#pediatric rule of nines
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Nonstop
I've been studying nonstop since I bombed my last exam. Five final tests to go. One today. My eyes are fried and I still have nine days of full time studying. It helped that the heat finally broke so I was able to enjoy a pre study walk this morning. Whenever I start to feel like I'm getting the material I realize there is so much more I don't know. They put both pediatric nursing and labor/delivery in the same course. It's way too much information and no wonder infant/mother mortality numbers are where they are at in this country. Pre-eclampsia and postpartum hemorrhage are the main reasons black women in this country are dying at such alarming rates during childbirth. The extent of acknowledging that was mentioning in passing that African American women are at a higher risk for these two conditions. No mention of how, why what can be done differently or (most importantly to get the point across) how bad it is.
Yesterday Bee got mad at Rebel (rightfully - as mentioned she's difficult nowadays) and said she's not my real sister. I'm not sure how to handle that. I'm going to ask my adopted parent group for advice. So far, I've countered with something along the lines of "she is but its okay to be really frustrated with her. Having a sister can be really hard." I don't want to dismiss her feelings but also don't want her to say hurtful things when she's upset. She's also made comments about her real Mom or her real cousins but not at times of anger. Thus far, I've ignore the "real" portion and address whatever topic she brings up. I'd be annoyed if Rebel ever said Bee wasn't her real sister. I don't want Bee to get away with things because she's adopted while also acknowledging her complicated feelings/confusion/etc.
Thinking of booking a Disney cruise for October and surprising the girls the morning of. It leaves from NYC and is five days. It's cheaper then I would have guessed. $850 including taxes/fee a person with all food, etc included. Which feels like a deal considering flights to Bermuda are $300-$400 a person. It spends two days in Bermuda but we are mostly in it for the on boat stuff. We'd skip the off boat excursions and hang at the beach. At first I thought the whole family could go but my husband doesn't have the vacation days and baby boy would not do well sleeping in a room with all of us. Plus, they have some strict rules about no diapers in the pool and even some splash pad areas. My Mom may join. The girls would miss three days of school but not worried about that at all.
This trip can only happen if the house sale goes through. Not happy we now have to wait for September for that to happen. The people who are buying our house are also bought the rental company that manages our house. Which meant they could also throw in no commission on the July/August rentals when they asked us to extend the sale. Which is a nice bonus. I'm dying to know how much they paid. It's a successful business with very little overhead - a website and an employee or two + a team of cleaners. They charge 25% of the rental income to the home owners and way over charge for all of the rental rates.
Baby boy court on Friday. Send out good vibes that something moves forward. He had his two year well visit yesterday. She wasn't worried about his eczema - even though I think it looks terrible right now. 99% for height and 80% for weight. She said he'll def be "well over 6 ft." I learned in nursing school if you double the 2 year old height you will get a rough estimate of their adult height. As of today that would put him at 6.2. They don't mention if its the beginning of being two or the end???
Back to burning my eyes out with studying.
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Why do some infants have delays in teeth eruption ?
The majority of baby teeth erupt from under the gums after birth, and tooth development in infants happens during the menstrual cycle. A kid usually has 20 milk teeth by the age of three, having begun the process of eruption, or the teeth poking through the gums, at roughly six months of age. It is advised to see a pediatric dentist to rule out any potential problems if teeth do not erupt by the age of nine months.
The following are potential causes of delayed tooth eruption:
Four teeth by eleven months, eight by fifteen, twelve at nineteen, sixteen by twenty-three, and twenty by twenty-seven months are typical teething patterns. Any deviations from this pattern could be signs of benign or hazardous conditions, requiring a dental appointment to determine the underlying cause.
FOR MORE INFO PLEASE VISIT : https://www.suryadentalcare.com/possible-causes-of-delayed-teeth-eruption/
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FDA accepts regulatory submission for Pfizer and OPKO Biologic’s long-acting growth hormone Somatrogon
The FDA has acknowledged Pfizer and OPKO Biologic's Biologics License Application (BLA) for somatrogon for the treatment of pediatric patients with development chemical inadequacy (GHD).
Somatrogon has a place with another class of long-acting development chemicals (GH), which are projected to rule the GHD market before very long. These medications are supposed to catch significant portion of the overall industry from the ongoing driving short-acting GH therapeutics, like Novo Nordisk's Norditropin (somatropin) and Pfizer's Genotropin (somatropin).
GHD is an intriguing endocrine problem. In 2020, the analyzed pervasiveness pace of GHD was just 0.014% across the seven significant business sectors (7MM) - US, France, Germany, Spain, Italy, UK, and Japan), as per GlobalData. It is described by insufficient discharge of GH from the front pituitary organ situated at the foundation of the cerebrum. In youngsters, the essential result of GHD is hindered development, while grown-up GHD is related with side effects, for example, low energy and rest aggravations because of different biochemical and metabolic anomalies.For quite a long time, the norm of care for GHD has been everyday infusions of recombinant human GH, albeit the convention is related with unfortunate treatment consistence and sub-par restorative results. This has prodded drug engineers to put resources into the improvement of long-acting GH plans that require less continuous dosing.
Novo Nordisk's Sogroya (somapacitan-beco) got FDA endorsement for the treatment of grown-up GHD in August 2020, making it the principal long-acting GH to acquire showcasing authorisation in this sign. As per GlobalData's Pharma Intelligence Center Pipeline Products Database, six out of the nine pipeline items in late-stage (Phase II turn of events and later) advancement for GHD across the globe are long-acting GHs.
Somatrogon is one of the most formatively progressed of these items. Notwithstanding the BLA being acknowledged for administrative accommodation in the US, the medication is likewise in Phase III improvement in the EU and Japan. Somatrogon's more extended acting definition is owing to combination of the recombinant human GH to three duplicates of the C-terminal peptide (CTP) of human chorionic gonadotropin (hCG). As this draws out the half-existence of the atom, somatrogon can be regulated week after week instead of day to day, which emphatically diminishes the infusion trouble for patients. Furthermore, somatrogon has shown non-mediocrity to the once-day to day GH Genotropin, as estimated by yearly level speed at a year in a Phase III pediatric GHD preliminary.Download free Lead Sheet In the event that fruitful, somatrogon is supposed to be endorsed in the US by Q4 2021. Pfizer, which additionally advertises Genotropin, will almost certainly use its significant experience and notoriety in the GHD space to work with the take-up of the medication. As well as focusing on new patients, the organization will most likely mean to change existing Genotropin patients to somatrogon.
In any case, somatrogon's business incomes are probably not going to match those of "ascendis pharma as marketing analysis" long-acting GH TransCon hGH (lonapegsomatropin), as would be considered normal to be somatrogon's primary rival inside pediatrics. The FDA has acknowledged a BLA for TransCon hGH for the treatment of pediatric patients, and a showcasing authorisation application (MAA) for the treatment of pediatric GHD has been submitted to the European Medicines Agency (EMA).Notwithstanding an expected before day for kickoff contrasted with somatrogon, TransCon hGH has shown prevalence over Genotropin in a Phase III pediatric preliminary with a fundamentally more prominent expansion in annualized level speed saw north of a one-year concentrate on period. Thus, GlobalData gauges that TransCon hGH will accomplish blockbuster status by 2025 while somatrogon will just produce $127M in worldwide deals income for that very year.Join Free Demo Secession Now
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At What What Age are Contact Lenses Appropriate for Children
There is no single answer to this question since every child is different and will therefore have different needs when it comes to vision correction. However, in general, most children can start wearing contact lenses around the age of eight or nine. This is because they need to have enough maturity to be able to take care of their lenses properly and follow all the necessary hygiene precautions.
Of course, some children may be ready for contacts at an earlier age while others may not be ready until they are older. If you think your child may be interested in trying out contact lenses, the best thing to do is talk to their eye doctor. They will be able to assess your child's individual needs and give you the best advice on whether or not contacts would be a good option.
At What Age Do Most Children Start Wearing Contacts
Most children start wearing contacts around the age of 10 or 11. This is when they are old enough to understand how to take care of their lenses and put them in and take them out properly. However, there are some children who start wearing contacts at a younger age, typically around 8 or 9. If your child is interested in wearing contacts, talk to their eye doctor to see if they are a good candidate.
How Do I Know my Child is Responsible Enough to Handle Contacts
There are a few things to consider when determining whether or not your child is responsible enough to handle contacts. The first is their age. If your child is younger, they may not be able to understand the importance of keeping track of contacts and maintaining communication with them. As children get older, they typically become more responsible and better able to handle this type of task.
Another factor to consider is your child's personality. Some children are naturally more responsible than others. If you feel like your child can be trusted to handle this type of responsibility, then they likely are ready for it. However, if you're unsure or have concerns about your child's ability to manage contacts, it may be best to wait until they're a bit older.
Finally, you'll also want to consider your child's maturity level. This includes things like whether or not they can follow simple instructions and whether they understand the importance of keeping in touch with people. If your child seems immature or unable to handle this type of responsibility, it's probably best to wait until they're a bit older before giving them access to contacts.
If you're still unsure about whether or not your child is ready for contacts, you can always talk to their pediatrician or another trusted adult for guidance. They may have some insight that can help you make a decision. Overall, there's no perfect answer when it comes to deciding if your child is ready for contacts. It's important to consider all of the factors involved and make a decision based on what you feel is best for your child.
Contact Pediatric ophthalmologist Canberra ?
If your child is having trouble seeing, you may want to consider contacting a pediatric ophthalmologist. A pediatric ophthalmologist can provide comprehensive eye care for children, including performing vision tests and prescribing glasses or contact lenses if needed. In addition, a pediatric ophthalmologist can diagnose and treat conditions such as amblyopia (lazy eye) and strabismus (crossed eyes).
There are several reasons why you might want to consider seeking out the care of a pediatric ophthalmologist rather than taking your child to see an optometrist or an ophthalmologist. Pediatric ophthalmologists have special training in diagnosing and treating disorders of the eye in children. In addition, they are more likely to be up-to-date on the latest treatments for conditions such as amblyopia and strabismus.
If you are concerned about your child's vision, the first step is to schedule an appointment with his or her pediatric eye specialist. The pediatric eye specialist will perform a comprehensive eye exam, which will help to rule out any underlying medical conditions that could be causing the problem. If the pediatrician suspects that your child may need to see a specialist, he or she will likely refer you to a pediatric ophthalmologist.
At your child's initial visit, the pediatric ophthalmologist will perform a thorough examination of your child's eyes. He or she will check for any signs of disease or damage, and will also test your child's vision. The pediatric ophthalmologist may also recommend that your child have his or her eyes checked on a regular basis, in order to catch any problems early.
If the pediatric ophthalmologist detects a problem with your child's vision, he or she will likely prescribe glasses or contact lenses. In some cases, surgery may be necessary to correct the problem. The type of surgery that is needed will depend on the severity of the condition. For example, if amblyopia is mild, glasses or contacts may be all that is needed to improve your child's vision. However, if the condition is more severe, surgery may be required to straighten the eyes or to improve vision in one eye.
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Tag Post
Movie/Bias Tag Game
Tagged by: @morningsunandnightsky
Rules: You're starring in a movie with the last person saved on your camera roll and the last song you listened to is the title. who and what is it?
