just kids | spring 2012
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Children's Hospital & Medical CenterTRANSCRIPT
JustKidsSpring 2012ChildrensOmaha.org
CHOKING HAZARDSKeep Your Child Safe 4
MENINGITISGet the Facts 6
URGENT CARE CENTERSTwo Convenient Locations 7
Do Your Kids get Enough
ZZZ’s? p5
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Twitter.com/ChildrensOmaha JustKids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2012. All rights reserved. Printed in U.S.A.
➍ Choking Hazards: Keep Your Child Safe
➎ Lack of Sleep Can Harm a Child’s Health
➏ Meningitis: Act Fast!
➐ Pediatric Urgent Care
➑ Your Infant’s Teeth
➒ Pediatric Dental Care Offered at Children’s
➓ Peanut Allergy Is Serious Business
Children’s Transport Team Marks Milestone
Contents
ChildrensOmaha.org JustKids Gary A. Perkins President and CEO Martin W. Beerman Vice President, Marketing
and Community Relations David G.J. Kaufman, MD Medical Advisor Dannee Schroeder Senior Editor
Learn more about this season’s merchandise at www.kohls corporation.com/communityrelations/Community02.htm. Or just use your smartphone to scan this Microsoft Tag. Visit www.ChildrensOmaha.org/2DCode to learn how to use tags.
On The WeB
Unintentional and preventable injuries are the leading causes of death for children younger than the age of 14. Many people are unaware that 80 percent of car seats are not properly installed, nor do they realize that fastening a seat belt or wearing a bike helmet can be the difference between life or death for a child.
Children’s Hospital & Medical Center is committed to the health and well-being of all children. The Kohl’s Keeps Kids Safe program, a partnership between Children’s and Kohl’s department stores, is dedicated to reducing the number of accidental injuries in children. Kohl’s Cares® earmarks net profits from the sale of its $5 books and plush toys for initiatives such as injury prevention, immunizations and education programs for diabetes, asthma and childhood obesity, among others. Since 2000, Kohl’s has raised more than $150 million to support children’s health and education initiatives nationwide.
Kohl’s has donated more than $1.2 million to Children’s Hospital & Medical Center in support of child injury prevention programs. Every time you purchase a plush toy and accompanying book offered at Kohl’s Department Stores in the Omaha area, Kohl’s shares the sales proceeds from this merchandise with Children’s Hospital & Medical Center.
Children’s and Kohl’s Committed to injury prevention
2 To find a physician, call 1-800-833-3100
What’snew?Children’s experts Offer helpful Tips with Free Parenting U ClassesWith the arrival of a child, there are some things you learn automatically, like how little sleep an adult actually needs to function, the importance of sippy cups, and that polar bears may be hiding in your closets. For other lessons—including the skills to get through those all-important first years—there’s Parenting U from Children’s Hospital & Medical Center. These are FREE classes given by professionals known for their knowledge of children. Along with a new topic each week, we’ll provide food, child care and prizes.
Free PArenTinG ClASSeS Call 800-833-3100, or log onto ChildrensOmaha.org/ParentingU to register today.
Parenting U Upcoming DatesEach session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Call 800-833-3100, or log onto ChildrensOmaha.org/parentingU to register today.
Tuesday, June 26preparing For Your newbornRachel McCann, M.D., F.A.A.P., Children’s Physicians
Tuesday, September 11preparing For Your newbornSteven Sindelar, M.D., F.A.A.P., Children’s Physicians
Tuesday, September 18Baby’s First YearsMichelle Mogenson, D.O., F.A.A.P., Children’s Physicians
Tuesday, September 25Effective Time-Out TechniquesAshley Harlow, Ph.D., N.C.S.P.Children’s Behavioral Health
Tuesday, October 2Mastering potty TrainingKatie Anglim, M.D., F.A.A.P.Children’s Physicians
Tuesday, October 23Childhood Obesity prevention & ManagementCristina Fernandez, M.D., F.A.A.P., Children’s Weight Management ClinicJennica Cornine, M.P.A.S., P.A.-C., Children’s Weight Management Clinic
ChildrensOmaha.org 3
Christopher Columbus used a compass, but
babies have other means of exploration—like
their mouths. Young children ages 6 months to
3 years often put objects in their mouths, and
sometimes they swallow odd things. Fortunately,
there are some things parents can do to lower
their child’s risk of choking.
identify Choking hazardsTo prevent your child from inhaling or
swallowing potentially dangerous items,
follow these steps:
• Place small items, such as toys with tiny
removable parts or common household
objects, in places that toddlers can’t access.
