This conference focuses on providing training to child health researchers on the design, implementation, and evaluation of interventions aimed at improving the health care services provided to children. Speakers and participants will focus on state-of-the-art methods to facilitate the conduct of rigorous QI research and implementation science. Selected abstracts will be presented in a virtual poster format at the conference. The author(s) of the top scoring abstracts will be invited to present during the virtual closing platform presentation session.
Conference participants will engage in highly interactive breakout sessions led by leaders in the fields of pediatric Implementation Science and Quality Improvement research. Attendees will learn when and how to use specific methodologies for the design and analysis of intervention studies. They will also explore facilitators and barriers to implementing these methods.
Keynote speakers: Dr. Jean Raphael, Director of the Center for Child Health Policy and Advocacy and Associate Professor of Pediatrics at the Baylor College of Medicine; and Dr. Rinad Beidas, Founding Director of the Penn Implementation Science Center (PISCE@LDI) and Associate Professor of Psychiatry; Medical Ethics & Health Policy; and Medicine.
Breakout Sessions include:
Interactive Virtual Poster Sessions
Anatomy of a Quality Measure
QI Shark Tank: Works in Progress
Publishing QI Research: SQUIRE 2.0 and Beyond
Complexity Science in QI Research
How to be a Critical Consumer of QI Research
Interrupted Time Series Analysis
AND MORE!
This course will provide education and instruction in core principles of ethics related to the practice of medicine, designed to satisfy ACGME Common Program Requirement IV.5. and provide much of the National Institutes of Health Requirement for Instruction in the Responsible Conduct of Research. It may also be incorporated into plans to satisfy National Science Foundation RCR training requirements. As such, this course will be substantially more in-depth than the briefer review of ethical issues that will be done during the concurrent APPD/PAS Core Curriculum – Track #2.
Agenda
9:00-9:15 – Introduction – Format for the conference. Intro of speakers.
John D. Lantos MD, Children’s Mercy Hospital, Kansas City
9:15-9:55 – Mentoring, coaching, and sponsorship for early career physicians and scientists
Tyler Smith MD, Children’s Mercy Hospital, Kansas City
This session will discuss how to enter into mentoring relationships, what to expect, and what to do when they are not working. We will analyze the role of mentor and mentee. We will also talk about how to end mentoring relationships with specific practical advice.
9:55-10:35- 360o of Human Subjects Protections in Clinical and Translational Pediatrics Research
Lainie Ross, MD, PhD. The University of Chicago
This session will cover the resources available to promote the ethical conduct of pediatric research. We will discuss the roles and responsibilities of the institutional review board (IRB), the research subject advocate (RSA), the research ethics consultation (REC), the Community Advisory Board (CAB), and the principal investigator (PI). We will then engage in an interactive discussion of various case studies.
10:35-10:45 Break
10:45-11:25 - Wellness and Professionalism: How to Not Freak Out (Too Much) nor Burn Out
and Have Some Fun, & Be Kind and Courageous
Chris Feudtner, MD, PhD, MPH. Children’s Hospital of Philadelphia
This session will talk about the psychological challenges that arise in the high-pressure environment of tertiary care pediatrics, cutting edge research, pressures to publish and succeed, and the need for work-life balance.
11:25-12:05 – Intraprofessional dynamics in clinical care and research
Angela Ellison MD. Children’s Hospital of Philadelphia
This session will deal with the team dynamics with a particular focus on microaggressions and microcompliments, disparate treatment based on race, ethnicity or gender, and the responsibilities that we have for one another on a clinical or research team.
12:05-1:00 Lunch Break
1:00-1:40 Cultural and Structural Humility in Research and Practice
Amy Caruso Brown, MD, MA, SUNY Upstate Medical University
We all bring certain cultural baggage with us to clinical and research encounters. Our patients and research participants do, too. And we meet in the cultural environment of medicine. Conflicts arise. In this session, we will analyze how to recognize and respond to those conflicts.
1:40-2:20 Openly Doctoring: Navigating Social Media as a Physician
Alyssa Burgart MD, MA, Stanford University
Physician social media use can bolster advocacy, academic work, and professional networking. In this session, we will discuss navigating the professional benefits and pitfalls of social media, and how being a small “p” public figure can impact your career.
2:20-2:30 Break
2:30-3:10 Who owns ideas?
John D. Lantos MD, Children’s Mercy/University of Missouri – Kansas City
In this session, we will talk about authorship and research collaborations. We will discuss questions about who owns ideas, who should be first author, order of authorship, and plagiarism. We will offer practical advice for claiming credit for ideas while maintaining harmonious collaborative relationships.
3:10-3:50 Case Studies in Ethics and Professionalism
The Faculty
In this last session, we will discuss particular cases from our own experience or from the workshop participants. Cases can be in clinical ethics, research ethics, professionalism, or any of the topics discussed during the day.
3:50-4:00 Wrap up and evaluationAn overview of our current understanding and latest discoveries in basic, translational, and clinical science of nutrition and metabolism from fetal metabolism to preterm infant post-discharge nutrition. In addition to delivering an overview of current research advances, each presentation will include ideas for development of research or quality improvement projects and with a career development pearl. Basic Science & Translational Science
9 am – Intrauterine growth restriction - Laura Brown, MD, University of Colorado School of Medicine
10 am – Necrotizing enterocolitis - Misty Good, MD, MS, Washington University in St. Louis
11 am – Metabolomics - Camilia Martin, MD, Beth Israel Deaconess Medical Center
Noon – one hour break
Clinical Science
1 pm – Nutrition and especially human milk for infants with cardiac disease - Amy Hair, MD, Baylor College of Medicine, Texas Children's Hospital
2 pm – Approaches to growth faltering in very low birth weight infants - Brenda Poindexter, MD, MS, Cincinnati Children's
3 pm – Post-discharge nutrition for preterm infants - Sarah Taylor, MD, MSCR, Yale University School of Medicine
1. Etiologies of Encephalopathy in the Newborn: 45-minute lecture with interactive cases throughout that will allow problem solving and questions to ensure active learning for adult learners. Andrea Pardo M.D., Interim Director, Neurocritical Care, Lurie Children's Hospital Taeun Chang M.D., Director of the Neonatal Neurology Program at Children’s National Hospital 2. The Hammersmith Neonatal Neurological Exam: a mini workshop about the principles of the comprehensive and standardized neonatal neurological exam. A didactic portion (20 min) about use and findings in HIE will be followed by a video demonstration and “how-to” (15 min); A scoring portion will challenge the audience to notice abnormal findings on a dictionary of videos (15 min). Hammersmith-approved workshop will be taught by SPR Junior member Kristen Benninger, M.D., Nationwide Children's Hospital 3. Acute Symptomatic Seizures in the Newborn: 45-minute lecture with interactive cases throughout that will allow problem solving and questions to ensure active learning for adult learners. Courtney Wusthoff, M.D., Director, Neurocritical Care at Stanford Children's Hospital Shavonne Massey, M.D., Children’s Hospital of Philadelphia 4. Outcomes in HIE: This will be a two-part 45-min. symposium followed with an additional 10 min throughout with questions and polling from the audience. The first part of this section will be prediction based on NICU treatment and neuroimaging results; the second will be on new interventions that change trajectories of development after the NICU. A case discussion will thread through the two parts, with a patient followed from birth to two years with imaging, predictions, and MRI. This case will tie into the next part of the course. This workshop will be taught Sunny Juul, M.D. PhD, University of Washington 5. Giving Diagnoses & Prognosis after Neural Insults: a 55-min. interactive workshop. This will start with a 5-min recorded video testimony from the parent in the previous section talking about how she experienced hearing the news about her child’s HIE in the NICU. It will be followed by a 25-minute lecture on literature and practical principles of giving serious diagnoses. Finally, in an interactive 25-min experience, the audience will see first a conversation that goes poorly between a physician and parent, then with the help of the moderator, will be able to change the conversation by sending in recommendations, to have a more supportive, honest, direct and hopeful conversation. The course is led by Sarah Winter M.D, University of Utah, and SPR Junior Member Mary Lauren Neel M.D., Nationwide Children’s Hospital 6. Designing a Research Question: 40-minute panel discussion with two experts. This session will breakdown the process of 1) identifying a question 2) designing a pilot study to test the hypothesis and 3) suggest the next funding/research step after the pilot. The three topics for the panel will be Animal Models, Translational, and Clinical Trials. The speakers will be Tommy Wood, BM BCh PhD, University of Washington, and Roberta Ballard, M.D., UC San Francisco. A moderator will ensure that questions from the audience can be passed seamlessly to the three speakers. To learn more about scientific journeys and basic, translational, and clinical research in HIE, we suggest attending the SPR-sponsored symposium "A Tribute to Dr. Maria Delivoria-Papadopoulos: From Basic Science to Clinical Trials – Physician-Researcher Journeys and Collaborations in Hypoxic Ischemic Encephalopathy.”
A postgraduate course covering the latest clinical, translational, and clinical research and practice in BPD. Basic and Translational Science - Moderator: Rita Ryan, MD 9 am – Antecedents to BPD and BPD-associated pulmonary hypertension - Steven Abman, MD, University of Colorado School of Medicine 10 am – Microbiomics and Metabolomics in BPD - Namasivayam Ambalavanan, MD, University of Alabama at Birmingham 11 am – MicroRNAs in BPD - Vineet Bhandari, MD, DM, Cooper Medical School of Rowan University Noon – one hour break Clinical Science - Moderator: Vineet Bhandari, MD 1 pm – Antioxidants and BPD - Trent Tipple, MD, University of Oklahoma 1:30 pm – A Primer on Severe BPD: Data from the BPD Collaborative - Leif Nelin, MD, Nationwide Children's Hospital 2:00 pm – Pharmacotherapy of BPD and BPD-associated pulmonary hypertension - Rita Ryan, MD, UH Rainbow Babies & Children’s Hospital 2:30 pm – Ventilation Strategies in Severe BPD - Martin Keszler, MD, Brown University 3 pm – Post-discharge Pulmonary Outcomes of BPD - Jennifer Landry, MD, MSc, McGill University 3:30 pm – Antenatal Approaches to Prevent BPD - Cynthia McEvoy, MD, MCR, Oregon Health & Science University
This conference focuses on providing training to child health researchers on the design, implementation, and evaluation of interventions aimed at improving the health care services provided to children. Speakers and participants will focus on state-of-the-art methods to facilitate the conduct of rigorous QI research and implementation science. Selected abstracts will be presented in a virtual poster format at the conference. The author(s) of the top scoring abstracts will be invited to present during the virtual closing platform presentation session.
Conference participants will engage in highly interactive breakout sessions led by leaders in the fields of pediatric Implementation Science and Quality Improvement research. Attendees will learn when and how to use specific methodologies for the design and analysis of intervention studies. They will also explore facilitators and barriers to implementing these methods.
Keynote speakers: Dr. Jean Raphael, Director of the Center for Child Health Policy and Advocacy and Associate Professor of Pediatrics at the Baylor College of Medicine; and Dr. Rinad Beidas, Founding Director of the Penn Implementation Science Center (PISCE@LDI) and Associate Professor of Psychiatry; Medical Ethics & Health Policy; and Medicine.
Breakout Sessions include:
Interactive Virtual Poster Sessions
Anatomy of a Quality Measure
QI Shark Tank: Works in Progress
Publishing QI Research: SQUIRE 2.0 and Beyond
Complexity Science in QI Research
How to be a Critical Consumer of QI Research
Interrupted Time Series Analysis
AND MORE!
Three tracks with three sessions (90 minutes each). The sessions will focus on skill and knowledge acquisition to provide a comprehensive core curriculum for fellows that address areas of academic development identified in the American Board of Pediatrics Guidelines for Fellowship Training. The topics covered are appropriate for individuals at the fellowship level of training and provide a foundation for those who may not have had exposure to some required topics, as well as those who wish to pursue a topic in greater depth in the future. It is intended that these themes will repeat each year so individual curriculums can be created to complement education provided by local fellowship training programs. Certificates of completion will be available for participants.
Three tracks with three sessions (90 minutes each). The sessions will focus on skill and knowledge acquisition to provide a comprehensive core curriculum for fellows that address areas of academic development identified in the American Board of Pediatrics Guidelines for Fellowship Training. The topics covered are appropriate for individuals at the fellowship level of training and provide a foundation for those who may not have had exposure to some required topics, as well as those who wish to pursue a topic in greater depth in the future. It is intended that these themes will repeat each year so individual curriculums can be created to complement education provided by local fellowship training programs. Certificates of completion will be available for participants.
Three tracks with three sessions (90 minutes each). The sessions will focus on skill and knowledge acquisition to provide a comprehensive core curriculum for fellows that address areas of academic development identified in the American Board of Pediatrics Guidelines for Fellowship Training. The topics covered are appropriate for individuals at the fellowship level of training and provide a foundation for those who may not have had exposure to some required topics, as well as those who wish to pursue a topic in greater depth in the future. It is intended that these themes will repeat each year so individual curriculums can be created to complement education provided by local fellowship training programs. Certificates of completion will be available for participants.
APS & SPR Virtual Journeys in Pediatric Research- Session 5
Join us for an in-depth discussion with neonatal experts feeding Evivo (activated B. infantis EVC001) in their NICUs
Our speakers will share:
● The unique clinical benefits and mechanism of feeding Evivo to infants in the NICU
● Published research on the strain superiority of activated B. infantis EVC001, the specific strain of bacteria used in Evivo
● Candid accounts of their experience implementing Evivo as a standard of care in their NICUs
● Clinical outcomes reported and observed with the use of Evivo
Dinner Speakers:
Mike Fitzgerald, MD
Attending Neonatologist
Medical Director, Elmhurst NICU
Co-Founder, DuPage Neonatology Associates
Dr. Fitzgerald trained at Loyola Medical Center in Chicago for pediatrics and neonatology and then went on to co-found DuPage Neonatology Associates, an academic, private practice group in Chicago. Dr. Fitzgerald continues to practice neonatology full time, has become a nationally and internationally recognized expert on infant nutrition, and is frequently asked to speak at the local, national, and international level.
Heaven Holdbrooks, RN, MSN, PNP, CNS, RNC-NIC
Clinical Nurse Specialist
Health System in Southern California
Heaven is a board-certified neonatal nurse and clinical nurse specialist working in a Level III NICU at a large healthcare system in Southern California. She has worked in the NICU for the past 10 years and is well versed in quality improvement initiatives.
Bethany Henrick, PhD
Director of Immunology & Diagnostics
Evolve BioSystems
Bethany is an immunologist with extensive experience investigating maternal and infant immunity as well as a decade of experience designing, optimizing, and bringing to market rapid point-of-care diagnostics focused on improving the lives of individuals globally. In addition to her position at Evolve, Bethany also serves as an Adjunct Assistant Professor in the Food Science and Technology Department at the University of Nebraska Lincoln. Prior to joining Evolve, she managed international, multi-discipline scientific projects at UC Davis as Associate Director of the Foods for Health Institute. Bethany received her Ph.D. in Medical Sciences, specializing in Infection and Immunity, from McMaster University.
Join alumni and friends of Cincinnati Children's for our annual social gathering during the PAS Conference. If you have issues connecting day of please reach out to alumni@cchmc.org.
This critical care nephrology session will focus on a potpourri of current topics with a focus on incorporating these practices and techniques into clinical care.
Current research efforts focused on the lates knowledge of possible etiologies and methods of diagnosis will be discussed.
In November 2019 the first PHM certification exam was administered, minting the first group of ABP certified Pediatric Hospitalists. Much is known about the current clinical roles served by hospitalists. However, the scope of clinical practice varies tremendously from general inpatient pediatric floor care to the intensive care units (neonatal and pediatric), newborn nursery, subspecialty inpatient care, surgical co-management, delivery room, sedation, complex care, and the emergency department. Prior to formal recognition of PHM by the ABP, the term hospitalist seemed to apply to everyone who worked in a hospital who did not have another certification beyond general pediatrics. The purpose of this session is to discuss the current scope of PHM practice and where, if at all, the edges of that practice should be. Absent delineation of scope and as several pediatric subspecialties workforce and trainees numbers decline, pediatric hospitalists have been and maybe further pushed into filling those gaps. Pediatric hospitalists have been at the forefront in providing value based care and have taken the lead in many quality improvement initiatives at hospitals around the country. These qualities and more make pediatric hospitalists a valued commodity as they fill these varied roles within the hospital. The presenters represent division leaders of groups with broad scopes of practice, a community hospitalist who covers the DR to ER, and the co-chair of the AAP Section on Hospital Medicine Neonatal Hospitalists sub-committee. Additionally all presenters can comment on even wider expansion of practice during the COVID surge. Updated
Maternal microbiota at the time of delivery has a multi-faceted role in determining the neonatal outcome: it may be a driver in the premature onset of labor, it may lead to life-threatening infection of the fetus/newborn and, in the vast majority of pregnancies, it will provide the pioneer colonizers for the newborn’s microbiome. This early microbiome plays an active part in interacting with the neonatal immune system and establishing the path for future health outcomes. While interventions that alter maternal microbiota such as perinatal antibiotics have significantly reduced adverse outcomes for mothers and neonates, this health gain has required widespread use. Half of women delivering in United States will be administered antibiotics prior to delivery either as surgical prophylaxis or for prevention of neonatal infection from pathogens such as group B streptococcus. What, if any, are the unintended consequences of interrupting the mother to child microbiota transmission? This Hot topic symposia will discuss determinants of neonatal microbiome, specifically, maternal microbiome in pregnancy and effect of perinatal antibiotics, and review the evidence for association of early life antibiotics with altered microbiota and adverse health outcomes. We will end with a discussion on emerging thoughts on alternate solutions and mitigation of potential risks
Over 30 million patients in the US live with a rare disease; 80% of them have an underlying genetic cause and a majority affect children. Exome/Genome sequencing is helping accelerate the diagnosis of these patients, although many cases remain undiagnosed despite these technologies. The Undiagnosed Disease Network (UDN), The Manton Center for Orphan Disease Research and several other centers are dedicated to helping those patients reach a diagnosis. Sadly, treatment options are nonexistent most of those patients, and the rarity of their conditions leaves many individuals effectively orphaned. New and creative tools and frameworks will be necessary to address these challenges. The approaches may include antisense oligonucleotides (ASO)/siRNAs, gene therapy, and CRISPR-CAS9 based gene editing. The therapeutic promise of ASOs has been seen especially in the CNS with the remarkable success of nusinersen for spinal muscular atrophy (SMA) as well as promising early phase investigations of oligonucleotides for ALS and Huntington’s Disease. We have recently shown that it is possible to effectively deploy a custom-designed ASO in less than a year for an eight-year-old girl with CLN7-related Batten disease, a rare, fatal disorder of neuronal lysosomal storage. Similarly, the recent approval of zolgensma in SMA has shown the potential of gene therapy in the near future. Hundreds of clinical trials are currently ongoing to use gene therapy approach in rare diseases. Lastly, the promise of CRISPR-based therapies where gene editing can fix the defect in the gene itself is rapidly progressing with many ongoing clinical trials.
No area of medicine has had as much success as newborn care. Fifty years ago, more than 75% of preterm infants died soon after birth. Those that survived were left with serious complications. Now, more than 75% of preterm infants survive, including those at the limits of viability. Such astounding achievements would not have been possible without research and the rapid implementation of research findings into clinical practice. Indeed, neonatal care is now one of the most active and cost-effective fields of research in medicine.
However, therapeutic drift has crept into many areas of our practice. Based on incomplete or little substantive evidence, our current treatment of sick infants and their mothers may actually do more harm than good and there are multiple areas where equipoise has been lost, which obstructs future research and evaluation of these missing pieces of information.
In this session, we look at some of the most important practices in neonatology that are now almost universally accepted despite little evidence of benefit or harm. Collectively, the topics discussed in this session have the potential to affect every single birth in the world (>130 million each year), including ~15 million of the sickest infants affected by prematurity and hypoxia, the two single most important causes of infant mortality and disability in the world.
Specifically, our speakers will address:
Antenatal steroids: used to promote lung maturation, steroids are now given to even early term infants and sometimes, in repeated doses with questionable benefit and possible harm to neurodevelopment.
Delayed Cord Clamping (DCC) is routinely used in extremely preterm infants to promote cardiovascular stabilization thereby aiming to reduce brain injury and mortality. DCC is routinely practiced in more mature infants as well as healthy term infants with potential adverse sequelae including hyperviscosity and jaundice.
Oxygen for newborn resuscitation. Studies on hypoxic full-term infants demonstrated significantly decreased mortality when the infants were resuscitated with air compared to pure oxygen. Over the years, clinicians have moved towards using lower oxygen strategies based on these studies and others which demonstrated oxidative stress and injury with high oxygen administration. Whether lower oxygen strategies are sufficient to prevent hypoxia, especially in preterm infants with lung immaturity is uncertain.
Apnoea affects almost every premature infant. It can be successfully treated with respiratory support and caffeine. However, there remains significant variability in the timing of discontinuation of caffeine, and convalescent preterm infants continue to have episodes of intermittent hypoxemia beyond the postmenstrual age when most clinicians stop caffeine therapy. Apnoea and intermittent hypoxemia is associated with poor neurodevelopmental outcomes but conversely, monitoring and prolonging supports like caffeine and oxygen supplementation beyond what the infant requires can do more harm than good, as well as being extremely costly.
Therapeutic hypothermia (TH) at 33.5◦C for 72 hours is the only proven therapy that reduces the risk of death or disability in infants with moderate or severe encephalopathy . Today, there is an increased use of TH in infants with mild encephalopathy, following cardiac arrest and other indications that do not reflect evidence from robust randomised controlled studies.