BROOOOOO WAIT IMA WRITE THIS DOWN CUZ EVEN IF IT WASN'T JOHNNY THIS IS A GOOD IDEA FOR A 20K+ FIC-
Tagging: Anyone who wants to do this!
Bias Type Tag
Tagged By: Same as Above
Rules: List nine of your biases and let your followers/moots decide if you have a type.
I can't fit the pictures for some reason lmao so I'll just list them out:
Kun (WayV)
Seonghwa (ATEEZ)
Namjoon (BTS)
Soobin (TXT)
Jaemin (NCT Dream)
Jaehyun (NCT 127)
Suho (EXO)
Ryujin (ITZY)
Somi (Soloist)
Tagging: Anyone who wants to do this
Bias Height Compared to Mine Tag
I'm actually a little scared to try this one cuz I never really thought of it lmfaooo
AHAHAHAHAHHAHAHAHAAHHAHAHAAHAHA THEY COULD ALL DROP KICK ME- and i'd say thank you
Tagging: Anyone who wants to do this
Get To Know Me Tag
Tagged by: Same as above!
Favourite colours: Burgundy, Dark Colors
Currently reading: Webtoons lmfao (rereading No Scope and Trying to get caught up on Cursed Princess Club)
Last song: "0X1=LOVESONG" by Tomorrow x Together
Last series: Doctor Who (I had to feel something again)
Last movie: "Eternals" (IT WAS A GREAT MOVIE)
Favourite musical artist: NCT (Specifically WayV)
Sweet, savory, or spicy: I'm personally a spicy person but I thoroughly enjoy savory as much, not too much of a sweet tooth though
Craving: Wendy's Spicy Chicken Nuggets 😔
Currently working on: What am I not working on? Infatuation, Without a Trace, [Redacted] 20K+ fic, TSTL rewrite, etc...
Top 3 biases: Kun, Seonghwa, Soobin
Top 3 bias wreckers: Yangyang, San, Yeonjun
Most used phrase: "That's bullshit" and "Fucking hell" (send help)
Tagging: Anyone who wants to do this!
Get To Know Me Tag Ver. 2
Tagged by: @i-just-like-goats
Rules: Answer questions and tag 20 blogs you are contractually obligated to know better!
Name/Nickname: Crys
Gender: F
Star Sign: Scorpio
Height: 4'11 (151 cm)
Time Currently: 4:48 PM
When is your birthday: October
Favorite Bands/groups: NCT/WayV
Favorite Solo Artist(s): Somi
Song Stuck In Your Head: What You Waiting For (Somi)
Last Movie You Watched: Eternals
Last Show You Binged: What If...? Because I got behind LMFAOOO
When You Created Your (Main-)Blog: Last year around April I believe
Last Thing You Googled: "Na Jaemin Height" LMFAOOOOO
Do You Get Asks: Yes keep them coming I love all of you
Why I Chose My URL: Cause I'm a multi-fan hehe
How Many People Are You Following: Around 68
How Many Followers Do You Have: 600+
Average Hours of Sleep: 6 on a good night
Lucky Numbers: 4
Instruments: Piano, Guitar, Ukulele, Otamatone, and a little bit of flute
What I’m Currently Wearing: A shirt that says Ah! The element of surprise in Periodic Table format
Dream Job: Pediatric Surgery!!!!
Dream Trip: Far away from here
Favorite Food: If you're familiar with filipino food Nilaga!
Favorite Song: At the moment it would be Favorite (Vampire).
Top Three Fictional Universes You’d Like To Live In: Marvel Cinematic Universe, Pokémon, Harry Potter
Tagging: Anyone who wants to do this!
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here it is,,,the big one,,,the one two years in the making that likely approximates living up to like a third of the hype,,,the one you’ve all been waiting for
BIG thanks to @elsaclack and @jakelovesamy, without whom this would not exist. pls feel free to direct all gratitude to me and all complaints to them
Amy Santiago feels almost naked without her backpack. A 64-set of colored pens was her sword, and multi-subject, college-ruled notebooks with dividers and reinforced pockets were her shield, but she’s been reduced to balancing on one foot with the other on the bench for better leverage, cramming a single pocket journal and eight (only eight!) pens into the front pocket of her lab coat.
Next to her, Jake’s reclining, almost impossibly relaxed. He’s somehow already spilled coffee down the front of his teal scrubs, and he’s got a smear of jelly from his “breakfast” at the corner of his mouth. He’s playing some colorful game on his phone, one that makes Amy’s eyes hurt just to think about, and he’s throwing his whole body into the tapping and swiping, as though stomping his foot in time will somehow help him beat the level. He teased her endlessly when he showed up at her door two nights ago and found her with all of her school supplies in chaotic piles, Amy frantically pacing between them with a checklist. She’d never admit it - most certainly not to his face - but she’s more than a little relieved he’s there. Rosa was starting in pediatrics, with Charles in neurology, but at least she had Jake with her in internal medicine. His presence was anything but calming, but it made her feel just a little bit more grounded.
If she were interested in introspection at this moment, she might acknowledge that her first real hands-on experience is terrifying, or that she’s worried about whether her memorized knowledge will serve her out of the classroom, or that her hands are shaking because she’s nervous about the change. Not because she can’t seem to fit her last two pens in her pocket, despite the fact that these scrubs are way too loose and airy. It’s nothing like a good pantsuit, it’s almost like she’s wearing pajamas--
“Of course you are! That’s the whole point, dummy!”
#med school au#my writing#b99#brooklyn nine nine#jake peralta#amy santiago#raymond holt#gina linetti#rosa diaz#peraltiago#b99 fanfic#jake peralta x amy santiago#kevin cozner#the whole damn GANG is here#terry jefforts#HIM TOO the first time i've ever written terry#charles boyle#who can forget
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As someone who works in medicine and someone who is a parent, the case of Justina Pelletier really interested me, and troubled me as well.
...
Justina Pelletier was brought to Boston Children’s Hospital at age 13, after testing and treatment at another hospital in Connecticut failed to resolve her health issues. Justina was born prematurely, and her parents reported she had experienced subsequent developmental delays and pervasive illnesses. At Boston Children’s, Justina presented with difficulty walking and talking, pain, and altered mental status. Doctors could find no medical explanation for her symptoms, even after extensive neurological testing. Eventually, they came to believe she may have suffered from somatoform disorder, in which psychological problems create, or exacerbate, physical problems.
There was also reason to believe Justina might be experiencing a form of medical abuse called factitious disorder by proxy (previously called Munchausen by proxy). Justina’s parents’ reported obsessiveness over her health, the multiple diagnoses they had sought, and the tangled network of doctors involved in her care all signaled possible “over-medicalization.” It was further documented that Justina seemed to be in better physical and psychological health when her parents were not present.
It was not just Boston Children’s providers who felt Justina’s parents may have contributed to their daughter’s poor health. Justina had previously received extended treatment at Tufts Medical Center, where doctors diagnosed her with mitochondrial disease but also observed both the psychosomatic severity of Justina’s symptoms and the possible barriers her parents may have created to her recovery. After Justina’s parents proved resistant to addressing the psychological aspects of her illness as well as the medical, the team at Tufts filed a report of medical child abuse with the Department of Children and Families in Connecticut.
As the providers at Boston Children’s struggled with how best to help Justina, they worked together with providers at Tufts to create a treatment plan for Justina, one that would address her mental health, help foster her independence, and minimize her parents’ involvement in her medical management. Justina began receiving intensive inpatient psychiatric treatment at Boston Children’s, but after a few days, her father demanded her release. Boston Children’s then initiated a report of medical child abuse with the Massachusetts Department of Children and Families. DCF took custody of Justina, authorizing her continued psychiatric institutionalization for nine months, with limited contact with her parents, before she was returned to the custody of her family.
In 2016, Justina’s parents sued Boston Children’s (and the doctors who treated her) for malpractice, alleging her treatment and limited contact with her parents caused PTSD in Justina and violated their family’s civil rights. Justina herself was adamant in her testimony that her hospitalization was a negative experience. After nearly four years of legal proceedings and a five-week-long trial featuring wildly varying accounts of Justina’s treatment and its effectiveness, a jury took six hours to rule in favor of the defendants, dismissing the Pelletier family’s suit. Now 21, Justina lives with her parents, who continue accompany her to hospitals in multiple states with complaints of undiagnosed illnesses. Her treatments, which include the removal of her colon, have been unsuccessful in alleviating her symptoms.
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Again, as a mother, the idea of one or more hospitals and state agencies swooping in to override my concerns is troubling. But, as someone in the medical field, I’m troubled more by the fact that medical child abuse is not at all rare. In just the past six months I’ve encountered more than one child victimized by their parents’ factitious disorder by proxy, helpless as their parents doctor-shop for the specific tests, diagnoses and medications they want their child to receive. I’ve also interacted with dozens of children whose parents are guilty of (in my opinion) a different type of abuse, in which they willfully withhold appropriate and necessary medical treatment in favor of the latest designer diagnoses (or wastebasket diagnoses, as clinicians might say) and the corresponding “holistic treatments” that actually keep their kids sick. So, with that in mind, in these kinds of cases my bias tends to lean toward the medical professionals - especially when it comes to pediatric practitioners, who have no motivation beyond trying to make children well. Parents may (and typically do) love their kids, but that doesn’t qualify them to diagnose and treat these fragile humans entrusted to their care.
#justina pelletier#factitious disorder#factitious disorder by proxy#munchausen by proxy#munchausen syndrome#child abuse#medical abuse#child neglect#medical#tales from healthcare#personal#rant
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this just in - DOMINIQUE “ NINA ” SANTORO has been in wickway for TWENTY SEVEN EIGHT YEARS. apparently SHE is a DOCTOR and a CIVILIAN / SANTORO RELATIVE, or so HER passport says. so far it’s known that SHE favors EAST BAY, and resides at EAST SIDE. SHE is also said to be AMIABLE & RELIABLE, but also GUARDED & BLUNT. at the end of the day, SHE can be described as THE PATTER OF BARE FEET ON WOODEN FLOORS, HUSHED SUNG LULLABIES AND THE SMELL OF MARC JACOB’S DAISY.
hello, everyone !!! i’m cami aka your local angst whore and i’m so very excited to be here <33 this here is nina who’s messy little pinterest you can find anywhere on this here little link.
