CHICAGO — An acid reflux drug often used for hard-to-treat asthma doesn’t help children with the breathing disease and may cause side effects, a study in 300 children found. The results echo recent research showing that a similar heartburn drug didn’t work in adults with asthma.

Use of these heavily promoted acid-blocking drugs, called proton pump inhibitors, has more than doubled in U.S. children in recent years, but the study results suggest doctors should put the brakes on that practice, said University of Arizona asthma expert Dr. Fernando Martinez.

The study found children on prescription Prevacid pills had more colds, sore throats and bronchitis infections than those given dummy pills. There were also signs that children given Prevacid were prone to broken bones. That finding was weak and could have been due to chance. But Martinez said it is worrisome, given a Food and Drug Administration advisory about fracture risks in adults using these drugs long-term. And he urged “great caution” in prescribing these drugs to all children, not just those with asthma.

The study and an editorial by Martinez were released Tuesday in this week’s Journal of the American Medical Association. Acid reflux involves stomach acid backing up into the throat, causing irritation and often symptoms including heartburn. Asthma is an unrelated lung disease involving narrowed airways, with symptoms including wheezing, breathing difficulties and coughs. Sometimes acid reflux can cause similar respiratory symptoms and in children it often occurs without heartburn.

Some doctors believe that airway irritation caused by acid reflux may make asthma worse, and that undiagnosed acid reflux might be a reason why some people on standard asthma medicines continue to have symptoms. Prescribing acid-blocking drugs is thus common in people with poorly controlled asthma even if they have no obvious symptoms of reflux.

Previous research by some of the same study authors found that another acid-blocking drug, Nexium, didn’t improve asthma symptoms in adults. Still, those drugs continue to be widely used in patients with asthma but no reflux symptoms, said Janet Holbrook, a researcher at Johns Hopkins’ Bloomberg School of Public Health, lead author of the new children’s study.

Holbrook said results from both studies likely apply to all proton pump inhibitor drugs, including those sold over the counter. Prevacid became available without a prescription during the study. The new study involved about 300 children and teens at 19 centers whose asthma wasn’t adequately controlled by steroid drugs. Half were given daily Prevacid pills for six months; the others received dummy pills.

Asthma symptoms didn’t improve in either group. They also didn’t improve in a subgroup of study kids who had airway tests that revealed undiagnosed reflux disease, Holbrook said. Bronchitis was twice as common in kids on Prevacid, and they were also 30 percent more likely than the others to develop colds and sore throats.

It’s unclear if those symptoms were caused by the reflux drug. But it’s possible that these drugs interfere with helpful bacteria in the body that fight infection, said Dr. Chitra Dinakar, an asthma specialist at Children’s Mercy Hospitals and Clinics in Kansas City, Mo. who took part in the study Dinakar said she will no longer be inclined to prescribe powerful acid-blocking drugs for kids with asthma but no obvious signs of reflux.

Dr. Daniel Searing, an allergy and asthma specialist at National Jewish Health in Denver, said the study provides important information to pediatricians wondering if the previous study in adults was applicable to children. The National Institutes of Health and American Lung Association paid for the study.

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The conjoined twin babies born to a woman Wajida wife of Mazhar Ali Lakhair, resident of Nau Goth of Mehar Taluka at Shaikh Zayed Hospital for Women in Larkana on Thursday last and were shifted to National Institute of Child Health NICH Karachi on Saturday, died on Sunday. The babies were joined with each other at chest and stomach.

Confirming the death of conjoined twins, NICH Director Dr Jamal Raza told that the case of conjoined twins was a very complicated one. The conjoined twins were kept in ICU of the hospital. Dr Mahesh Kumar of Paeds Surgery Department of Chandka Medical College Hospital had advised the parents to shift the babies to Karachi for further management for being precarious condition of the twin babies as according to him both seemed to share single liver and heart and added that if both had single heart then it was extremely difficult to save their life. Wajida and her husband Mazhar told journalists that twin babies were their first child.