This AAP session will feature highly ranked 2021 PAS abstracts plus the Silverman Lecture
Bronchopulmonary dysplasia (BPD) is a developmental lung disorder of preterm infants primarily caused by immature host defense mechanisms that prevent tissue injury and facilitate repair. This disorder is the most common complication of premature birth, and its incidence remains unchanged over the past few decades. Additionally, BPD increases long-term cardiopulmonary and neurodevelopmental morbidities of preterm infants. Pulmonary hypertension (PH) is a common morbidity of BPD. The pooled prevalence of PH in mild, moderate, and severe BPD is 6%, 12%, and 39%, respectively. Importantly, the presence of PH increases both short- and long-term morbidities and mortality in BPD infants. Further, there are no curative therapies for this disease complex. Not surprisingly, BPD is the second most expensive childhood disease after asthma. Thus, the need of the hour is to understand the pathogenic mechanisms of BPD-associated PH (BPD-PH) and develop meaningful strategies to prevent and treat this devastating disease of preterm infants. This symposium is designed to fulfill this timely need. Dr. Abman will begin the session by presenting the overview and impact of this symposium on the cardiopulmonary health of preterm infants. Dr. Shivanna will then emphasize the importance of rigor and transparency in phenotyping experimental BPD-PH, discuss the need for several models of this disease complex to avoid a “one-size-fits-all” approach, and build a case for endotype- and phenotype-targeted clinical trials. Later on, Dr. Abman, Dr. Ambalavanan, Dr. Young, Dr. Bhandari, and Dr. Wedgwood will present the new and novel pathogenic mechanisms of BPD-PH learned from the state-of-art animal studies. A primary emphasis of all the panelists will be on how this new knowledge can be translated from bench to bedside to impact the well-being of infants with this disease. Finally, the symposium participants will be allowed sufficient time to have a robust discussion with the panelists about the roadblocks to the clinical translation, directions of future research, and opportunities for collaboration.
School readiness has impact on academic, health and economic outcomes across a child’s lifespan. The pandemic undermines traditional health and early education settings and threatens to worsen child outcomes. In face of a rapidly changing landscape to deliver care to young children and their families, unique collaborations between pediatrics and education are driving innovative solutions that will have impact beyond the pandemic.
Early childhood is a critical period of brain and socio-emotional development for establishing a strong foundation for learning and is highly vulnerable during this disruptive, traumatic time. Children living in poverty and in communities of color are burdened with the greatest educational disparities compounded by the multi-pronged impacts of the pandemic. Child health providers have unparalleled, systematic access to children ages zero to five years with multiple touchpoints a year. In particular, child health providers may serve as the most consistent service sector for young children living in poverty, especially during the pandemic. Early child educators have a wealth of expertise and innovation in preparing young minds for a lifetime of learning. Unfortunately, the fields of early childhood education (ECE) and child health largely work in parallel to support the development of children ages 0-5. The pandemic highlights the powerful impact of bridging these fields to transform outcomes for children who face disparities in educational readiness and achievement. How might pediatrics best partner with ECE to eliminate disparities in kindergarten readiness? What innovations in early education can bridge child health and ECE? How might philanthropy drive momentum to harness child health and ECE? What lessons have we gained during the pandemic about collaboration and innovations across our fields? In this session we bring together thought leaders from across disciplines to spark creative solutions and partnerships that will support early minds to be ready to learn during and beyond COVID-19.
The panel discussion will feature an interdisciplinary group of pediatricians including a general pediatrician, pediatric complex care hospitalist, pediatric emergency medicine physician, and pediatric pulmonologist to discuss the challenges faced in caring for the emergent needs of children with medical complexity across all medical settings. Children with medical complexity represent a medically and socially vulnerable group of children who require extraordinary resources to address their emergent needs. As such, collaboration and innovation across disciplines in pediatrics is essential to address the inherent challenges. The panel will briefly discuss current challenges, research, and initiatives designed to improve urgent and emergency care of children with medical complexity. As experts in the field, they will then discuss opportunities for improvement, including proposed innovative solutions that are yet to be implemented and tested. The session then will be opened for questions from the audience.
Hormones are powerful modulators of cell lineage and differentiation. Whereas appropriate exposure can serve as an accelerant to mature organ function in the human fetus and premature infant, they can harm if used inappropriately. Prenatal glucocorticoids differentiate epithelial cell functions of the lung, skin, gut, kidney, eye and CNS and thereby help ensure normal ex utero multiorgan adaptive capacity. While absence of glucocorticoid signals can be detrimental, excessive exposure can induce injury such as brain and hippocampal atrophy. The ubiquitous organ level effects of thyroxine during development are well established and its robust role in brain development is absolute. Yet, animal results did not always translate successfully into effective thyroxine interventions in clinical trials (THOP trial NS045109-01). Although, beneficial results of thyroxine are encouraging in animal models of neonatal brain ischemia and hemorrhage, no neonatal clinical trials exist. The promise of high does erythropoietin on improving neurologic outcomes was unfulfilled (PENUT Trial (NS077953). Estrogen therapy reverses the lost maternal in utero hormonal exposure as evident by its role in neuroprotection during hypoxia. Might these well-defined animal models someday contribute to improving neurodevelopmental outcome of premature infants? This symposium will highlight recent advances from basic, translational, and clinical research to provide a comprehensive update on the risks and benefits of hormonal therapy in premature infants at risk for hypoxia and neurological delays.
Despite large-scale initiatives to promote workforce diversity in academic pediatrics, the current state of underrepresented in medicine (URiM) reflects marginal improvements in some areas and clear regression in others. The proportion of URiM faculty in US academic institutions has essentially remained flat over the past two decades while the number of African-American males in medical school is presently lower than it was in 1978. These data demonstrate that workforce diversity in medicine is not only stagnating but failing to keep pace with population trends toward a more diverse country. For URiM who do pursue a career in academic pediatrics, they must overcome the “diversity tax”, defined as the burden of extra responsibilities placed on URiM faculty to achieve diversity. Guidance from, and relationships with, senior leadership have been promoted as evidence-based strategies to foster URiM professional development and scholarly advancement. Historically, efforts have primarily focused on mentorship. However sponsorship and coaching also offer powerful relationships that can be leveraged to support URiM. This Hot Topics session will begin with a brief overview of diversity trends in academic pediatrics and differentiation of mentorship, sponsorship, and coaching. Subsequent presentations will focus on the ideal characteristics of junior and senior individuals in each of these relationships. We will conclude with discussion of the roles and responsibilities of academic leadership in developing best practices and outcome measures for career advancement of URiM.
This video is unavailable at the request of one or more presenters.
This session will review clinical, translational and basic science advances in development nephrology and urology. It will identify current and future methods to optimize kidney outcomes.
The biological differences between the sexes manifest quite early during fetal life. The crown-rump length is larger in male fetuses compared to females in the first trimester. Placentae of male and female fetuses have different protein and gene expressions, especially in adverse conditions. Even within the intrauterine milieu, the same extracellular micro RNA may show upregulation in females and downregulation in male fetuses. There appears to be a natural survival advantage for females. Maternal glucocorticoids (GC) play a key role in fetal growth and organ maturation. However, excess glucocorticoids can not only affect growth, but the response may be sex-specific and probably mediated through glucocorticoid receptors (GR) in the placenta. Mild pre-eclampsia and asthma are associated with normal growth patterns in males, but in female fetuses, they are associated with a slowing of growth rate without causing IUGR, probably as an adaptive response for future adverse events. Thus, female fetuses survive while male fetuses exhibit IUGR, preterm delivery, and even death in the face of another adverse event.
There is growing evidence that maternal pre-pregnancy overweight or obesity status is directly associated with a higher risk of obesity in a male child, but not in a female child, at one year of age. It is fascinating that male and female fetuses respond differently to the same intrauterine environment, and this suggests a fundamental biological variation most likely at the cellular and molecular level.
It is well-known that weight, length, and head circumferences are greater in male preterm infants at all gestational ages. We have sex-specific growth charts such as Fenton-2013 for the preterm infants starting from 22 weeks of gestation. It is intuitive to wonder if growth rates are different between male and female ELBW infants, then their nutritional requirements would also be different. There is some preliminary clinical evidence suggesting the same. Poindexter et al., in their “early vs. late amino acid initiation study,” noted that males in the late amino acid administration group had increased odds of having a suboptimal head circumference at 18 months corrected gestational age.
There are sex-specific differences in the outcomes associated with birth asphyxia. Males have poorer neurodevelopmental outcomes for a similar degree of hypoxic-ischemic encephalopathy. Pharmacologic studies in a traumatic brain injury piglet model have shown striking differences between males and females. A subset analysis of the multicenter randomized controlled trial in extremely low-birth-weight infants found that the prophylactic use of indomethacin prophylaxis slightly favored males regarding the development of severe IVH (grades III and IV) and on long-term outcomes.
Yet, many large perinatal studies have not explored if there were any sex-specific differences in the outcomes. Caffeine for Apnea of Prematurity trial showed gross motor functions were not different in those exposed to caffeine versus controls. Though animal studies have shown that neonatal caffeine exposure has sex-specific benefits; However, as the sex-specific analysis is not performed, any specific sex-related benefits of therapy may have been masked.
We, therefore, believe that bringing awareness about sex-specific analysis of the data in all the neonatal studies may help us all understand the therapeutic options better in the future. This session involves basic science and animal research scientists, as well as perinatal clinical scientists, to discuss the Cross-Disciplinary Spotlight on this hot topic.
Although the field of neonatology has evolved significantly since patients were routinely administered chloramphenicol and 100% oxygen, major knowledge gaps and unmet therapeutic needs persist. The majority of drugs used to treat critically ill neonates are used off-label, with incomplete information on dosing, safety, and/or efficacy. Despite efforts to design and perform high-quality neonatal clinical trials, optimal treatments for the unique conditions related to preterm birth remain elusive. To begin addressing these unmet needs, the Food and Drug Administration (FDA) and the Critical Path Institute (C-Path) launched the International Neonatal Consortium (INC) in May of 2015. The Consortium convenes academic experts, regulators, nurses, industry sponsors, and patient/parent advocates from across the globe to “forge a predictable regulatory path for evaluating the safety and effectiveness of therapies for neonates.”
In its first 5 years, INC has achieved notable successes through interdisciplinary collaboration, including:
Publication of: “Safety, Dosing, and Pharmaceutical Quality for Studies that Evaluate Medicinal Products (Including Biological Products) in Neonates” to assist investigators and sponsors in designing clinical trials (used in FDA Guidance)
Development of standardized definitions, outcome measures, and master protocols for clinical trials of treatments of retinopathy of prematurity (ROP), bronchopulmonary dysplasia, and seizures in order to obtain consistent, robust, and discriminatory data
Development of a neonatal adverse event severity scale to harmonize adverse event reporting for neonatal clinical trials
Publication of a paper optimizing long-term neurodevelopmental follow-up assessments following trials of medicinal products in neonates
Our Cross-Disciplinary approach will highlight the interaction and collaborative efforts needed by key stakeholders to create tools to streamline research on neonatal therapies.
The most important congenital viral infection in the developed world, and probably globally, is congenital cytomegalovirus (CMV). Congenital CMV is the most common infectious disease responsible for neurocognitive deficits in children, and is the leading infectious cause of sensorineural hearing loss. Although development of a vaccine has been a major public health goal for decades, development of a vaccine has been limited by emerging knowledge about the potential for re-infection of immune women during pregnancy with resultant transmission of new strains of viral to the fetus, leading to injury and long-term disability. Thus, there are unresolved questions about the protective role of pre-existing maternal immunity and the viral and host correlates of such immunity. Indeed, some experts suggest that the bulk of disability caused by congenital CMV occurs in the context of infections that occur in the face of preconception immunity. If natural immunity does not protect, then how can a vaccine - which would need to induce immune responses superior to "natural immunity" - succeed?
To address these controversies, advances in molecular virology and viral immunology research that explore these topics will be presented at this symposium, along with a summary of the CMV vaccines that are currently in clinical trials. A major emphasis will be placed on how this new knowledge is likely to have an impact on the health of children, particularly with respect to long-term disabilities, but other topics, including health policy issues (CMV as a disease of health disparities) and adolescent vaccination questions (how to incorporate another vaccine into the routine schedule) will be reviewed. Policy issues and translational approaches in clinical trials will be integrated with basic science data (the virology and molecular immunology of CMV) to ensure an eclectic, but accessible and informative, program. This state-of-the-art plenary will be of broad appeal to a large number of academic pediatricians. The session will consist of invited lectures from internationally recognized, NIH-funded leaders engaged in study of this topic.
Seasoned baseball scouts are experts at identifying talented prospects just as experienced clinicians are experts at diagnosing and managing patients’ medical conditions. Although both scouts and clinicians may be correct most of the time, mistakes can be costly, leading to millions of dollars of losses for baseball franchises, and potentially preventable morbidity in the health care setting. Over the last 15 years, baseball executives have sought to guard against such mistakes by largely embracing the use of advanced analytic tools to identify those baseball prospects with the most potential for success. Termed “Moneyball,” and immortalized in a film of the same name, advanced analytics have revolutionized the sport as athletes are now throwing harder and hitting more home runs than ever before.
Health care, on the other hand, has lagged behind. Although we know that health outcomes are largely influenced by behaviors, social circumstances, and physical surroundings, this information is rarely collected and used in diagnosis or medical decision-making. Tools to collect and methods to analyze this important information have not yet been robustly developed, nor adequately applied in healthcare settings to improve outcomes. These skills are needed now more than ever, as pediatricians strive to provide care that is equitable and support patients and families affected by systemic racism, other social injustices, and the COVID-19 pandemic.
But this is about to change. With the use of advanced technologies such as geospatial analysis, machine learning, and natural language processing, we are now developing tools to not only improve the identification of clinical, but also social and environmental risk factors, and to incorporate this information into clinical decision-making at the point-of-care. Such methods are simultaneously helping to build situational awareness capabilities, critical in the midst of the COVID-19 pandemic. These methods, when fully implemented, represent important strategies of enhancing delivery of high-value, equity-driven care. Indeed, clinicians, researchers, communities, and health systems that can harness the vast quantities of clinical, community, education, and government data will be well-positioned to improve child health outcomes, mitigate disparities, optimize decisions, and enhance the value of care. With its focus on utilizing cutting-edge technologies to develop data-driven improvement in outcomes across multiple disciplines, this presentation aligns well with the PAS Meeting’s Strategic Plan.
The speakers will describe examples of research programs and quality improvement initiatives that have capitalized on each of these three advanced analytic methods. They will discuss how such approaches can be applied across disciplines and sub-specialties, using the fields of public health, general pediatrics, emergency medicine, and hospital medicine as examples. PAS attendees across a multitude of disciplines will be interested in this presentation as it is relevant for those interested in the Digital Therapeutics, Clinical Research, and Advocacy Pathways.
Using the revolution of baseball analytics as an analogy, the first speaker will set the stage, describing the gap between current analytic capabilities and how pediatricians currently make clinical decisions. All speakers will then focus their discussion on a description of a particular methodology (geospatial analysis, machine learning, and natural language processing), their specific motivation, challenges encountered, how barriers were overcome, and outcomes achieved. They will also discuss how principles can be applied across disciplines and future implications of their work, including challenges and opportunities, specifically as related to equity in care and development of population health situational awareness capabilities. If able, the speakers plan to use a polling system throughout the presentations to more fully inform the depth of each presentation and engage participants. A 20-minute Q&A session will follow the three presentations, allowing audience members to interact with the speakers. Audience members will leave the session with a clear understanding of the capabilities of these technologies and how they might be able to implement them with their own work at their institution.
This AAP session will feature highly ranked 2021 PAS abstracts plus AAP leader speaking.
Gastroenterology and Hepatology topics
Despite recent advances in neonatal intensive care medicine, several neonatal disorders remain major causes of mortality and morbidities. Few effective therapies are currently available to ameliorate the injuries resulting from these disorders. Therefore, developing new safe and effective therapies to improve the outcomes of these disorders is an urgent and considerable issue. Recently, various preclinical studies have shown that stem cell therapy significantly attenuates injuries in newborn animal models of neonatal complications. These findings suggest that stem cell therapy/regenerative therapy might represent the next breakthrough in therapy of these currently intractable and devastating neonatal disorders. In this session, we focus on the results of preclinical/clinical research in several neonatal complications.
Intestinal failure continues to be a significant problem affecting neonates and children. A multi-disciplinary approach to care is essential, as long term survival is dependent on successful nuitritional support with optimoal growth, anticipation of and avoidance of complications, and advancing techniques for improving gut function. The team is complex and requires ongoing involvement of neonatologists, gastroenterologists, hepatologists, surgeons, nutritionists, and social workers.
Over the last forty years, the diversity of medical school matriculants has increased dramatically. In the US, women represent half of medical students and the ethnic diversity of medical students has increased, but much more slowly. However, women are underrepresented among leaders who hold leadership roles such as Professor, Department Chair, and Dean. The relative lack of women and underrepresented people in leadership roles may be related to factors including lack of opportunity, lack of mentoring, discrimination, and personal preference. During this session, influential leaders in academic pediatrics and academic medicine will share insights and lessons learned, including review of the most recent data on the representation of women and diverse individuals in leadership roles and highlight programs and efforts to increase diversity among leaders. Building on institutional examples shared by the panelists, we will engage in a discussion to identify new strategies to increase diversity among leaders in academic pediatrics.
The scope of maternal drug use is staggering. In Western societies, at least 1 in 3 children under the age of 14 are estimated to live with a parent or caregiver using some form of drug of dependency. This accounts for more than 9 million children in the USA alone. Enormous attention has been placed on the consequences of maternal opioid use which can result in the Neonatal Opioid Withdrawal Syndrome (NOWS) or Neonatal Abstinence Syndrome (NAS), one of the fastest growing and costly public health epidemics in the world.
Mothers, however, use many other drugs besides opioids and their newborns can be affected by all of them. These drugs can be illegal (e.g. cocaine, methamphetamines), some are essential for maternal health (e.g. prescription medications), and others are an almost ubiquitous element of society (e.g. alcohol, tobacco, marijuana). The adverse consequences of these drugs are extensive, pervasive, and enduring. Not only is the individual child affected, but the family, society and even subsequent generations can be impacted by maternal drug use. At a societal level, maternal drug use is inextricably intertwined with profound economic, intergenerational, and perpetuating burden and harm. On an individual level, the drug-exposed infant is not only at risk of withdrawal but also of teratogenicity, epigenetic change, neurocognitive impairment, and poor adult outcomes (dependent on both prenatal exposures and postnatal environmental influences).
Efforts to minimize harm from parental drug use requires global, coordinated, and continuing efforts. This is especially true with regard to the impact of the current COVID-19 pandemic on maternal use of addictive substances and its relation to translation of research and practice to policies that have considerable potential to influence individuals, families, and whole communities around the globe. In this session, international clinical, research and policy experts will discuss the latest evidence and knowledge gaps in this area. We will discuss contemporary evidence from randomized controlled studies and observational and cohort studies, particularly focusing on NOWS and other drugs of addiction that may not cause classical signs of abstinence such as cannabis, cocaine and methamphetamines. We will also examine the rationale behind decision-making at clinical and policy levels for the care of children affected by parental drug use in the USA and around the world. We will discuss the long-term and including epigenetic and non-withdrawal implications of prenatal drug exposure and also the legal, societal and health implications of legal drugs of addiction such as alcohol, nicotine and prescription medications.
This session will emphasize the necessity of international collaboration and the consideration of other drugs besides opioids in the quest for improving the lives of children affected by maternal drug use especially in the current crisis of the COVID-19 pandemic
This video is unavailable at the request of one or more presenters.
Three generational animal models now conclusively demonstrate that fetal exposure to the same environmental chemicals now found in virtually every human pregnancy is linked to multigenerational disease. The diseases range from onset of puberty abnormalities, obesity, immune disorderes,cancer,polycystic ovaries, abormal sperm,behavioral abnormalities and perinatal complications. The mechanism of transmission of disease across generations appears to be non-genetic and correlates with epigenetic changes seen in exposed offspring and their descendants.This symposium will present the latest animal data after fetal exposure to: pesticides (DDT, premethrin,vinclozolin,atrazine, glyphosate,DEET), dioxins, jet fuel, plastics, BPA,(M Skinner), The latest data on human pesticide exposures and outcomes of pregnancy: glyphosate (P. Winchester) and long term outcomes after organophosphate exposures in pregnancy (B.Eskenazi). Diseases which have been induced in third generation descendants in rodents will be compared with human disease trends and latest funded research will be reviewed. Environmental contaminants are pervasive in pregnant women, and diseases which they cause in animals are increasing in humans. Can we begin to apply what has been learned in animals to human health (while we wait the 100 years it might take to follow a three generational human study)? Finally, we will discuss the state of governmental agencies whose mandate to protect our pregnant mothers and our children from environmental contamination. (R. Etzel).
Virtual event that would replace an in person reception
Virtual Alumni & Friends Event
Central precocious puberty (CPP) is the onset of development signs of sexual maturation earlier than would be expected based on population forms, typically defined as puberty onset before 8 years in girls and 9 years in boys. Early identification and treatment are critical when true precocious puberty is present. The need for timely attention to apparent premature development is augmented by the possibility that precocious puberty is the result of a tumor or other disorder. In this virtual CME-accredited satellite symposium, two experts in CPP will discuss strategies for improving early detection of this disorder by recognizing clinical signs and symptoms, review testing options for diagnosis, determine when to refer to a pediatric endocrinologist for further management, and reviewing existing and newly available treatment options for patients with CPP. Register here: https://us02web.zoom.us/webinar/register/WN_TMSGkNMNQb25ddYvefibwQ
In November 2020, voters cast their ballots for president and public officials up and down the ballot. Their choices have significant ramifications for the future of pediatric research and child health policy in the United States. With the COVID-19 pandemic continuing to dominate the nation's attention, health care policy has never been more relevant to the national policy debate. The pandemic has highlighted both longstanding inequities and the strengths and weaknesses of American public health and biomedical research infrastructure. Elected leaders are taking the mandate given to them by voters and crafting policies to address this public health emergency and those to come. At this critical moment, it is critical to engage elected officials on child health policy to strengthen the pediatric research enterprise and improve the health and well-being of America's young people. This session will focus on opportunities to advance a child health agenda in the current political environment. It will review the child health and economic policies being debated and analyze their potential impact on child health outcomes. The session will discuss how the current political environment and public opinion may offer opportunities and challenges to advance a child health agenda. Mark Del Monte, JD, chief executive officer and executive vice president at the American Academy of Pediatrics, and Shetal Shah, MD, chair of the Pediatric Policy Council will be joined by a political expert to offer commentary and engage the audience in dialogue on these critical public policy issues.