𝐁𝐀𝐒𝐈𝐂𝐒 ▸
FULL NAME: DOMINIQUE MIA SANTORO
NAME MEANING / PRONUNCIATION: DOMINIQUE, THE FEMININE VERSION OF HER FATHER’S NAME MEANING “ OF THE LORD ” AND MIA MEANING CHOSEN ONE OR MINE. ( DO-ME-NEEK MEE-AH )
AGE: TWENTY EIGHT ( HER BIRTHDAY PASSED AWW )
DATE OF BIRTH: SEPTEMBER 7TH
RANK / TITLE: CIVILIAN
OCCUPATION: DOCTOR ( GENERAL MEDICINE BUT PREFERS EMERGENCY PEDIATRICS )
HAIR COLOR: DIRTY BLONDE / LIGHT BROWN
EYE COLOR: BLUE
𝐈𝐍𝐓𝐄𝐑𝐈𝐎𝐑 ▸
POSITIVE: AFFABLE, AMIABLE, ATTENTIVE, ARTICULATE, CONVIVIAL, CULTURED, DETERMINED, DRIVEN, GRACIOUS, HOSPITABLE, INSIGHTFUL, PERCEPTIVE, PERSONABLE, SCRUPULOUS, WHIMSICAL
NEGATIVE: BLUNT, CAPRICIOUS, COMPASSIONATE, GUARDED, METICULOUS, SECRETLY SENTIMENTAL, SOMETIMES STOIC,
𝐅𝐀𝐌𝐈𝐋𝐘 ▸
FATHER: DOMINIC SANTORO ( alive deceased )
MOTHER: ABIGAIL REED ( deceased )
CHILDREN: NIKOLAS “ NIKO ” CAMERON SANTORO ( alive, two years old, name meaning people of victory but with a “k” instead of a “c” )
𝐇𝐄𝐀𝐃𝐂𝐀𝐍𝐎𝐍𝐒 / 𝐅𝐀𝐂𝐓𝐒 ▸
her name is the feminine take on her father’s name, given to her by her mother in honoring him and having loved the name herself.
her father and her have a very good relationship, she’s kind of a daddy’s girl. the apple of his eye and what not. because she was so tender from a young age, he never wanted her around or involved in the gang. hence, she isn’t an ex-con and she was never involved in anything relating to the gangs. not to say that she’s as innocent as she seems because, well, she’s her father’s daughter.
she’s actually not very tall, 5′3 at best..
dominic and her mother were actually together for a year which means that she hadn’t actually known him to have been romantic with abigail considering the fact that she had been in her mother’s womb for the most part. at the age of five years old, her mother was killed. though, the authorities ruled it a suicide. hours later, she was in her father’s arms and not a moment after did she return to her old home. instead, she was raised by dominic alone - often visiting her maternal grandparents for summer or minimal holidays.
she began to gymnastics at the age of six years old and would, eventually, move on to cheerleading. nina was actually on the cheerleading squad in her middle school and on the varsity team of her high school for all four years of high school. she was good and because of her build, nina made an amazing flyer.
dominique left wickway for college when she attended yale university and would remain there for pre-med. though, of course, because of her discipline when it came to her studies, it took her less time to graduate and was officially a doctor by the age of twenty four.
a little after, she found that she was pregnant and nine months later... she gave birth to a little baby boy whom she named nikolas, changing the “ch” for a “k”.
she’s kind-hearted and a total softie when it comes to her family so... it’s rare times that she’s actually angry. however, when she’s angry - it’s not pretty.
can be brutal with her words and even her actions, it’s not cute but it’s definitely in her blood.
𝐖𝐀𝐍𝐓𝐄𝐃 𝐂𝐎𝐍𝐍𝐄𝐂𝐓𝐈𝐎𝐍𝐒 ▸
for starters, i’d love to have the father of her son. i’m a bit of an angst whore, as i stated before, so there’s really a lot we can do if you think your muse could fit or something !!
friends !! be it college friends, childhood friends, school friends, new friends, any friends <33
frenemies
rivals
best friend(s)
girl squad ?? or just a squad ??
maybe an ex that isn’t niko’s dad ?? ended on good terms or bad
unrequited crush ??
bad influence
unlikely friend
honestly, anything !!
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Wednesday, November 4, 2020
The coronavirus is surging, but Canada is keeping schools open
(Washington Post) It’s been an uncertainty-ridden time for parents across Canada. As cases surge again, provinces are closing businesses, reimposing restrictions on public spaces and urging people to curb private gatherings. Still, as in European countries that are also tightening their rules, Canada is prioritizing keeping its schools open. All 13 provinces and territories are holding classes in person; in only some are hybrid or remote learning even options. In the United States, in contrast, nine states and territories have ordered some or all schools to hybrid or remote learning only, according to a tally kept by Education Week. Individual districts in other states are limiting or banning in-person classes. The incidence rate of covid-19 in people under 20 has increased since schools reopened, a trend the Public Health Agency of Canada says could be tied both to a growing number of school outbreaks and an increase in testing for that age group. Officials are responding by isolating sick pupils, quarantining classes hit by the virus and, in some cases, closing schools temporarily. But they’re resisting the blanket closures and wholesale shift to e-learning of the spring. “On balance, it’s been as expected,” said James Kellner, head of the pediatrics department at the University of Calgary. “And how that’s been has been concerning, but not terrible so far.”
Are ‘Kidfluencers’ Making Our Kids Fat?
(NYT) Parents beware: Many YouTube channels that are wildly popular with young children are targeting them with thinly veiled ads for sugary beverages and junk food. That is the conclusion of a new study published on Monday in the journal Pediatrics. The authors of the study analyzed over 400 YouTube videos featuring so-called kid influencers—children with large social media followings who star in videos that show them excitedly reviewing toys, unwrapping presents and playing games. The study found that videos in this genre, which attract millions of young followers and rack up billions of views, were awash in endorsements and product placements for brands like McDonald’s, Carl’s Jr., Hershey’s, Chuck E. Cheese and Taco Bell. About 90 percent of the foods featured in the YouTube videos were unhealthy items like milkshakes, French fries, soft drinks and cheeseburgers emblazoned with fast food logos. The researchers said their findings were concerning because YouTube is a popular destination for toddlers and adolescents. Roughly 80 percent of parents with children 11 years old or younger say they let their children watch YouTube, and 35 percent say their children watch it regularly. Young children are particularly susceptible to marketing. Studies show that children are unable to distinguish between commercials and cartoons until they are 8 or 9 years old, and they are more likely to prefer unhealthy foods and beverages after seeing advertisements for them.
Turkeys
(AP) A pertinent question coursing through the $4.3 billion turkey business is a basic one: how many turkeys are we gonna need for this Thanksgiving? It’s an incredibly complicated proposition. Grocery chain Kroger’s research found that 43 percent of shoppers plan to celebrate Thanksgiving with only their immediate family, which if true means that the birds people will want may be smaller, but they’re going to need way more of them as normally large gatherings (which would use a single large bird) temporarily splinter into smaller more intimate gatherings (necessitating multiple smaller birds). A lot is at stake, as in 2019 Americans spent $643 million on turkey in November. Walmart will carry 30 percent more turkey breasts in its stores for those who don’t want a full bird.
As the U.S. votes, the world watches with anxiety and hope
(Washington Post) As Americans cast their votes in Tuesday’s presidential election, the world is watching closely, especially allies in Europe and rivals such as Russia, China and Iran, which could expect a very different U.S. foreign policy depending on the outcome. The choice of a U.S. president is always a matter of global importance—to allies, rivals, trading partners, and the web of treaties and institutions that bind countries together. This time, however, the stakes are exceedingly high. Analysts around the world expressed fears for America’s political system, speaking in terms often reserved for fragile democracies. Some commentators in China hope that a Joe Biden win could usher in a diplomatic respite, but fear that the deepened U.S.-China rivalry could persist, whoever wins. Pro-Kremlin media warn elections could lead to chaos and street fighting, predicting that President Trump will be forced to retreat to his White House bunker. Many European leaders fear Trump would weaken or destroy NATO if reelected. In Israel, where Prime Minister Benjamin Netanyahu has made much of his close ties with Trump, analysts wonder if a Democratic win might weaken the Israeli leader’s long hold on power.
Presidential race too early to call
(AP) The Associated Press is not calling the presidential race yet because neither candidate has secured the 270 electoral college votes needed to claim victory. Republican Donald Trump said, “Frankly, we did win this election” over Democrat Joe Biden and said he would take the election to the Supreme Court. His assertion of victory does not match the results and information currently available to the AP. Trump or Biden would need 270 electoral votes to win. Several key states are too early to call, including Pennsylvania, Georgia and Michigan.
Hurricane Eta slams into Nicaragua as Category 4 storm
(AP) The heart of powerful Hurricane Eta began moving ashore in Nicaragua Tuesday with devastating winds and rains that had already destroyed rooftops and caused rivers to overflow. The hurricane had sustained winds of 140 mph (220 kph), according to the U.S. National Hurricane Center, down from an overnight peak of 150 mph (240 kph). Landfall came hours after it had been expected. Eta’s eye had hovered just offshore through the night and Tuesday morning. The unceasing winds uprooted trees and ripped roofs apart, scattering corrugated metal through the streets of Bilwi, the main coastal city in the region. Nicaragua’s army moved red-helmeted troops specialized in search and rescue to Bilwi, the main coastal city in an otherwise remote and sparsely populated area.
France ponders new Paris curfew as lockdown rebels frustrate government
(Reuters) France could reimpose a night curfew on Paris and possibly the surrounding region amid government frustration that too many people are ignoring lockdown rules as COVID-19 infections soar. France dramatically slowed the spread of the coronavirus in the spring with one of Europe’s strictest lockdowns. But 10 months into the epidemic and with winter drawing in, many are reluctant to endure another period of confinement. New COVID-19 lockdowns and curbs have stirred resistance across Europe even as countries including France and Spain deal with record daily infections and hospitals buckle under the strain.
Bad blood—why France-Turkey cartoon row could leave lasting impact
(Reuters) Slights and barbs have marred relations between France’s Emmanuel Macron and Turkey’s Tayyip Erdogan for years, but the row over cartoons of the Prophet Mohammad has dragged them to a new low which could have more lasting consequences. If they cannot find a way to mend bridges, momentum is likely to build for a proposal, driven by France, for European Union sanctions on Turkey’s already-fragile economy, according to Turkish analyst Sinan Ulgen. “Neither Erdogan in Turkey nor Macron in France will step back,” said Ulgen, head of the Istanbul-based Centre for Economics and Foreign Policy Studies think tank. A French official familiar with policy towards Turkey said that in the light of the events of the past few weeks: “The question of sanctions is going to be raised.” EU leaders have already said that if Turkey fails to de-escalate tensions in the eastern Mediterranean by Dec. 10, sanctions would follow, though there is no draft proposal yet.
5 dead in Vienna attack
(AP) Five people died, including an assailant, and 17 others were wounded in a shooting in the heart of Vienna hours before a coronavirus lockdown started, Austrian authorities said Tuesday. The dead attacker was a 20-year-old Austrian-North Macedonian dual national who had a previous terror conviction. Two men and two women died from their injuries in the attack Monday evening, Chancellor Sebastian Kurz said. The suspected attacker was shot and killed by police. Vienna’s hospital service said seven people were in life-threatening condition Tuesday after the attack, the Austrian news agency APA reported. In total, 17 people were being treated in hospitals, with gunshot wounds but also cuts. “It is now confirmed that yesterday’s attack was clearly an Islamist terror attack,” Kurz said. Interior Minister Karl Nehammer later told APA that the dead assailant, who had roots in the Balkan nation of North Macedonia, had a previous conviction under a law that punishes membership in terrorist organizations. The attacker, named as Kujtim Fejzulai, was sentenced to 22 months in prison in April 2019 because he had tried to travel to Syria to join the Islamic State group. He was granted early release in December under juvenile law.
Ukraine close to catastrophe, minister says
(Reuters) The situation with the coronavirus in Ukraine is close to catastrophic and the nation must prepare for the worst, health minister Maksym Stepanov said on Tuesday. Ukraine registered a record 8,899 new COVID-19 cases in the past 24 hours, the ministry said, up from the Oct. 30 high of 8,312. Total infections stood at 411,093 by Tuesday with 7,532 deaths. Ukraine imposed a strict lockdown in March but eased it in May. Stepanov said the government would consider how to preserve the economy and save people at the same time.
