BACKGROUND School‐environments are thought to be strong influences of behavioral choices. There is limited research available on the role of physical activity (PA) and school success among children with special health care needs (CSHCN). The purpose of this study was to explore differences in PA among CSHCN and non‐CSHCN and how the school success index is related to PA in both groups. METHODS Data were taken from new version of the National Survey of Children's Health (NSCH), which consolidated questions from the previous NSCH and the National Survey of Children with Special Health Care Needs (NS‐CSHCN). Chi‐square and logistic regression analyses were employed to examine group differences. RESULTS There were significant differences among both subgroups, although most school‐aged children did not meet recommended PA guidelines. Chi‐squared analyses indicated; school engagement and the parent's perception of child safety at school were associated with the likelihood of meeting PA guidelines. Logistic regression analyses showed that the odds of meeting PA guidelines were associated with the school success index. CONCLUSIONS Comprehensive school health programs should focus on PA both subgroups. School health educators should continue to advocate for safe and structured extracurricular activities to improve the child and adolescent's engagement and overall well‐being.

Recent studies have found that racial health disparities are a direct result of the residential segregation, racial differences in socioeconomic status, health care access, and other social determinants of health that affect segregated minority groups. This study analyzed local health departments' (LHDs') efforts to decrease health disparities in their communities by using negative binomial regression models to examine the relationship between residential segregation and LHD health disparity activity engagement from the 2016 National Profile of LHDs-National Association of County & City Health Officials (NAC-CHO) and the 2017 County Health Rankings (CHRs). Significant associations were found between the incident rate ratios of activities performed by LHDs and the nonwhite/white residential segregation index, use of CHRs, LHD governance, per capita expenditures, and race of LHD top executive. The findings will help improvement in collaborative efforts between community agencies and LHDs in order to improve health disparity responsiveness. KEY WORDS: health care, health disparities, local health departments, residential segregationL ocal health departments (LHDs) are described as the backbone of local public health infrastructure and are well positioned to address health disparities through community partnerships, an equitable practice approach, the use of informatics, and multisectoral collaboration. [1][2][3] Health disparities of a community are rooted in the underlying social determinants and in order to address them, dedicated and proactive efforts are needed from LHDs. 4 Racial residential segregation is known as the spatial

reviewed retrospectively. Complications were the primary outcome and were divided into major (i.e., bleeding requiring transfusion or sutures) and minor (bleeding requiring pressure or local hemostatic agents). RESULTS: From January 2012 to December 2014 a total of 1071 medical records were reviewed. Gomco was the more common technique used [55.84% (598/1071)]. The overall complication rate was 3.83% (41/1071), all involving bleeding. Only 3 [7.32% (3/41)] major complications were encounter, requiring suture placement. No transfusions required. The rest were minor bleeding complications, controlled either by pressure [58.54% (24/41)], silver nitrate [26.83% (11/41) or thrombin [7.32% (3/41)]. Use of the Gomco clamp was more likely to result in bleeding than was the Mogen clamp, 5.69% (34/598) vs 2.96% (14/473), P5.03. Statistical significant difference was noted between pediatricians complication rate (11.49%), compared to OB/GYN physicians (3.08%) (P5.0002).CONCLUSION: Neonatal circumcision is a fairly safe procedure when performed in a hospital setting by attendings or proper supervised physicians in training. The most common complication found in our cohort, was bleeding and the majority resolved with either suture or pressure. No significant major complications were found. In our hands, the Mogen clamp was associated with less bleeding than was the Gomco clamp.INTRODUCTION: Hartford Healthcare, a five hospital system in Connecticut, integrated simulation with risk management training into a single educational curriculum to both improve patient safety and mitigate malpractice risk for the specialty of obstetrics. The first year of the curriculum focused on shoulder dystocia and documentation, and will be expanded to other high risk areas in subsequent years. METHODS:A Work Group, comprised of simulation experts, medical malpractice defense attorneys, risk management consultants, and clinicians, was commissioned to construct the program. Both clinical and risk management learning objectives were identified, and an integrated curriculum was developed using an evidence-based approach. This Group was responsible for implementing the program to 350 participants across five sites. RESULTS:The Group developed customized evaluation and assessment tools that were administered to each participant. These tools aimed to measure participant receptivity and overall buy-in of the program. For the simulation session, 100% of participants stated it was worth their time, and 99% indicated the program would change their practice. For the risk management presentation, 97% of participants said it was worth their time, and 93% of participants indicated the program would change their practice.CONCLUSION: This integrated simulation and risk management training was found to be a worthwhile use of participants' time and have an impact on participants' practice. Simulation training offers a safe and controlled environment in which to train obstetrical emergencies. By integrating risk management with simulation, we can impact both patien...

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