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BACKGROUND The patient-centered medical home (PCMH) has been proposed as a model for comprehensive care coordination and delivery for children with sickle cell disease (SCD), yet little is known regarding the implementation of PCMH core concepts on adherence to preventative care measures, health care utilization, and parent satisfaction. PROCEDURE We implemented the newborn cohort clinic (NCC) to explore the application of the PCMH model for infants and children with SCD from birth to age 3 years in 2011. In July 2017, we conducted a retrospective chart review to evaluate subjects currently or previously followed in the clinic. We surveyed parents in the NCC to assess their satisfaction with their experience. RESULTS A total of 112 patients have been managed in the NCC. All patients received penicillin prophylaxis, while 70% and 73% of patients, respectively, received the 23-valent pneumococcal vaccine and an initial transcranial Doppler by age 36 months. Most (92 of 112) of the subjects utilized the emergency department (569 encounters), with 86% of encounters for fever or other sickle cell-related complications. The majority of parents indicated satisfaction with the clinic, with 71% saying clinic providers always or usually spent enough time with their child, listened carefully to them (81%) and were sensitive to family values and customs (77%). CONCLUSIONS A comprehensive sickle cell clinic as a component of a PCMH is feasible and can achieve high levels of preventative care. Parents are largely satisfied with this model of care. © 2020 Wiley Periodicals, Inc.BACKGROUND To describe how pediatric cancer-induced financial distress and perceptions of their social role affected fathers' psychological responses to this distress, and quality of life (QOL) for them and their families. PROCEDURE We analyzed father-only responses from a larger cross-sectional survey study about the impact of pediatric cancer-induced financial distress on parents. Our analytic sample was n = 87 fathers who participated in the larger study. We analyzed their data using descriptive statistics and directed content analysis. RESULTS Conflicting role responsibilities (be there for child; work to maintain income and insurance coverage) seemed to generate responses resembling characteristic posttraumatic stress symptoms in reaction to acute declines in family finances and/or the chronic stress of insufficient finances to meet financial demands, that is, financial trauma. Fathers' personal sense of not being able to adequately provide for their child with cancer and also meet their family's basic needs produced embarrassment and humiliation, which led to discomfort talking about finances; fear, persistent thoughts and anxiety about money; reduced joy; beliefs that they did not deserve to express their needs; and feeling vulnerable to repeated financial stressors. CONCLUSIONS Pediatric cancer-induced financial burden contributed to fathers' symptom severity and burden, and QOL declines. Clinicians should develop sensitivity to the multiple ways that pediatric cancer affects individuals and families. Future research should examine the effects of pediatric cancer-induced financial burden on mothers, and develop ways to sensitively and systematically assess financial burden, associated psychological responses and declines in QOL, and intervene as indicated. © 2020 Wiley Periodicals, Inc.BACKGROUND In-stent restenosis (ISR) is the major concern of vertebral artery stenting (VAS). We aimed to investigate the feasibility and outcome of redo angioplasty for ISR of vertebral artery. METHOD The patients were retrospectively reviewed for the significant ISR (>50%). Redo angioplasty including balloon angioplasty and stenting was performed for symptomatic ISR (>50%) or asymptomatic ISR (≥70%). The clinical follow-up was performed on the 1, 3, 6, and 12 months and then yearly in the clinic or by telephone. The angiographic follow-up was performed at 6-12 months after redo angioplasty. RESULT A total of 72 patients had significant ISR and 48 redo angioplasty (92.3%, 48/52) were successfully achieved with 13 located in the V4 and 35 in the ostium of vertebral artery. Twenty-six lesions were implanted by the second stent and the others received balloon angioplasty. No stroke or transient ischemic attack (TIA) occurred in the perioperative time. One patient died 2 months after redo angioplasty due to nonstroke cause. Redo angioplasty nonsignificantly decreased the stroke or TIA compared with medical treatment. Sixteen patients developed the binary restenosis, which was lower in the patients receiving stent implantation than balloon angioplasty. CONCLUSION Redo angioplasty was a feasible method for the ISR of VAS and redo stenting might be the first choice. © 2020 Wiley Periodicals, Inc.INTRODUCTION This study aimed to create a composite measure of a healthy lifestyle for adolescents, and analyze its relationship to sociodemographic factors. METHODS Data were from the Health Behavior in School-Aged Children 2014 International survey. Participants were 167 021 adolescents (48.2% boys and 51.8 girls), aged 10-16 years, from 38 countries. RESULTS Five healthy behaviors used in this study included engaging in ≥60 minutes of physical activity every day, daily consumption of fruit and vegetables, spending less then 2 hours daily immersed in screen-based behaviors, and abstinence from alcohol as well as from tobacco products. Only 1.9% (95% CI 1.4%, 2.3%) of adolescents had a healthy lifestyle, achieving all five healthy behaviors. In contrast, 4.2% (95% CI 3.7%, 4.6%) reported none of the healthy behaviors. Selleckchem Abiraterone CONCLUSIONS Despite the benefits of engaging in physical activity, engaging in low levels of screen-based activity, regular consumption of fruits and vegetables, and abstaining from alcohol and cigarettes, only 2% of adolescents could be classified as having a healthy lifestyle. © 2020 Wiley Periodicals, Inc.OBJECTIVE To assess the effect of manual thrombectomy (MT) on microvascular obstruction (MVO) using cardiac magnetic resonance (CMR) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS Three hundred and eighty-three patients admitted for STEMI and undergoing CMR fulfilled the inclusion criteria and were categorized into two groups (did or did not undergo MT). The two primary endpoints were the occurrence and extent of MVO, analyzed as a categorical variable and as a semicontinuous variable. Among the 383 patients, 49.1% exhibited MVO. Both the incidence of MVO and the median number of segments presenting with MVO were significantly higher in the MT group than in the no-MT group, (59.5 vs. 38.9%, p less then  .001) and (1.5 [0;4] vs. 0 [0;2], p less then  .001). Analysis stratified on coronary thrombus grade showed similar results, only in patients with a high thrombus burden (60.7 vs. 43.5%, p = .004, and 2 [0;4] vs.