India, U.S., Japan and Australia kick off large naval drills
(Reuters) India, the United States, Japan and Australia began their largest joint naval exercises in over a decade on Tuesday, Indian government sources said, seen as part of efforts to balance China’s vast military and economic power in the region. The annual “Malabar” wargames that India holds with the United States and Japan have been expanded to include Australia this year to cover all members of the Quad, an informal group of the four largest democracies in the Indo-Pacific. Five ships of the Indian Navy, including a submarine, were deployed in the exercise along with U.S. Navy’s John S McCain missile destroyer, Australia’s Ballarat frigate and a Japanese destroyer, the Indian ministry of defence said. Later this month, India and the United States will deploy aircraft carriers in the drills, a military source said.
Almost Like Clockwork, Talk of a Military Coup Follows Thai Protests
(NYT) There are certain constants in Thailand: the drenching monsoons, the grand openings of new shopping malls and the rumors that the Royal Thai Armed Forces are plotting another coup. For weeks now, student-led protesters across Thailand have taken to the streets every few days, calling for a new constitution with authority over the monarchy, an end to the persecution of the political opposition and the resignation of Prime Minister Prayuth Chan-ocha, the retired general who led the most recent military coup, in 2014. While the security forces have not cracked down violently on these peaceful rallies, it’s unclear how long such restraint will last. Nor is it certain how long the army is willing to stay in the barracks, plotting against Mr. Prayuth, who was once one of their own. Whenever the generals launch a coup, the refrain is the same: Thailand needs a return to order, without messy rallies or dissenting voices. “I see a coup as not a bad thing,” said Sondhi Limthongkul, a prominent royalist. As recently as last week, Mr. Sondhi publicly called for yet another military intervention to restore stability and protect the monarchy, urging the military to quickly hand over power after seizing it so the king could oversee the formation of a unity government.
Oman to bring in income taxes
(Foreign Policy) Oman is planning to introduce an income tax on top earners, beginning in 2022, in what would be a first for Gulf nations. The move comes as Oman attempts to narrow its budget deficit from 19 percent of GDP today, to closer to 2 percent in four years’ time. Up until now, Oman, Saudi Arabia, and the United Arab Emirates, have been taxing their populations slowly, using a value-added tax on purchases rather than taxing income.
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Time Warp
Chapter 02
Hi guys! How are you on the other side of the screen?
First of all, I'm so sorry for not being able to upload the chapter last week. I fumbled with this semester's final exams and failed.
Second, my sincere thanks to Carly Giuliani, whoknows33, Calzonafan123, ChrisM92, NDenner, brady25, Tifenn: tifustiti, perpetualblyss and @loudwithlaughter for all your reviews.
Last but not least, my big thanks to my dear friend and beta reader @tiggermay
Arizona was on a high. After Jackson Prescott’s case she’s been on a string of good results, with no children dying on her hands in the last couple of weeks.
Arizona skated all over the hospital (where the nurses allowed - she had tried to skate at NICU only to be tackled by one of them). She and Kai were dancing every day in her apartment. She was even running in the park!
Her life was practically perfect. All that was missing was Nick arriving in Seattle (he promised that he was just tying up his business there, and… you know, having to walk a trail to the nearest town where he would rent a car to get to the airport).
And Calliope.
So, Arizona was basically floating in a pink cloud when Dr. Dixon asked her to consult on Stacy Pollock.
Arizona sighed before walking over to Bailey (who had been telling anyone and everyone who wanted to listen, -or didn’t -, that Arizona Robbins was Seattle Grace's best acquisition in a long time, and no one should touch a child without her permission…. Her new rule to her residents.), to confirm the diagnosis of cor pulmonale.
As soon as Dr. Dixon left, Bailey grabbed her lab coat. “Aren't you going to scrub in this surgery? You... You’re the peds surgeon!”
Arizona smiled in surprise. "Bailey, this is a cardiac case. You and Dr. Dixon can handle it."
Bailey shook her head. “She's just a child. And I…” she trailed off.
Arizona gently put a hand on her friend's shoulder. “Children are tough. And maybe you’ll open this girl's chest and fix something simple. Or maybe she’ll need a transplant and a backpack with a portable pump that will deliver her medicine at the right times so she can have a childhood. Either way, you’ll give her the rest of her life. And I'm telling you that you’ll want to be there for this moment. Because Stacy? She needs you.”
***
Arizona returned to her office. She had been trying to write an article about Jackson Prescott's treatment, but how could she explain that she knew what to do, before ever touching the boy, well… In a way that wouldn’t guarantee her, a one-way trip to the psyche ward, anyway?
She was turning the pages of his exams when she heard knocking on the door. She didn't usually close her office door during the day, so it was open, and Paul Anderson was there looking anxious.
Arizona widened her eyes for a second before she remembered that Wallace was alive. Then she gave her best and most charming smile and stood up. "Hey! How can I help you?"
Paul took a deep breath and walked into the office, closing the door behind him. "Dr. Robbins, correct?"
Arizona nodded and reached out to greet him. The grip was tight, though Paul's hands were shaking. “I’m Paul Anderson. My son, Wallace, is a patient here. Dr. Kenley was his doctor.”
They sat down, and Arizona quickly closed the folders in front of her. "I think I haven't met Wallace yet."
Paul shook his head. “He… He has short bowel syndrome. He had the last surgery with Kenley a few months ago. His eleventh bowel resection.” Paul took a deep breath, and Arizona noticed Kai rising from the couch to stand beside her. “My wife, Bethany, she attends a support group to parents in this situation. And she heard about Jackson Prescott's recovery. So, I want to transfer Wallace's care to you as well as discuss the best course of treatment.”
Arizona took a deep breath. "Do you have his latest exams?"
Paul nodded eagerly, and opened his briefcase, offering her a binder.
Arizona smiled reassuringly and put her hand over Paul's. “I'm going to study Wallace's case. And the possible alternatives we have. And then we can decide our next step, okay?”
Paul took a deep breath. “He's nine years old… And he's done more than twice as many surgeries than Bethany and I combined. They keep saying that he doesn't have much of a chance of living... But, he's my son, Dr. Robbins. He's my boy.” He said brokenly while staring at Arizona. He lifted a hand to rub at his tired eyes and she couldn’t help but feel her heart twist at the anguish and fatigue that she could see in him. She remembered how emotionally draining, worrying for Sofia had been… And God… Sofia. She missed her baby so much.
Arizona nodded sympathetically. "I... Let's make a plan." She said, clearing her throat.
Paul nodded. They exchanged contacts and soon the man said goodbye and left the office. Arizona closed the door and crouched on the floor covering her face.
"I need to save Wallace, Kai."
The angel took an apple. "Do your best. But remember that some things are immutable.”
Arizona nodded, and when she saw Kai eating her apple, she couldn’t help but roll her eyes at him. "How many of these have you eaten?"
Kai laughed hoarsely. "Four? I like the taste. Theoretically, I don't need to eat.” He smiled sympathetically at Arizona. "I think it's cute that you prepare your snacks like you're doing it to Sofia. If you weren't having lunch at the cafeteria, I bet you'd make your lunches in the same way."
Arizona shrugged. "Force of habit."
Kai nodded. "Want some help thinking of something for the Anderson boy? I can help you remember their exams from the other timeline."
Arizona nodded. "Let's get to work then, Kai"
***
A few hours later, Arizona was preparing a file for the Anderson family. She wanted Wallace to have a bowel transplant. Her thoughts were interrupted by frantic knocking on the door.
"Come in," she called.
Miranda Bailey came into her office out of breath, but with a smile on her face. “You're brilliant!” she stated. “I was in surgery with Stacy and Dixon said she would need a transplant. And, and I had to leave. Because I couldn't handle the idea of this little girl slipping through my fingers and I went to visit my son at the daycare. When I saw the backpacks, and I remembered what you said. So, I ran back, and I told the parents what we could do... I would have come before, but Dr. Dixon... Well, she had a moment. But we can put the portable pump on Stacy, and she can have a childhood!”
Arizona's eyes widened. "Dr. Bailey, you talked to Dr. Dixon before talking to the parents, correct?"
Bailey's smile slowly died. “Well… She was breaking the news to her parents! They needed to know!”
Arizona sighed. “And she's chief surgeon on this case. And she deserves our respect. So, I'll be happy to assist on this surgery, but you need to apologize to her.”
Bailey grunted softly but nodded. "But you’re going to scrub in on the surgery, right?"
Arizona laughed softly and nodded. “Great save, Bailey. I’m proud of you."
Bailey's chest filled with pride and she passed the exams to Arizona as they walked to the OR.
***
Arizona smiled encouragingly at Bailey once the surgeon had started. Kai was watching over Dixon's shoulder, a certain fascination in his angelic expressions.
"I'm sorry for my outburst." Bailey started breaking the uncomfortable silence. "I should've spoken to you first."
Dixon nodded, her focus completely on the procedure. “It was inappropriate, but I've come to expect it from pediatric surgeons. Always breaking protocol.” She sighed and shook her head.
Bailey looked surprised at Dixon. “I'm not a pediatric surgeon. I've landed a few peds cases recently, but I'm getting back to general surgery the first chance I get.”
Arizona tilted her head. Bailey would be a great pediatric surgeon. However, Webber had chosen her to follow his footsteps. And she had already tried to have this fight and lost.
“You touch the child whenever you speak with her.” Dixon continued “You explain conditions to the child, not just the parents. You react to the patient as if it was your own child. You break protocol, which is inappropriate. Except in pediatric surgery, where protocols are constantly evolving. You are not a general surgeon. You're a pediatric surgeon.”
Arizona smiled at Bailey. Dixon was right. Bailey would be excellent at peds.
***
Arizona was heading for the locker room so she could change. Some nurses had invited her for a drink after work and she was happy to accept. When she saw Bailey smiling outside Stacy Pollock's room, she stopped beside her to watch the girl showing her backpack full of ornaments to her parents.
"Oh my God," she exclaimed. "Did you use a bedazzler?"
Bailey lifted the machine, a smile on her face. “Circa 1986. As seen on TV.”
Arizona laughed in surprise. “Dixon’s right, you know. You do belong in peds surgery. Although, I think Ri... The chief. The chief has already chosen you to take his place.”
Bailey shook her head. “My own baby almost died last year. The doctors in this hospital, my friends, all worked to save his life. And I stood outside the room feeling so useless, so powerless and helpless. Like I was losing everything in the world and couldn’t do a single damn thing to stop it. And when he didn’t die, I knew I didn't want to be anywhere near that feeling again, so I think that makes me pretty unsuitable for pediatric surgery.”
Arizona looked away for a minute. She knew the feeling Bailey was narrating. She had felt it on her skin when her baby was born four months too soon after that terrible car accident. She shook her head, trying to clear her thoughts.
“I'd say that makes you uniquely qualified. And if you have an interest and Richard Webber allows it, I'd love to have a chance to rob you into pediatric surgery.” she said smiling at Bailey before walking away.
***
Arizona was sitting at the bar laughing at what some nurse was saying. She had had her fair share of affairs in Seattle before she time travelled, and now no one understood why she was suddenly celibate.
