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U.S. heart-transplant rules to save children not effective – Study

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U.S. heart-transplant rules to save children not effective – Study

A U.S. rule meant to increase the number of heart transplants for the sickest children has not resulted in improved survival, a new study has found.


The March 2016 change in how organs are allocated gave first priority to children born with significant heart defects, such as when most of the left side is missing.

Those with a kind of pumping deficiency called cardiomyopathy, on the other hand, were in most cases given lower priority – on the theory that their cases were more manageable with medication.

But since the change took effect, physicians have been more likely to seek special exceptions for certain cardiomyopathy patients, bumping them up to top-priority status and partly undoing the intent of the policy, the authors wrote in the American Journal of Transplantation.

Survival rates did not improve among any categories of children waiting for heart transplants, and the rates even got a bit worse for patients with certain kinds of cardiomyopathy, who were not assigned top-priority status.

The study authors did not fault the physicians, who sought exceptions, as they were trying to save the lives of desperately ill children.

But the policy language that allows for the exceptions may be “too loosely worded,” said senior author Brian Feingold, medical director of pediatric heart failure and heart transplantation at UPMC Children’s Hospital of Pittsburg.

“There is no ill intent here. Obviously we have to prioritise, and we have to do it in the best way possible to maximize survival,” Feingold added.

He said it could be hard to predict which children were in greatest need of a transplant, in part because there were few of them overall, encompassing a wide range of complex conditions.

Each year, roughly 50 to 70 children die while waiting for a donor heart, according to the U.S. Organ Procurement & Transplantation Network.

“I would love to have a tool, a calculator that I could plug in various characteristics of a patient’s case and understand with good certainty whether this was a patient who had two weeks to survive, three months to survive, or three years to survive.

“We don’t have that,” he added.

At Children’s Hospital of Philadelphia, pediatric cardiologist Matthew O’Connor said he had obtained exceptions as allowed by the policy, acquiring the highest priority on the wait list for the most gravely ill cardiomyopathy patients.

Many such patients can delay the need for a transplant by getting an implanted pump called a ventricular assist device but some smaller children might not be good candidates for the device, leaving a transplant as the best option, said O’Connor, who was not involved with the study.

He agreed with the study authors that better tools are needed to predict survival.

“I think it’s still showing that we are having a difficult time determining who really the sickest patients are in our field,” he said.

The head of the national committee that oversees pediatric heart transplant allocation policy, Dallas-based pediatric heart surgeon Ryan Davies, was not available for comment.

To obtain top-priority status for a heart-transplant candidate who would not otherwise qualify, a physician must demonstrate “using acceptable medical criteria, that a heart candidate has an urgency and potential for benefit comparable to that of other candidates at the requested status,” according to the policy.

Physicians were most likely to obtain exceptions for patients with a form of cardiomyopathy called “dilated,” in which the ventricle is stretched thin and cannot pump as strongly.

Some were younger than one year of age.

In the region of the national organ-transplant system that includes Pennsylvania and New Jersey, patients with dilated cardiomyopathy were significantly more likely to obtain top-priority exceptions after the policy was changed.

From December 2011 to March 2016, two out of 57 candidates in the region obtained that type of exception – a rate of less than 4 per cent.

From March 2016 to Sept. 2018, nine of 32 regional candidates obtained that type of exception, a rate of 28 per cent.

FAT/YEE

(NAN)
Edited by Fatima Sule/

Fatima Sule: is a graduate and a professionally trained journalist, with experience in national news reporting/editing and verification at the News Agency of Nigeria. NNN is a Nigerian online news portal that publishes breaking news in Nigeria, and across the world. Our journalists are honest, fair, accurate, thorough and courageous in gathering, reporting and interpreting news in the best interest of the public, because truth is the cornerstone of journalism and they strive diligently to ascertain the truth in every news report. Contact: editor[at]nnn.com.ng

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Study shows 75 pct of Australians hold bias against Aboriginals

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Around 75 percent of Australians hold an implicit bias against indigenous people which may lead to widespread racism, according to a study released Tuesday.