Remember to hide the usual suspects—pins,
needles, coins, latex balloons, pen caps,
marbles and tiny balls. Also, don’t forget
atypical items like high-powered magnets;
these small magnets are fun stress relievers
for adults to keep on their desk, but can also
be choking hazards for young children or
even teens who use them to mimic piercings.
• Avoid giving young children foods that
can cause choking. Keep little ones younger
than age 4 away from seeds and nuts; sticky,
gummy or hard candy; peanut butter chunks;
popcorn; hot dogs; whole grapes; big chunks
of cheese or meat; raw veggies and raisins.
• Monitor children closely when they play
and eat.
• Get down on your hands and knees and
experience your house like a baby does.
Look for unsafe objects your child might
find, and baby proof the house accordingly.
Button Batteries Pose extra riskIn addition to being a choking hazard, round
button batteries, when swallowed, can cause
dangerous internal chemical burns in children.
Damage can occur in as little as two hours after
ingesting. According to the U.S. Consumer
Product Safety Commission (CPSC), children
most often gain access to button batteries directly
from games, toys, calculators, remote controls
and other common household items.
The CPSC recommends the following
steps to prevent battery ingestion:
• Discard button batteries carefully.
• Do not allow children to play with
button batteries.
• Keep remotes and other electronics out
of the reach of children if the battery
compartment does not have a screw to
secure it. Use tape to help secure the
battery compartment.
• If a button battery is ingested,
immediately seek medical attention.
if Your Child Swallows SomethingWhile most swallowed objects, other than
batteries, pass through a little one’s
digestive system symptom-free, it may take
up to one month for the item to pass.
Parents should check their child’s stools to
ensure that the item has been expelled.
Objects that get inhaled and lodge in the
windpipe can put your child’s life at risk.
Swallowed items may also get caught in the
digestive track or obstruct the esophagus.
Here are the symptoms to look for:
• Constant coughing with no obvious cause
• Chest or stomach pain
• Hoarseness or drooling
• Vomiting
• Pain or difficulty when swallowing
If your child has any of the above
symptoms, seek prompt medical attention.
If your child suddenly starts to choke,
wheeze or has trouble breathing after
swallowing, handle it as a medical
emergency. Perform the Heimlich
maneuver, and immediately call 911 or
your local emergency number.
CHOKING HAZARDS: Take Steps to Keep Your Child Safe
PrOTeCT YOUr ChilD FrOM ChOKinGTo learn more, enter the search term “choking hazard” at our website at HealthLibrary.ChildrensOmaha.org.
4 To find a physician, call 1-800-833-3100
SUSPeCT A SleeP PrOBleM?Are you concerned that your child isn’t getting proper rest? If so, talk with your child’s primary care provider. To find a physician for your child, call the Children’s Find-A-Doctor service at 1-800-833-3100.
When children are young, we tuck them in
at night and see them off to school in the
morning. As they turn into teenagers, though,
it gets harder to track how much time they
actually spend asleep. Now a growing body
of research shows we need to watch children’s
shut-eye at every age.
Sleep’s Deep effects on ChildrenThe average child sleeps 13 months during
the first two years of life. All this sleep helps
a baby’s brain develop. As children grow older,
they need fewer hours of sleep: 10 to 12 hours
a night for preschoolers, at least nine for
school-age children and teens. But the
importance of sleep doesn’t diminish.
Sleep helps us solve problems, react quickly,
form memories and learn. Inadequate sleep
affects how well children do in school. It also
impacts a child’s physical well-being. The
body releases hormones during sleep that
aid growth, build muscles and repair cells
and tissues.
Lack of Sleep Can Harm a Child’s HealthA study in Pediatrics found that childhood
sleep deficiencies may be linked to future
problems, too. Among them: decreases in
mental functioning that begin as early as
adolescence. Increasing evidence also suggests
that poor sleep contributes to major health
problems, such as obesity.
help Cultivate Your Teen’s DreamsResearchers say children’s sleep problems
shouldn’t be ignored. While parents are often
involved in the sleep schedules of young
children, they tend to step back in high
school. Because sleep is so critical, however,
you should stay involved.