She was talking to a girl from Pathology when her eyes landed on Calliope. She looked so sad. The weight of the world on her shoulders and still the most beautiful woman she had ever seen.
Arizona saw Little Grey exchange a few words with her before she got up and went to the bathroom.
Kai poked her shoulder. "Go after her, Robbins!" He murmured in her ear.
Arizona smiled and excused herself as she went to the bathroom. Butterflies on her stomach, her hands sweating... God, the effect Calliope had on her, even after all this time...
She opened the bathroom door and couldn’t help but cast an appreciative glance across Calliope's shape, leaning over the sink, touching up her makeup.
“Hey”
"Hey" Calliope answered without turning to her, almost like an automatic answer.
"Ortho, right?"
“Yeah, right. Hi.”
“I'm Arizona Robbins. Peds surgery” (your future wife, mother of your daughter, the love of your life). “I've seen you at the hospital” she took a deep, nervous breath. "Are you ok?"
Callie ruffled her hair, clearly upset. "You know... I'm fine."
And she turned around. And Arizona almost lost her breath at seeing her eyes so closely. She had almost forgotten how expressive and captivating those eyes were. Callie has always been so open... Before all the pain she caused. Pain, she could now, fix.
“Fine. People talk. Where we work. They talk. A lot.” Arizona started anxiously, her speech stilted and awkward, (God what is wrong with her?). "So, for the sake of being honest, I think I should tell you that I know things about you" (because I’m from the future and we were married. Because I asked about you). "Because people talk.”
Callie bowed her head, the smile on her face faded for a second. "Oh... You mean... Terrific." She said muttered tiredly, huffing a sarcastic, breathy laugh.
Callie looked down and Arizona stepped a little closer. “It is, actually. The talk.” Callie leaned against the sink. “People really like you over there. They respect you and they're concerned and interested. They really like you. Some of them really like you.”
Kai shook his head. "Where are you going with this?", he said not expecting an answer.
Arizona took a deep breath. "You just… You look upset. And I thought that you should know that the talk is good. And when you're not upset, when you're over being upset, there will be people lining up for you.”
Calliope laughed and it was one of the most wonderful sounds Arizona had heard. "You want to give me some names?" She asked wryly.
Arizona smiled coyly and approached Callie. She would never understand how Callie could doubt how attractive she was. How magnetic she could be. She leans in and slowed down a bit just an inch before Callie’s lips, not wanting to spook her but also not willing to let a chance by, and when she didn’t move back, leaned in kissed her gently.
Fireworks. Arizona thought. And those lips...
She pulled away slowly. "I think you'll know" She smiled at Callie mischievously before leaving the bathroom.
Kai was laughing alongside her as she paid for hers and Calliope's tabs before leaving the bar to return to her apartment.
“Jesus, that conversation was kind of painful to watch”. Kai said, wincing theatrically “You couldn’t think of anything else to say to her? God! Talking about other people talking, we really need to work on your conversational skills.” Kai sighed dramatically and shaking his head back and forth his wild black curls flopping around, when suddenly he lifted his head to exclaim: “But, hey the kiss! I knew you had it in you!”
Arizona laughed as she threw herself on her bed, her fingers touching her lips gently. She had almost forgotten Calliope's innocent glances. Her charming insecurity. And the lips... Oh those lips! “Reliving this moment is worth any price for coming back here, Kai” she whispered.
Kai's canines flashed in the light for a second before Arizona heard his hoarse laugh fill the apartment.
That night she dreamed of her wedding day.
***
Arizona knew Calliope was following her around the hospital and asking about her, working up the courage to ask her out. And each time she could see a shadow of her getting close, even for a second, she needed to stop and take a deep breath.
Kai seemed to be having fun like never had before, watching this cat and mouse game.
She had just helped the nurses set up a scavenger hunt for the children (they heard about the interns’ scavenger hunt and they wanted to do one too) when Paul and Bethany knocked on her office door.
“Mr. Anderson, Mrs. Anderson! Please come in!” she greeted them excitedly.
Bethany smiled. "Call me Bethany, Doctor Robbins."
"If so, please call me Arizona."
She picked up two folders she had prepared for them, a thing Nicole Herman had taught her for when parents needed to make a medical decision. She took a deep breath before she started. “Wallace's case is quite severe. And I disagree with the treatment made by Dr. Kenley. I think repeating the same surgery more than ten times won’t yield new results. After studying and contacting some colleagues, my official recommendation is that Wallace should’ve a bowel transplant.”
Paul closed his eyes, releasing a heavy breath and Bethany began to cry silently. Arizona gently pushed the folders toward them. “However, no decision needs to be made today. For now, Wallace is stable and maybe he’ll stay in this state. But… In case, we need to interfere… When we discuss transplants, in addition to the risks of surgery, we’re talking about a lifetime of periodic hospital visits and medicines to keep his immune system in check. I have prepared this document for you to help you understand what it might mean in the long run for Wallace and you both. So, you can read, and I’ll be happy to answer your questions. Of course, if you want a second opinion as well, fell free to take it to a second doctor.”
Paul took the folder with shaking hands, tears keeping him from reading. "But would he live?"
Arizona nodded. "I believe this is the best chance for us to extend Wallace's life."
Bethany looked at Arizona for a moment. "Do you have children, Arizona?"
She opened her mouth for a moment almost saying yes, she had. She had a beautiful daughter. But no. She didn't have her daughter. Yet. Arizona smiled. "Not yet."
Bethany nodded. "A transplant means he would have a childhood... A normal life."
“He would need take medicine and need to see a doctor more than usual, yes. But I firmly believe this is Wallace's best chance.”
Before Paul could speak, she smiled. “You don't have to decide anything right now. Take this information home. Read it calmly. Talk to his pediatrician. When you guys make the decision, Wallace will enter a list and then we'll have to wait. There is no rush.”
Paul took a deep breath. "If a transplant is what is needed to see my son grow up, Dr. Robbins, you can put him on that list."
***
Arizona took a deep breath handing the forms to the nurse. Wallace Anderson was officially on the transplant list. Now she just had to wait.
She walked to her office, slowly. She felt the beginnings of a migraine starting to build up just behind her eyes. Arizona closed the door slowly and sat down, resting her head in her hands. She grunted in frustration at Miranda Bailey's application for a fellowship in pediatric surgery. She had noticed the hesitation in Bailey to get away from Richard Webber.
She was exhausted from all these waiting games. It seemed that waiting was all she been doing lately. Wait for Calliope to talk to her. Wait for Sofia to be born. Wait for Richard Webber to stop Bailey from doing the fellowship. Wait for Karev be interested in peds. Wait for Nick’s and April’s arrival. It had all become one big waiting game. And she was shaking with anxiety to begin her life!
***
Arizona massaged her temples while reading Miranda Bailey's application. She needed to talk to Bailey. While it was true that she had a gift for pediatrics and would be a wonderful addition to Arizona’s team she refused to go into battle with Richard Webber, over a resident who still wasn’t all that sure about actually joining. Arizona took a deep breath and skated to the General Surgery Nurse Station. She smiled when she saw Bailey there.
“This is the first step in the beginning of a new life” she stated, pointing to the letters of recommendation in Bailey's hands. “How are we feeling? Positive? Confident?”
Bailey took a deep breath, as if trying to calm down. “I’m good. Great.”
Arizona nodded, crossing her arms. “Peds Surgery is super competitive.” Arizona said, gently trying to poke Bailey. She needed to know if this time the woman was serious about delving into this world. She wouldn’t put her neck on the line for someone unwilling to get on her ship.
Bailey nodded. For the first time in a long time, the great Miranda Bailey found herself wanting to impress an attendant. “That's why I'm armed with letters of recommendation to put the competition to shame. Shepherd says I'm talented and resourceful. Sloan finds it an honor to work with me.”
Before she could continue, Arizona interrupted. “What does the chief think?”
“I'm still working on that.” she promised.
Arizona sighed. “Look, I'm not going to get into a tug war with Richard Webber, Miranda. He's grooming you to take his place, so it's not just his recommendation that matters.”
Bailey looked at her in surprise. “Richard Webber has no decision-making power over my future. You calm down. I've got it under control.”
Arizona smiled. “Good. Because speaking on my behalf, we couldn't be more excited to have you.” Arizona saw Richard coming down the stairs and decided to just skate away. That was a fight she had no interest in getting into.
Bailey almost sighed in relief. She didn't want to go to war with the chief, but that didn't mean Arizona didn't want her as a student.
***
Arizona was analyzing some post-op exams when she felt Calliope approaching. She bit the inside of her cheek trying to stay calm.
Kai appeared beside her. “Here she comes. Try to be smoother than your last conversation.” He said teasingly, winking at Arizona playfully while nudging her shoulder with his.
"Hey," Calliope said, taking a deep breath, resting a hand on the counter.
Arizona turned to her, turning her back to Kai and his theatrics, a big smile on her face. “Calliope. I haven't seen you around!” (Alright, she had seen Calliope watching her through the hospital, but she didn't need to tell her that).
"Well," Callie continued, a big smile on her face. “I've been avoiding you”
Arizona made a false expression of surprise and crossed her arms.
"Is that your best surprise face, woman?!" Kai criticized, but with a fond and exasperated smile on his face. He had never seen Arizona smile so big.
"I know, it's so weird," Callie said, clearly embarrassed by the reddening of her cheeks. “You share a kiss with a woman you've never seen before…”
Arizona's smile faded a little as she saw Callie looking around, as if to make sure no one was listening. Damn, she had forgotten that right now, she was a newbie in the LGBT+ world.
“Honestly, this is a new adventure, one I'm ready to take, for the second time, and… Anyway. Do you want to go on a date with me?”
Arizona tilted her head slightly and smiled. "I would love to."
Callie's eyes widened in surprise. "Oh really?! I mean... This... This is great!”
Arizona giggled softly. She took a piece of paper from her pocket and quickly wrote down her number (old number, current number, Thank God for Kai by her side saying the right one). She steps closer to Callie and puts the paper in her pocket. "I'll wait for your text, Calliope," she murmured, her lips close to Callie's ear before she walked away.
Kai was doing a little dance next to Arizona. “You have a date! You have a date!” He hummed, his bare feet tapping the hospital floor in time with his silly little tune.
Arizona bit her lower lip and couldn’t help but follow Kai’s rhythm. God, she had a date!
***
Callie froze in shock, a huge smile on her face. She honestly thought Arizona would dismiss her. But she had said yes! Her eyes widened. Arizona had said yes. She was expecting a text. She had to plan their date! Callie had never planned a date. God, she had a date!
***
Callie hurried to Bailey's side. Everyone on the surgical staff had heard Bailey sing Arizona’ praises. Bailey was trying to become the woman’s student, for God's sake. She should know Arizona well enough to give some tips, right? Right.
Callie bit her fingernail, waiting for the chief to move away from Bailey. She'd really thought Arizona was going to say something like she wasn't lesbian enough for her, not in a million years did she think she might end up with a date. She tried to approach the other woman casually, leaning over the counter.
"So, Bailey..." she began. "You and Arizona Robbins are kind of friends, right?"
Bailey was way too focused on reading whatever paper she had on her hands to look at Callie. Callie took a deep breath. "Bailey? Bailey, I'm trying to get some help over here."