Most Australians tested for unconscious bias hold a negative view, regardless of gender, age, ethnicity, occupation, religion, education level, geography or political leanings, said the findings from the study from the Australian National University (ANU).

The researchers analyzed data from the Implicit Association Test conducted by a joint initiative of universities including Harvard, Yale and the University of Sydney, covering 11,099 Australians over a 10-year period.

The findings, from the first survey of its kind for Australia, were published in the Journal of Australian Indigenous Issues.

“These results show there may be an implicit negative bias against Indigenous Australians across the board, which is likely the cause of the racism that many First Australians experience,” said Siddharth Shirodkar, a researcher based in the ANU College of Arts and Social Sciences and author of the study.

“This study presents stark evidence of the solid invisible barrier that Indigenous people face in society,” Shirodkar added.

(XINHUA)

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Children play at Pavilion of Knowledge – Ciencia Viva Centre in Lisbon

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PORTUGAL-LISBON-CHILDREN-SCIENCE” src=”https://nnn.com.ng/wp-content/uploads/2020/06/139108670_15911009255981n.jpg” sourcename=”本地文件” sourcedescription=”网上抓取的文件”>


PORTUGAL-LISBON-CHILDREN-SCIENCE” src=”https://nnn.com.ng/wp-content/uploads/2020/06/139108670_15911009255981n.jpg” sourcename=”本地文件” sourcedescription=”网上抓取的文件”>

Children play at the Pavilion of Knowledge – Ciencia Viva Centre, a scientific and technological space, in Lisbon, Portugal on June 1, 2020, the International Children’s Day. (Photo by Pedro Fiuza/Xinhua)

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Spotlight: As restrictions ease further, Europeans mark Children’s Day with messages of hope

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European countries took another step to normalcy on Monday with a further easing of anti-coronavirus restrictions, as part of the continent celebrated the International Children’s Day with public figures sending messages of consolation and hope for better days ahead.


In a phased approach, lockdown measures have been lifted cautiously by European governments, with a new phase of easing often coming on Mondays. Across Europe, businesses are reopening and many children are back in school.

An online dashboard, maintained by the WHO European Region, showed that 2.16 million confirmed COVID-19 cases had been reported in 54 countries, with 180,650 deaths as of 10:00 a.m. CET (0800 GMT) on Monday.

ANOTHER STEP TO NORMALCY

Starting on Monday, more than 10 European countries further eased their coronavirus lockdown restrictions, including Belgium, the Netherlands, Italy, Romania, Cyprus, Greece, Finland and Albania.

In the Belgian capital of Brussels, the iconic Atomium building reopened its doors to the public, after having been closed since March 14 when Belgium imposed a nationwide lockdown to limit the spread of COVID-19.

Built on the occasion of the 1958 Universal Exhibition and representing the conventional iron crystal mesh magnified 165 billion times, the Atomium is on the verge of bankruptcy, with an estimated loss of 3 million euros (3.3 million United States dollars) due to the lockdown measures.

Belgian Prime Minister Sophie Wilmes said the Atomium’s reopening marked the return of some degree of freedom. Even if masks and social distance were necessary, she noted, this “should not keep us from enjoying the culture,” Brussels Times reported in an online story.

Also on Monday, the Netherlands reopened restaurants, cafes, theaters, concert halls, museums and cinemas after two and a half months.

“We are taking the second step in easing the anti-coronavirus measures today,” Dutch Prime Minister Mark Rutte said on Twitter. “Only if everyone adheres to the measures can we take a step forward.”

Greece also took another step to normalcy with the reopening of primary schools and kindergartens, open-air cinemas, hotels and swimming pools among other businesses which had closed since March.