George Armstrong established the first dispensary for children in London, England in 1769. This honorary lecture showcases an outstanding contributor to our knowledge of the care of children. The 2021 George Armstrong Lecturer is Dr. Makini Chisolm-Straker, the co-founder of HEAL Trafficking and associate professor of emergency medicine at the Icahn School of Medicine at Mount Sinai.
In 2016, the American Academy of Pediatrics published a policy entitled "Poverty and Child Health" recommending screening families for the social determinants of health (SDOH) and connecting families with resources in their community to help them with basic needs and benefits. Many pediatricians and pediatric programs have worked on setting up systems to make this happen. We know from research performed by the faculty of this session that while most pediatricians think that screening for addressing health-related social needs is important, many fewer report that screening is feasible or feel prepared to address families’ social needs. This symposium brings together national experts in SDOH and implementation science as well as members of a large collaborative that worked with 11 health care institutions over several years to integrate SDOH screening and referral at the primary care level with community-based organizations to improve the health and welfare of children. We will start with an overview of the evidence for both the need for these activities as well as the evidence for effective implementation and positive effects on child outcomes. We will next describe the design and results of the collaborative effort, including modifications during the COVID Pandemic with real-life details from one of the health care sites. This will allow attendees to get into the nuts and bolts of such efforts. Faculty will then reflect on what was presented and re-connect these efforts to the national scene, highlighting the degree to which the Pandemic has magnified the importance of addressing the SDOH.
Pediatric patients with kidney disease are often inundated with medical interventions including medications, dietary and fluid restrictions, dialysis regimens, and blood pressure monitoring. Realistically, it is rare that patients and their families can adhere to every aspect of a complex care plan, even in the best of circumstances. However, medication adherence remains a major predictor of clinical outcomes over time has care evolved. This sessions will cover the factors that can modify adherence and interventions to improve adherence adaptable to all aspects of pediatric kidney health management.
Antibiotic stewardship has been defined as "coordinated interventions designed to improve and measure the appropriate use of antibiotic agents." More than 80% of all antibiotics given to children are prescribed in the outpatient setting, yet there remain few formalized activities to promote antibiotic stewardship in this setting. During this session, national leaders will highlight novel settings for outpatient pediatric stewardship and discuss useful and effective outpatient stewardship interventions and techniques. These will include best practices in communicating about antibiotics with parents, description of behavioral nudges to improve antibiotic prescribing, harnessing electronic tools to drive improvement, identifying best practices in use of ambulatory diagnostic tests to guide antibiotic management, and data demonstrating ways in which antibiotic prescribing for children is racially biased. This session will therefore provide practical tools for participants to improve the quality of their antibiotic prescribing, will address important issues of equity in medicine, and will be relevant to general pediatricians, hospitalists, emergency medicine and infectious diseases specialists, and those who work in emergency departments, urgent care centers, ambulatory clinics, and ambulatory health care systems.
The human microbiome and their metabolic processes play a vital role in human pathophysiology. Advancing technology including metabolomics and next generation sequencing have provided a better and holistic understanding of disease pathophysiology as it relates to the human microbiome. In this proposed symposium, we will discuss the influence of microbial metabolites and products on mucosal immunology and health of the central nervous system. We will also explore the role of microbial metabolites as opportunities for discovery of biomarkers and novel therapeutics.
The Microbiome in Early Life: The fetus and newborn undergoes major transitions in relation to microbial exposures before, during and shortly after the birthing process. The relatively naïve neonatal microbiome along with the interaction between microbial components and metabolites and the hosts’ responses mature and evolve rapidly. Prior to birth, emerging evidence supports that the maternal and fetal ecosystems play a role in timing of delivery. At birth, vaginal versus cesarean delivery and the events surrounding these processes, as well as feeding and feeding composition, antibiotic exposure and the environment influence the developing neonatal microbiome. During the neonatal period, microbial dysbiosis has been implicated in neonatal diseases such as necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia. Dysbiosis of the intestinal microbiome has been implicated in immune dysregulation (allergic and autoimmune disorders). A genetic predisposition, along with an altered microbiome and environmental triggers have been associated with a “perfect storm” for the pathogenesis of Type 1 diabetes and other autoimmune diseases.
Metabolomics is the latest of the ‘omics’ technology and identifies distinct patterns of small molecules generated during both host and microbial cellular metabolism. These biomarkers may help in disease diagnosis, prediction or prognostication. Microbial metabolite pattern may be useful in diseases associated with dysbiosis. Metabolite patterns are dynamic, changing with gestational age, chronological age or disease process and gives us a snapshot of the metabolic milieu of the organism. Nuclear magnetic resonance spectroscopy and mass spectrometry are the ones most common techniques employed. The metabolites produced by microbes and/or the host may regulate transcriptional and translational events that can be evaluated using transcriptomics and proteomics.
Microbiota, metabolites and CNS health: The intestinal microbiota and the brain communicate in many ways via the immune system, metabolites, the vagus nerve and the enteric nervous system (ENS). Microbial metabolites including those of tryptophan metabolism, short-chain fatty acids, branched chain amino acids, and peptidoglycans may act as signaling molecules that have direct or indirect effects on the CNS and the ENS. Gut microbiota have been shown to influence developmental processes including neurogenesis, myelination, glial cell function, synaptic pruning and blood‐brain barrier permeability and in adult animals, microglial activation and neuroinflammation. It is possible that there may be a critical period or window in early life when the gut microbial composition is crucial and perturbation of the gut microbiota during this period causes long‐lasting effects on the development of the CNS and the ENS. The intestinal microbiome (gut)-brain axis has been implicated in neurodevelopmental disorders such as autism spectrum disorders, anxiety, obesity, schizophrenia, Parkinson’s disease, and Alzheimer’s disease. Most of the studies have shown associations without strong support for causality. Although animal and cell culture models can be helpful to better delineate mechanisms and causality, translational research with multi-omic approaches can provide evidence of causality.
Microbiota, metabolites and mucosal immunology: The commensal microbiome in the intestine regulates the maturation of the mucosal immune system, while the pathogenic microbiome causes immune dysfunction, resulting in inflammation and disease. The gut mucosal immune system, which consists of lymph nodes, lamina propria and epithelial cells, constitutes a protective barrier for the integrity of the intestinal tract. The composition of the gut microbiota is under the surveillance of the normal mucosal immune system. Inflammation, which is caused by abnormal immune responses, influences the balance of the gut microbiome, resulting in intestinal diseases. Microbiota as well as their cell components and their metabolites act as environmental triggers that influence mammalian gene expression as well as innate and adaptive immune responses. Recognition of commensal-derived PAMPs, such as lipopolysaccharides (LPS) by the intestinal epithelial cells (IEC) induce secretion of the antimicrobial peptide RegIIIg, which mediates colonization resistance in the gut. Microbiota-derived signals, butyrate, propionate and acetate (short chain fatty acids, SCFAs), induce IL-18 production from the IEC through activation of NOD-like family, receptors (NLRs) . Acetate produced by Bifidobacteria promotes epithelial cell barrier function by inducing an anti-apoptotic response in the IEC. The tryptophan/serotonin metabolic pathway, crucial in regulation of numerous neural responses rely on microbial production.
Microbial metabolites for diagnostics and therapeutics: Since presence of microbial dysbiosis may represent a disease phenotype, the intestinal microbiota and their metabolites have become effective targets for the development of new diagnostic methods. These diagnostic method may target markers of intestinal inflammation/ injury or those of systemic inflammation. Biomarkers include testing the blood (e.g. cytokines, CRP, procalcitonin, intestinal fatty acid binding protein, I-FABP) or non-invasive from stools (e.g. calprotectin, volatile organic acids) or from urine (I-FABP in urine, serum amyloid A in the urine). If dysbiosis is associated with disease, then optimizing the gut microbiome will likely represent an effective treatment for intestinal or other inflammatory diseases (fecal microbial transplant therapy).
Hypoglycemia and hyperglycemia have important implications to the developing brain, especially in newborns with neonatal encephalopathy or born preterm. This Symposium will discuss neonatal glucose homeostasis and brain metabolism with special emphasis on the newborns with high risk of neurologic injury. We will discuss the lessons learned from hypoglycemia in asymptomatic infants which can guide management of other cohorts of at-risk newborns. We will review the emerging evidence for distinct neuroimaging and electrographic phenotypes of brain injury and adverse outcomes in relation with early glycemic status in newborns with hypoxic ischemic encephalopathy. We will also review the current understanding and management recommendations for disturbed glycemic status in preterm newborns with emphasis on neurodevelopmental outcomes.
This video is unavailable at the request of one or more presenters.
The toll of gun violence on young people represents one of the most significant public health challenges facing contemporary America. In recent years, firearm-related injury and death has made headlines routinely, including mass shootings at schools, public festivals, and places of worship, while daily occurrences of gun violence affect local communities. Gun violence touches young people directly, impacting them, their family members, and friends. Additionally, the ongoing threat of gun violence, reinforced through regular active shooter drills in schools and media reports, extends the detrimental effects of gun violence further through biological stress mechanisms. Despite the frequency of these tragic events, too little research into interventions and public policies to reduce gun violence has been conducted in over two decades due in large part to a reticence on the part of the federal government to fund such work. In 2019, the Pediatric Policy Council engaged in successful advocacy efforts that helped to appropriate $25 million to the Centers for Disease Control and Prevention and the National Institutes of Health to administer grants for firearm research. Still, the United States has lagged behind its peers in identifying and implementing policies to address this problem. This session will explore the role of public health research in iterative policymaking to reduce gun violence in America. The goal will be to introduce key concepts to pediatric academicians, setting the stage for a moderated panel discussion.
This video is unavailable at the request of one or more presenters.
Through the topic of development of HIE therapeutics and trials, we want the audience to gain an understanding of the continuum between basic science, epidemiological, patient-oriented and clinical research, all while keeping in mind the driving reasons behind neonatal research: patient care. During decades of an incredible career, Dr. Delivoria-Papadopoulos contributed immensely to our understanding of the cellular mechanisms of cerebral injury following hypoxia. We dedicate this session to Dr. Delivoria-Papadopoulos, in recognition of her many contributions and mentoring to advance the field of basic-translational HIE research. In honor of her vision, each researcher across the continuum will show how collaboration with others has contributed to either a critical finding or overcoming a major obstacle. Dr Donna Ferriero will introduce the tribute and Dr Nathalie Maitre will moderate the Q and A session.
Presenters will explain the evolution of their science through their career, with one key finding and challenging time and the collaborations and partnerships they have leveraged along the way. The following four researchers across the continuum of career trajectories (mix of senior, mid and early career investigators) will discuss both scientific and career lessons learned from working in the field of neonatal neuroprotection.
Through the topic of development of HIE therapeutics and trials, we want the audience to gain an understanding of the continuum between basic science, epidemiological, patient-oriented and clinical research, all while keeping in mind the driving reasons behind neonatal research: patient care. During decades of an incredible career, Dr. Delivoria-Papadopoulos contributed immensely to our understanding of the cellular mechanisms of cerebral injury following hypoxia. We dedicate this session to Dr. Delivoria-Papadopoulos, in recognition of her many contributions and mentoring to advance the field of basic-translational HIE research. In honor of her vision, each researcher across the continuum will show how collaboration with others has contributed to either a critical finding or overcoming a major obstacle. Dr Donna Ferriero will introduce the tribute and Dr Nathalie Maitre (?) will moderate the Q and A session.
Presenters will explain the evolution of their science through their career, with one key finding and challenging time and the collaborations and partnerships they have leveraged along the way. The following four researchers across the continuum of career trajectories (mix of senior, mid and early career investigators) will discuss both scientific and career lessons learned from working in the field of neonatal neuroprotection.
From the first preclinical work on Erythropoietin to current large clinical trials, Dr Juul’s research trajectory gives us an overview of what it is to bring a treatment for HIE from the bench to the bedside. She will discuss a few key findings, transitions and challenges that led to large scale research on one of the first new neuroprotective agents in neonatal care.
Dr Tai Wu, an early career investigator and newly elected SPR member, will describe how MRI areas of higher brain temperature correlate with energy failure and excitotoxicity, and describe the challenges of translating fundamental in vivo findings to the bedside.
Dr. Chalak will illustrate the importance of developing novel assessments in patient-based research for HIE. She will demonstrate how an array of rigorous measurement of treatment effect, spanning serum biomarkers to a novel brain-based pattern of classification, can offer mechanistic insights to clinical HIE trials. She will talk about the challenges of using traditional clinical trials models in current HIE reserch.
Dr Yvonne Wu, a senior investigator will finish by commenting on a combined approach using clinical trials and epidemiologic studies to develop new strategies for treating and preventing HIE. She will discuss her work on developing novel strategies during labor and delivery that will better predict HIE and related birth outcomes so that treatments and biomarkers have a greater impact in the long-term.
Antibiotic use in hospitalized children is now closely scrutinized by antibiotic stewardship programs. This session will involve 3 debates on hot topics relating to how antibiotic use should be managed for hospitalized children, including whether antibiotic use for non-infectious conditions (such as to promote gastric motility) should be regulated and reduced; whether early transition to oral antibiotic therapy for infections in hospitalized children is safe and effective; and whether other diagnostic tests – biomarkers like CRP or procalcitonin – should be used to guide antibiotic therapy in our patients. During this session, national leaders in Gastroenterology, Infectious Diseases, and Critical Care Medicine will debate these topics. The format will involve three 30 minute debates, in which each speaker will review the scientific evidence for her/his position for 8-10 minutes (maximum 20 minutes total), each speaker will have a chance to respond to the other speaker for 2 minutes (4 minutes total), and in which audience participation will be garnered through live polling and questions will be allowed (remaining 6-10 minutes total). The presentation of the initial position could be pre-recorded, while the rebuttals and Q&A section would be live. The overarching goal of the session is to highlight the evidence for and against the antibiotic management strategies covered for these common situations in hospitalized children, and to provide a fun and interactive session reaching a broad multidisciplinary audience.
This engaging session will therefore be relevant to those who care for hospitalized children, including medical student and resident trainees, general pediatricians, hospitalists, and specialists in emergency medicine, gastroenterology, and infectious diseases.
The goal of this session is to address specific issues that contribute to shortened lifespan, even after successful pediatric kidney transplantation. The leading cause of late mortality is premature cardiovascular disease, and this risk of death is much greater after graft failure and return to dialysis. Therefore, strategies to improve immunologic outcomes and prolong the life of a child’s first graft are paramount, and will be addressed in the first 2 talks. The second 2 talks will focus reducing mortality in our patients who are already successfully transplanted per our current protocols. First we will discuss the current data on CVD outcomes in this population, and the relative roles of both modifiable and non-modifiable risk factors. The final talk will address multidisciplinary ideas for practical, programmatic ways to teach and encourage healthy lifestyle choices, and to empower transplant recipients toward self-sufficiency and self-care as they mature.
The COVID-19 pandemic challenged doctors and hospital administrators as did no other event in our lifetimes. Leaders needed to develop a pandemic command structure with the agility to respond to rapidly evolving situations. They had to deal with drastic financial implications, develop new methods of delivering health care, and collaborate regionally. They learned the importance of communication with staff, policy makers, the local medical community, and the public. They had to allocate of scarce resources internally and externally, and balancing rational policy making against irrational fears. For children’s hospitals, some specific challenges included determining our role in a pandemic that predominately affected adults, doing research on the unique pediatric manifestations of disease, and dealing with questions about schools and daycare. In this workshop, leaders from hospital administration, infectious disease, and disaster preparedness will review and analyze some of our experiences and responses at a large quaternary care children’s hospital. We will use specific events and decisions to illustrate the unique challenges and our retrospective analysis of whether we could have done better. The goal of the interactive workshop is to learn together from our collective experience in order to be better prepared for future events.
This video is unavailable at the request of one or more presenters.
Embargoed Content Notice: The content of this clinical practice guideline has been approved by the American Academy of Pediatrics (AAP) board of directors. As a date for publication in Pediatrics has not been set, the clinical practice guideline and associated written materials are embargoed. Therefore, the contents of this presentation cannot be duplicated or shared.
Members of the multidisciplinary guideline committee (general pediatrics, hospital pediatrics, pediatrics emergency medicine, pediatrics infectious diseases, epidemiology, practice management, family medicine, informatics) will discuss:
1. Foundational Evidence
2. Understanding cntext and risk (Primary care, ED, Hospital, ID)
3. Building consensus through shared decision making
4. How recommendations should and should not be used
5 How recommendations will be evaluated
6. What is on the horizon
We expect that our clinicians provide evidence-based care for their patients. Similarly, we should expect that our educators provide evidence- based teaching for their learners. However, navigating the educational literature and interpreting the nomenclature can feel daunting. With impactful, high quality publications ranging across the continuum of undergraduate, graduate, and continuing medical education, in addition to educational innovations being described in specialties beyond pediatrics, it would be useful to have a tailored resource for pediatric educators.
This session plans to address that need.
Now in our fourth year presenting this Symposium (fifth year accepted), we will present and synthesize the most relevant and practice-changing articles in medical education from the year 2020. An expert panel of pediatric educators from the APA Education Committee will review the medical education literature using a modified Delphi approach to determine the top 15-16 articles in medical education. These articles will have the highest relevance to the teaching of pediatrics and potential to change teaching and curricular development across the continuum of education. The articles will be grouped into thematic areas that develop through the process (not selected a priori), but attention will be paid to providing a diversity of articles covering all points in the education continuum. Members of the expert panel will present the different thematic areas as "Hot Topics" for this presentation, including areas of controversy and areas for further scholarship. Audience members will be invited to engage with the presenters to discuss the issues.
Survival rates for extremely low birth weight infants have improved dramatically over the past 10-15 years. These advances are likely to be multifactorial and relate to increased appreciation of developmental organ vulnerability, improved understanding of disease mechanisms and contributing factors, enhanced diagnostic precision and therapeutic options. Unfortunately, enhanced survival does not guarantee avoidance of neonatal morbidity or adverse long-term health care outcomes. The traditional focus of outcomes research relates to neurodevelopment and cognitive functioning. Recent evidence highlights the relationship between prematurity and increased risk of adverse cardiopulmonary health during early adulthood, even in healthy and more mature premature infants. Unfortunately, data are limited regarding the relationship of heart function or other cardiovascular illness during the perinatal period and these outcomes. There is a critical need to increase awareness of these adverse health care outcomes and establish research teams to investigate risk factors and develop preventative approaches. In this symposium, we will review the developmental vulnerability of the premature infant; discuss the impact of prematurity of right/left ventricular function and vascular performance in the pulmonary/systemic beds and highlight areas for innovation and future research that may provide mechanistic insight and guide prevention and treatment approaches.
This session is a presentation by Pediatricians Against Racism and Trauma (PART), a group of more than 80 pediatricians from across the United States trying to fight racism, bias, discrimination and hatred as it impacts children and families. While structural racism and bias exist throughout society, racism is also "baked into" medicine itself, including pediatrics. This session will bring national leaders and experts together to bring the various aspects of racism in medicine and medical education into focus and suggest ways we can move towards being anti-racists in clinical care and medical education. The session will have the following topics: 1. The norm of whiteness in medicine and medical education; 2. Racial-ethnic inequities in clinical care due to implicit and explicit bias; 3. The inappropriate use of race in clinical algorithms or as a risk factor for outcomes, with the implication that race is a genetic biological trait rather than a social construct; 4. The problematic experiences of URiM students and trainees, including bias in grading, low social capital/belonging (isolation), exposure to microaggressions, and having to deal with cultural differences in performance expectations. Finally speakers will bring these issues together with possible solutions to move pediatrics and pediatricians into being anti-racist.
This pro-con debate will review the problem of hypoglycemia detection andmonitoring in critically ill children admitted to the pediatric intensive care unit with impact on neuro-cognition and other outcomes. There is not quite enough evidence for harm, but the data is mounting. While data from neonates is more convincing for harm from hypoglycemia, the evidence is not so clear in older critically ill children. Recent trials of tight glucose control in this population of critically ill children did not observe any convincing benefits from such a strategy, but all trials uniformly observed variable increase in hypoglycemia rates. More concerningly, many critically ill children may have hypoglycemia even in the absence of tight glucose control and detection is often difficult due to the inability to discern symptoms. However, it remains unclear if hypoglycemia is transient or sustained due to current intermittent sampling methods with implications for detection and impact on outcomes.
Speed mentoring
Aspiration and reflux cross several disciplines in pediatric care. An understanding of the physiology of swallow and the causes of reflux are important in the care of these children who often present with challenging problems. A multidisciplinary approach has become more important in evaluating and planning treatment strategies for children with chornic health problems related to aspiration and reflux.
This would be a panel presentation of experts discussing the various cardiopulmonary issues that patients wtih Down syndorme (DS) may encounter during their lifetime.
-Topic 1 - Genetics involved in the development of congenital heart disease (CHD) in the DS population
-Topic 2 - Possible changing CHD phenotype in the DS population.