"The chief..." she started indignantly. "He wrote me a form letter of recommendation." She said showing the paper to Callie.
“What? That's insane. He's the chief, and you're Bailey.” Callie started reading. “Pleasant in the OR and gets along well with the nurses and rest of the staff. She's completed a serviceable amount of research. A fine addition to any program.”
Callie raises her eyebrows in surprise. This couldn’t be a letter about Miranda Bailey, especially not one coming from the chief. The man was practically grooming her to take his place! That’s the best he has to say?!
“Fine! He used the word fine! A blank page would mean more. I pulled off a twelve people domino surgery. I took out and put back six of a dying girl's organs! I'm Dr. Bailey. I'm better than fine!” Bailey marched off furiously.
Callie hurried after her. "Yes, you are! So much that you want to study with Arizona! And I just asked her out and- “
Bailey came to sudden halt and looked at Callie dumbfounded. "Stop. Did you just say that you asked Dr. Robbins out?”
Callie nodded. "And I need help."
Bailey took a deep breath. “You need to not screw it up, because that woman is the best pediatric surgeon I've ever seen. She is almost six weeks without losing a patient. The hospital needs her, and I need her. And now I need to talk to Richard Webber.”
Callie froze in place. Oh, beloved Jesus... What would she do?! She needed Mark. Mark would know what to do.
***
She only found Mark when he came after her… After punching Derek Shepherd. Callie took a deep breath to calm her nerves. Maybe this was not a good time to talk about her love life.
***
Arizona smiled as she saw Callie coming out of the elevator. "Calliope!" She called happily.
Callie turned to her with clearly anxious eyes. "All right! Look, I asked you out, but I don't know how to do that! I kind of just got into this whole girl story… Women. And maybe I'm inexperienced in that. But I am experienced in other things. I mean... I'm a senior resident. I'm a great surgeon. I'm a divorcee., I was in the Peace Corps. Botswana. It was what convinced me to go to med school. And, mostly recently, I've experienced the joy of cooking. And, and maybe now you are thinking you should’ve said no but-” she didn’t seem to be getting anywhere near a pause… Or a breath for that matter.
Arizona bit her lower lip. God, she had almost forgotten how Calliope could get lost into her own head and come to all these conclusions before anything even happened. It was so... Cute. Annoying when it was about decisions in their relationship… But cute. "Calliope?" She interrupted tentatively.
Callie paused for breath, her cheeks burning with embarrassment.
Kai was laughing. "That explains a lot."
Arizona smiled. “Do you want to go out to dinner with me Friday? I'd love to talk more about your experiences.”
Callie smiled with relief. “Yeah. That would be great."
Arizona smiled. "Well, you have my number."
Arizona’s pager started ringing. She pouted. "Damn it. I'd love to hear more, but I need to go.” She approached Callie, her lips almost touching her earlobe. "Bye, Calliope," she muttered breathily before running back to the NICU.
Kai's laugh rang in her ears, but a huge smile was on her face all night long.
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More kindergartners in California were up-to-date on their vaccinations in 2017, following three statewide policies, scientists say.
Two stricter laws on vaccine exemptions and a school admission policy, enacted from 2014 to 2016, were associated with a decrease in the rate of kindergartners who were behind on required vaccinations for nine diseases including measles, mumps, pertussis and chicken pox. The rate, which had increased from 7.8 percent in 2000 to 9.8 percent in 2013, dropped to 4.9 percent in 2017, researchers report online July 2 in JAMA.
“The study illustrates that stricter immunization laws improve vaccination rates,” says Jana Shaw, a pediatric infectious disease specialist at the State University of New York Upstate Medical University in Syracuse not involved in the research.
Other states can learn from California’s experience, she says, “and adopt laws that would protect children at schools from vaccine-preventable diseases.”
States can allow children to forgo vaccines for medical reasons or religious or personal beliefs, although which exemptions are permitted depends on the state. A law making it harder to obtain a vaccine exemption based on personal beliefs took effect in California in 2014. Two years later, another law got rid of personal-belief exemptions altogether. And in 2015, the state’s department of health tightened requirements for allowing children who are behind on their immunizations to begin school.
To examine the effect of the three initiatives, researchers analyzed school-entry data for more than 9 million California children from 2000 to 2017. Along with the drop in the rate of kindergartners not caught up on required vaccinations, the chance of two kindergartners behind on vaccinations coming into contact with each other at school fell from 26 percent in 2014 to 4.6 percent in 2017.
There were also fewer schools located in geographic pockets with a high concentration of kindergartners behind on vaccinations: 1,613 schools in 110 areas in 2016–2017, a drop from 2012–2013 when there were 3,026 schools in 124 areas.
These findings suggest that “the risk of a disease outbreak also decreased over the course of the interventions,” says Cassandra Pingali, a public health researcher who worked on the study while at Emory University in Atlanta. Areas that contain many unvaccinated people or those behind on vaccinations can diminish herd immunity, which describes how many people in a population need to be vaccinated to stop a pathogen from spreading (SN Online: 4/15/19).
Because the three measures were implemented over a short period, with some overlap, the researchers were unable to tease out the effect of each policy separately, says Pingali, who is now on a fellowship with the U.S. Centers for Disease Control and Prevention in Atlanta.
The researchers also noted that with the elimination of personal exemptions, the rate of medical exemptions went up, from 0.19 percent in 2013 to 0.73 percent in 2017. That could be because some parents found ways around the personal-exemption ban by instead getting medical exemptions for their children.
As of June 27, there were 1,095 confirmed cases of measles in 28 states this year, making it the country’s biggest outbreak in 27 years, according to the CDC. In May, Maine joined California, West Virginia and Mississippi in permitting exemptions for medical reasons only, a policy then adopted by New York in June. In a narrower change this year, Washington removed the personal belief exemption specifically for the combined measles, mumps and rubella vaccine.
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Colombia grants citizenship to 24,000 children born to Venezuelan mothers
https://wapo.st/2OFtRQO
Colombia grants citizenship to 24,000 children born to Venezuelan mothers
By Dylan Baddour | Published August 05 at 11:07 AM ET | Washington Post | Posted August 5, 2019 |
BOGOTA — Colombia granted citizenship Monday to more than 24,000 children born to Venezuelan migrants on its territory since 2015, as well as to all those who will be born in the next two years, in an effort to address a growing problem in one of the world’s largest refugee crises: undocumented babies.
“Today we can say, amid difficulties, that the way of xenophobia is not the right way,” President Iván Duque told an assembly of U.N. officials, representatives of other nongovernmental organizations and Colombian officials at the presidential palace. “In defense of brotherhood, we will attend to this situation.”
Most nations in the Americas confer citizenship on babies born on their territory automatically, but Colombia requires at least one parent to have legal residence. Duque’s decree loosens that standard, the latest move aimed at accommodating the continuing rush of refugees from neighboring Venezuela into this country.
More than 4 million have fled the hyperinflation, blackouts, and shortages of water, food and medicine of Venezuela under President Nicolás Maduro, according to the U.N. refugee agency. Nearly 1.5 million have ended up in Colombia.
Officials here say Duque’s decree will protect a generation of children.
“The Colombian government has been firm in its commitment to rise to the height of ethical responsibility and offer help to the Venezuelans who feel forced to leave their country,” Felipe Muñoz, appointed by Duque to manage the Venezuelan border, wrote in response to questions from The Washington Post. “Let’s remember that decades ago it was they who received us Colombians in their country, when the situation was inverse and it was us fleeing difficult local conditions.”
Poverty and conflict have displaced more people in the world today than at any time in human history. Some countries, including the United States, have responded by tightening borders and immigration policies. Amal de Chickera, co-director of the Institute on Statelessness and Inclusion in London, praised Colombia for taking the opposite approach.
“In the current global climate, to see Colombia actually going the other way and taking a decision to meet its obligations under international law, it’s incredibly heartening,” he said.
Nine-month-old Rossani Tua is now one of Colombia’s newest citizens.
Her parents, Nixon, 35, and Rossana, 33, traveled 10 hours by bus from their home in the northwestern state of Lara, Venezuela, in late 2017. Then they walked and hitchhiked to Bogota, the capital. They slept in a park for a time, then found shelter with a good Samaritan before eventually settling in a brick shack in La Magdalena, a bustling slum where people survive by collecting, sorting, cleaning and recycling the city’s garbage.
Rossana gave birth to Rossani in November. If she’d had a Colombian visa, the child would have been a citizen at birth. But because she has no nationality, Rossani’s parents have been unable to obtain the documentation, such as a national ID card or passport, that would enable her to access public services or travel.
“We have her practically in limbo,” said Rossana, holding the baby in the door of their small home. “She’s not Venezuelan or Colombian. She doesn’t have a right to anything. We don’t know what to do.
Miriam Rivera is director of the Karol Wojtyla Foundation, an organization in Bogota that provides legal guidance to immigrants.
Not only will the decree benefit the children, she said, but it also will provide a path to citizenship for immigrant parents, who under Colombian law can earn nationality through their children.
Colombian Foreign Minister Carlos Holmes Trujillo said the measure will be reviewed in two years and could be prolonged.
Trujillo blamed the problem on “insuperable obstacles” created by the Venezuelan consular service to register the children for Venezuelan citizenship.
“Those children have a right to Venezuelan nationality,” he said. “But it’s been practically impossible.”
It’s the latest effort by the government here to accommodate the Venezuelan influx.
The country has loosened ID requirements for Venezuelans to enter, offered special residence and work permits to migrants, and opened public schools to their children.
The special relationship between the two countries goes back two centuries, leaders here often recount, when Simón Bolívar led a ragtag army from Venezuela to liberate Bogota from Spanish rule. For a time, they were both part of a single nation — Greater Colombia — that also included present-day Ecuador, Panama and parts of Brazil, Guyana and Peru.
More recently, tensions between a succession of center-right governments in Bogota and the socialist governments of Maduro and Hugo Chávez have been strained. But Duque still speaks of “our Venezuelan brothers and sisters” when addressing migration.
“Today we are giving a light of hope to thousands of kids and to thousands of families,” Duque said Monday. “We can show that in these moments of difficulty, fraternity prevails.”
Colombia’s policies on Venezuelan migrants have increasingly set it apart. Peru, with nearly 800,000 Venezuelans, and Chile and Ecuador, with nearly 300,000 each, have tightened restrictions on Venezuelans crossing their borders — although all grant birthright citizenship.
Humanitarian groups have applauded Colombia’s approach.
Marianne Menjivar, Colombia director for the International Rescue Committee, called the citizenship decree “a testament to Colombia’s pro-refugee stance, one which is increasingly under threat in the region and which deserves international support.”
She said other South American countries should prioritize registration and legal status for Venezuelan refugees, followed by programs for social and economic integration.
The Organization of American States last month predicted that the Venezuelan exodus would surpass the 6.7 million people who fled the Syrian civil war by 2020 to become the world’s largest.
The organization said international funding for the Venezuelan crisis amounts to about $100 per person displaced. For the Syrians, the figure peaked at $5,000.
That has left Colombia mostly on its own to foot the bill for the humanitarian crisis spilling over its border.
Duque called on other nations to offer more support.
“This requires that the world does not remain indifferent,” he said.