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When a toddler has a broken bone, pediatricians may be more likely to suspect abuse if the family is lower-income, a new study finds. Researchers found that pediatricians who read a fictional case report of a toddler with a leg fracture were more likely to suspect abuse if the child was described as coming from a lower-income family.

The hypothetical child’s race, on the other hand, did not appear to influence doctors’ opinions. The second finding is somewhat surprising, according to the researchers. Studies looking at real-world cases have found that minority children are more likely to be evaluated for abuse than white children are. And it’s well known that the child welfare system in the U.S. has a disproportionate number of minority kids.

“There’s very strong evidence of a racial difference in how patients are handled,” said lead researcher Dr. Antoinette L. Laskey, a pediatrician at the Indiana University School of Medicine in Indianapolis. But, she told Reuters Health, the reasons for that have not been clear — including whether doctors may act based on unconscious racial stereotypes. The current results suggest “there’s more than race involved,” Laskey said. She was also quick to say, however, that the study doesn’t mean pediatricians are consciously “classist” or otherwise biased when evaluating children’s injuries.

The study, reported in the Journal of Pediatrics, included 2,100 U.S. pediatricians who responded to a survey that described one of four hypothetical cases. All cases included an 18-month-old with an “ambiguous” leg fracture — a type that can be caused by abuse or an accident. But the cases varied by the child’s race (black or white) and the family’s economic situation; parents were described as having either professional jobs (accountant and bank manager) or working-class jobs (grocery clerk and factory worker).

Race had little effect on the doctors’ responses. The study found that when the child was black, 45 percent of doctors believed there had “possibly” or “almost certainly” been abuse; another 32 percent were “unsure.” If the child was white, 46 percent of pediatricians suspected abuse, with 28 percent saying they were unsure. In contrast, there was evidence that parents’ job descriptions swayed doctors’ opinions. When the child’s family was lower-income, 48 percent of pediatricians thought there’d been abuse, versus 43 percent when the family was higher-income.

It’s hard to know whether doctors’ responses to a fictional case would be the same in real life. And it’s not clear, according to Laskey, whether attitudes about socioeconomic status might explain some of the racial differences in child abuse reporting seen in earlier studies. She also stressed that she does not think pediatricians are consciously basing their diagnoses on parents’ job titles. But in general, unconscious stereotypes can influence anyone’s thinking. “People tend to think that child abuse, or domestic violence, doesn’t happen in upper-middle-class families, but of course it does,” Laskey said.

It’s important, she said, for doctors to be aware that unconscious generalizations could get in the way of diagnosing child abuse — either missing it in kids from affluent families, or over-diagnosing it in children from poorer or minority families.

“My big take-home message for doctors is that we need to rely on the objective data,” Laskey said.
It is true that studies have found children in poorer families to be at greater risk of abuse. But the poverty, itself, is not a “causative factor,” Laskey said. “Race and socioeconomic status shouldn’t be things used in a diagnosis of abuse,” she said.

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Alabama's successful efforts to increase the number of children with health care coverage has made it a standout in the region, according to a national study released Wednesday.

The study by the Kaiser Commission on Medicaid and the Uninsured lists Alabama among four states that are regional leaders in making gains in children's health care. The others are Iowa, Massachusetts and Oregon.

Alabama recognizes the importance of health care coverage for kids, said Trisha Brooks, a co-author of the report and a senior fellow at the Georgetown University Center for Children and Families. "There definitely are things Alabama has sort of quietly been a leader on," Brooks said.

Alabama health officials said they have been working for years to provide health care coverage to more children. "It's not news to us," said Jim McVay, director of the Bureau of Health Promotion and Chronic Disease at the Alabama Department of Public Health. "(But) it's always nice to take a larger view of what's going on in our state and in the nation."

Last December, Alabama received a $19.8 million performance bonus from the Centers for Medicare and Medicaid Services. The Kaiser report noted that Alabama has simplified enrollment in its children's health insurance program, called All Kids, and in Medicaid, the federal-state health insurance program for low-income children and families.

The state has reduced paperwork, utilized technology and improved coordination between programs, the report said. Alabama was among the first states to provide online applications to renew coverage and allow electronic signatures, according to the report. It also verifies eligibility, including citizenship, electronically.

