children with autism

Over more than a decade, specialist Applied Behavior Analysis (ABA) schools or classes for children with autism have developed in the UK and Ireland. However, very little is known internationally about how ABA is defined in practice in school settings, the characteristics of children supported in ABA school settings, and the staffing structures used. To answer these questions, the focus of the present research was a nationwide census of ABA schools throughout the UK. As far as it was possible to ascertain, we achieved a 100% return rate. There were 14 ABA schools and classes throughout the UK, supporting 258 children with autism, and employing 382 staff that supported ABA teaching. The mean ratio for ABA staff to children was 1.4 staff members: 1 child (range 0.7:1-2:1). The majority of all staff members were graduates or had a higher academic qualification (67.7%). This census methodology, if repeated, may help to identify future trends and can provide a baseline for developments in ABA schools/classes in the UK.     

Comparison of Turkish Disability Policy,the United Nations Convention on the Rights of Persons with Disabilities,and the core concepts of U.S. disability policy

This article compares Turkey's Constitution and its Disabled Persons Act with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and the core concepts of United States (U.S.) disability policy. Conclusions are that Turkey's Constitution and statutes are remarkably congruent with the UNCRPD and the core concepts. They are not, however, identical. This fact suggests that Turkey can still improve its statutes to reflect more closely the UNCRPD and core concepts. The review of these policy documents suggests that there are other steps Turkey can take to improve disability policy and its implementation. They are to amend Turkey's laws, determine the status of individuals and families affected by disability, and pursue vigorous implementation of their rights.