Children have proved costly, drawing state funding for birth services and space in public schools. Thousands of Venezuelan mothers have migrated to Colombia specifically to give birth.
For Osmari Cemplin, 18, delivering in her Venezuelan hometown of Maracaibo would have meant buying medical supplies she couldn’t afford, so her family pooled their money to help her move in with a cousin in Bogota, where she gave birth last year.
Her son, Yonaiker, has no citizenship. When he was 2 months old, he came down with a fever, and some months later, his face and eyes swelled up. But undocumented immigrants are eligible to receive only emergency treatment free, and the family couldn’t afford anything more.
“They said I’d have to bring her in almost dead to tend to her,” she said. “We all went home and cried.”
Maikely Rojas, 18, delivered Matias in Bogota two years ago. But she and her husband struggle to feed themselves, and their son wears clothing for a 6-month-old.
Rojas said that she has asked for nutritional assistance and pediatric care from state hospitals, but her son doesn’t qualify.
As a Colombian citizen, he will.
#u.s. news#politics#trump administration#politics and government#us: news#international news#must reads#immigration#migrant crisis#refugees#human rights#humanrights#human trafficking#Venezuela
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Swipe left! This is two reference guides to a method of estimating the percentage of body surface area in burns. This is an EMT and Paramedic level skill by NREMT.
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The rule of nines is simple, each part of the body is given a percentage, either a multiple or a number divisible of 9. The only variation is adult genitalia is worth 1% and pediatric legs are worth 14% total for each leg.
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An alternative method of estimating BSA in burns is to use the rule of ones, or the palmar method. This is where you’d take the circumference of the PATIENTS palm and see how many palms would fit over the burn. Each palm is worth 1%. You don’t have to physically take their palm and measure it out, but you’d estimate to the best of your ability.
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When communicating burns to other providers, you want to give the percentage of burn for each degree. If you have both 2nd and 3rd degree burns, the other provider will be expecting to know what percentage of 2nd degree burns exist and what percentage of 3rd degree burns exist.
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Total BSA burned is important to know for both communicating burns as well as calculating fluid resuscitation.
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There are plenty of apps & resources you can use to determine the BSA of burns, but you shouldn’t need to rely on them if you know your job.
#ems#emslife#emt#emtlife#emergency medicine#ambulance#paramedic#medic#medblr#emergency#code green campaign#emergency medical technician#code green#emergency medical services#emsblog#911#medicine#first responders#ambulance driver#codegreencampaign#emergency services#hospital#not just an ambulance driver#emergency room#flight ambulance#savingpublicsafety#trauma center#firefighter#medical#combat medicine
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NAME: Lisa
TIMEZONE: GMT+1
PREFERRED PRONOUNS: She/her
WHO DID YOU APPLY FOR? OR ARE THINKING OF APPLYING FOR?: I got three babies coming in because what is self-control?? So buckle up fam this might get fucking long:
First of all, meet MATEO DE LUCA. Thirty-six years old. He was born and raised in New Orleans in a pretty fucking poor family. They often didn’t have enough to eat and he also never got to go on school trips or whatever so he was the odd one out for a very long time. Was blessed with a super smart brain though and used that to his advantage for amazing grades and a scholarship in medicine. Specialized in pediatric and neonatal surgery over the years. Got quite the perfect life going on for him for a while, and naive as he is, he never thought it could go downhill. Married his best friend, bought a house, got a super cute dog and eventually they had a son. Their son died only a little over a year after his birth of cancer though and that threw Mateo in a super big black hole. His marriage crumbled because his wife ran away from him instead of mourning with him (think Jackson and April vibes if you’ve ever seen Grey’s Anatomy okay) and they got divorced about a year ago. He’s still picking up the pieces, moved into a new house with his dog, turned into a true workaholic and when he’s not working he’s usually drinking. Got that sad puppy face going for him 24/7.
Secondly, there is SOFIA CORINTHOS. Twenty-eight years old. Aka Queen B, aka a princess, aka one of the most sarcastic bitches you’ll see walking down the streets of New Orleans. Was born into the infamous Corinthos family, and although she was indeed often treated like a princess, she was also often misunderstood by her family and ruled out as weak as a child. Eventually started to build herself an armor to hide her ‘weaknesses’ and soft sides behind. Drowned her thoughts in liquor from an early age on, and could wrap girls and boys alike around her finger at sixteen as if she’d been doing it for decades. Never really learned how to work for something, and wasn’t really involved with her family’s crimes either because her father didn’t trust her with that anyway. She blames herself for her brother’s death as they attended the same party together where he overdosed at, but she never told anyone how she feels about the whole thing. She just started drinking and fucking around more because why not? Eventually her daddy told her to start working for her lifestyle or he cut her off and now she owns La Dolce Vita, which is a coffee shop but actually just a front for some shady drug deals. It’s not like she really lifts a finger though, she just cures her hangovers with coffee or pretends to listen to meetings. Will joke about murder and crimes wherever she can ( much to her daddy’s dislike ), because that’s the only thing that gives her joy tbh.
Last but not least, OLIVIA SLADE. Twenty-nine years old. This girl is literally the purest and most innocent little rainbow you’ll find around New Orleans. Got a twin sister, was their parents’ favorite but not a REAL favorite because she didn’t go out enough and talked too much about fictional characters for their liking. Was always seen with a book in her hands as a child, and after being bullied, tricked and used one too many times by so called friends, she just decided to give up on that aspect of life all together. Her sister is her best friend pretty much, and outside of her books all she ever cared about was make up. She had her first kiss at eighteen, and that’s about all there is to it. Yes, girl is still a virgin, and also has no clue whether she wants to change that, or how to change that. Is a freelance make up artist and traveled around the world for a handful of years to perform jobs wherever she was needed. Had some hook ups here and there, but never went all the way because she was too afraid to be hurt in the end. Eventually returned to New Orleans to settle down. Got herself a small house and basically runs her one-man-make-up business from there. If there’s a party, wedding or whatever other occasion in town, she’ll gladly do anyone’s make up. Talks too much when she drinks and doesn’t know how to take compliments. Loves dogs and animals in general.
GIVE US THREE HEADCANONS ABOUT YOUR CHARACTER(s). CAN BE ANYTHING!:
For Mateo:
He can’t sleep alone. After sharing the bed with his ex-wife for so many years, he just can’t sleep when one side of the bed is empty. He either doesn’t sleep, falls asleep on the couch, or lets his dog sleep next to him.
Mateo has the first and last heartbeat of his son tattooed onto the inside of his left upper arm.
Mateo has actually been struggling a lot more with losing patients since he lost his own child. It’s like he has to watch his son die over and over again whenever one of his patients doesn’t make it, and it’s slowly but surely breaking him.
For Sofia:
Sofia is afraid of the dark. She has never told anyone about this, but she usually sleeps with some sort of lights on, whether it’s just some fairy lights, her laptop, or the lamp on her night table. She also always has the flashlight on her phone on when she’s out at night in the darkness.
Sofia has an addiction for pretty lingerie. A big portion of her wardrobe consists of nothing but underwear, and she’s not ashamed to just stare at herself in it in the mirror forever, that’s how much she loves herself to be honest.
She loves to pierce her ears. Her left ear is pretty much full of piercings by now, and she intends to do the same with the right side.
For Olivia:
Olivia writes short stories. Not all the time though, and she’s never shown them to anyone, nor has she ever told anyone about them. It’s a very personal thing to do for her, to let out her emotions mostly.
Olivia is dying to have a small tattoo, but is too afraid to do it. Needles scare her, which is also why she hardly goes to the doctor, no matter how sick she is.
She has a soft spot for rescuing kittens that have no home. She never keeps them though, even if she very badly wants to.
WHAT SORT OF PLOTS ARE YOU HOPING TO DO?: In general, I want all the friendships in my life because those are literally my favorite dynamics, as well as family ties. Also, I’m hoping to explore the relationship between Mateo and his ex-wife. There’s a lot of unresolved tension there, a lot of hidden pain that could explode in one big chaos and I’m here for the angst tbh. I’m also here for people Sofia can drive nuts, whether in good or bad ways, but also maybe someone who manages to show her the way back to her roots, and lets her be more of who she truly is inside, who lets her be soft instead of always strong. As for Olivia, give me all the people for her support system! People who make her feel loved, people who have her back, just people who love her for who she is in general because I’m here for pure, irrevocable support basically.
DID YOUR CHARACTER HAVE ANY RELATION TO ELIZABETH?: Mateo and Olivia hardly came into contact with Elizabeth, but Sofia ran into her at parties every once in a while -- she wasn’t a big fan of her though, and therefore hardly cares about her death either.
WHO DO YOU THINK KILLED ELIZABETH? DO YOU HAVE ANY THEORIES?: I guess we’ll all wait and see ;)
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Dozens of unexplained cases of liver inflammation seen in UK children
U.K. health officials are investigating dozens of cases of unexplained hepatitis, or liver inflammation, that have recently emerged among young children there. Similar cases of pediatric hepatitis have also been reported in the U.S. and Spain.
Some of the affected children in the U.K. have required assessment at specialized centers and a “small number” of kids have undergone liver transplantation procedures, the U.K. Health Security Agency (UKHSA) announced on April 8. Although hepatitis viruses (hepatitis A, B, C, D and E) are often the cause of hepatitis, these viruses have been ruled out, the statement said. Potential complications of hepatitis include liver failure and death, and liver transplants are typically used to treat end-stage liver failure, according to Stanford Children’s Health.
“That’s the only definitive treatment for acute liver failure,” said Dr. Rachel Tayler, a pediatric gastroenterologist at the Royal Hospital for Children in Glasgow.
Tayler and her colleagues authored a report about recent hepatitis cases among children in Scotland, which was published Thursday (April 14) in the journal Eurosurveillance. In most of these cases, the children recovered with only supportive care in the hospital, which involved maintaining their fluid levels and nutrition and monitoring for blood clots. However, in a minority of cases, children needed to be assessed for potential liver transplants, and in some cases, underwent transplant surgery, Tayler told Live Science.
Related: Nobel Prize in Medicine goes to discoverers of hepatitis C
As officials continue to investigate the cause of these severe acute hepatitis cases, clinicians have been urged to look out for potential signs and symptoms of liver inflammation in pediatric patients, the UKHSA statement reads. The condition is sometimes preceded by gastrointestinal symptoms, including vomiting and abdominal pain, and affected children often develop jaundice, meaning yellowing of the skin or the whites of the eyes. “In milder cases, it can be quite difficult to see,” Tayler noted.
Other potential symptoms of hepatitis include dark urine, pale feces, itchy skin, joint stiffness, muscle pain, fever, nausea, abdominal pain, lethargy and loss of appetite, according to the UKHSA statement.
“Parents should be cautioned to take seriously children who have severe vomiting or who develop jaundice and should seek medical attention immediately if these occur,” Dr. Jeremiah Levine, director of the Division of Pediatric Gastroenterology at NYU Langone Health, who was not involved in the investigation, told Live Science in an email. Children should wash their hands to prevent potential exposure to viruses that can cause hepatitis, Tayler said. If any kids catch an infection, they should be kept home to prevent spread of the germ, she added.
As the investigation unfolded in the U.K., another cluster of unexplained pediatric hepatitis cases was reported in the United States.