In addition, Alabama is the only state in the South to provide health care coverage to children in families with incomes up to 300 percent of the poverty level, or $55,590 for a family of three, according to the report. Many states provide coverage to children in families with incomes up to 250 percent of poverty, or $46,325 for a family of three.

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Some students in the Mid-Ohio Valley have gym class a few times a week, but others attend a school where gym class is offered just one semester out of the school year. When you also consider that school recesses have been trimmed, you see how important it is for parents to make sure their children get the physical activity they need outside of school.

Kids used to get a lengthy recess each day as well as gym class one to three times each week. But for many schools, a lack of funding means that's no longer the norm. Families need to take a look at their own routines to see how they can work more physical activity into their days or weeks.

If you aren't convinced of the benefits of exercise to children, consider this information from kidshealth.org:

- Exercise benefits every part of the body including the mind. It encourages sleep and overall, will make a child feel better physically and emotionally. That will help them have the confidence and self-esteem they need to be successful.

- Exercise will help maintain a healthy weight and prevent the onset of health problems like diabetes and high blood pressure.

- Regular exercise can help improve a youngster's energy throughout the day, helping him to be more alert and retain more of what he learns.

Exercise doesn't have to mean a formal workout. For kids and teenagers, it often means playing ball, skateboarding, swimming or riding bikes. Playing at a playground or taking family hikes or walks are other ways to make physical activity fun. Generally, it's recommended that children be physically active for an hour or more a day. When you consider many kids watch three or more hours of television a day, it's easy to see there is time to work in some physical activity.

Parents need to set a good example. They can't just talk the talk, they literally have to walk the walk. Parents who make physical activity a priority are likely to raise kids who are physically active. And an active child is most likely to become and active adult, which will lead to all kinds of health benefits down the road.

For those schools that have had to cut back on physical education or cut it out completely, there's still a role for you to play. Schools should do what they can to sponsor family fun nights, which encourage families to come to the gym for a night of fun, physical activities. Or schools could challenge families to school-wide contests in which the families that log the most walking or running miles win prizes.

The health of our school children is everyone's responsibility. We hope schools and families will look for more ways to work together to keep kids active all year round.

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I had an incredible experience the other night. A group of middle school students came to talk to me about childhood obesity. They were doing a school project and wanted to know specific activities they could teach other kids to help them become more active. They also wanted to learn about healthy food options.

I was absolutely blown away by their questions. These young kids were asking questions about Omega 3s, the difference between the meat of a chicken leg and a chicken breast, and being vegetarian.

We talked about everything — from how you gain weight to why a peanut butter and jelly sandwich is better for you than just a jelly sandwich. It made my heart so happy! For an entire hour, the questions kept flowing. They were listening to every word — and some were even taking notes and taping the session.

I enjoyed the time with the students so much because they weren't afraid to ask questions. They wanted real answers and truly wanted to understand the information that I was telling them. If something I said didn't make sense, they stopped me to clarify.

After reflecting on our conversation, it made me wish that grown-ups were the same way. Why don't adults ask questions like children? Is it pride or just a feeling like as adults we should have all the answers already?

We hear claims about new fad diets, magic skinny pills and things that melt fat. We are inundated with ridiculous tools and things that are flashed in our faces over and over again. People buy into them and will dial a toll-free number in a heartbeat to buy the next cool thing without asking a single question.

What happens after that? The new workout tool or product arrives and it doesn't work and they think weight loss is for the birds. Then they think they are stuck and can't get out of their weight problem.

Adults desperately want to get weight off, but they aren't willing to educate themselves on what it really takes. These middle school students have the right idea. They already understand a healthy lifestyle is about two things — physical activity and healthy eating.

How come adults can't understand that?

One of the last questions asked that evening was the most powerful. It makes my stomach turn just thinking about it now. The question was, "How can we get parents to buy healthier food for their children?"

My heart sinks for every child out there who doesn't get the chance to eat healthy foods at home. If this doesn't make a parent look in their pantry twice, it should! I told the students, "Encourage your friends to ask their parents for these healthy foods. Ask them to buy it, and then pre-slice things for ease and convenience."