-Topic 3 - Pulmonary hypertension issue in the DS population
-Topic 4 - Cardiac morbidity and mortality in the DS population
-Topic 5 - Longterm/adult cardiopulmonary outcomes in the DS population
In recent years, immune dysregulation syndromes have been increasingly recognized as a source of human disease requiring a multi-disciplinary approach to diagnosis and management. These children may present to a variety of pediatric sub-specialists for care, for example for early-onset diabetes, inflammatory bowel disease, rheumatic disease, and autoimmune cytopenias. This session will highlight a number of aspects of immune dysregulation of interest to the non-rheumatologist and to pediatric trainees in order to provide a shared mental model of what these conditions look like. The first presentation will introduce the concept of autoinflammation, discuss how to make some sense of a truly dizzying number of single-gene diseases, and show how instructive these rare diseases have been in understanding more common symptoms. The second presentation will use a stepwise, case-based approach to give a few examples of how immune dysregulation can hide in numerous pediatric clinics. The third presentation will describe how immune dysregulation syndromes may be inherited and explain how alternative mechanisms of disease, including somatic mosaicism, may lead to immune dysregulation. Finally, the fourth presentation will provide a practical, multi-disciplinary, and replicable approach to the diagnosis and management of these syndromes.
Personalized medicine is a National Institutes of Health major initiative and focuses on delivering the right treatment to the right patient at the right time instead of a one-size-fits-all approach. Although pediatricians excel at patient-centered care and weight-based dosing, few other data are incorporated into dosing decisions for children. Pharmacogenetics is the study of how the genetic makeup of a person influences the response to drugs and is an essential pillar to advancing personalized medicine. Advances in pharmacogenetic testing have been made in the field of pediatric psychiatry to provide individualized management of common mental health disorders. As the number of children and adolescents who require treatment for mental health is on the rise, general pediatricians are expected to initiate and titrate psychotropic medications. However, many pediatricians have not received formal training on pharmacogenetic testing, and are unaware of the tests available, the indications for testing, the limitations to test interpretation, and how to adjust therapy based on findings. In this panel discussion, attendees will hear from experts on the current state of pharmacogenetic testing in drugs commonly used in pediatric mental health disorders and how to implement testing clinically in their practice. This session will include discussion of each specific topic throughout, as well as broad discussion based on audience questions and/or sample cases from the presentation team.
With a lack of quality improvement/quality assurance (QI/QA) sessions in most large pediatric nephrology meetings, I thought that this session could highlight and show off some of the impressive QI/QA work being done in different areas of pediatric nephrology. This workshop will focus on QI as an academic pursuit, showing both small and large scale initiatives that have been successful in the area of nephrology QI. ASPN
Join us for an in-depth discussion with two Pediatric experts who will share newly published research revealing that infant gut dysbiosis is widespread in the U.S. and what this means for your infant patients, including:
● Why common conditions: colic, eczema, gassiness, fussiness, and diaper rash are signs of gut dysbiosis in infants
● How gut dysbiosis impacts the development of a healthy immune system
● How to restore beneficial B. infantis and resolve dysbiosis
● The latest peer-reviewed reported outcome data on improved symptoms after feeding activated B. infantis
Speakers:
Karl Sylvester, MD, FACS, FAAP
Professor of Pediatric Surgery
Associate Dean of Maternal Child Health Research
Stanford University
Whitney Casares, MD, MPH, FAAP
Pediatrician and AAP author
Pediatric Associates of the Northwest in Portlanda
Chorioamnionitis is a pregnancy inflammation that is diagnosed by histologic analysis of the placenta. In its most severe form, chorioamnionitis can induce a fetal inflammatory response. It typically presents with clinical symptoms in the mother or fetus (clinical chorioamnionitis), particularly in term gestations. Conversely, histologic chorioamnionitis (HCA) is often clinically ‘silent’ and closely linked to preterm birth. HCA may contribute to the pathogenesis of neonatal complications (sepsis, brain injury, chronic lung disease, necrotizing enterocolitis). Mounting evidence also suggests that fetal exposure to inflammation could contribute to health issues in later life, including cardiovascular disease, asthma, and cognitive dysfunction. The goal of this Scientific Session is to highlight cutting-edge research focused on the pathogenesis of HCA as well as on the mechanisms that contribute to adverse fetal and neonatal outcomes. The target audience includes clinicians and scientists interested in perinatal outcomes, developmental immunology and/or mechanisms of inflammation.
Critically ill children may be particularly vulnerable to social determinants of health (SDOH) across the continuum of illness. Substandard living conditions may predispose children to higher risk of critical disease; long-standing toxic stress may worsen illness severity; limited family and community infrastructure could hinder recovery and potentiate post-PICU morbidity. The full impact on critical illness and outcomes is poorly understood, as screening has not been widely implemented.
Universal screening for SDOH in the acute care setting is recommended by the American Academy of Pediatrics. Routine screening for social conditions impacting health and disease can be justified under Wilson and Jungner’s criteria including: recognized need, clear screening objectives, a target population, evidence of effectiveness, ability to test, quality assurance, ability to minimize risks, and informed choice. Identifying socially disadvantaged children and families may improve outcomes by 1) mitigating parental stress through resource provision; 2) preventing hospital readmission and 3) decreasing morbidity after discharge by improving access to post-hospital care that meets needs of limited-resource families. Despite potential benefits, screening is not routinely done.
Several barriers to screening exist. Screening can uncover psychosocial trauma and requires training in trauma informed approaches. Time to screen can be challenging in the busy PICU setting. Clinic and community resources may vary between institutions, and identification of unmet needs with inability to provide resources could lead to unnecessary “labeling” of families. To reduce risk of and improve outcomes from critical illness, these concerns must be balanced against the need to describe the scope of the problem to generate additional resources. Identifying appropriate ways to screen is of critical importance. Using existing tools in emergent settings may be challenging, creating an opportunity for development of additional tools.
We argue a strengths-based screening approach may be an effective means of identifying needs while also increasing willingness to participate. Strengths-based tools, however, do not exist. This panel will discuss creation, validation and implementation of a strengths-based, resilience-oriented and stakeholder-informed social history screening tool for use in the acute care setting, through multidisciplinary collaboration, including patient and family engagement.
The COVID-19 pandemic has presented a kind of “double whammy” (Saleh, 2020) for pediatricians, of acute problems on top of longstanding chronic stress. Prior to the pandemic, nearly 1 in 2 general pediatricians was already burned out (Shanafelt et al., 2015). Now, pediatricians are having to balance old challenges with new ones, such as widespread office closures and reduced volume, with some clinics facing drops in patient visits by 60% or more (Gold, 2020). They are also contending with constantly changing work protocols, increased isolation and ostracization from colleagues, peers, and friends, role-juggling and competing work-family demands. Furthermore, earlier shortages of PPE, combined with societal demands for heroism have caused some physicians to feel more like martyrs than heroes, requiring them to make difficult decisions about their safety, and that of loved ones. Academic researchers have also contended with a chaning landscape of what studies are allowed to continue vs. be deferred and many academic pediatricians have pivoted their work to answer key questions of the day rather than the ones they worked so hard to write grants to answer. This panel will explore these and other ways that COVID-19 is affecting pediatrician clinician attendings, residents, and researchers' health and wellbeing during the global pandemic. It will combine a range of perspectives from clinician educators, to private practice, to academic pediatrics, to sociology to consider how practicing pediatricians are experiencing the crisis—and what might be done to help improve that experience.
Works cited:
Gold, J. (2020). Pediatric Practices Struggle To Adapt And Survive Amid COVID-19. Retrieved from https://khn.org/news/pediatric-practices-struggle-to-adapt-and-survive-amid-covid-19/
Saleh, M. (2020). A Double Whammy: The COVID-19 Pandemic and Burnout in Medical Professionals. Retrieved from https://leanforward.hms.harvard.edu/2020/04/09/a-double-whammy-the-covid-19-pandemic-and-burnout-in-medical-professionals/
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600-1613. doi:10.1016/j.mayocp.2015.08.023
This session will discuss the interface between nephrology and oncology in pediatrics. Topics will include acute complications and late effects of treatments for childhood cancer, including chemotherapy, radiation, bone marrow transplant as well as targeted and immune-therapies. This session will also address malignancy complicating pediatric kidney transplant. Emphasis will be on recent evidence.
In 2019, the WHO has named vaccine hesitancy as one of the top 10 threats to global health. Vaccine
hesitancy is complex and context specific across time, place and vaccines; however, it is a
communicable condition spreading around the world through the internet. This session takes up three
representative problems: MMR vaccine in the Western countries, HPV vaccine in Japan, and dengue
virus vaccine in the Philippines. Understanding why there is a tendency to hesitate those vaccines
may lead to the solutions of problems. Moreover, the session introduces some enlightening activities,
including a joint project of AAP and Japan Pediatric Society.
Applied machine learning and artificial intelligence continue to invade modern life, driving everything from advertising to automobiles. Big Data are increasingly being used for both research and clinical care. Despite the increase of machine learning applications in both these fields, there remains minimal work being done specifically in pediatrics, which presents a unique environment compared to adult care. Thankfully, pediatricians hold a unique understanding of brain development, which helps provide a baseline for understanding the machine learning concepts modeled after the human brain. At this critical point in informatics research and application, pediatricians must develop a conceptual model of machine learning techniques, identify acceptable use of artificial intelligence methods in medicine, and provide examples of state-of-the-art projects being done to help provide the best possible care for their patients.
Dr. Dufendach is a neonatologist, assistant professor, and informaticist at Cincinnati Children’s Hospital Medical Center. He will provide a complete primer on machine learning and artificial intelligence from the pediatrics perspective, leveraging the clinician’s conceptual model of brain development to help explain how a neural network works. He will introduce and illustrate the seven steps for developing machine learning algorithms using tangible examples.
Dr. Dexheimer is a biomedical informaticist with a focus in machine learning and decision support, and associate professor at Cincinnati Children’s Hospital Medical Center. She will highlight research being performed at Cincinnati Children’s. She will discuss the role and impact of AI and ML in research with the electronic health records, explore unique aspects of conducting work in pediatrics with biomedical informatics, and discuss the integration of ML into clinical care.
Dr. Kirkendall is the Deputy Director, Center for Healthcare Innovation & Director of Digital Health Innovation at Wake Forest Baptist Health. He will discuss the integration of ML and Natural Language Processing into clinical care and the challenges associated with doing so. He will also highlight research using artificial intelligence being performed at both Cincinnati Children's Hospital and Wake Forest Medical Center.
Dr. Grundmeier is a pediatrician and the Director of Clinical Informatics at the Children’s Hospital of Philadelphia. He is a national expert in the repurposing of clinical data for secondary use in clinical and genomics research. He will provide a broad review of the pediatric-related machine-learning literature and put it into context for the pediatric provider and will highlight state of the art work currently being performed at the Children’s Hospital of Philadelphia.
Urinary tract infection (UTI) is one of the most common bacterial infections in infants, and occurs in up to 10% of febrile infants <2 months old. Young febrile infants with UTI are commonly encountered in outpatient and inpatient settings and across specialties such as general pediatrics, emergency medicine, hospital medicine, neonatology, and infectious diseases. Current AAP UTI Guidelines address diagnosis and management for 2-24 month olds but do not provide guidance for infants younger than 2 months of age. Consequently, there is uncertainty and variability in diagnosis and management of UTI in the <2 month age group. This session will use case vignettes to provide an engaging review of the latest evidence and multidisciplinary discussion of the following topics: 1) Different definitions of UTI and the role of colony count, urinalysis results and collection method, 2) Routine vs. targeted lumbar puncture in infants with a positive urinalysis, 3) Duration of parenteral therapy for UTI with and without bacteremia, and 4) Imaging following first febrile UTI.
A panel of experts on urinary tract infection in febrile young infants representing diverse fields (general pediatrics, hospital medicine, emergency medicine, and infectious diseases) will discuss these topics in a moderated format. The session will begin with a brief review of the AAP UTI Guidelines and reasons for special considerations in the <2 month age group. Each topic will begin with a case vignette with audience response polling to assess current practice related to that topic. A focused review of relevant pediatric literature will be provided, followed by a moderated panel discussion to discuss various perspectives. There will be 19 minutes allotted for each topic (12 min presentation followed by 7 minutes of discussion and audience question-and-answer session). Audience members will be able to submit questions through the PAS virtual presentation platform. The moderator will select from the audience questions and facilitate the question-and-answer session per topic, allowing for a total of 28 minutes of attendee-driven discussion to promote in-depth conversations about current controversies. The session will conclude with an overview of future directions for research. Attendees will gain a strong evidence base from which to manage UTI in the <2 month population.
Outline:
1. Overview of AAP UTI Guidelines and Special Considerations for <2 month old infants (10 min)
2. Defining a “Gold Standard” for UTI Diagnosis: Role of the Urinalysis, Urine Culture, and Method of Collection (19 min)
3. Routine vs. Selective Lumbar Puncture in Infants with a Positive Urinalysis (19 min)
4. Duration of Parenteral Antibiotic Therapy and Outcomes (19 min)
5. Routine Imaging Following First Febrile UTI (19 min)
6. Future Directions (4 min)
The coronavirus pandemic threatens low and middle-income countries (LMICs) raising great concern about the direct as well as indirect impact of the coronavirus disease (COVID-19) on the health and well-being of children and adolescents. Children in LMICs constitute a high proportion of the population and may have a high prevalence of risk factors for severe lower respiratory infection such as HIV or malnutrition. Not only is their physical health impacted by COVID-19, but their countries’ economies and capacity of existing health systems to manage the additional burden are compromised. Further challenges in LMICs include the inability to implement effective public health measures such as social distancing, hand hygiene, timely identification of infected people with self-isolation, and universal use of masks. Finally, significant indirect effects of the pandemic on child health are of considerable concern, including increasing poverty levels, disrupted schooling, lack of access to school feeding schemes, reduced access to health facilities. and interruptions in vaccination and other child health programs.
In this panel, international experts will describe global, country, and local responses to these challenges including community partnerships, stakeholder coalitions, and innovations. Speakers will also outline research priorities and key calls to action for the international community.
Progressive post-hemorrhagic ventricular dilatation (PHVD) affects more than half of extremely premature infants with severe intraventricular hemorrhage and contributes to their high risk for adverse motor and cognitive neurodevelopmental outcomes. Despite being investigated for many decades, there is no agreement among neonatologists, pediatric neurologists, and neurosurgeons as to the best management approach to PHVD. Very recently, the ELVIS study (Randomized Controlled Early versus Late Ventricular Intervention Study) demonstrated improved 2- year outcome in the early intervention group.
This hot topic symposium will be led by experts in the field who will elaborate on the following aspects:
- Pathophysiology and neuropathology of PHVD- Terrie Inder
- Intervention studies for PHVD- Linda de Vries
- Surgical interventions for PHVD- David Limbrick
- Future directions and other neuroprotectors- Praveen Ballabh
- Consensus approach for evaluating and managing PHVD- Mohamed El-Dib
This will be followed by panel Q&A allowing for audience interaction.
Webster’s Dictionary defines a “dogma” as a settled opinion, principle, or maxim. When concepts become rigid dogmas, creative thinking is obstructed. This further impedes the development and incorporation of innovative approaches and ideas. Increasingly, attention has been given to clinical practices or “dogmas” that may not be evidence-based. This investigative approach to widely held clinical practices has been promoted through the lauded Choosing Wisely campaign and the “Things We Do For No Reason” series in the Journal of Hospital Medicine. Yet, within education, much like the clinical realm, we have adopted certain widely accepted educational strategies and practices that are potentially futile, or even harmful, for educators and learners rather than being evidence-based or even “best practice”.
During our session, we will review well-known educational approaches that have become common parts of educators’ teaching toolboxes but that have little evidence to support them and provide little educational value to our learners. These topics, which will be relevant to educators who work with learners of varying levels and in a variety of settings will include: millennial learners, cognitive biases, learning styles, time-based training and simulation based training.
The session will begin with a brief history of dogmas in general. Then, each panelist will present one medical education dogma that lacks robust evidence for 15 minutes which will include at least 5 minutes of audience participation (Q/A, reflection questions, polling questions) Panelists will also share alternative evidence-based teaching practices that audience members can use in place of the dogma. Finally, we will solicit from audience members other widespread teaching practices that are difficult to justify based on current evidence. Our goal is for this session to assist educators in realizing that not all educational approaches, including “best practices,” have evidence. We hope this session will serve as a starting place for increased research, further investigation into the suggested dogmas and active discussions amongst educators.
This diverse panel will summarize known inequities facing women in academic pediatrics, including gaps in compensation, professional opportunities, and academic promotion. Panelists will explore how the current COVID-19 pandemic is exacerbating inequities, and discuss additional barriers faced by women of color. With the problem thus framed, panelists will propose strategies to mitigate gender inequities at the institutional, journal, and societal level. The essential role of male allies will be explored. Audience members will have an opportunity to interact and ask questions via live chat. Participants should leave this session armed with knowledge about the structural and social causes of gender inequity, as well as strategies to address it in their own professional environments.
Resuscitation of critically ill children presents unique challenges to both pediatric and general acute care providers. Resuscitation team members are drawn from a large pool of health care providers (HCP) with highly variable skill and experience levels. These teams are often required to perform resuscitations with limited information on underlying patient morbidity or physiologic risk factors, at any time of day or night, and with minimal advanced warning. Such fundamental procedures as cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) are universally required but infrequently performed. The high acuity, low frequency nature of these events make it difficult for the individual health care provider, and by extension, the resuscitation team, to maintain clinical competency and to provide optimal resuscitation to those children who are critically ill.
The use of videorecording during clinical care has robust history in trauma resuscitation and care of the newly born infant in the delivery room. Over the past decade, a growing body of literature has demonstrated the usefulness of video review as a needs assessment, a quality improvement tool, and a data source for research in pediatric resuscitation. Video review provides clear, unbiased data on these uncommon and highly dynamic patient encounters and can yield elusive information about clinical care, teamwork, communication, and provider interactions.
In this presentation, we explore the use of clinical videorecording and several applications to assessing and improving resuscitative care. All presenting authors work in academic pediatric centers and have independently, and jointly, led efforts to improve both the care of critically ill patients in the PED and PICU and the training and education of the HCPs who provide this care. Topics covered in this presentation will include: 1) the use of video review as a novel methodology for teaching both CPR performance and ETI skills, 2) application of Crew Resource Management methods for improving resuscitation team leadership and communication, 3) development and implementation of high frequency, on-shift, in-situ simulation programs, and 4) the use of safety checklists to decrease systems variability and cognitive workload during resuscitations.
Bronchpulmonary dysplasia (BPD) has been used for over 30 years as a predictor of early respiratory morbidity, but increased survival of extremely low gestational age newborns (ELGANs) and changes in NICU practice have resulted in limitations to BPD as a predictive value. The Premature Respiratory Outcomes Program (PROP) and Trial of Late Surfactant for Prevention of BPD (TOLSURF) Study are NIH-funded longitudinal birth cohorts of ELGANs that have provided a wealth of clinical, biochemical, and genetic data to study the association of preterm birth with respiratory morbidity. This session hopes to provide clinicians from Neonatology, General Pediatrics, and Pulmonology with an update on predictors of respiratory morbidity in preterm children.
Advanced chronic kidney disease is a treatable, but life-limiting and incurable process characterized by significant burdens for the patient, family, and even clinicians. Recognition of the importance of palliative interventions to minimize these burdens has increased dramatically in recent years in adult dialysis patients and other pediatric populations, and palliative care consultation is now included in standard recommendations such as the RPA guideline on shared decision-making in dialysis. Despite this, pediatric nephrology has had a relative dearth of scholarship in palliative care. This symposium will unite experts in palliative medicine and nephrology to disseminate expertise in symptom management, communication, compassionate conservative care, and provider moral distress and burnout in order to empower pediatric nephrologists to take an increased role providing primary palliative care to their patients and propose new avenues of collaboration and scholarship between pediatric nephrology and palliative care.
This video is unavailable at the request of one or more presenters.
One third of United States children live in a home with a gun. Easy access to firearms leads to hundreds of intentional and unintentional pediatric deaths annually and has resulted in the United States being the world leader in pediatric firearm mortality. As the death toll mounts, and mass shootings become sadly commonplace, a groundswell of activism to change gun laws led by grassroots groups has erupted. Unfortunately, policies advocated for rarely have a strong evidence base as research into the causes and solutions to gun violence have been hamstrung by federal policy. Gun violence is a public health crisis finally beginning to get the attention it deserves.
The response to this crisis has been multifaceted. Parents and children directly affected by mass shootings have founded and championed grassroots movements to change gun culture and legislative policy. Physician scientists have begun to determine the efficacy of legislative policy reducing firearm morbidity and mortality to inform the legislators on Capitol Hill to reduce pediatric morality. This cross-disciplinary plenary will address how patient advocates, researchers, and legislators can work together to enact evidenced based legislation to keep children out of the line of fire.
The plenary speakers will consist of 1) a gun violence survivor 2) a health services researcher expert in firearm legislation efficacy, 3) a leader of a grassroots firearm violence reduction group, and 4) a US Senator expert in firearm legislation.
Timing: 90 minutes total
5 min: Drs. Hogan and Silver--Introduction
15 min: Julvonnia McDowell--Mother of child killed by an unsecured firearm
20 min: Rebecca Cunningham, MD--Vice President of Research at the University of Michigan, Principle Investigator of the Firearm Safety Among Children and Teens Consortium.
20 min: Shannon Watts (Invited)--Founder of Moms Demand Action the largest grassroots organization in the United States dedicated to reducing gun violence.
20 min: The Honorable Christopher Murphy, United States Senate (Invited)--Senator Murphy is leading voice in the United States Senate for firearm legislation. He has sponsored numerous bills supporting gun violence reduction strategies, increasing funding for the CDC and NIH, and this year published a new book on the gun violence epidemic: The Violence Inside Us: A Brief History of an Ongoing American Tragedy.
10 min: Drs. Hogan and Silver moderating--Question and answer session
This multi‐disciplinary session will focus on clinical and research gaps in caring for transgender youth undergoing gender affirming therapy. Specific topics will include mental health, statural growth, fertility, and cardiometabolic health. Presenters will summarize the current gaps in knowledge, provide practical,considerations for clinical care, and identify critical areas for future research.