Dr. Hannah Kirking, a medical epidemiologist for the Centers for Disease Control and Prevention (CDC), informed the Eurosurveillance report authors that the U.S. agency is investigating a cluster of hepatitis and adenovirus cases among children in the country. Specifically, nine such cases have been reported in children ages 1 to 6 in Alabama, according to STAT. These cases occurred between October 2021 and now.
Three additional hepatitis cases have been reported in Spain, in children between 22 months and 13 years old, the World Health Organization (WHO) reported Friday (April 15). Five more confirmed or possible cases have been reported in Ireland and are now under investigation, the WHO noted.
In general, severe acute liver disease in children is “relatively uncommon but occurs occasionally,” Levine said. These bouts of severe liver disease tend to be caused by an infectious agent, like a virus, but that said, affected children should undergo a complete evaluation to check that they don’t have an underlying metabolic disorder, Levine added.
In regard to the hepatitis cases in U.K. children, “what is unusual is the number of patients affected and the clustering of cases in the U.K.,” Levine said. “The severity is unfortunately relatively typical.”
Related: How do you die from hepatitis A?
In England, there are 60 cases of pediatric hepatitis under investigation, most in children ages 2 to 5, according to UKHSA. And so far, 13 cases have been identified among young children in Scotland, according to the Eurosurveillance report.
The first cases in Scotland were reported on March 31 by the Scottish NHS. Within a three-week period, five children, ages 3 to 5, had been brought to the Royal Hospital for Children in Glasgow with severe hepatitis of unknown cause. In a typical year, fewer than four unexplained hepatitis cases are reported in Scotland, the report notes.
“Very quickly, over the course of a week, I had seen four, and then five [cases],” Tayler told Live Science. “The initial cases all presented with jaundice … what the parents picked up is that the children had just gone yellow.”
After the NHS issued its alert about the cases, Public Health Scotland (PHS) launched an investigation into these first five cases, which are described in detail in the Eurosurveillance report. Clinicians tested the children’s blood upon admission and found “exceptionally high” levels of alanine aminotransferase, a liver enzyme whose quantity tends to increase in the blood after liver damage.
Three out of the five children were transferred to specialized centers in England to be evaluated for liver transplant, and one child received a transplant.
After investigating these five cases, the PHS team launched a wider investigation to see if any other children had been admitted to Scottish hospitals with unusually high liver enzyme levels or jaundice of unknown cause. Through this search, they identified eight additional cases of acute hepatitis of unknown origin in children between 3 and 5 years old, bringing the total number of cases to 13. Twelve of these cases occurred in March and April, and the other case occurred in January.
All the children had been admitted to a hospital for at least six days as of April 14, and five were still hospitalized, including the one who’d undergone transplant surgery in England.
Four of the 13 children had tested positive for SARS-CoV-2, the virus that causes COVID-19, in the weeks or months before their hospitalization; and one tested positive on a rapid test for the coronavirus upon their admission, but this result was not confirmed with a PCR test. Five of 13 children tested positive for adenovirus on a PCR test of their blood, stool or throat swabs at the time of admission.
What is causing these cases?
The cause of these hepatitis cases remains unknown, but officials suspect that the culprit to be an infectious pathogen or a toxic exposure to contaminated food, drinks or toys, the Eurosurveillance report noted. An infectious agent is considered the more likely cause at this point, based on the nature of the cases and their timing, the report added. Levine told Live Science that he also thinks “an infectious etiology is more likely than a toxic exposure.”
The leading hypothesis, for now, is that an adenovirus might be the underlying cause, the Eurosurveillance report authors wrote. This adenovirus might be “either a new variant with a distinct clinical syndrome or a routinely circulating variant that is more severely impacting younger children who are immunologically naïve,” they noted.
“With all the social distancing, children for the last two years may not have been exposed to the common viral pathogens and that may lead them to be more susceptible to adenovirus or other similar viral infectious [agents],” Levine told Live Science.
“We have a group of children [whose] immune system has evolved in a very different way to what it would have done normally, in terms of exposure to common viruses,” Tayler said, echoing Levine’s sentiment.
That said, as an alternate theory, “this may be related to some new SARS-CoV-2 variant,” Levine suggested. U.K. children below age 5 are not currently cleared to receive any COVID-19 vaccines, so none of the children in their report had been vaccinated against the virus, Tayler noted.
Analyzing samples of liver tissue from the children, especially those who required transplants, may help reveal the underlying cause of the disease, Levine said. These sorts of analyses are being conducted in England, Tayler confirmed.
Originally published on Live Science.
New post published on: https://livescience.tech/2022/04/15/dozens-of-unexplained-cases-of-liver-inflammation-seen-in-uk-children/
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More than 6,200 vaccination appointments booked for children aged five to 11 in New Brunswick
New Brunswick announced Wednesday that more than 6,200 appointments have booked for children aged five to 11 to receive their first dose of the pediatric COVID-19 vaccine.
Tuesday was the first opportunity parents and guardians had to book an appointment online at vaccination clinics offered through Vitalité and Horizon health networks.
“It is wonderful to see so many appointments booked for the clinics, which are starting across the province on Friday,” said Dr. Jennifer Russell, chief medical officer of health.
“This is an important step forward in reducing the spread of the virus and protecting all New Brunswickers.”
CASE NUMBERS
New Brunswick reported 87 new cases of COVID-19 on Wednesday, along with 60 recoveries, brining the total number of active cases in the province to 692.
According to the province, 19 of the new cases are in the Moncton region (Zone 1), and include:
• six people 19 and under;
• two people 20-29;
• four people 30-39;
• two people 40-49;
• a person 50-59;
• two people 60-69; and
• two people 70-79.
Seventeen cases are under investigation and two cases are contacts of previously confirmed cases.
The 29 new cases in Zone 2 (Saint John region) are as follows:
• 10 people 19 and under;
• five people 20-29;
• two people 30-39;
• four people 40-49;
• two people 50-59;
• five people 60-69; and
• a person 80-89.
Twenty-two cases are under investigation and seven are contacts of previously confirmed cases.
The 20 new cases in Zone 3 (Fredericton region) are as follows:
• six people 19 and under;
• a person 20-29;
• three people 30-39;
• three people 40-49;
• four people 50-59;
• a person 60-69; and
• two people 70-79.
Seventeen cases are under investigation and three are contacts of previously confirmed cases.
The two new cases in the Bathurst region (Zone 6) are as follows:
• a person 20-29; and
• a person 50-59.
One case is a contact of a previously confirmed case and the other case is under investigation.
The 17 new cases in the Miramichi region (Zone 7) are as follows:
• four people 19 and under;
• three people 20-29;
• a person 30-39;
• five people 40-49;
• a person 50-59; and
• three people 60-69.
Nine cases are contacts of previously confirmed cases and eight cases are under investigation.
Health officials say, of the new cases, 35 per cent are unvaccinated, eight per cent are partially vaccinated, and six per cent are fully vaccinated.
CLIMBING CASES
There is concern that the climbing cases could interrupt a ‘normal’ holiday season.
Opposition leader Roger Melanson questions if enforcement should increase to get things under control.
“Some people were not respecting the circuit breaker, so that’s off the table now,” he said.
“Public safety needs to, in my opinion, show more enforcement and make sure that people are respecting the rules in place, because the rules are there to protect everyone, even the people that obviously do not respect the rules.”
Health minister Dorothy Shephard says they’re keeping a close eye on the case numbers, but their “real key indicator is how many are in hospital, how many are in the ICU and can we manage that?”
“Most of the transmissions are in households,” said Shephard.
“So we really need to go back to the basics for a bit to see how this is going to work, and then we’re going to have to address what our holidays might look like.”
Premier Blaine Higgs acknowledged “following the rules is a challenge” and said they’ll never catch every single person who is not adhering to public health measures.
“So where we’re really focused is hospital count. And you know, we could all test positive but if we’re all vaccinated, then it is what it is. But it’s how do we manage the hospitals, and not lose control because that’s where the weakness could be,” said Higgs.
CONFIRMED CASES IN SCHOOLS AND CHILD-CARE FACILITIES
A case has been confirmed at New Maryland Kidz Klub in Zone 3 (Fredericton region). If you or a family member have been in close contact with a case, you will be notified by Public Health or the facility for contact tracing. If you are not notified directly, you have not been identified as a close contact.
Since Sept. 7, 87 early learning and child-care facilities have had confirmed cases of COVID-19.
CASE BREAKDOWN
There are 45 people in hospital. Of these 45, 11 contracted the virus while hospitalized for other reasons due to the ongoing outbreaks in certain units at the Moncton Hospital.
Nineteen people are in an intensive care unit, 10 per cent of those cases are unvaccinated, three per cent are partially vaccinated, and one per cent are fully vaccinated.
To date, 550,858 COVID-19 tests has been conducted in New Brunswick.
CASE LOCATIONS
The number of cases are broken down by New Brunswick’s seven health zones:
• Zone 1 – Moncton region: 2,390 confirmed cases (248 active cases)
• Zone 2 – Saint John region: 1,006 confirmed cases (143 active cases)
• Zone 3 – Fredericton region: 1,576 confirmed cases (169 active cases)
• Zone 4 – Edmundston region: 1,462 confirmed cases (8 active cases)
• Zone 5 – Campbellton region: 688 confirmed cases (2 active cases)
• Zone 6 – Bathurst region: 312 confirmed cases (13 active cases)
• Zone 7 – Miramichi region: 459 confirmed cases (109 active cases)
VACCINATION UPDATE
The province says 87.6 per cent of eligible New Brunswickers are fully vaccinated against COVID-19 and 93.5 per cent have received their first dose of a vaccine.
In total, 1,260,532 vaccine doses have been administered in New Brunswick.
Health-care personnel, including those working in long-term care facilities, and residents of First Nations communities can now book an appointment to receive an mRNA COVID-19 booster dose if six months have passed since their second dose of a vaccine. They must bring their proof of vaccination, i.e. immunization record, to their appointment.
People 65 and older and school personnel are permitted to book an appointment to receive an mRNA COVID-19 booster dose if six months have passed since their second dose of a COVID-19 vaccine.
Fully vaccinated people who have received one or two doses of the AstraZeneca vaccine in their series are permitted to book an appointment to receive an mRNA booster dose if 28 days have passed since their second dose.
International travellers with mixed first two doses of vaccine products are eligible to book an appointment to receive a booster dose of an mRNA COVID-19 vaccine. This applies to anyone who must travel outside of North America for work, education or medical procedures. A booster dose of an mRNA vaccine will be available as long as a 28-day interval has passed since their previous dose.
A detailed list of those eligible for a booster dose is available online.
Appointments for first and second doses, as well as a booster dose for those eligible, can be scheduled for a regional health authority community COVID-19 vaccination clinic through the online booking system or at a participating pharmacy. Residents of First Nations communities can also book an appointment at a community clinic.
A list of upcoming mobile and walk-in clinics is available online.
POTENTIAL PUBLIC EXPOSURES
A full list of potential COVID-19 exposure notifications in New Brunswick can be found on the province's website.
Anyone with symptoms of the virus, as well as anyone who has been at the site of a possible public exposure, is urged to request a test online or call Tele-Care at 811 to get an appointment.
from CTV News - Atlantic https://ift.tt/3xs3DEf
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