So, let's learn from our children. Ask questions, search for answers and don't be fooled by false claims and silly trends. If it seems too good to be true, it probably is.

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UNDERWOOD Some might look at it as playing in a sand box, but at The Kids Therapy Center, it is a form of exercising mental health. Sand tray therapy is one of the many forms of therapy that can be found at The Kids Therapy Center, which opened in Underwood in December.

"With the population growing ... we are seeing more and more (patients)," said Valerie Meyers, who owns the center in Underwood, as well as a similar center in Bismarck. "So, we decided to expand out to the rural community to help with travel time."

Meyers, who is originally from Mandan, received her master's degree at the University of Wisconsin, majoring in clinical mental health counseling with an emphasis on children and adolescents. She had worked in Minneapolis and for five years as a therapist at the Dakota Children's Advocacy Center, in Bismarck, where she provided counseling for children affected by child abuse. A year-and-a-half ago, she opened The Kids Therapy Center in Bismarck, where she sees patients from across the state, from "Jamestown to the Montana border" and up to Canada.

"It's not uncommon for a parent and child to drive hours to get here," Meyers said. The centers specialize in mental health counseling for children and adolescents. "We really see a broad range, from toddlers to teens," Meyers said.

In addition to sand tray therapy, which uses a sand tray and miniature figurines to allow a child to tell a story, The Kids Therapy Center utilizes creative therapies, such as play therapy and the usual talk therapy. Play therapy involves "a room with toys that allow kids to express themselves," Meyer said.

"The therapist is trained so she's not sitting down and playing, but using the toys to allow the child to express themselves and tell their story through the play. We believe in meeting the child at their level, instead of them coming up to our level."Even before the center officially made Underwood its home, it received a warm welcome from the community.

"We got a call from the Underwood Clinic asking us if we wanted to come in there, because they were so excited about having us as part of Underwood," Meyers said. Talesa Heger, a therapist with the Underwood center, said that having it located in the same building as the Underwood Clinic is a good fit.

"I just think the community, as a whole, and parents are excited to have such a service offered in our community," Heger said. "Often times they have to travel to Bismarck to receive services, and this is something that can serve the McLean County area."

There are meetings this week "with area social workers that want to meet with us and get our information for the referral process," Heger said, noting that the school has also had interest. "They all see a need in rural communities."

Meyers noted that in the past, there have been suicides in the Underwood and Garrison areas. "There were two last year and one just recently," Heger said. With the center located in Underwood, it "can help kids and give kids tools at an early age for depression and anxiety and different struggles they are having," Heger added.

Heger, who was raised in nearby Turtle Lake, said that in the past, mental health services weren't readily available in the area but now, with the concept of mental health being more and more accepted by society, more services are available.

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Last month, the Centers for Medicare & Medicaid Services awarded 23 states approximately $296 million in bonuses for increasing the number of children enrolled in health insurance programs.

The bonuses, funded by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), came a week after the Centers for Disease Control and Prevention released a report stating that about 1.2 million more children have health insurance in the United States than three years prior.

According to the most recent estimates, approximately 93 percent of the nation’s children now have some form of health insurance coverage, a 2 percent increase from federal levels around 2008. When the Children’s Health Insurance Program was initially created in 1997, the national statistics hovered around 86 percent.

In addition to providing performance bonuses for states that simplify and increase coverage for children, CHIRPA provisions allow states to enroll children using information culled from other public programs, as well as automatic eligibility for babies whose mothers are already covered by Medicaid or CHIP programs.

Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services, said that although the nation faces “serious fiscal challenges,” she still believes that children’s health should remain “a top priority” for states. “Not only have more states qualified for performance bonuses in the past,” she said, “but many have continued to improve the efficiency of their programs.”

In 2010, the Centers for Medicare & Medicaid Services awarded more than $217 million in CHIPRA Performance Bonuses to 16 states, all of which qualified for performance bonuses again in 2011.