Pediatric Nutrition
The effect of adverse childhood experiences (ACEs) on health outcomes across the lifespan is well recognized among pediatric practitioners. Increasing the ability of healthcare providers to recognize and respond to ACEs can buffer the long-term negative physical and mental health impacts of adversity and also increase patient-centered care.
For pediatric practitioners, there are multiple ways to address ACEs. This symposium will review approaches at the patient, systems (clinic/hospital), community, and education level. It will also highlight the importance of interdisciplinary collaborations in moving this work forward.
At the patient level, the symposia will review the experience of Atrium Health Levine’s Children’s Hospital, as a pilot site for the National Pediatric Practice Community of the Center for Youth Wellness. Dr. Shivani Mehta will discuss the facilitators and barriers to ACE screening implementation in both the academic and community primary care pediatric settings and review the use of resource referrals as a key intervention in promoting wellbeing and resilience.
At the clinic and hospital level, the Substance Abuse and Mental Health Services Administration delineates a framework to guide the creation of trauma-informed systems. Dr. Anita Shah, will review the experience of Cincinnati Children’s Hospital Medical Center in developing a trauma-informed strategic plan with multidisciplinary partners.
Community partnerships can be critical in securing resources to build resilience and preventing childhood adversity. Dr. Nia Bodrick will highlight two exemplary community partnerships, the Early Childhood Innovation Network and the Building Communities Resilience National Coalition.
Lastly, education on ACEs and trauma-informed care is essential in assuring the sustainability and integration of approaches to confront adversity. Dr. Heather Forkey, will describe the Pediatric Approach to Trauma, Treatment, and Resilience (PATTeR) program, supported by the American Academy of Pediatrics. The PATTeR program has trained over 400 pediatricians and clinic team members about childhood adversity and trauma-informed care.
The session will begin with a 10-minute introduction on the sciences of adversity and trauma-informed care delivered by Dr. Chokshi. Each of the four speakers will then give a 10-minute talk, followed by 5 minutes of moderated question and answer. This will leave 20 minutes for a interactive group discussion.
Given the current epidemic of faculty burnout, many academic health centers are looking for ways to enhance engagement and provide faculty development. Fostering interpersonal relationships is one individual factor that has been suggested. Developing support networks allow for a sense of collegiality and connection that is increasingly lacking for many faculty. One model of connection that has been used successfully in the past is the traditional mentor-mentee relationship. In this setting, an older, wiser faculty mentor tells the junior mentee what to do based on his or her own interpretations and expertise. Although beneficial, traditional mentoring has its potential limitations including bias and having the mentee feel unheard. To address these limitations and emphasize the value of a support network as more effective than a singular construct, innovative models of peer mentoring have been designed.
During this panel discussion, physician directors of five faculty professional development programs will each describe their program. The first program, established in 1995, is a national/international year long, part-time national fellowship program for women across all disciplines of medicine, as well as dentistry, public health, and pharmacy, who are well established in their scholarship, have a leadership position, and are designated by their dean and other institutional leaders as someone with great leadership potential. The second program began in 2009, and is a health system-wide initiative and incorporates the role of a peer coach blended with multiple mentors across domains of interest. The third program housed in a pediatric department began in 2011 and is a blended model that utilizes a skill development curriculum, along with senior faculty facilitation and small group peer mentorship. The next department-wide program was launched in 2014, and is a mixed peer-and-senior multidisciplinary model that emphasizes group discussion on practical concepts. The final program was established inside a pediatric deparment in 2017, and uses a peer group model where each group consists of 3 mentees, who receive domain-specific mentorship from one mentor and oversight by one coach. All five programs have had sustained success and their various program outcomes will be presented. Audience members will have an opportunity to comment and ask questions following each presentation.
The dangers of opioid, vaping and cannabis consumption are ever present within the pediatric community. Current U.S. trends related to these substances reveal an alarming dependence and abuse potential for these drugs with lethal consequences. This session will consider and present: 1) the current status of the opioid crisis across pediatric population groups specifically focusing upon new and innovative technology that is able to detect drug withdrawal in neonatal abstinence syndrome (NAS) and analgesia, diversion or recreational use in children and adolescents; 2) describe the natural history of current use and disposition of medical cannabis products and understand the pharmacokinetic and pharmacodynamics of these products in pediatrics; 3) provide up-to-date regulatory data and information from the Food and Drug Administrative (FDA) concerning the agency’s actions and recommendations for the public regarding Electronic Nicotine Delivery Systems (ENDS) including vaporizers and e-cigarettes and 4) describe the health risks associated with the use of vaping, an evolving epidemic in children and adolescents. Session speakers are recognized experts in their respective fields, including academia and the FDA. The session will include an interactive panel discussion, designed to facilitate discussion of high-impact clinical questions and strategies with potential for multi-institutional collaboration. At the conclusion of this session, learners may participate in a discussion of research priorities, collaborative opportunities, and strategies for clinical implementation of the information presented in the symposium
Probiotics are increasingly used in pediatrics, spanning outpatient general pediatric practice, the emergency department, and hospitalized patients, including those in intensive care units. Although some studies have shown efficacy in acute infectious diarrhea, antibiotic-associated diarrhea, viral respiratory tract infections, and inflammatory bowel disease, reported benefits are typically probiotic-formulation-specific, and recent clinical trials have raised questions about the potential benefits. Recent data also highlight the risks of bacteremia and sepsis related to probiotics as well as the impact of probiotics on the microbiome. This session will provide an overview of probiotic use and clinical trials in pediatrics, including what is known about probiotics in COVID-19.
A systemic literature review of evidence based neonatal skin care practices (2015 – current). Register here: https://waterwipes.site/symposium
All are welcome.
Although rates of HIV infection declined in the United States for many years, recently the number of annual infections have plateaued since 2013, likely due to disparities in the delivery of effective treatment and prevention efforts. Adolescents and young adults continue to have high rates of HIV, comprising 21% of new HIV infections in 2017, and are often diagnosed late in their disease course. Additionally, youth are the least likely of any age group to be linked and retained in HIV care. Since 2006, the Center for Disease Control and Prevention has recommended opt-out HIV screening to be part of routine clinical care in all health-care settings starting at age 13, in order to increase early diagnosis and antiretroviral initiation and to decrease HIV transmission, morbidity, and mortality. More recently, the federal government has proposed Ending the HIV Epidemic: A Plan for America, which aims to achieve early HIV diagnosis and treatment and to utilize pre-exposure prophylaxis (PrEP) to prevent HIV transmission. Universal HIV screening has been successfully implemented in general emergency departments (EDs) and the pediatric ED has the potential to play a similar role in diagnosing HIV in adolescents. This session will focus on institutional successes and barriers in implementing universal HIV adolescent screening in the pediatric ED and will explore the role of the ED in identifying adolescent patients eligible for PrEP initiation services.
The science and sophistication of resuscitation continues to evolve. As our understanding
has evolved the potential to employ mehtods to predict and prevent arrest have become a
reality. Likewise, methods to improve resuscitation and recovery are being implemented
with great success. This symposium will bring together experts in Cardiology, Critical
Care and Extracorporeal support to discuss advances in resuscitation related to cardiac
arrest prediction, prevention, intervention and recovery.
Although hypertension is identifiable in children and adolescents, there are many knowledge gaps on how to best define and manage high blood pressure in the young. SHIP-AHOY (Study of High Blood Pressure in Pediatrics: Adult Hypertension Onset in Youth) is being conducted to address these knowledge gaps. With a goal to recruit five hundred adolescents who will undergo ambulatory blood pressure monitoring, echocardiographic, vascular, and cognitive assessments, as well as epigenetic studies to identify mechanisms that underlie the development of hypertensive target organ damage, we expect to be able to fill some of these gaps. The primary aim of the study is to develop a risk-based definition of hypertension in the young that will result in better understanding of the transition from blood pressure in youth to adult cardiovascular disease.
Details of the rationale for and design of this study will be discussed, and early results of outcomes of SHIP-AHOY will be presented here.
Food allergies, especially peanut allergy, are on the rise. They can present in breastfed infants, and several IgE- and non-IgE-mediated presentations have been described. Often, the symptoms are nonspecific and commonly seen in other disorders. Too often breastfeeding is discontinued in order to manage the symptoms, when maternal diet manipulations could result in favorable outcomes allowing continuation of breastfeeding. This seminar will discuss feeding difficulties and presentation of food allergy in breastfed infants. In addition, we will discuss latest advancements in our understanding of the role of prophylactic interventions such as early peanut introduction and novel treatment options such as immunotherapy. Lastly the management of food allergies in breastfed infants and the nutritional implications of maternal elimination diets will be discussed.
This session will provide guidance on judicious utilization and accurate interpretation of infectious disease diagnostics (both novel and familiar) in a variety of different pediatric hosts.
Speakers:
1. Not as simple as a "positive Karius test": interpreting results on a continuum in immunocompromised children (Katy Goggin, Emory)
2. Biomarkers, Babies, and Bayes: Diagnosing Neonatal Sepsis (J.B. Cantey, UT San Antonio)
3. The new Biofire pneumonia panel for BAL and the immunocompromised host (Jack Schneider, Riley/Indiana)
4. Diagnostic Stewardship in Microbiology: Because you can’t do everything for everyone, all the time (Christopher Doern, VCU)
5. Choosing Tests Wisely in the Era of Rule-Out MIS-C (Preeti Jaggi, Emory)
In the years to come, many disorders of brain aging will reach epidemic proportions. Currently, there is greater appreciation of how fetal and early life exposures, lifestyles, and injuries are determinants of adult health in many domains of medicine. Astonishingly, the fields of neonatal brain injury and adult brain disease have been viewed historically as distinct non-overlapping entities, despite the existence of disorders like Down’s syndrome and leukodystrophy. Currently in neurology and neuropathology, repetitive and chronic traumatic encephalopathy and the recognition that diseases like Alzheimer’s disease and even ALS might have very long prodromal states are focusing more light on the relationships of brain events in early and later life. In this seminar we will focus on consequences of early life brain injury when superimposed on genetic predisposition to adult neurodegeneration, long term structural alterations in the brain and attention deficits as a consequence of intrauterine growth restriction, potential reprogramming of brain growth after preterm birth, and consequences of preterm birth on the cholinergic forebrain and potential mechanisms of cholinergic systems injury and recovery after neonatal hypoxia-ischemia.
Session Content
Overview: A problem without known scope Dr. Raul Chavez- Valdez
The intersection of early life brain development and injury and genetic susceptibility to adult neurodegeneration
Dr. Lee J. Martin
Does preterm birth reprogram brain growth and function: What does it mean for the future adult?
Dr. Terrie E. Inder
Brain changes in adults born preterm:The cholinergic basal forebrain
Dr. Christian Sorg
The Cholinergic system after neonatal HI; A possible new therapeutic target?
Dr. Frances J Northington
Multiple structural and functional alterations of the CNS in adults due to SGA at birth.
Dr. Gregory A. Lodygensky
Wrap up and Discussion Dr. Raul Chavez-Valdez
Adult consequences exist for every alteration or injury to the developing brain and examining multiple models of early injury and the multitude of long term consequences will reveal mechanisms that can inform recovery, appropriately timed interventions, need for lifelong monitoring of outcomes, and options for “late” therapeutics. The public health import of a link of common early life brain alterations and injuries, to later in life brain function and neurodegeneration cannot be overstated.
After six years of interdisciplinary expert discussion and critical evidence review, the 2014 vision to develop evidence-informed guidance for the nutritional care of preterm infants has come to fruition. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Academy of Nutrition and Dietetics (AND) initiated this multiphase process involving expert physician, dietitian, and pharmacology scientists. The first phase, Pre-B, addressed the existing evidence and research needs for clinical questions within four themes 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. This first phase was published in 2016 by Raiten et al as “Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants—the Pre-B Project”. The second phase of this process is a systematic review of the literature led by the AND Evidence Analysis Center and includes an international workgroup of clinical and research experts who will now share the results of this extraordinary multi-disciplinary effort in this Hot Topic Symposium. Specifically, the presentations will focus on clinical questions where the existing evidence conflicts with current clinical nutrition recommendations and where the expert work group experienced more difficulty reaching a consensus. Each presentation also will describe areas where existing data is lacking and therefore research should be prioritized. The audience will participate throughout the presentation with polling and with a 15-minute question and answer with the expert work group.
Incident command systems, under emergency management are utilized during circumstances when the local systems are overwhelmed and are not sufficient to manage the event or disaster. A hallmark of a disaster is the scarcity of resources. Health resources include but are not limited to medical equipment, medications, areas available to care for victims, transport vehicles to get victims to timely care, personnel to help victims at the scene in a coordinated manor, health care providers to care for injuries or medical problems, and other support staff to provide communication, leadership, and reunification when families are disrupted. For this delicate dance to occur, protocols are built to treat everyone equally at baseline and then prioritizes basic medical needs and resource availability. The COVID-19 Pandemic has underscored a problem that has plagued disaster recovery, the asymmetric impact of disasters on a population. In this panel discussion, emergency management will be examined through a lens of social and physical determinants of the local population. Scenarios in disaster care will be presented addressing a conflict with one of each determinant. The panel will include a specialist in bioethics, disparities in health, and emergency management. Each case will be discussed by each panel expert to gain a full understanding of how the victims and population are impacted. Each panelist will be prompted with questions to gain insight into their reflections on the scenarios. The audience will be polled with each case before and after each panel discussion. A question and answer period will be available at the end of the session for audience inquires not addressed in the discussion.
As the COVID-19 pandemic expands in low and middle-income countries (LMICs) governments and communities have mobilized to protect the health of infants, children and adolescents. While initially weakened by the shut-down of the flow of goods, services, and international travel, pre-existing international coalitions have responded by strengthening local capacity, supporting COVID research, and providing on-line educational opportunities. International experts in this session will describe how international partnerships have adapted to challenges posed by the COVID pandemic to innovate and support child and adolescent health in LMICs.
All are welcome.
Ten percent of the U.S. population is labeled penicillin (PCN) allergic. Recent studies have demonstrated that the majority of symptoms reported as an allergy by parents are often low-risk non-IgE mediated adverse reactions. The majority of these are cutaneous reactions that are frequently interpreted as PCN-induced but are often viral or viral-drug mediated and are not a contraindication for future PCN use. Studies have shown that the presence of a PCN allergy label results in the avoidance of the entire antibiotic class with subsequent use of broader spectrum, and more expensive suboptimal antibiotics. Appropriately de-labeling PCN allergy has been shown to improve patient safe care through antimicrobial stewardship and lowering health care costs. Recent studies have highlighted approaches for de-labeling children with PCN allergy, however rates of de-labeling remain low and a more systematic approach is needed. Furthermore, there is significant variation among institutions, clinical settings and individuals concerning which patients can be de-labeled, and how to de-label and in the different settings.
The outcome of the Presidential election has significcant impact on the child health policy agenda. The aim of this session is to provide a forum for policy and physician experts to predict major legislative and policy changes which will occur over the next four years. The session will focus on 5 major areas of concern to pediatricians/researchers. The goal is to prepare academic pediatricians so they can be ideally positioned to promote or impede specific policies which are not evidenced-based to improve child health.
Introduction: Dr. Shetal Shah, MD (Pediatric Policy Council, Society for Pediatric Research)
1) Health Insurance Coverage for Kids (Stephanie Glier, MPH- American Academy of Pediatrics)
2) Drug Pricing for Children (Dr. Jonathan Davis, MD- American Pediatric Society, Society for Pediatric Research)
3) The Pediatric Research Funding Environment (James Baumberger, MPP - American Academy of Pediatrics)
4) Healthcare Disparities/Poverty (Dr. Benard Dreyer MD- Academic Pediatric Association)
5) Immigrant Issues (Dr. Julie Linton MD- American Academy of Pediatrics)
The events of the past few months have propelled extensive discussions of racism and social justice. Education in these topics has emerged as one of many necessary mechanisms to promote real change. Therefore, this session will focus on innovative approaches to educating residents and faculty through development of anti-racism and social justice curriculum. Although the three examples target faculty and residents, these are broadly applicable to educating medical students, residents, fellows, and faculty. After a brief introduction, the session will be opened by Dr. Elena Fuentes-Afflick to frame the topics that will be discussed in this session and to establish the importance of educating faculty and learners across the educational continuum on racism, anti-racism, and social justice. This will be followed by 3 very innovative examples of anti-racism and social justice curriculum that have been successfully implemented. These projects are inspirational and highly effective. After the speakers conclude, the session will end with 20 minutes for audience interaction with speakers in a moderated discussion and question/answer session. We anticipate there will be great interest and vigorous discussion of both the topics presented and the individual speakers' curricula.
Primary care clinicians are often tasked with prescribing psychotropic medications for pediatric patients, but training, time, and reimbursement issues hamper best practice. Psychiatrists and psychologists embedded in the medical home can enhance care coordination via collaborative medication-related roles. This presentation aims to present data from innovative medication consultation models involving psychiatrists and psychologists. Mixed-method approaches provide qualitative and quantitative data regarding improved access to psychotropic medication management for patients and families, improved standard of care and adherence to prescribing guidelines and algorithms, and improved training and learning enhancement for prescribing pediatricians. The innovative medication consultation models using interprofessional approaches will be described and incorporate audience feedback and discussion. This cross-disciplinary spotlight presentation targets real-world skills that clinicians can incorporate into their practices. Implications for COVID-19 and telehealth adaptations will be discussed.
The use of various imaging modalities in the management of critically ill neonates with cardiopulmonary disturbances have evolved overtime. Point-of-care ultrasound of the lung provides non-invasive, real-time evaluations, that can be performed longitudinally at the bedside. This modality can be used as a biomarker for disease pathology and can be implemented for assessment and management of multiple respiratory pathologies. Targeted neonatal echocardiography allows for an in-depth hemodynamic assessment of cardiopulmonary disturbances including evaluation and management of acute and chronic pulmonary hypertension. While longitudinal bedside evaluation is vital, state of the art-techniques in pulmonary MRI and CT are also demonstrating great promise for providing identification of pulmonary and airway pathology. This session will provide an in-depth discussion on the evoluation of neonatal imaging in the assessment and management of the critically ill neonate. The session will focus on the utility of various novel imaging modalities in the evaluation for neonatal respiratory pathologies including development of bronchopulmonary dysplasia, acute and chronic pulmonary hypertension, and tracheomalacia.
Racism in healthcare is pervasive and deeply troubling. It affects patients as well as healthcare providers. In this session, we will hear from four physicians – two trainees and two more senior faculty members – about their own deeply personal stories. The presenters come from backgrounds that have been historically underrepresented in academic medicine. Each of the presenters will reflect on their own professional journey and consider the influence of more senior colleagues encountered along the way. These personal stories will form the basis for a discussion featuring “prescriptions” from panel members. The session will seek to identify steps and best practices that we might identify and adopt to recognize and combat either visceral or systemic racism.
This session will focus on secondary causes of hypertension. There will be an overview of testing and evaluation for secondary hypertension with a focus on who should be tested, when this assessment should occur, and how patients should be evaluated. The session will then shift to provide an overview of the epidemiology, presentation, diagnosis, and treatment of secondary causes of hypertension. Topics to be covered will include: pheochromocytoma, obstructive sleep apnea, hereditary causes of hypertension, and renovascular hypertension.
An update on Systemic Vasculitis, particularly ANCA-associated vasculitis, but also on CNS vasculitis, PAN and Takayasu’s arteritis. The focus for AAV would be around the new Canadian Vasculitis guidelines, the latest trials (including PEXIVAS), treatment controversies and uncertainties. The focus on the other vasculitides would include an update on the new diagnoses (DADA2 for example), the role of genetics in discovery and the treatment of these rarer vasculitides, including updates on SLE
E-cigarette or vaping-associated lung injury (EVALI) has focused significant attention on the short-term health harms of electronic cigarettes and vaping devices (collectively referred to as e-cigarettes). E-cigarettes are battery-operated devices which produce an aerosolized mixture from a solution of solvents, flavoring chemicals, concentrated nicotine and other substances to be inhaled by the user. Specific additional health harms associated with e-cigarette use include nicotine addiction, transition to cigarette and marijuana use, increased cough, wheeze and asthma exacerbations (for those with asthma), seizures, increased risk for cardiovascular disease, relapse to tobacco use among former quitters and renormalization and glamorization of smoking and tobacco use. New products, emerging research, clinical recommendations and policy updates are developing at an extremely rapid pace – making it difficult for the practicing pediatrician to keep up.
Youth use of e-cigarettes is a public health crisis: In 2019, one in four high school students is a current e-cigarette user and the effect of the COVID-19 pandemic on youth use is unknown. Many factors may account for the rapid rise in popularity of new tobacco products, including aggressive youth-focused marketing and advertising, particularly by newer e-cigarette companies such as JUUL and Suorin. JUUL, the e-cigarette brand with the highest market share in the US (>70%) , contains a very high (59 mg/mL) nicotine concentration. Longitudinal data shows a concerning trajectory of youth transitioning from e-cigarettes to use of conventional cigarettes one year later, and more recent anecdotal reports of youth turning to combusted tobacco to help them quit vaping high nicotine devices. E-cigarette emissions (i.e. secondhand aerosol) contain harmful constituents such as volatile organic compounds, heavy metals and ultrafine particles, posing risks to non-users.
The panel of pediatricians presenting this session have been at the forefront of the American Academy of Pediatrics’ tobacco control efforts to craft clinician-facing policy statements, educate and inform government policies regarding all aspects of e-cigarettes. This symposium will highlight the most updated current scientific evidence on electronic cigarettes and their impact on youth tobacco use, potential youth health and public health effects. In addition, this presentation will address how the global pandemic may affect rates of youth e-cigarettre use and on how vaping may affect COVID outcomes. Current recommendation for helping youth with e-cigarette cessation will be reviewed, along with resources for prevention, refusal skills, opportunities for youth engagement, and currently available resources for teens and parents. Up to date information on regulations and legislation (and anticipated impact) will be reviewed, providing participants with information necessary for advocacy at local, state and federal levels. This session will have broad appeal given the importance of this topic to our adolescent populations and their families.