First, recognize the signs that your teen isn’t
getting enough sleep. Two key signs: changes
in mood and a slide in motivation. Sleepy
teens have trouble waking up in the morning,
are irritable late in the day, sleep extra long
on weekends and doze off during the day.
Next, understand what’s keeping your teen
awake. Many factors may play a role, and
some—such as early school start times—
you can’t control. But some you can.
how to help Your Child Sleep WellHelp your child get a good night’s sleep with
these steps:
• Encourage a consistent sleeping and
waking schedule.
• Ban the use of computers, TVs, music
players and phones close to bedtime.
• Help your child create a good sleep
environment—a place that’s quiet
and dark.
• Limit teens’ caffeine intake, especially
energy drinks.
Sometimes, a sleep disorder is responsible
for poor rest. For example, sleep apnea causes
pauses in breathing during sleep and leads
to daytime tiredness. If you think a sleep
disorder may be affecting your child, talk
with a doctor.
ChildrensOmaha.org 5
Meningitis Requires Fast Action
Meningitis can strike fast and hard. Some
forms of this disease can kill a healthy child
in as little as 24 hours.
Meningitis is an inflammation of the
membranes that cover the brain and spinal
cord. A virus or a bacterium usually causes
meningitis. It’s important to try to find out as
quickly as possible what’s causing the illness.
That’s because the treatment and the severity
differ depending on the cause.
You can help by learning the signs and
symptoms of meningitis and having your
child evaluated as soon as possible. Prompt
diagnosis and treatment give your child a
better chance for complete recovery.
Bacterial meningitis—a more severe
form of the illness—can have very serious
complications, such as brain damage, hearing
loss and learning problems. Even with
treatment, there is still a risk for death.
You can prevent many forms of meningitis by
having your child vaccinated as recommended.
The Symptoms of MeningitisIf your child has any of these symptoms,
contact your doctor immediately:
• Stiff neck
• Fever
• Headache
• Nausea and vomiting
• Red or purple rash
• Fatigue or extreme sleepiness
• Seizures
• Irritability, lethargy and poor feeding,
which may be the only symptoms in infants
A physical exam and a history of symptoms
help tell a doctor if meningitis is likely. A blood
test and a spinal tap can determine whether
a virus or bacteria are causing the infection,
which determines treatment.
Viral meningitis, which isn’t as severe, usually
goes away on its own. Doctors treat bacterial
meningitis with intravenous antibiotics. Serious
cases may require intensive care.
Take Steps to Prevent MeningitisThe Centers for Disease Control and
Prevention (CDC) recommends that children
be vaccinated against bacterial meningitis.
These vaccines are safe and effective, the CDC
says. Different vaccines are given to infants
and young children, preteens and teens.
College freshmen need a second vaccination
unless they have already received two doses.
Some forms of bacterial meningitis are
contagious and can be spread through
coughing, kissing and sneezing. Anyone in the
same household, day care center or other site
who has been in close contact with someone
with these forms of the disease should receive
antibiotics to prevent infection.
There are no vaccines for viral meningitis.
However, you can reduce your risk for
infection by washing your hands thoroughly
and often. You should also avoid kissing or
sharing glasses or eating utensils with
someone who is sick.
hAve QUeSTiOnS ABOUT MeninGiTiS?To learn more about meningitis, visit HealthLibrary.ChildrensOmaha.org and enter the search term “meningitis.”
6 To find a physician, call 1-800-833-3100
Two Locations for Children’s Urgent Care Centers
Children become sick. Teens are injured
playing sports. And, children will be
children, so sometimes accidents happen.
When your child has an illness or injury
that’s not serious enough for the
emergency room, but can’t wait until
tomorrow, visit one of the two Children’s
Hospital & Medical Center Urgent Care
locations.
When your doctor’s office is closed,
Children’s Urgent Care Centers are open.
Hours of operation are Monday through
Friday from 6 to 10 p.m., and weekends
and holidays from noon to 10 p.m.