States qualifying for FY2011 CHIPRA Performance Bonuses include: Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Virginia, Washington and Wisconsin.

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There aren’t enough hours in the day for parents who pursue the mature student life, writes SHEILA WAYMAN WITH THE CAO deadline looming on February 1st, parents all over the State are trying to concentrate the minds of Leaving Cert students on what and where they would like to study at third-level.

But some parents are filling in application forms for themselves – as mature students. College is no longer seen as a phase of life to put behind you when you are in your early 20s. Apart from the full-time courses offered by the higher education institutes (HEIs) covered by the CAO, there are numerous part-time and evening courses available through classroom attendance and distance learning.

The adult learning sector has never been more flexible or accessible, whether you want to enhance your career, embark on a new one or follow a passion. But it can be a real challenge when you have young children to care for. Four parents, currently pursuing third-level study, explain how and why they do it.

Jenny McElroy (32) lives with her fiance, Paul McBride, and their 15-month-old daughter Amy in Bettystown, Co Meath. She works a four-day week with Electric Ireland (formerly the ESB) in Santry, north Dublin, and is studying part-time for a degree in business studies run by the Institute of Public Administration at Dundalk Institute of Technology in Co Louth.

Returning to college when her daughter was just three and a half weeks old was a real test of McElroy’s commitment to further education. She had become pregnant during her first year of the part-time course, but was keen to continue after giving birth at the beginning of September, 2010.

“It was a big decision to go back when she was so young, but I felt if I didn’t go back – I missed the first week I think – I would never have gone back.”McElroy is the first to say she could not have done it without the support of her fiance and extended family – especially after her maternity leave finished last August.

“It was a new chapter to learn how to juggle because for my first year of college, I only had work but was pregnant; the second year I wasn’t at work, was just a parent; and this year now I have all three: I have work, Amy and college.

“I am finding it tougher,” she says. “It took a while to get all the logistics in place.”Her weekly schedule is an impressive mix of hard work and family co-operation, with Amy’s grannies, both of whom live in Dundalk, taking turns, week on week off, to help with childcare. On Monday morning, whichever granny is “on” arrives in Bettystown to collect Amy and bring her back to Dundalk, about 45 minutes away, while McElroy drives her 40-minute commute to Santry.

She finishes work at 5pm and has to be in Dundalk for the first of her twice-weekly lectures at 6.30pm. Three hours later, she goes to stay the night in the home of the granny who has Amy. McElroy sees her daughter the following morning before heading to work. On Tuesday evening, McElroy and her fiance return to Bettystown after work and a granny drops Amy home. As Paul works most weekends, he often has Wednesday and Thursday off and can care for Amy then.

That means McElroy can return home after her second night at college on Wednesday. She usually spends Friday, Saturday and Sunday at home, but every fifth weekend has to attend college.

McElroy mostly studies at the weekends after Amy has gone to bed. “I try to get two to three hours in on one of the evenings just to catch up.” Coming up to assignments and exams, she will try to squeeze study every night into what is a gruelling schedule. “You can get lazy, but then it all gets on top of you,” she says. “On Wednesday evenings after work, it is tough to drive the hour to Dundalk, sit for three hours and then drive home again and you will be exhausted on the Thursday, but you really have to push yourself.”

The course can be done by distance learning, but she says she would not have the discipline to do it remotely. Her social life is the main casualty. “I have sacrificed all my nights out. The socialising we do is during the day, with Amy.”

McElroy looks both to the past and the future for motivation to stick at it. She always regretted not continuing her childcare studies to degree level, instead opting to travel after gaining a diploma when she was 19.

Now in a completely different field of work, she believes a degree could help her progress from her current status as team leader. “I have gone as far as I could go. I don’t think I could get a manager’s job without a degree.”

Kathy Endersen (42) lives in Shankill, Co Dublin, with her husband, Laurence, and their three children, Sarah (11), Laurence (8) and Louise (7). She is studying at UCD for a degree in health and performance science.

Having given up a full-time accountant’s job in 2002 when her first child was two, Endersen tried part-time study four years and two more children later, “to see if I could use my head again and manage with the kids”.