Recording not available.
All are welcome.
This session will highlight aspects of childhood-onset systemic lupus erythematosus (cSLE) beyond the clinical diagnosis and immunosuppressive treatment. The first presentation will discuss genetic associations in cSLE and implications for treatment of sub-phenotypes and monogenic forms of the disease. The second presentation will continue the discussion of the genetic landscape of cSLE from a global population perspective and include review of global disparities in access to care and gaps in research. The third presentation will address psychiatric comorbidity in patients with cSLE and strategies for mental health intervention. Lastly, the fourth presentation will review treatment of hypertension and edema from nephritis, sodium and fluid retention from steroids, BP control of extra-renal vasculitis, and cardiovascular disease in patients with cSLE.
Environmental health disparities are well described within rural and minority communities, particularly regarding infant mortality. The US continues to lag behind developed countries, despite committing massive resources. Why isn't US health care improving infant mortality? Are personal habits to blame, or are we missing something? Are regulations achieving results in the most vulnerable communities? If not, why not? Why are rural areas continuing to welcome dysfunctional policies while communities of color are unable to control their own exposure?
Dr. Norma Kreilein has been involved in regional and national environmental advocacy for over a decade while practicing community pediatrics in a rural setting for 30 years. Her presentation will highlight examples of 1) flawed data collection and official conclusions lacking sampling/statistical validity, 2) deliberate inadequate monitoring of clustered industrial polluters, and 3) conflicts of interest and bureaucratic processes which obstruct and obscure the environmental component to infant mortality and other measures of public health.
Knowledge of how and and to what extent environmental regulations are circumvented is critical to directing research, advocacy, and clinical practice toward closing existing loopholes and benefitting disproportionalely burdened communities. This presentation seeks to make clinicians and research faculty "environmentally aware" in addition to being "trauma aware."
This State of the Art Plenary will bring together national experts on child poverty, racism and racial inequities, immigrant health, Native American culture, and environmental threats to discuss the intersectionality of child poverty. Poor children don't just suffer from "double jeapardy", but frequently "multiple jeapardy" from many overlapping threats to their health and development. The COVID-19 pandemic has further unearthed as well as intensified these threats to children including loss of financial resources, loss of nutritional supports, loss of family members, and loss of educational opportunity. Our speakers will be able to elucidate and contextualize the living "venn diagram" of these intersections for children and families. All of the speakers will also address the specific impact of the COVID-19 pandemic on these families who are vulnerable because of being under-resourced and often are marginalized, and will leave the attendees with what is a call for action to all of us.
This video is unavailable at the request of one or more presenters.
9:00 Welcome and introduction - Co-Chairs
9:05 Speaker 1 --Neal Halfon
9:20 Q&A for Speaker 1
9:25: Speaker 2 --Charlene Wong
9:40 Q&A Speaker 2
9:45 Speaker 3 --Joshua Sharfstein
10:00 Q&A Speaker 3
10:05 Open Panel Discussion
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Competency-based medical education has begun to permeate medical programs throughout North America. How these programs function, both in general, and specific to nephrology, is a significant shift for this generation of medical teachers and trainees. This session will examine some of the core issues for teachers and learners focused on the assessment of competency and grading responsibility and how generational perspectives influence the adoption and success of these programs. ASPN Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Since 2000, firearms have killed over 120,000 children and young adults and injured another 550,000. As the start of the SARS-CoV-2 pandemic incited widespread panic, March 2020 saw the highest gun sales recorded in United States (US) history, possibly increasing either numbers of children living in homes with guns,or increasing numbers of guns that children and teens may access. Now more than ever, two intersecting public health crises (an infectious pandemic and a national epidemic of gun violence), further threaten the lives of children in the US. As mental health concerns rise due to increasing financial and social stressors amplified during the pandemic, there are plausible concerns for increases in gun violence in the setting of both homicide and suicide.
Our workshop aims to increase awareness and empower providers into action around firearm safety in their communities. We begin the workshop with an interactive poll to assess participant knowledge and experiences with firearm safety/violence screening and counseling. We will review pediatric firearm injury epidemiology, state based legislation, and family interventions to reduce unsafe firearm exposure adaptable for various settings. Through the workshop we focus on four domains in which providers can address firearm safety: Advocacy, Education, Clinical Care and Research. Participants will be able to participate in two small group discussions based on their areas of interest: the first breakout either Advocacy or Education, and the second, either Clinical Care or Research. Case-based scenarios tailored to the area of interest will be used to stimulate conversation if needed. Interspersed between breakouts will be a large group report-out with short didactic review of ways providers can address firearm safety though each domain (advocacy, education, clinical care and research).
We will provide a resource guide for participants to help address pediatric gun safety, view the brief Be SMART video (developed by Everytown for Gun Safety), and highlight other accessible resources, including national organizations, community resources, advocacy opportunities and mental health resources. We will also review practical information and demonstrate for workshop attendees on different types of safe storage options (locks, safes, etc). We will conclude with reflection, asking participants to commit to one actionable item they plan to pursue to reduce pediatric firearm injuries, and allow an opportunity for questions. Pediatric providers routinely address second hand tobacco smoke exposure and motor vehicle safety; through this workshop we hope to inspire and enable providers to tackle pediatric firearm safety in the same manner. Additionally, we hope to connect advocates, educators, researchers and dedicated clinicians interested in firearm safety to foster future multi-center collaborative projects. This workshop has a limited capacity. Please register in advance by clicking the ""register"" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This video is unavailable at the request of one or more presenters.
This club session features two presentations, including a description by Dr. Katlyn McGrattan of the growing prevalence of pediatric dysphagia presenting with signs and symptoms of oropharyngeal impairment. Key questions are raised concerning the 'physiologic' nature of dysphagia and aspiration during development in the context of oral feeding function among healthy infants. Research findings are presented regarding feeding attributes among healthy non-dysphagic infants. The second presentation by Dr. Britt Pados will review the findings of a descriptive, cross-sectional study to identify factors related to the symptoms of problematic feeding in the first 7 months of life in 337 infants offered both breastfeeding and bottle-feeding. Results on the Neonatal Eating Assessment tool, including three subscales [Mixed Breastfeeding and Bottle-feeding Sensory Responsiveness subscale, Feeding Flexibility subscale, and Gastrointestinal Tract Function subscale] will offer new insights on risk factors (adjusted for age) contributing to feeding disorders.
1:00p | Welcome and Club Introduction - Chair: Dr. Steven Barlow
1:10p | Recent Advances & Speaker Introductions: Dr. Emily Zimmerman
1:20p | Speaker 1: Dr. Katlyn McGrattan
1:50p | Speaker 2: Dr. Britt Pados
2:20p | Q&A - Discussion
Escalating behavioral health challenges and diagnoses across all pediatric age groups and populations constitute a crisis in health care that requires inter-professional collaboration and innovation. While national statistics indicate one in five children suffer from a mental health issue, the practical experiences of primary and specialty care pediatric providers suggests that over 40% of patient visits have a primary or secondary behavioral health concern. Anxiety, depression and trauma in children and youth has escalated even further this year, precipitated by the isolation, loss of social supports, family stress and growing social determinants risks related to the COVID-19 global pandemic. The reality of long waiting lists for available services and access to behavioral health practitioners, along with limited access currently to school supports for many children further exacerbates the problem and points to the imminent need to strengthen preventive and primary care treatment approaches to help our children, youth, and families. While a lack of access to acute and ongoing mental health services is a reality that impacts children and families across our entire nation, regardless of socio-economic and regional variation, there are certain populations who face additional barriers. Such barriers include high poverty rates, elevated exposure to violence and trauma, substance abuse, and inconsistent communication between systems that serve children who are most marginalized and at the highest risk. While children’s behavioral health workforce and systematic service expansion will be necessary to adequately address the needs, the issues at play are complex and on such a scale that we cannot simply “treat our way out” of this crisis through expansion of current services alone. Upstream approaches to prevention and universal screening in primary care and community settings, integration of behavioral health services, family support, and connection to community-based resources and education settings, along with enhanced training for child health professionals at all levels, should be leveraged to improve child behavioral health and mental wellness. The purpose of this Special Interest Group is to promote new opportunities for collaboration, research, training and networking across multiple disciplines focused on pediatric behavioral health. For this first SIG session, the presenters will briefly outline common key components to successful behavioral health models including prevention and universal screening in primary care and community settings, integrated and aligned primary and specialty care behavioral health services, connection to care management and coordination with behavioral health services in childcare, early education settings and schools, and the promotion of protective factors and skills building for children and families. Additionally, presenters will engage attendees in dialogue around inter-professional training opportunities and education models for practicing primary care providers and pediatric specialists. This inaugural Behavioral Health SIG will focus on challenges and opportunities in addressing the behavioral health needs of children and adolescents. Participants should come prepared to speak for 2 to 3 minutes about best practices or innovative approaches from their own programs and experiences. The 3 breakout groups will foster conversations around 1) Cross-Sector Community Collaboration (connecting schools, primary care and behavioral health teams), 2) Behavioral Health Integration Models in Primary and Specialty Care, and 3) Training and Support Models to Expand the Scope of Practice for Primary Care Providers Agenda 1:00 pm I Welcome and Introductions - LJ Shipley, Co-Chair 1:15 pm I Mike Scharf, Co Chair 1:30 pm I Attendees split into 3 Breakout rooms -presenters/facilitators in each 2:00 pm I Switch to next breakout room 2:30 pm I Return to full group/Report out and Next Steps Co-Chairs: Michael Scharf, MD (Child and Adolescent Psychiatry) and Dr. Laura Jean Shipley, MD (Academic/Primary Care Pediatrics) Faculty: Cori Green, MD, MS, Weil Cornell Medicine/NY Presbyterian Hospital (Academic/Primary Care Pediatrics) Elizabeth Wallis, MD, MS Medical University of South Carolina (Adolescent Medicine) URMC Faculty Facilitators: LeKeyah Wilson MD (Adolescent Medicine/School Health), Linda Alpert-Gillis, PhD, Melissa Heatley, PhD Allison Stiles, PhD (Child Psychology)
Telemedicine use has grown in recent years, exponentially so during the current COVID-19 pandemic, with pediatric providers rapidly adopting various telehealth platforms for delivery of care in a number of settings. The combination of increased availability of and familiarity with necessary technology offers the opportunity for more systematic implementation and study of telemedicine initiatives to improve quality of care.
We will have a brief 5-minute introduction of the current state of pediatric telemedicine including different formats, goals, and licensing and reimbursement considerations. The core of the session will consist of a series of three 20-minute presentations in which departmental leaders will review their experiences in needs assessments; program development and implementation; ongoing program review and improvement, with discussion of both published and unpublished data; and future directions of several divisional initiatives in telemedicine. We will have interspersed 5-minute (maximum) Q&A sessions to allow participants to learn more about presenters’ work and conclude with a 10+-minute interactive Q&A session to delve further into desired topics (e.g., reimbursement), and share details of their own established or developing programs.
Introduction (5 minutes)
Case Symposia
- Critical Care (20 minutes)
- Acute care consultation regarding pre-transport patient stabilization at referring hospitals - program implementation and lessons learned
- Virtual parent participation in bedside patient rounds
- Remote simulation-based education
- Critical Care Q&A (3-5 minutes)
- Hospital Medicine (20 minutes)
- Patient/family and PCP needs assessments, development and implementation of post-discharge virtual visit program
- Data from in-depth chart review demonstrating significant clinical impacts; provider and family satisfaction
- Discussion of program improvement and expansion, with specific focus on patient with limited English proficiency
- Hospital Medicine Q&A (3-5 minutes)
- Infectious Disease (20 minutes)
- Initiation of virtual follow-up visits and expansion to virtual outpatient consultations during pandemic
- Implementation of asynchronous eConsult program to provide subspecialty advice to outpatient providers
- Data from chart review demonstrating benefits to patient care and education, as well as provider satisfaction survey
- Discussion of ongoing program evaluation and improvement
- Infectious Disease Q&A (3-5 minutes)
Wrap-up/Q&A (10-16 minutes)
- Interactive poll to determine specific needs of audience
- Potential topics for Q&A:
- Sharing of specific materials from needs assessments, chart review, additional data
- Deeper discussion of hospital stakeholder engagement; licensure and malpractice considerations; privacy and confidentiality; reimbursement
- Brief highlights of telemedicine work in other divisions (e.g., pediatric primary care, Down Syndrome clinic)
- Participants' experiences with their own hospitals' telemedicine programs
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This video is unavailable at the request of one or more presenters.
Climate change is an existential threat to children’s health. Could pediatricians be doing more? A recent survey found that most pediatricians wanted additional training about what they could do to address climate change, how to advise patients, how to become more effective teachers about climate and health, how to become more effective advocates, and how to help their communities adapt to the effects of climate change. This session will describe tools available to become more active in taking action to address the climate crisis.
The Lung Club is an annual event that honors a prominant scientist or clinician in the field of neonatal pulmonology.
Rhythm’s Genetic Obesity Learning Development (GOLD) Academy brings together healthcare providers to learn about rare genetic diseases of obesity and the role of the melanocortin-4 receptor pathway in regulating hunger, caloric intake, energy expenditure, and consequently body weight. These physician-led programs are virtual or live and focus on educational topics including distinguishing hyperphagia from other overeating behaviors and key clinical characteristics of rare genetic diseases of obesity. Please join us to learn more about why not all obesity is the same.
9:00-9:10 | Welcome / Introductions 9:10-9:15 | Objectives / Agenda 9:15-9:25 | Review recent literature on WIM (include Summary of AAP’s Wellness through Equity & Leadership project discussions from National Academy of Sciences) 9:25-9:35 | Large group discussion: What questions have been answered? What still needs to be answered? 9:35-9:40 | Large group didactic: comparing and contrasting qualitative and quantitative research 9:40-9:55 | Dorene Balmer’s presentation and discussion: Applying the Theory of Gendered Organizations to the Lived Experience of Women with Established Careers in Academic Medicine 9:55-10:05 | Large group didactic: Sampling strategies in qualitative research 10:05-10:25 | Small group skills session: Developing a sampling strategy for a qualitative research question related to WIM 10:25-10:35 | Debrief small group session 10:35-10:45 | Large group brainstorming of possible research collaborations between WIM and QR SIG members 10:45-10:50 | Combined SIG Wrap up 10:50-11:00 | Individual SIG business meetings
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
1:00 | Welcome and Introduction 1:15 | Patient and Parent Panel 2:00 | LGBTQ+ Health Curriculum; attendees split into 3 breakout rooms, spend 15 minutes per room (curriculum, competencies, EPA); rooms change at 2:15 and 2:30 2:45 | Conclusion
While neonatal mortality has significantly decreased over the past decades, long-term morbidity following prematurity or neonatal injury remains a significant problem.
Cell-based therapies have created much excitement in neonatology based on the promise of organ regeneration. Fueled by promising preclinical studies, first early phase clinical trials have begun using a variety of cells for different indications. While mesenchymal stromal cells (MSCs) isolated from umbilical cord tissue or cord blood represent the front runner amongst cell-based therapies, the feasibility and safety of human amnion epithelial cells or cord blood derived mononuclear cells are also being explored to prevent lung and brain injury. These are early days for cell-based therapies in neonatology and much remains to be learned about the biology of repair cells, their manufacturing, safe and practical delivery and clinical trial design to optimize their efficacy.
To improve the efficacy of clinical translation of this disruptive technology, principal investigators of trials on cell-based therapies will share their experience to answer the following questions:
How to choose the optimal cell or cell-derived product?
How to monitor safety of cellular biological products in a neonatal setting?
What are the optimal outcome end-points to assess safety of cell-based interventions?
What is the optimal target population for early phase trials?
What are the regulatory requirements?
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Open to All PAS Attendees
Continuous renal replacemtn therapy (CRRT) is a common modality for treatment of severe acute kidney injury (AKI) in children. Adult technologies routinely utilized to provide this therapy have a large extracorporeal volume. The PRIMSAFLEX HF20 filter set has a relatively low extracorporeal blood volume of 60 mL, which provides technological benefit for smaller children compated with current filter sets available in the USA.
9-910 Session Introduction 910-925 Global Health Award 925-930- Speaker Introduction 930-950 Speaker I 950-955- Speaker Introduction 955-1015 Speaker II 1015-1035 Panel 1035-1100 Social activity- Break out Groups
Breastfeeding advocacy and human milk research have progressed exponentially over the past 30 years. Research agendas for the next decade are focusing on resolution of persistent breastfeeding disparities and on deeper scientific investigation of the mechanisms by which human milk promotes health. PAS Milk Club 2020 presents the current state and ongoing priorities for breastfeeding and human milk science. Research strategies will be presented by Dr. Andrew Bremer, Chief of the Pediatric Growth and Nutrition Branch at NICHD, and will address the importance of studying (i) the nutritive and non-nutritive bioactive components of human milk as well as factors influencing their variability between women and throughout gestation and lactation, (ii) the functional mechanisms by which human milk components – acting both individually and together – promote intestinal maturation, protect against infection and inflammation, and stimulate immune development in the infant, and (iii) the safety of medication use during pregnancy and lactation to allow more women the opportunity to achieve their lactation goals. Specific goals in advocacy will be presented by Dr. Lori Feldman-Winters, an international expert in breastfeeding and safe sleep promotion, and include (i) specialized programs to reach populations previously on the perimeter of breastfeeding promotion, (ii) recommendations to optimize and reduce disparities in safe sleep and breastfeeding concurrently, and (iii) communication strategies to disseminate novel research describing the association between breastfeeding and reduced infant mortality.
9:00 | Welcome and Introduction of Dr. Bremer 9:05-9:45 | Dr. Bremer presentation 9:45-10:00 | Q&A and Introduction of Dr. Winter 10:00-10:40 | Dr. Winter presentation 10:40-10:55 | Q&A 10:55-11:00 | Close
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Objective/Synopsis:
This session will review recent findings on the use of rabies immunoglobulin in pediatric patients as part of postexposure prophylaxis for prevention of rabies disease, discuss the epidemiology of adult versus pediatric patients receiving rabies immunoglobulin in the US, and highlight representative cases of patient wound patterns and treatment considerations for suspected rabies exposure.
Speakers:
[11:00-11:30]
James Linakis, MD, PhD: Provide an overview of rabies disease state and primary results of recent clinical trial results on safety, tolerability, and efficacy of rabies immunoglobulin (human rabies immune globulin (HRIG150)) when used as part of postexposure prophylaxis in pediatric patients with suspected exposure to rabies virus.
[11:30-12:00]
Nicholas W. Hobart-Porter, DO: Present case examples of pediatric patient presentations with indication for postexposure prophylaxis, and their effect on dosing and administration considerations to ensure appropriate use and protection.
[12:00-12:30]
Rita V. Burke, PhD, MPH: Present epidemiology of pediatric and adult patients that receive rabies immunoglobulin in the US, and differentiating patient characteristics associated with each population.
[12:30-1:00]
Roundtable discussion and panel Q/A
This video is unavailable at the request of one or more presenters.
The workshop will address the important components for promoting and sustaining successful participation clinical research across a spectrum of opportunities. The workshop will comprise of presentations focusing on a range of topics including legal and regulatory aspects, study coordinator support, requirements and processes for conducting pharma trials, drug development in pediatric nephrology as well as the pros and cons of participating in other clinical research studies and networks. The didactic sessions will be followed by allowing Q&A session to allow the speakers to address audience questions that include specific needs, experiences, best practices and challenges in conducting clinical research at their respective institutions. ASPN Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
ASPN Business Meeting
APS & SPR Virtual Journeys in Pediatric Research - Session 6 Career Journey Kevin B. Churchwell, MD, President and COO Boston Children’s Hospital Harvard Medical School Teaching Hospital Martine Rothblatt United Therapeutics Corp
9:00 | Welcome and Introduction, Slide 1: Insert Polling Question (what EHR do you use? have our ever incorporated CPG's into your EHR? do you "build" in your EHR?) 9:10 | Speaker 1: Sarah Bauer 9:20 | Speaker 2: Caroline Wright 9:30 | Speaker 3: Sansanee Craig, will include instructions for breakout rooms 9:45 | Attendees split into 3 breakout rooms (outpatient, inpatient, peri-operative) - One presenter in each, give 5-10 min for participants to fill out worksheet, then 3 participants share 10:30 | Return to same room - Poll Polling Question TBD 10:30 | Q&A
This video is unavailable at the request of one or more presenters.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Open to All PAS Attendees
1-1:05 I Welcome and Intro: Ashaunta Anderson 1:05-1:25 I Race/ethnicity based inequities highlighted by COVID-19- Andrea Cruz 1:25-1:40 I Impact of Police Violence of Child and Adolescent Health- Tiffani Johnson 1:40-1:55 I Community Violence- Shani Buggs 1:55-2:05 I Q&A- Facilitated by Ashaunta Anderson 2:05-2:55 I Panel Discussion: Addressing the triple threats of our time through research (Nia Heard-Garris), advocacy (Rhea Boyd) and organized medicine (Joseph Wright)- Facilitated by Angela Ellison 2:55-3:00 I Closing remarks RIM/SOEM co-chairs
The AAP Section on Hospital Medicine will host a session on an important topic related to Pediatric Hospital Medicine (PHM) -- Healthcare Improvement Innovation: The Role of the Pediatric Hospitalist -- with posters presented by PHM fellows centered on that topic.