Children’s two Urgent Care Centers
are staffed by pediatricians and pediatric
nurses from Children’s Hospital &
Medical Center. No appointment is
necessary.
What Our Urgent Care Offers• The only pediatric urgent care centers
in the area
• Board certified pediatricians and
pediatric nurses
• Digital X-ray and lab services on site
• Treatment of cuts and lacerations
• Treatment of sports injuries, minor
injuries and illness
Life doesn’t stop after 6 p.m. NEITHER DO WE.
2 WEST ViLLagE pOinTE110 North 175th Street, Suite 1000(175th and Burke)402-955-8300
Both Children’s Urgent Care Center locations are open Monday through Friday from 6 to 10 p.m., and weekends and holidays from noon to 10 p.m. 1 VaL VErDE
9801 Giles Road, Suite 1(96th and Giles)402-955-7200
ChildrensOmaha.org 7
PROTECT YOUR INFANT’S TEETHBefore your infant goes off to sleep at the end
of the day, you should do more than kiss the
little one good night. Make sure your baby’s
developing teeth are not at risk from nursing
or bottle tooth decay.
That happens when juice or milk stays
in the mouth while a baby sleeps, especially
when sucking on a bottle all night. The sugars
in the mouth are metabolized by bacteria,
which produce acid that eats away the enamel
of the teeth. This results in cavities. Cavities
must be repaired before they extend into the
pulp—commonly called the nerve—of the
tooth, requiring either a root canal or the
tooth to be pulled.
When your baby is awake, saliva bathes the
teeth, removing much of the sugar from foods
and keeping the bacteria in check. But while
your baby sleeps, saliva production lessens,
and the decay rate increases.
Healthy teeth can last a lifetime. So teach children good dental care at an early
age. Even before the first teeth appear, wipe milk or juice off your baby’s gums with a clean gauze pad.
Dental Care
8 To find a physician, call 1-800-833-3100
establish Good habits early in lifeHealthy teeth can last a lifetime. So teach
children good dental care at an early age. Even
before the first teeth appear, wipe milk or juice
off your baby’s gums with a clean gauze pad
after every feeding. When teeth do appear,
brush them with a soft toothbrush after the last
feeding before bed and again in the morning.
Start flossing your child’s teeth as soon as any
two teeth touch. Once children begin brushing
their own teeth, supervise them to make sure
they are doing a good job. Because letting food
sit on the teeth promotes tooth decay, teach
children to brush after meals.
healthy Teeth Tips for BabiesExperts recommend that by the time babies
are a year old, they should drink from a cup.
If the bottle helps a baby settle down, fill it
with plain water. Never put a baby to bed
with a bottle of milk, juice or sugary drink.
The American Dental Association (ADA)
makes these recommendations:
• Begin to clean your baby’s mouth during
the first few days after birth. Use a soft
washcloth or damp gauze and gently
wipe along the gum.
• When teeth begin to appear, the cloth
can still be useful, or use a soft-bristled
toothbrush without toothpaste.
• Talk with your pediatrician about dental
care for your baby. The ADA recommends
that children receive their first dental visit
within six months of eruption of the first
tooth and no later than 12 months of age.
Practitioners can start your child on a
lasting program of dental care.
For the first time ever, dental care is
available for children on the Children’s
Hospital & Medical Center campus.
The UNMC Pediatric Dental Clinic at
Children’s is located in the hospital’s
state-of-the-art Specialty Pediatric Center
(SPC) located at 84th and Dodge Streets.
While new to Children’s, the clinic
represents an expansion of pediatric
dental services offered by the University
of Nebraska Medical Center (UNMC)
College of Dentistry.
Better Access to Dental Care“This is an exciting collaboration with
real benefits for families. The ability
to offer this service in our Specialty
Pediatric Center improves access to
dental care, particularly for those
children who have a great need due
to a chronic condition or illness,” says
Justin Bradshaw, vice president of
ambulatory services at Children’s.
Because the pediatric dental clinic is
physically located in the Specialty Pediatric
Center, the other clinics in the facility have
a dentist on the team for the first time.