In Italy, lovers of archeology and antiquity were rewarded by the reopening of the Colosseum Archeological Park and its monuments — which include the Colosseum, the Roman Forum, and the remains of the Emperor Nero’s Palace, the Domus Aurea — all of which are on the UNESCO World Heritage list as sites of “incomparable artistic value.”

HOPE FOR CHILDREN

June 1 is the International Children’s Day in more than 10 European countries, including Romania, Portugal, Albania, the Czech Republic, Poland, Bulgaria, and Serbia.

In Romania, this year Children’s Day has become a big day for people of all ages, since it’s the first day that most of the anti-virus measures were lifted.

When the Grigore Antipa National Museum of Natural History opened at 11 a.m., there was already a long queue at the gate. Zoos and parks in Romania were also favorite choices for children. In parks, children can be seen happily playing with rollers and skateboards.

In Portugal, President Marcelo Rebelo de Sousa visited the Sagrada Familia Social Complex, where he met children from daycare centers and schools in the metropolitan region of Lisbon.

Prime Minister Antonio Costa published a message on his social media as the country entered the third phase of de-confinement.

“On the day that we celebrate another Children’s Day, we return to socializing in pre-school establishments. Fifteen days ago, we reopened the daycare centers, demonstrating that … we could have our children in these establishments again,” wrote Costa in his tweet.

The Polish government and organizations helped the children celebrate the International Children’s Day with various online activities. The authorities organized a number of online readings for children, including Prime Minister Mateusz Morawiecki who read a Polish children’s poem for kids.

In Albania, authorities lifted restrictions for citizens to visit parks and playgrounds. The Children’s Day was celebrated with fun activities dedicated to children at the newly reconstructed “Rinia” park in the center of the capital.

Children accompanied by their parents enjoyed the new playgrounds, toys, the concerts with songs and dances, sports games, circus and other fun activities organized by Tirana Municipality.

Albanian President Ilir Meta paid a visit to an orphanage in Tirana, where he donated books and drawing notebooks to the children.

Meta commended New beginnings orphanage for helping some 200 abandoned children, orphans or children from families with major social or financial problems, for 25 years.

“Your mission throughout these years has been to help, support and invest in the children with major social problems, and have them educated and get them out of…poverty, preparing them for the challenges of the future,” he said.

(XINHUA)

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Albania celebrates Int’l Children’s Day

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International Children’s Day was celebrated on Monday with fun activities dedicated to children at the newly reconstructed “Rinia” park in the centre of the Albanian capital.


Children accompanied by their parents enjoyed the new playgrounds, toys, the concerts with songs and dances, sports games, circus and other fun activities organized by Tirana Municipality.

On Monday, health authorities lifted restrictions for citizens to visit parks and playgrounds. President Ilir Meta paid a visit to an orphanage in Tirana, where he donated books and drawing notebooks to the children.

Meta stated that on this day all children, especially those without parental care and those belonging to families in economic difficulties need more love, support, understanding, health care, free education, and protection from all forms of exploitation.

The president commended New beginnings orphanage for helping some 200 abandoned children, orphans or children from families with major social or financial problems, for 25 years.

“Your mission throughout these years has been to help, support and invest in the children with major social problems, and have them educated and get them out of…poverty, preparing them for the challenges of the future,” Meta said.

On Monday via a Facebook message, Minister of Education, Sport and Youth Besa Shahini said that children have the right to live a healthy and safe life without violence or discrimination, and to receive a good education, and underlined that adults and state institutions have “the obligation to ensure these rights.”

International Children’s Day this year was also very unusual because activities dedicated to children were limited due to the coronavirus situation.

On Monday children across the country were allowed to return to kindergartens and nurseries as the government has authorized them to resume activities under strict hygiene and protective protocol.

Kindergartens and nurseries will be open throughout the summer and will give priority to children with working parents.

For more than two and a half months, all public and private kindergartens and nurseries in Albania had been closed due to the COVID-19 outbreak.

(XINHUA)

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