Agenda
1:00 pm – Attendees Arrive and Salutations
1:35 pm – Welcome and Introductions
1:45 pm – Presentation by Speakers: Drs Joanne Leyenaar, Dartmouth, and Sunitha Kaiser, UCSF
2:25 pm – Q&A with Audience Participation
2:35 pm – Abstract Presentations - Theme: QI work in Community Settings
2:55 pm – Closing Remarks
1:00 pm - 1:05 pm | Welcome and Sponsor Acknowledgement Section Leader and Club Leaders 1:05 pm -1:10 pm | Introduction of Speakers Club Leaders 1:10 pm – 1:50 pm | Topic Presentation Faculty 1:50 pm – 2:10 pm | Q&A with Audience Participation – Part 1 Faculty and Club Leaders 2:10 pm – 2:40 pm | Abstracts: QI work in Community Settings Selected Presenters 2:40 pm – 2:55 pm | Q&A with Audience Participation – Part 2 Abstract Presenters and Club Leaders 2:55 pm - 3:00 pm | Closing Remarks
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
The COVID-19 pandemic has not only upended society and medicine but has also introduced a myriad of moral dilemmas in pediatric practice and policy. Many of these dilemmas are well-worn quandaries adorned in a new context, such as: how should children fare in resource allocation frameworks when adults fare worse with COVID-19? How do different national health policies impact children’s health and well-being during a pandemic? Should COVID-19 mitigation strategies, such as a vaccine, be required for children to attend school? How can clinicians manage the potentially harmful psychological toll of COVID-19 on children, particularly children of color? There is perhaps no more important issue today facing child health than the COVID-19 pandemic. Though children are at low risk of COVID-19 disease, strategies to mitigate the pandemic have made them pay a disproportionate price. It is therefore essential that we devote the careful deliberation and attention needed to navigating the ethical issues it poses in order to provide the best care to the children and communities we serve.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Open to All PAS Attendees
Recording is not available.
Monitoring growth is an integral part of antenatal and newborn care worldwide, yet appropriate standards for fetal growth, newborn size, and the postnatal growth of preterm infants are not commonly used in clinical practice, nor is there adequate classification of infants born preterm and/or small for gestational age. The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project has produced an integrated set of international standards for evaluating growth and development from early pregnancy to 2 years of age based on studying healthy, well-nourished and educated women from 8 urban areas across 5 continents. This lecture will present data from the INTERGROWTH-21st Project and how the research has altered our overall understanding of early human growth and development.
1:00 Welcome and Introduction of Speaker 1:15 Speaker Stephen Kennedy 2:15 Question and Answer
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
9:00 | Introduction - Jason F. Woodward, MD 9:10 | Keynote - Margaret McManus, MHS 9:35 | Speaker 1 - Mary R. Ciccarelli, MD 9:50 | Speaker 2 - Thomas Walter Davis, MD 10:05 | Speaker 3 - Cynthia Peacock, MD 10:20 | Guided Q&A with panelists - Lynn F. Davidson, MD Moderator 10:50 | Wrap Up - Parag Shah, MD
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
The SARS-CoV-2 pandemic has changed the way we care for our patients, do our jobs and live our lives. While many of our hopes for a return to more normal times are pinned on an effective vaccine, the history of vaccination pregnant women and newborn infants - the patients we take care of - is one that is complicated by both a complex biology and social perception of vulnerability and safety. The explosion in vaccine development and research may also be fruitful in preventing and improving outcomes from many other neonatal infectious diseases. Maternal and neonatal vaccination may provide direct and indirect protection against neonatal infection-possibly even early and late-onset neonatal infections. What do we know about the safety of maternal vaccines, their efficacy in protecting the newborn and the challenges of eliciting immune response in newborns upon vaccination? How does this knowledge translate to what we can expect with the anticipated vaccine against SARS-CoV-2? Drs. Swamy and Levy will help us answer some of these questions while informing of us of the advances we can expect and how we can participate in the process of protecting our patients 9:00 | Welcome and Introduction - Dr Dustin Flannery 9:15 | Dr Geeta Swamy 9:45 | Dr Ofer Levy 10:15 | Q&A 10:45 | Closing remarks - Dr David Kaufman 11:00 | session ends
Open to All PAS Attendees
KOL 1
Overview of PH1 including prevalence
Metabolic and genetic testing in the diagnosis of PH1: Case 1 and Case 2
KOL 2
OXLUMO- a FDA-approved therapeutic for PH1
Mechanism of Action
Study design and data overview for ILLUMINATE-A and ILLUMINATE-B
Dosing
KOL 2/ KOL 3
Case 3 – show a real-world case where patient was treated with OXLUMO
Conclusions and Discussion
Panel based Q&A
Fibrodysplasia ossificans progressiva (FOP) is an inherited autosomal dominant condition that causes progressive heterotopic ossification (HO), which is the disabling conversion of connective tissue and muscle to bone. Current management strategies center around avoiding events that trigger HO, and a growing understanding of disease pathology has led to the development of targeted therapies, which are being evaluated in advanced phases of clinical trials. These investigational therapies may offer proactive treatment options that mitigate the pathology and progression of FOP. However, as an ultra-rare disease, FOP remains under- or misdiagnosed, and healthcare providers may miss distinct clinical characteristics that are highly suggestive of the disorder. Patients who lack a timely and accurate diagnosis often undergo unnecessary therapeutic interventions that may cause harm and may be precluded from accessing appropriate management. This educational activity seeks to present pediatric healthcare providers with FOP disease background and strategies to facilitate early recognition and diagnosis, as well as review the most recent clinical trial data of emerging targeted treatment strategies. https://docs.google.com/forms/d/e/1FAIpQLSfR0Cy-oa8x8fnD9mgUVR33rPU5WYw-3Hd-y6Mdru0y3VdixQ/viewform
Clinical Care, Education, Research, and Advocacy in Complex Care and Disability 1:00PM Welcome and Introductions - Rishi Agrawal New Beginnings: SIG Name, Structure and Leadership - Diana Cejas, Meg Comeau, Catherine Diskin, Emily Goodwin, Debbi Harris, Kathleen Huth, Ruchi Kaushik Polling Questions 1:30PM - Strategic Partnership in the Complex Care and Disability SIG - Meg Comeau, Debbi Harris 2:00PM - Affinity Groups: Opportunities for Collaboration - multiple speakers 2:40PM - Discussion and Next Steps 3:00PM - Adjourn
1:00 Welcome & Introductions - Nancy Graff, MD & Dean Sidelinger, MD, MSED 1:15 Preventing and Reducing Youth Vaping: The Tobacco Prevention Toolkit - Bonnie Halpern-Felsher, PhD, FSAHM 1:50 Practical Concepts for Tobacco Dependent Treatment- Frank Leone MD, MS 2:25 Tobacco Policy Update - James Baumberger, MPP 2:50 Wrap-up - Nancy Graff, MD & Dean Sidelinger, MD, MSED
The exploitation and trafficking of children and adolescents is widespread in the US and worldwide. Multiple factors that serve to increase the vulnerability of individuals to exploitation and trafficking have worsened during the COVID-19 pandemic. Lockdowns, increased economic hardship, and decreased access to school and other critical social activities for children have contributed to increased risks for children and their caregivers. Pediatric providers are poised to recognize children and caregivers who are at risk of or engaged in exploitation and trafficking, intervene to reduce their risks, and advocate for policies and programs to assist and support these families.
In this program, a multidisciplinary group of experts in the field of child exploitation and trafficking will address this critical topic with special attention to the impact of the global pandemic. First, a physician with expertise in child abuse pediatrics and domestic and international child trafficking will review risk factors for child exploitation and trafficking, identify ways in which the COVID-19 pandemic has increased these risks for both children and their caregivers, and provide recommendations for what pediatric providers can do to address and mitigate these risks. Second, internationally recognized experts in adolescent medicine and children’s rights law will speak about the limitations of existing responses to child exploitation and trafficking, describe how a comprehensive public health approach should be used to more effectively combat this problem, and discuss the specific role of the health care sector, particularly within the context of the COVID-19 pandemic. All speakers will highlight the unique roles that pediatric providers play in the prevention, identification, and response to child exploitation and trafficking in the areas of clinical care, advocacy, and policy.
Learning Objectives
After attending this session, participants will:
Identify the ways in which the COVID-19 pandemic has amplified existing risks and created new risks for child exploitation and trafficking.
Highlight the key components and benefits of a comprehensive public health approach to the prevention of child exploitation and trafficking.
Learn strategies for preventing, identifying, and responding to child exploitation and trafficking within the areas of clinical care, advocacy, and policy.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
The perinatal brain club address be new developments in term neonatal brain injury. The speakers will address new opportunities for promoting optimal neurodevelopmental outcomes with a precision child health lens.
May 20, 2021 from 9:00 AM to 11:00 AM
9:00 AM | Steven Miller: Introduction/Setting the Stage (5 min)
9:05 AM | Linda De Vries: "Precision diagnosis of HIE mimics" (30 min)
9:35 AM | Iona Novak: “Why Stem Cells are better than Oreos” (30 min)
10:05 AM | Adam Kirton: “Personalized plasticity: Neuromodulation following perinatal brain injury” (30 min)
10:35 AM | Panel Discussion and Q&A (Miller moderator) (25 min)
This video is unavailable at the request of one or more presenters.
1:00 Welcome and Introduction - Chairs (Dr. Allen and Dr. Cardoso)
1:05 Didactic Session on Storytelling (Dr. Olson and Dr. Trappey)
1:15 Virtual Story Slam
2:15 Guided Reflective Writing Exercise
The Directors of Research in Pediatrics meet annually at the PAS meeting. The purpose of this Club is to bring together individuals with an interest in child health research. This includes, but is not limited to, those who have leadership roles in academic pediatric departments, those who are interested in practice-based networks, those who are active investigators in basic, translational and clinical research, and trainees at all levels who would like to learn more about research-related issues in pediatrics.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This is open to all APA region 1 members.
This is open to all Region 2 and 3 APA members
This is open to all region 4 APA members
This is open to all region 5 and 6 APA members
This is open to all region 7 & 8 APA members
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
With a lack of quality improvement/quality assurance (QI/QA) sessions in most large pediatric nephrology meetings, I thought that this session could highlight and show off some of the impressive QI/QA work being done in different areas of pediatric nephrology. This workshop will focus on QI as an academic pursuit, showing both small and large scale initiatives that have been successful in the area of nephrology QI. ASPN Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Open to All PAS Attendees
This is open to all region 9 and 10 APA members
This video is unavailable at the request of one or more presenters.
We are planning a collaborative session for PAS 2021 combining the Special Interest Groups of the Environmental Health, Sustainability, and Climate Change Special Interest Group with the Developmental Behavioral Pediatrics Special Interest Group. The focus will be on chemical exposures and developmental delay, and building links among primary care, tertiary care, and the community. Questions examined will include: What is the relationship between environmental exposures in early life and developmental disability in childhood? Can parents lower their future children’s risk of disability by avoiding certain exposures, such as plasticizers, flame retardants, or pesticides? When parents ask pediatricians about chemical exposure risk, what are reliable online resources for parents and clinicians? Finally, how does the disability community feel about research involving environmental exposures and disability? The workshop format will be an online panel discussion and question/answer session.
15 minutes: Epidemiology of environmental exposures and outcomes of developmental disability in childhood
15 minutes: Clinical perspective: Talking to parents and patients about exposure risks
15 minutes: Community perspective: Meaningful outcomes for disabled people
15 minutes: Question and Answer Session with Panelists
The effect of traumatic exposures, or adverse childhood experiences (ACEs), on health outcomes across the lifespan is well recognized among pediatric practitioners. Increasing the ability of healthcare providers to recognize and respond to ACEs can buffer the long-term negative health impacts of adversity and increase patient-centered care.
Training physicians in the principles of trauma informed care is being recognized as an essential need in health care as a universal mechanism to respond to ACEs. A trauma-informed approach is especially important during COVID-19, due to the high level of stress that the pandemic has created for our patients and their families.
This interactive workshop will start with a brief review of the sciences of childhood adversity. (10m) Then we will introduce a concrete, easy-to-use, trauma-informed framework, CARES, rooted in the Substance Abuse and Mental Health Services Administration’s (SAMHSAs) trauma-informed approach: C: central tenet of trauma informed care, A: ask about trauma, R: resiliency/resources, E: educate and S: self care. (30m)
Participants will then be able to apply and critically reflect on the CARES framework by working through small group role-plays simulating common patient visits. The role plays will highlight language to use when initiating and engaging in sensitive conversations related to adversity exposures, how to engage patient/families in treatment plans through education, and lastly how to utilize resources of support in empowering and collaborating with patients on treatment plans. (20m)
The facilitators will then describe a strengths based trauma informed approach, with an interactive discussion focused on the key components of building resiliency in pediatric patients. (15m) Participants will work through patient cases first in dyads and highlight opportunities for resiliency building during patient-provider conversations related to trauma and adversity, with subsequent facilitated discussion in the larger group. (20m)
Participants will leave with a new trauma informed skillset with which to approach patient care to increase positive health outcomes for patients and families, especially in the setting of the collective community trauma of COVID-19.
This workshop will be facilitated by a multidisciplinary team from Children’s National Hospital in Washington DC. All presenters have trained multiple audiences, ranging from school resource officers and district judges to medical students and attending pediatricians, in trauma informed care principles.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Recording not available.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Quality improvement (QI) relies on data and measurement. Statistical process control (SPC), pioneered in manufacturing, combines mathematical time-based data analysis with graphical data displays, and is widely recognized as an optimal method of data analysis for QI. While the value of SPC in health care has been increasingly recognized, its methods are not routinely taught and clinical leaders continue to commonly conduct QI projects without the benefit of SPC.
In this workshop, we will provide a practical introduction to two primary SPC tools, run charts and control charts. Part 1 will be an interactive presentation reviewing SPC theory and tools, and benefits of SPC for QI as compared to other types of analyses. QI examples from the literature will be used to illustrate key points. Part 2 will be a hands-on session guiding attendees through the creation and analysis of run charts and control charts. We will use sample QI project data to demonstrate chart creation using widely available software; data sets and software will be made available to attendees in advance to enable them to create the same charts as they follow along. Multiple examples will be shown during the workshop, and data sets and instructions for additional exercises will be made available for independent work. Part 3 will cover more advanced control chart concepts, and will include an open discussion of questions that arise. Specific issues related to QI projects being done by participants can also be discussed. A bibliography, key readings, and exercises will be provided.
Attendees are strongly encouraged to download software and sample data sets to their own computers in advance. Participants who are not able to do this will still be able to follow along and participate extensively in the workshop.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Recording not available.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
Open to All PAS Attendees
9:00 am Open/Welcome, introduction of SIG chairs, introduction of speakers (SIG co-chairs) 9:10 am Moment to Center (Tony Cooley, Jamie Palaganas) 9:15 am speaker Tony Cooley 9:30 am speaker Jamie Palaganas 9:45 am speaker Kim Giuliano 10:00 am Panel discussion/Q&A 10:20 am wrap up/break 10:30 am Meet in individual SIG breakout rooms 11:00 am Adjourn
(By Invitation Only) G-SPAN aims to provide a unique, interdisciplinary forum for globally minded general pediatricians and pediatric subspecialists to unify the global health efforts from each of the PAS partners, affiliates and alliances. The aims of this group are to share updates regarding GH initiatives; synergize common GH activities at PAS conferences; and support PAS to offer innovative, state-of-the-art GH programming, professional enrichment opportunities, and networking experiences to our North American and international conference participants. The vision for this group is a PAS venue where participants may interact with global health luminaries from organizations that impact global child health research priorities and policies, and support the career development of pediatric researchers and academicians from countries where child health needs for applied research are greatest and where the knowledge gap is the greatest.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
1:00 | Introduction to group and new co-chairs 1:10 | Keynote pro-con discussion on CMV screening 1:40 | Hot Topic on Perinatal COVID-19 Infection 1:55 | Hot Topic on Improving Health Equity in the Newborn Nursery 2:10 | Poster session 2:40 | Annual business Meeting 3:00 | Adjourn
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
9:00: Welcome and Introductions of SIG Leadership 9:15: Lisa Abougi- Children with COVID-19 in Colorado: evaluating risk factors for severe disease and ethnic disparities (The CCC Study). 9:40: Rheanna Platt Spanish-language Group Well Child Care 10:05: Breakout rooms to discuss opportunities and challenges in research with Latino populations in the era of Covid-19 10:35: Report outs and large group discussion 10:55am: Closing remarks
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This video is unavailable at the request of one or more presenters.
The COVID-19 pandemic has necessitated a shift in teaching, meetings and clinical patient care to virtual platforms. Interacting through a screen creates many challenges, especially developing the feeling of connectedness. Medical improvisation (improv) is the adaptation of theater improvisation principles and skills to the healthcare setting. Three focal skills of medical improv include: 1. Attunement- awareness of oneself and others through being present and deep listening; 2. Affirmation- acknowledgement of what is being spoken, heard and perceived; and 3. Advancement- moving the conversation forward using spontaneity, creativity and clarity of thought and expression. This workshop aims to foster these skills, while considering how these skills must be thoughtfully adapted to improve connection when communicating across the virtual setting.
The workshop will begin with a brief introduction to medical improv and its applications to clinical care and education. We will discuss the basic rules of improv, including “yes and” and the concept that every word and nonverbal action that transpires is a “gift.” The bulk of the workshop will then focus on experiential learning in a series of interactive exercises, in both the large group and in small breakout rooms of 8-10 participants. These exercises will explore a variety of topics including attention, focus, flexibility, adaptability, nonverbal communication, expression of emotions and demonstration of status. Each exercise will be followed by a debrief session to encourage reflection on individuals’ attitudes, emotions and behaviors, as well as to discuss relevant connections of these skills to clinical practices interacting with patients and healthcare teams, and to our roles as educators interacting with a variety of learners through a virtual platform. At the conclusion of the exercises, the large group will reconvene for participants to discuss their take-aways from the workshop and ways to apply the skills learned to various aspects of their lives. The workshop will conclude with a brief narrative reflection activity. No acting or theater improv experience is expected or required.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
Recording is not available.
1:00 | Introduction: Objectives and Agenda (5 mins) 1:05 | Large Group Discussion (15 mins) 1:15 | Speaker 1 (10 mins) 1:25 | Breakout Groups (10 mins) 1:35 | Large Group Discussion (10 mins) 1:45 | Speaker 2 (10 mins) 2:00 | Breakout Group (15 mins) 2:15 | Large Group Discussion (15 mins) 2:20 | Wrap-up/Q&A (5 mins)
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This video is unavailable at the request of one or more presenters.
PLEASE NOTE: This session has been moved to June 3 at 9-11am CT. The dual plagues of COVID-19 and systemic racism have called into stark view the disadvantages that minoritized families and children face in daily life. As health does not occur in a vacuum, racism and its impact on the social determinants of health (SDOH) contribute to poor health outcomes. The urgent need to address and improve societal inequities is challenging the professional identity of pediatric clinicians, who must seek the knowledge and skill to bring about change. Although academic medicine has not traditionally fought against structural and systemic racism explicitly, there is no longer doubt that pediatricians and other pediatric providers must join in the fight for social justice, racial equity, and resultant health equity. Racism is a public health crisis and medicine must respond accordingly. This session will support Pediatric clinicians who wish to engage in these efforts by sharing the work of three nationally known experts in social injustice, racism and pediatric health.
Please register in advance by clicking the "register" button. A confirmation email will be sent to you with a link to join the session.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop. If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This video is unavailable at the request of one or more presenters.
This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
Firearm related injuries are a serious pediatric and public health problem in the United States. Advocacy for a public health approach is critical but often does not involve pediatricians. In 2018, a dedicated Pediatric Gun Safety Advocacy Committee was created by the New York State – American Academy of Pediatrics (NYS-AAP). The purpose was to galvanize and organize pediatricians and trainees in advocating for evidence-based gun safety policies and practices that prevent firearm-related injuries in children. Committee advocacy activities were categorized into 3 tiers: 1) Clinical advocacy 2) Community advocacy 3) State legislative advocacy. Our workshop led by Dr. Nina Agrawal, Dr. Jeffrey Oestreicher, Dr. Jennifer Grad, and Mr. Daniel Pahl will present the AAP-NY Gun Safety Committee’s utilization of the three-tiered approach to advocacy. The workshop will be structured around each of the three tiers by presenting the committee’s advocacy activities as practical tools and engaging workshop participants in advocacy skill building in each domain.
The clinical advocacy component will focus on ways to integrate evidence-based gun safety practice and policy into medical education. Committee advocacy activities will be provided as examples, including specialty organization meetings, grand rounds, and trainee driven noon conferences. Participants will be engaged in gun safety counseling skill building (ex. safe storage) using video content and pediatric clinical learning scenarios. The community advocacy component will focus on key concepts in building partnerships with community organizations and educating communities on evidence-based gun safety policies. Participants will learn how to identify local collaborators and engage stakeholders, particularly youth. Participants will brainstorm types of organizations in their communities to engage in partnerships and creative ways to engage their communities around gun safety. The legislative advocacy component will focus on evidence-based gun safety policies that prevent injuries in children, with attention to safe storage laws and extreme risk protection orders. Participants will learn through active engagement how to identify legislative opportunities, build relationships with elected officials, and advance state-based legislation.
This workshop is designed to introduce and disseminate a 3-tiered model for gun safety advocacy for use by pediatricians and trainees dedicated to child health and well-being.
Telemedicine expanded at an exponential rate during the COVID-19 global pandemic and its use is already changing the way medicine is practiced. Despite its rapid growth, telemedicine has not been traditionally integrated into medical training, leaving each academic center to develop curricula on their own, if at all, and potentially leaving learners to enter medical practice without important skills. The purpose of this session is to share universal elements of these curricula in an interactive fashion, providing teachers with tools to incorporate telemedicine into their curriculum and precept and evaluate trainees accordingly, regardless of specialty or practice type, all while meeting ACGME and AAMC competencies. Learners will become familiar with strategies to implement telehealth into their teaching curriculum. The session will draw on participants’ experience with telemedicine to identify curriculum development elements that are applicable to all training programs.