This is incredibly beneficial for those
programs that treat children with complex
conditions, as well as for the patients and
families. Take the Osteogenesis Imperfecta
(OI) Clinic, for example. Also called brittle
bone disease, OI affects a child’s bones,
including the teeth. Children treated in
the OI Clinic now benefit from a
dentist on staff to collaborate with the
multidisciplinary team to improve
treatment.
In addition, dentists will coordinate
with other pediatric specialists and do
general dental work on a patient while
the child is under general anesthesia
for another medical procedure.
All Children Are WelcomeWhile the pediatric dental clinic is a
benefit for children with complex
medical conditions, it treats all children,
including those with no other medical
condition, or those who do not have other
medical conditions treated at Children’s.
John Reinhardt, dean of the UNMC
College of Dentistry, sees this clinic as a
great step forward for UNMC, the Omaha
community and the college. “Having a new,
modern postgraduate pediatric dentistry
clinic located at the Children’s Specialty
Pediatric Center, surrounded by pediatric
medical specialists, is definitely good for
all. Our clinical service and educational
programs will rise to an even higher level
of excellence through this opportunity.”
DenTAl CliniC hOUrSThe dental clinic is open during weekdays from 7:30 a.m. to 4 p.m. it is closed on weekends. For more information, call 800-833-3100.
Pediatric Dental Care Offered at Children’s
To learn more about caring for your infant’s teeth, visit HealthLibrary. ChildrensOmaha.org and enter the search term “baby teeth.”
MOrE BaBY TEETH TipS!
ChildrensOmaha.org 9
feature story
A party at school turned into a life-threatening situation for 7-year-old
Max Roseland. Celebrating a movie and snack day, the kids were
encouraged to bring their favorite stuffed animal to school, wear
pajamas and bring snacks to share with the class. While this seems
like harmless fun, things took a serious turn when Max took a bite
of a peanut butter chocolate chip granola bar.
You see, Max has a severe peanut allergy. And that little bite started
a series of events that led to Max fighting for his life in a pediatric
intensive care hospital bed.
Peanut Allergies CommonPeanut allergy is the most common type of food allergy among
school-aged children, and reactions can often be severe. While some
children may only experience hives or vomiting, others experience
life-threatening throat swelling, difficulty breathing and other serious
complications. In addition, reactions tend to worsen over time.
Max had suffered reactions twice before. The first as an infant, which
prompted his parents to have him tested, and the second a year and a
half ago. That time, he was rushed to the emergency department and
immediately given epinephrine. This time was a little different.
“I got the phone call from Max’s teacher a little after noon,” says
Amy Roseland, Max’s mom. “I sent a snack with Max that day, and his
teacher had me come in that morning. I approved two snacks for Max
to eat. One was mini marshmallows and one was a bag of Vic’s
caramel popcorn.”
But somehow, in the dark classroom things got mixed up. The granola
bar had unknowingly come out of someone’s lunch. Max asked his teacher
if he could eat the granola bar and was told everything was safe for him to
eat. After one bite, his tongue immediately felt itchy. He went to the school
nurse, who gave him a dose of Benadryl and monitored his vitals. Things
seemed fine by the time Amy got to the nurse’s office. Max was breathing
and hadn’t broken out in hives.
PEANUT ALLERGY IS SERIOUS BUSINESSChildren’s state-of-the-art care saves boy’s life
10 To find a physician, call 1-800-833-3100
As Amy and Max left the school, however, Max started crying hysterically
and saying that his stomach hurt. Amy called Max’s pediatrician, who
instructed them to head straight to Children’s Hospital & Medical Center.
While in the Emergency Department, Max broke out in hives on the back of
his neck, face and down his body. He started coughing and wheezing. Soon,
he couldn’t breathe. Max was experiencing a delayed allergic reaction.
“They gave him two shots of epinephrine and three vials of prednisone,
and then they started doing breathing treatments,” says Amy. “But he was
so far gone that nothing was working. Max was begging that he couldn’t
breathe. They sedated him to insert a tube down his throat, but when
they went to insert the tube, his heart stopped.”
Staff at Children’s immediately started CPR. After a minute of chest
compressions, his heart rate went back up. They intubated him, then
rushed him upstairs to Children’s Pediatric Intensive Care Unit (PICU).