She is now in the second year of a full-time degree course, which involves 16 hours of lectures a week in UCD, “but they expect you to work 40 hours a week”. All her children are finished school by 2.30pm and a childminder comes into their house three afternoons a week.

Having had their mum at home for some years, do the children resent her absence? “No, they actually resent me coming home early!” she replies with a laugh. “They love the minder.”She tries to go straight into UCD every day after dropping the children at school, either for scheduled lectures or to study in the library. There is a breakfast club at the school, which means the children can be dropped in at 8am the mornings she has 9am lectures.

“The three afternoons I have a minder, I would try to stay in UCD and study until 5pm. The other two afternoons I give over to the kids – it is very hard to study when they are here.”She works after they have gone to bed if she has to and during exam weeks before Christmas she got up at 6am for last-minute study. “I only get an hour, but it does make a difference if you get a run at it. You have got to get in the zone.”

She finds she can become quite preoccupied with her studies, especially around exams. “The kids are talking to me in the car and I try to act interested and ask them a question and they say, ‘I just told you that mum’.”Ironically, considering the course subject, the main thing that suffers is her personal fitness.

“I am walking the dog, play a bit of tennis and am out and about with the kids on the bikes, but unfortunately I am not training.” In recent years she has played a lot of tennis, running and completed triathlons.

What is “fantastic”, she says, is the way the course is divided into 12-week semesters and the big element of continuous assessment – when she was sitting the pre-Christmas exams they were for only 50 per cent of her marks.

“That does take the pressure off. Because I have dependants, anything can happen with them.”Her husband, Lar, works long days in financial investment, so the lion’s share of running the household falls to her. But, with a passionate interest in what she is studying, she is glad to be doing the course. “It is expanding my knowledge, using my brain and it is good to be up and out in the world,” she says.

Although, as this is her second degree, there is a big financial commitment of having to pay annual fees of €7,000-plus. She hopes she is a good role model for the children – “what I would hope to pass on is that education is a life thing”. But most people, she adds, “think I’m mad!”

Fergal O’Donovan (39) is director of technical operations with the pharmaceutical company MSD in Brinny, Co Cork. He lives in Ballinhassig with his wife, Martina, and their three children, Jack (8), Faye (7) and Charlie (4), and is studying for a masters in biotechnology online with the Institute of Technology in Sligo.

A few months ago when O’Donovan was in the US for his work, he logged on for the latest lecture in his course, which was delivered live from Singapore, and it was all through Sligo IT.

It is an example of how flexible distance learning is and how well-suited to a busy man such as O’Donovan, who works full-time and has three young children. However, he says it can all be a struggle at times.

“Something has to give. Since I started the education, work hasn’t suffered, the education hasn’t suffered, I put in the hours, but the family has.”The support of his wife, Martina, a stay-at-home mother, is what makes it possible.

The course takes about 10-15 hours a week, which means there are three or four nights he does not see the children before they go to bed because he does the course work in the office before leaving.

He has had to fine-tune his time management. At first he would try to do course work whenever he had a free minute at home but then he heard the children saying, “Dad is always studying”. So now, at weekends, he will do four hours on Saturday morning and then stop. “I find that much better. Everybody knows to leave Dad alone until 12 o’clock and then it’s a free for all.”

He also stresses that since the college work comes in blocks of 11 weeks, he is not living his life to that degree of intensity all year round. “You stop wasting time; I just don’t watch telly anymore and I am up every Saturday morning at seven, whereas before I might have slept in.”

Upskilling like this is, he believes, essential for his job, and he is delighted with the option he chose to pursue because it is very “industry friendly”. He can relate much of his project work to the day job.

“It is working well. I am delighted I have done it. I feel my confidence really has grown in the role and I do feel the day job has benefited from it.”Sarah McKevitt (22) has a two-year-old son, Kiernan, and lives with her mother and three siblings in Darndale, Dublin. She is studying journalism full-time at Rathmines College, Dublin.