Introduction [15 minutes]
Audience response polling to establish audience experience with telemedicine and resident education on telemedicine
Brief overview of telemedicine in the COVID-19 Era
Benefits and Barriers [20 minutes]
Small Group Break Outs – each group assigned a topic to discuss regarding benefits and barriers based on results of the audience polling
Large group report out with virtual blackboard
Designing a Resident Telemedicine Curriculum [20 minutes]
Brief overview of best practices on telemedicine communication skills including simulation of virtual visit
Small Group Break Out discussing methods for teaching and precepting telemedicine skills, including use of the electronic medical record
Each group will be given a different element inherent to telemedicine including teaching communication skills, teaching clinical reasoning, and precepting
Large Group Report Out
Sample Curriculum [10 minutes]
Recap the development and implementation of resident telemedicine curricula at 2 NYC institutions
Evaluation [20 minutes]
Overview of ACGME and AAMC Telemedicine Competencies
Jigsaw Method – small groups will each focus on a specific skill or competency and determine methods to evaluate residents
Large Group Report Out
Sharing of evaluation tools from presenters’ institutions
Lessons Learned [20 minutes]
Discuss lessons learned from 2 NYC institutions who implemented resident telemedicine curricula
Sharing as a group what participants will bring back to their institution
Conclusion [10 minutes]
Questions
Benjamin Franklin stated, “Joy is not in things, it is in us.” Yet, rates of burnout in medical providers have increased. Finding joy in practice is even more challenging in view of the COVID pandemic along with continued social and racial injustice. Bodenheimer and Sinsky added to the Institute for Healthcare Improvement’s (IHI) Triple Aim by adding a 4th aim: Improving the work life of health care providers, including clinicians and staff.[i] While there has been much focus on individual resilience strategies including mindfulness, eating well, and exercising, these strategies may amplify the feeling of being overwhelmed by adding to our to-do lists while away from work and putting more stress/responsibility on the individual. More attention needs to be paid to strategies that can strengthen our relationships with our patients, colleagues, and learners while at work.
This workshop will focus on sparking joy during the hours that occupy our wakeful moments throughout the week and most of the year: while at work.
After welcoming participants and introducing the agenda, participants will complete the PERMA Profiler[ii], a validated 23-question survey that measures overall well-being. We will then describe the PERMA framework[iii] (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) for measuring joy in work. Participants will divide into 5 breakout rooms, each with 2 facilitators. For 15 min, participants will score their PERMA surveys and then discuss “what surprised them.” The small groups will return to the large group briefly in order to be re-randomized to another small group. For 15 min, participants will reflect on existing examples of joy in work, and think-pair-share by phone with a partner (cell phone numbers will be shared directly between pairs with chat function). After being re-randomized to the 3rd small group, facilitators will use screen share and participants will use whiteboard as a group to devise strategies to foster joy in themselves, their patients, their colleagues, or learners utilizing the 5 elements of the PERMA framework.
After the breakout sessions, participants will return to the large group. The small groups will report out to the large group feasible ways to spark more joy at work using padlet through screen share by the facilitator. Next, the large group will continue to use padlet to identify barriers and solutions for sparks of joy. With these ideas in mind, individual participants will then have time to reflect and to draft and send an email to the workshop leader their own commitment to spark joy at work. Two weeks following the workshop, participants will receive a summary of all ideas generated in both the small and larger groups (sparks of joy that already exist, how to spark joy in others at work, new commitments to spark joy in work). Three months later, participants will receive a reminder email of the commitments they made to spark joy at work.
Timeline:
Didactic time: 20 min, Interactive time: 100 min
5 min Welcome (Hetzler)
10 min Participants take PERMA self-assessment (Nicklas)
15 min Introduce PERMA framework (Serwint)
05 min Introduction to small groups (Serwint)
45 min Breakout rooms on Zoom- 5 small groups (15 min each, 2 facilitators per group) (Facilitators: All)
1st 15 min: Score PERMA self assessment and discuss “surprises” within small group
2nd 15 min: Self reflection on examples joy in work (think-pair-share)
3rd 15 min: Small group discussion of strategies to foster 5 elements of PERMA
15 min Large group report out using Padlet (shared screen) (Fenick)
10 min Large group barriers/solutions discussion using Padlet (shared
screen) (Nicklas)
10 min Individual commitment(s) (Gustafson)
[i] Bodenheimer, T., & Sinsky, C. (2014). From Triple to Quadruple Aim : Care of the Patient. Annals of Family Medicine, 12(6), 573–576. https://doi.org/10.1370/afm.1713.Center
[ii] Butler, J., & Kern, M. L. (2016). The PERMA-Profiler: A brief multidimensional measure of flourishing. International Journal of Wellbeing, 6(3), 1-48. doi:10.5502/ijw.v6i3.1
[iii] Seligman, M. (2011). Flourish. New York, NY: Free Press.
Commercial sexual exploitation of children (CSEC) includes the trafficking of minors in sexual acts in exchange for something of value such as food, housing, money, drugs, or alcohol. The average age of entry into this industry is 12 to 16 years old and many of these children come from vulnerable backgrounds including a history of sexual/physical abuse, drug/alcohol abuse, unstable housing and/or violence at home. As many as 88% of victims are seen by a medical provider at some point while they are being trafficked; however, the majority of providers are not trained to recognize potential victims and are unfamiliar with how the medical team and institution can provide immediate and long-term care for these victims. In addition, the COVID pandemic has exacerbated vulnerability and increased the risk for human trafficking. Physicians must therefore be trained to recognize victims, as well as understand how to care for victims, how to approach safe discharge and what resources can be used for multi-disciplinary management.
Using case-based and team-based learning techniques, participants in this workshop will be introduced to clinical scenarios of victims of trafficking and exploitation when they present to the healthcare system. Through interactive small and large group discussions, participants will first learn the key steps in identifying and caring for these victims: 1) recognition of potential indicators of victims of trafficking and exploitation, 2) trauma-informed care approach to management, 3) important discharge planning strategies, and 4) applicable policies and resources. The audience will then learn about potential hospital-wide interventions such as policies and protocols that can be implemented in their institution to improve victim identification, management, and prevention. Finally, they will gain a deeper understanding about key policy and legal protections for which they can advocate in their communities. The diverse backgrounds and experiences of those who work with this vulnerable population including workshop facilitators and audience members will provide a breadth of insight into a complex issue during the workshop discussions. Participants will walk away from the workshop with a knowledge of best practices, common resources, and ideas for system changes that can be brought back to their home institution for wider recognition and important intervention for this vulnerable population.
Most pediatricians consider themselves good communicators, and when it comes to clinic encounters, bedside rounds, or speaking to small groups; this is to be expected, as this type of communication is a core part of medical training. Few clinicians, however, have received coaching or formal training in effective communications strategies despite being called upon to make presentations frequently, in a variety of settings, and to a variety of audiences. The result is lost potential for the speaker and diminished impact upon an audience. The good news is that presenting with clarity, power, and authenticity is an attainable, learnable skill.
In this highly interactive workshop, participants will learn the keys to effective oral presentations. Drawing from multiple professional spheres, including education, business, theatre, marketing, and law, core principles of effective communication will be presented, such as understanding the dynamics of audience demographics and matching delivery style to a setting. Particular emphasis will be placed on adult learning theories, as well as strategies to engage millennial audiences. The challenges of presenting in virtual forums and strategies to engage audiences virtually will be discussed.
At the outset of the workshop, participants will learn the basics of public speaking including vocal range, vocabulary, pitch, rhetorical awareness, and non-verbal communication. Next, participants will learn techniques to improve their delivery through facilitator-led small group exercises focusing on enunciation, projection, and body language. Following a short didactic on the special skills of dramatic and persuasive speaking, participants will practice these newly learned skills. During the workshop, successful techniques for virtual audiences will be demonstrated. Finally, participants will be guided toward developing a personalized action plan for addressing their difficulties with oral presentations and practicing techniques for increasing the persuasiveness and effectiveness of their verbal communication.
This workshop will introduce learners to Practitioner Action Research (AR), reviewing the approach, application, and expected outcomes from a Practitioner AR study. Practitioner AR is an approach that falls under the broader umbrella of Action Research. AR pursues action (social change) and research (knowledge generation) simultaneously, tackling issues relevant to the community/organization. AR is “a participatory, democratic process concerned with developing practical knowledge in the pursuit of worthwhile human purposes, grounded in a participatory worldview which we believe is emergency at this historical moment” (Reason & Bradbury, 2001).
Primarily studied and used within education, Practitioner AR is increasingly becoming recognized and utilized in healthcare. Practitioner AR allows for systemic inquiry in the context of focused efforts to improve the quality of practice and has the potential to generate genuine and sustained improvements. The approach is typically conducted by practitioners who analyze data to improve their own practice and/or address a systemic problem within the organization.
During this workshop, we will discuss the scope of Practitioner AR and its broad applicability within healthcare. We will review examples of Practitioner AR and have participants brainstorm ideas for the use of the approach within their work settings. Additionally, we will review data collection methods and tools essential to Practitioner AR including critical reflection, large group assessment, and qualitative interviews (structured, semi-structured and unstructured). Finally, we will discuss potential challenges that participants may face during a Practitioner AR study and how to disseminate Practitioner AR within the academic field.
Proposed Timeline/Agenda
8-8:10 am
Introductions
Review the agenda
8:10-8:45 am
Overview of Practitioner AR- Definition and principles, applicability, review examples within healthcare,
Watch Dr. David Coghlan’s video “A comprehensive Framework for Action Research”- 7 mins
8:45-9:30 am
Methods of Practitioner AR- review data collection methods and tools including, critical reflection, large group assessment, and qualitative interviews (structured, semi-structured and unstructured).
9:30-9:40 am
BREAK
9:40-9:50 am
Watch Dr. David Coghlan’s video “Further Development of First-Person Voice”- 2 mins
Individual reflection about an important problem within your healthcare setting
9:50-10:20 am
Small group discussion and framing of individual’s problem/question
10:20-10:45
Large group discussion about the process, perceived challenges of Practitioner AR, and how to disseminate findings of Practitioner AR studies
10:50-11:00 am
Comments/suggestions/final questions
Evaluation and wrap up
Editor-in-Chief William F. Balistreri, MD, and Associate Editors Sarah S. Long, MD, Denise M. Goodman, MD, MS, and Paul G. Fisher, MD, MHS, from The Journal of Pediatrics will demystify the submission, review, editorial, and publication process to increase your potential for publication in any journal. In this learner-centered workshop, the facilitators will discuss the preparation of scientific manuscripts, including determining authorship, describing reporting guidelines, deciding which data sufficiently justify publication, and choosing the optimal journal based on factors such as audience, focus, and impact. Other topics will include journal author guidelines; clinical trial registration; the meaning of open access and predatory journals; and an overview of the peer-review process, from selection of reviewers to responding to reviewer comments.
In this highly interactive session, attendees will participate actively in multiple small group exercises: to target the “right” journal for a manuscript, revise an abstract and optimize figures and tables, condense manuscript text, suggest reviewers, anticipate outcomes of the review process, respond to an invitation to revise a submission, and make a plan if your manuscript is rejected. Attendees are expected to participate actively both individually and in small groups, and even sometimes play a “flipped role” as the editor or reviewer. Learners can expect to gain practical strategies and the resources to navigate successfully the entire editorial process, from manuscript writing through final publication and article promotion.
This workshop has been postponed. The new date/time will be posted later in June. This workshop has a limited capacity. Please register in advance by clicking the "register" button. Capacity permitting, your attendance will be approved and you will be sent a confirmation email that contains a link to join the workshop. Please note that your spot is not guaranteed until your registration is accepted and you receive a confirmation email which contains a link to join the workshop.
If you are no longer available to attend please cancel your registration, which can be done using the cancel link at the bottom of your confirmation email.
This video is unavailable at the request of one or more presenters.
Institutional racism persists within medicine, academic health centers, and training programs. This creates negative health effects for children and numerous challenges for physicians from backgrounds under-represented in medicine (UIM). Diversifying the workforce is one of the promising strategies that may lead to a reduction in institutional racism and foster equity. The Pediatric Residency Program at Children’s National Hospital has successfully recruited an increasingly diverse resident body as one step to graduate self-actualized future pediatric leaders equipped with the knowledge, skills, and attitudes to dismantle structural racism.
This workshop will provide participants with an overview of specific strategies that they can introduce at their home institutions to increase UIM diversity. The workshop will begin with a discussion of racism and diversity in academic medicine. Using audience polling technology, we will guide an interactive and evidence-based discussion demonstrating how diversifying the workforce drives equity. We will then present a variety of strategies that have been implemented at our institution to address institutional racism. Then participants will divide into small breakout groups to explore three strategies in-depth: (1) the “Minority Senior Scholarship Program”, a pipeline program to increase UIM student interest in academic pediatrics and introduce them to our residency program; (2) “Enhanced Recruitment and Interview Practices” encompassing strategies from pre-interview season recruitment through applicant review to increase the chances of matching excellent UIM applicants; and (3) strategies used to build community, support UIM residents, and promote inclusion. In small groups, the workshop participants will discuss necessary investments, implementation strategies, measure of success, and assessment approaches for each strategy. Each participant will rotate through each of the small groups.
A large group discussion will then focus on implementation challenges and opportunities. At the conclusion of the workshop, participants will leave with a toolbox of strategies that can be used to diversify their respective educational settings.
Genomic testing is now a routine component of pediatric care. From selecting the appropriate patient for testing to integrating findings into clinical care, all pediatric providers require competency in genomic medicine. Using an interactive, case-based, small-group approach, faculty will review introductory principles related to selection of testing and the interpretation and communication of results. The workshop includes practical hands-on instruction with the use of online genomic tools and databases that participants may find particularly useful in their daily practice.
The design of this workshop is based on an interactive team-based learning (TBL) model developed by the Training Residents in Genomics (TRIG) Working Group for pathology residents, that has since been adapted for oncologists, cardiologists, neurologists and medical students. A project group focused on rare genetic diseases, made up of pediatricians, geneticists, genetic counselors, and pathologists of the National Human Genome Research Institute (NHGRI) Intersociety Coordinating Committee for Practitioner Education in Genomics (ISCC-PEG) has adapted these exercises for pediatricians for delivery through a virtual model. The goal of the project group is to educate healthcare professionals on available resources to address the challenges of rare genetic diseases, such as limited genomic testing options, diagnostic delays, and educational barriers.
The workshop will consist of brief lectures to provide the foundation for small break out groups where participants will collaboratively work through an interactive case. It will consist of a case vignette and a series of questions to facilitate critical thinking around the genetic testing process, from test selection through communication of results and incorporation into clinical care. During small-group discussions, facilitators will be available for questions. A final large group discussion will provide an opportunity to review cases and address broad genomics questions.
Cases will familiarize participants with multiple genomic technologies including microarrays, next generation sequencing (NGS) gene panels and whole exome and genome sequencing as well as the use of commonly utilized resources such as MedlinePlus Genetics, GeneReviews, ClinGen and ClinVar. There is a focus on practical applications with the objective of having participants leave the workshop with knowledge and skills that can be directly applied in their clinical practices.
Despite the growing understanding that caring for children who have experienced trauma is the fundamental role of the pediatric provider, until now, there have been few practical programs for HOW to do this beyond calls for screening. This program provides a practical approach to the patient who has experienced trauma with office- and hospital-based appropriate (and immediate) responses, tools and techniques. Join us to improve your recognition of the symptoms of stress, and how to promote resilience in your patients. Providing timely trauma treatment, immediate stress support and concise clinical consultation within the constraints of the clock and costs will be the focus of this workshop. We will cover how to recognize and promote resilience skills in children and families, review the most common symptoms of trauma and how to identify them, and apply brief, office-based techniques to help children and families recover. Specific skills include: engagement, matching affect, use of body language and vocal tone, recognizing attachment types, ways to identify symptoms of trauma and how to raise and respond to trauma concerns. With case presentation, video examples and brief techniques to practice, participants will leave with experience utilizing these skills. Participants will also leave with ways to talk with children, teens and families about trauma, specific guidance for a variety of trauma situations, and understanding of when and how to access further evidence based mental health services for these patients.
The provision of adolescent-focused care and research involving sensitive topics, such as sexual health, can be challenging in any setting, especially in the time of COVID-19. Laws for confidential clinical care vary among states, and several of these laws do not support best research practices. Additional issues, such as adolescent research consent, also provide challenges in initiating and executing both single- and multi-site studies.
This workshop will expose attendees to various consent, privacy, confidentiality, and research-related challenges affecting adolescents, particularly in the emergency department (ED) setting, and provide tools to address these challenges in their own setting. Many of the challenges faced and tools to address them are relevant outside the ED and will be relevant to providers in a variety of practice settings.
The workshop will begin with an introduction of the topic, the presenters, and the attendees. Next, attendees will be divided into 3 breakout sessions where they will be assigned a clinical care or research-related question focusing on an adolescent sexual health topic and a corresponding scenario. For example, one group may be asked to address a difficult situation that hypothetically arose with the development or execution of a research project (e.g. a consent challenge delaying IRB approval or a parent issue when approaching a family for enrollment). Each group will discuss among themselves how they would address the specific question posed to them, and a facilitator will act as a moderator for each group. Groups will then come together for facilitated discussion.
The facilitators will present a focused, didactic overview of issues related to each scenario, with continued dialogue between facilitators and attendees to generate creative solutions. Each small group will have the opportunity to present their scenario with didactics and discussion following. During these group exercises, participants will be asked to electronically send any questions they have related to IRB review/approval, and the workshop will conclude with a facilitated Q&A style session with IRB leaders from pediatric research institutions.
The leaders of the this workshop consist of the current Chair and members of the Adolescent Sexual Health Working Group from PECARN (Pediatric Emergency Care Applied Applied Research Network). Together, we work collaboratively to improve the sexual health of adolescent ED patients and conduct patient-centered, evidence-based research.
Addressing a paucity of training in multilingual research methods, we propose a unique workshop to provide child health researchers with pragmatic skills to engage Limited English Proficiency (LEP) children and families in research. In the US, there are approximately 7.8 million children and adolescents with no English-proficient parents and approximately 2.4 million children who are themselves English language learners. Asian and Latino children are over-represented in LEP populations and under-represented in pediatric research. By offering training in multilingual research methods, we hope to help transform the practice of pediatric research by making inclusion of LEP children and families the norm rather than the exception.
The workshop will begin with a brief introduction in which the facilitators—who include applied linguists, professional interpreters, and multidisciplinary child health researchers—will share foundational concepts about language and multilingual research. We will also review the ethical and practical implications of inclusion of LEP children and families, e.g., better adherence to NIH policies. Subsequently, we will break into small groups for facilitated, hands-on activities to teach practical approaches to multilingual research, including selecting study instruments that are appropriate for multilingual data collection; selecting and applying a translation strategy; budgeting; and communicating effectively when working with an interpreter. We will then reconvene as a larger group for reflection. Dialogue throughout will create space for attendees to explore and collectively problem-solve challenges in multilingual research. We will close the workshop by exchanging contact information to encourage the development of a scientific community of child health researchers whose protocols are inclusive or seek to become inclusive of LEP children and families.
The purpose of this Special Interest Group is to promote new opportunities for collaboration, research, training and networking across multiple disciplines focused on pediatric behavioral health.
This video is unavailable at the request of one or more presenters.
A cutting edge scientific meeting is dependent on skilled peer reviewers to aid in the development of a rigorous and stimulating program. Selection as a peer reviewer acknowledges the professional reputation of a faculty member and helps to provide evidence to support academic advancement and promotion. However, few faculty receive training to learn how to do this important task. This workshop applies to participants from all disciplines and will focus on advancing skills to be an effective reviewer. The session will provide participants with an opportunity to gain insight into the PAS scientific abstract and workshop proposal review and selection processes as well as assist attendees in providing specific, constructive feedback to colleagues who wish to disseminate their work in this venue. After an exercise to identify common challenges in reviewing and common writing pitfalls that may preclude an abstract from being accepted, a brief didactic presentation will provide an overview of how to apply PAS reviewer instructions and scoring rubrics. The majority of the workshop will be devoted to interactive small group break-out sessions facilitated by workshop leaders during which participants will review and score de-identified and modified scientific abstract submissions and workshop proposals. Attendees will also have the opportunity to address the challenge of selecting proposals when narrative review comments are limited or too general or do not align with scoring determinations. Discussions will be summarized in a large group brainstorming activity to create tips for reviewing using the lessons learned from the exercises. Participants will leave equipped with the tools to be effective reviewers and with learning that they will be able to apply as they mentor others who are creating proposals for consideration in a peer-review process.
Pediatricians are playing an increasingly important role in quality improvement (QI) initiatives within their hospital systems. While tasked with the education of the next generation of clinicians, pediatricians receive little training in how to teach QI methodology to the learners on their teams. Although formal teaching of QI principles as part of a longitudinal curriculum has been described previously and is in place in many training programs, how to teach QI concepts in busy inpatient and clinic setting has not been well-described and remains a formidable challenge for the busy clinicians.
Through case simulations and group exercises, this workshop will instruct clinicians on effective real-time and near-time teaching of QI. After a discussion of the challenges inherent on busy services or clinics, such as how to create an active learning environment, participants will learn through group activity how to identify opportunities to teach QI in these settings. We will review stakeholder interests, patient safety principles, effective teamwork, and communication.
Next, participants will learn how to teach QI concepts in real- and near-time without major disruptions to rounding or workflow. Through an interactive case simulation, participants then will explore how to incorporate “QI on-the-fly” at their home institutions using a novel planning tool created specifically for the workshop, the QI-STONE (Quality Improvement - Structured Tool for Organization of Needs). Methods for pre- and post-assessment of learners, such as using the Quality Improvement Knowledge Application Tool – Revised (QIKAT-R) will be discussed as well.
Note: This workshop assumes participants have a basic understanding of the principles and concepts of QI.