Introduction: Thoughts and ideas on the intersectionality of identity

An introduction to the journal is presented which the editor discusses an article on critical race feminism by Venus E. Evans-Winters and Jennifer Esposito, a report on critical race theory and critical pedagogy and a review of literature on the educational experiences of Latinas and Latinos in the U.S

Landslide Stabilization at Missouri Route K Bridge over Blackwater River

In May 2002, a landslide on the south bank of the Blackwater River damaged the Missouri Route K bridge that crosses it. A flood on the river triggered the landslide. Based on the field investigation and stability back-analysis, it appeared that the landslide actually consisted of two separate slides – a shallow slide triggered by rapid drawdown of the river and a deep slide triggered by artesian water pressures in a subsurface gravel layer. A rock berm that was keyed into the gravel was constructed to stabilize the slope. The rock toe berm was designed to resist both the shallow and deep slide by providing weight to the slope to prevent a rapid drawdown failure and providing a drainage outlet to relieve artesian pressures in the gravel layer

Healthcare utilization and spending by children with cancer on Medicaid

BackgroundChildren with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization.ProcedureWe performed a retrospective, cross‐sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0–18 years) with cancer (Clinical Risk Group 8). Healthcare utilization and spending (per member per month, PMPM) were assessed overall and across specific healthcare services.ResultsChildren with cancer (n = 5,405) represent less than 1% of the 1,516,457 children with medical complexity in the dataset. Children with cancer had high services use: laboratory/radiographic testing (93.0%), outpatient specialty care (83.4%), outpatient therapy/treatment (53.4%), emergency department (43.7%), hospitalization (31.5%), home healthcare (9.5%). PMPM spending for children with cancer was $3,706 overall and$2,323 for hospital care.ConclusionChildren with cancer have high healthcare resource use and spending. Differences in geographic distribution of services for children with cancer and the trajectory of spending over the course of therapy are areas for future investigation aimed at lowering costs of care without compromising on health outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138316/1/pbc26569_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138316/2/pbc26569.pd

Reflux related hospital admissions after fundoplication in children with neurological impairment: retrospective cohort study

Objective To examine the impact of fundoplication on reflux related hospital admissions for children with neurological impairment

Trends in Resource Utilization by Children with Neurological Impairment in the United States Inpatient Health Care System: A Repeat Cross-Sectional Study

Jay Berry and colleagues report findings from an analysis of hospitalization data in the US, examining the proportion of inpatient resources attributable to care for children with neurological impairment

Metachromatic Leukodystrophy: A Case of Triplets With the Late Infantile Variant and a Systematic Review of the Literature

Metachromatic Leukodystrophy is a rare disorder with great clinical variability. We report the first case of triplets with the late infantile form of the disease and their systematic progression of symptoms. We reviewed the literature and identified all human studies that reported new cases since 1921. We analyzed survival by decade to assess the impact of historical changes in management of care. Mean age at death and 5-year survival from onset of symptoms for late infantile, juvenile and adult phenotype were 4.2 years and 24.9%, 17.4 years and 70.3%, and 43.1 years and 88.6% respectively. 5-year survival of cases reported after 1990 was significantly better than cases reported before 1970 in all subtypes of metachromatic leukodystrophy (late infantile: 52% vs. 14%, juvenile: 100% vs. 46%, adult: 95% vs. 67%). Survival in the late infantile subtype was worse than in other subtypes. Survival significantly improved over time in all subtypes