For the first year and a half of parenthood, McKevitt felt stuck in the house and unable to do anything, other than care for her baby son. The eldest of four children, she shares a bedroom in the family home in Darndale with her sister, while Kiernan sleeps in with her two brothers.

A turning point in McKevitt’s life was doing a course on careers and personal development with One Family, a national organisation for one-parent families. Although keen to go to college, she did not know what she wanted to study and this course helped her make up her mind. “I love writing,” she explains. “I hadn’t really thought about it as a career since I left school and just did it in my spare time.”

Through the One Family course, she was able to shadow a journalism student at Rathmines College. “I really like the feel of Rathmines and the atmosphere, which is why I chose that college.”Kiernan goes to a community creche near their home from 9am to 5pm every weekday and if McKevitt has to leave the house earlier to get the bus across the city to Rathmines, her mother will drop him in.

Although she attends college Tuesday to Friday, she still puts Kiernan into the creche on Mondays so she can study at home or work on assignments. The rest of the week she can study in the evenings after he has gone to bed at 7.30pm or 8pm – “he loves his sleep”, she says thankfully. Deadlines for assignments in the run-up to Christmas meant a lot of late nights, but she always faces a 6am start with Kiernan the next day.

“It’s exhausting trying to juggle, but it has to be done and I’m not going to start complaining. A couple of years of hard work will make the difference.”McKevitt hopes to get paid work after completing the higher diploma course, preferably in a newspaper, although she knows jobs are few and far between. “I just have to wait, work hard and hopefully make myself stand out and get a job, if all’s going well.”

Conscious of being a role model, not just for her son but also her siblings, she believes it shows “we can do what we want to do. If I can do it with a child, they can do it,” she adds, “no excuses for them.”

Useful websites
Cao.ie: entry criteria for mature students are not the same as for school leavers, but they still need to apply to HEIs through the Central Applications Office. Bluebrick.ie: offers information and advice on flexible learning opportunities for “non-traditional” learners. Qualifax.ie: look for its online Mature Student Directory. Maturestudents.ie: information and advice from the network of mature student officers in the HEIs.

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He didn’t wrap them in festive paper and affix glittery bows, but Uncle Sam did deliver a couple of huge gifts to Washington state this holiday season.

First out of the sack was $60 million to help the state expand its efforts to prepare more children for kindergarten. Washington was one of nine states to submit winning early learning applications.

The state plans to use the money to expand a quality rating system for preschools, to measure the readiness of kids for kindergarten, and to finance scholarships for child care workers who want to pursue college degrees, according to an Associated Press article.

Investing in early learning is smart, because it eventually pays for itself. Many studies have shown that children who show up at kindergarten behind their peers aren’t likely to ever catch up. Society as a whole pays the price with fewer productive citizens and more government spending on crime and punishment.

The keys are giving the parents of underprivileged children high-quality preschool options and treating early learning as an essential long-term commitment. It has to be much more than day care, and the teachers must be more than baby sitters.

Washington already has a 10-year plan to expand early learning, which gave it a leg up on competitors for federal money. The award softens the blow from failing twice to win “Race to the Top” education grants.

The second gift was a nearly $17 million performance bonus for meeting and exceeding federal targets for enrolling children in health care programs. The Children’s Health Insurance Program Reauthorization Act of 2009 includes incentives for states to make it easier to enroll children in Medicaid and CHIP plans.

Washington was one of 23 states to get a bonus by meeting at least five of eight criteria designed to cut red tape and increase the participation rate of qualifying families. Plus, the state nabbed extra cash by exceeding the enrollment benchmark by at least 10 percent. It is one of only a handful of states that have won a bonus all three years.

However, this bonus was more of a relief than a windfall, because the money had already been factored into the state’s health care budget. That was a savvy budgeting move because it makes it more difficult to divert the money elsewhere. The state has long been a national leader in access to health care for children and, with looming budget cuts to Basic Health and possible cuts to Apple Health for Kids, the federal bonus was vital.

What’s remarkable is that during a time of deep economic troubles, the nation has been able to extend early learning opportunities and health coverage to a higher percentage of children. Those efforts reflect commendable values, which the state of Washington has worked hard to uphold.

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