The Children’s DifferenceChildren’s PICU is the only pediatric intensive care unit in the region to
offer 24/7 in-hospital coverage by board-certified physicians trained in
pediatric critical care. The PICU is also continuously staffed by nurses
and respiratory therapists trained in the care of critically ill and injured
children. It’s also the only hospital in the area that provides ECMO
(extracorporeal membrane oxygenation) support for all patients, from
newborns to adults. ECMO is a potentially life-saving procedure that
provides mechanical oxygenation and cardiac support for patients in
cardiac, pulmonary or cardiopulmonary failure.
The procedure normally involves removing blood from the body and
bypassing the heart and lungs. This allows a machine to oxygenate the
blood and rest of the heart before returning the blood back to the body. In
Max’s case, his heart was fine, but his lungs were in trouble. So, pediatric
intensivists at Children’s used a type of ECMO, called veno-venous ECMO,
to combat his failing health. The pediatric specialists at Children’s are the
only professionals in the area who perform this type of ECMO.
“The PICU staff saved his life,” says Amy. “I can’t thank them enough
for their hard work. It takes a certain type of person to do that job. We’ll
be forever grateful to them for saving our Max.”
A Community issueWhile Max’s story has a happy ending – he was off the ventilator the
next day and home soon after, his mom, Amy, wants people to know that
peanut allergies are serious business.
“I want parents to understand how important it is to not send peanut
treats to school when they’ve been warned not to, even in their own
child’s lunch,” says Amy. “You really need to pay attention to that and be
aware of and sensitive to others with food allergies. That is our vision.”
TAKe FOOD AllerGieS SeriOUSlY
To learn more about food allergies, visit us online at HealthLibrary.ChildrensOmaha.org and enter the search term “food allergy.”
Max Roseland was having fun at a school party until a peanut butter chocolate chip granola bar accidentally got mixed into his bag of treats. A delayed allergic reaction turned into an emergency situation. Fortunately, Max got the care he needed at Children’s Hospital & Medical Center.
Max
2011
ChildrensOmaha.org 11
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PAIDChildren’s Hospital & Medical Center
8200 Dodge StreetOmaha, NE 68114402-955-5400
881M
Children’s Hospital & Medical
Center welcomed 2012 with high
expectations for a growing
program. Children’s Critical Care
Transport Service logged a record
1,000 patient transports in 2011.
The milestone was achieved
on Saturday, Dec. 31. Children’s
Transport team went by
ambulance to northeastern
Nebraska to assist with twins
who needed additional care. The
infants were admitted to Children’s
Hospital & Medical Center.
Service Still Growing“Our transport service has
experienced tremendous growth
over the past five years. We’ve
expanded in size and in our
capability to travel, so critically
ill infants and children from
across the region have access to
specialized pediatric care,” says Rob
Chaplin, M.D., medical director of
ChildrensOmaha.org
SUBSCriBe nOW To subscribe to health-e kids, our free monthly e-newsletter, visit ChildrensOmaha.org and click on the e-newsletter icon located on the right side of the home page.
Children’s Transport Team Helps 1,000 patients
Children’s Transport Service.
Ground transportation is the top
mode of travel. Children’s dedicated
ambulance accounted for 898 of the
1,000 transports. Eighty-five trips
were made by helicopter, while the
team hopped on board fixed-wing
aircraft for 17 patient trips.
The greatest distances traveled
took Children’s to Rapid City, S.D.
and St. Louis, Mo.
“We completed more than 600
transports in 2010 and with such a
large increase last year, we know
there is a significant need for this
service,” says Dr. Chaplin. “Our
team provides crucial intervention
that can dramatically improve a
child’s outcome.”
improving CapabilitiesRecent highlights for Children’s
Transport Service include the
debut of fixed-wing aircraft in
August 2011, through a partnership
with Air Ambulance
Specialists, Inc. (AASI) and
Crow Aviation; a 2010
partnership with LifeNet, in
association with AirMethods
Corp., for helicopter travel;
and the introduction of a
customized Children’s
ambulance equipped
exclusively for pediatric patients
with American Medical Response
(AMR), in the fall of 2009.
The Children’s Critical Care
Transport Service is available
24/7. It is activated by physician
request.
Above: Children’s transport team
members load an infant into the
helicopter. Top photo: Members of
Children’s transport team pose with
the program’s fixed-wing aircraft.
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