Medicine and Health Sciences Commons^™

The Impact Of Medication Therapy Management Services On Pediatric Patients With Medical Complexities, Charisma Osuagwu, Erica Wong, Savion Carswell, Sophia Jenkins, Xinyu Wang, Yujin Kim

Research Day

Introduction

Medication Therapy Management (MTM) is a service provided by healthcare providers to ensure the best medical outcomes, particularly for those with multiple chronic conditions. It is often provided for senior populations supported under the Centers for Medicare & Medicaid Services. Studies show that patients provided with MTM services have higher medication adherence rates and experience fewer complications. However, there are few studies on MTM counseling in pediatric populations. In this literature review study, we investigated the potential impact of MTM services for underserved pediatric populations with chronic conditions or disabilities who are likely to benefit from MTM services.

Methods …

Participation Of Children And Youth With And Without Cerebral Palsy Across Settings: An Exploratory Study, Teresa Long Pierce, Alyssa Laforme Fiss

Research Day

Introduction: Cerebral Palsy is one of the most common pediatric health conditions resulting in childhood disability. Children with CP experience varying levels of functional impairments due to muscle weakness, alterations in muscle tone, balance deficits, and loss of selective motor control. These impairments and activity limitations are thought to contribute to lower levels of participation. Studies examining participation of children with CP have found that participation is positively correlated with increased physical activity and have concluded that environment is a significant predictor of participation. However, research examining participation across specific environments is lacking. Additionally, research investigating the influence of various …

Association Of Operative Approach With Postoperative Outcomes In Neonates Undergoing Surgical Repair Of Esophageal Atresia And Tracheoesophageal Fistula, Devon Pace, Paulo Castro, Shale J. Mack, David H. Rothstein, Courtney Devin, Emily Sagalow, Allison F. Linden, Matthew Boelig, Loren Berman

Research Day

Introduction: Minimally invasive surgery (MIS) is gaining traction as a first-line approach to repair congenital anomalies. This study aims to evaluate outcomes for neonates undergoing open versus MIS repairs for esophageal atresia/tracheoesophageal fistula (EA/TEF).

Methods: Neonates undergoing EA/TEF repair from 2013-2020 were identified using the National Surgical Quality Improvement Program-Pediatric database. Proportions of operative approach (open vs. MIS) over time were analyzed. A propensity score-matched analysis using preoperative characteristics was performed and outcomes were compared including composite morbidity and reintervention rates (overall, major [thoracoscopy, thoracotomy], and minor [chest/feeding tube placement, endoscopy]) between operative approaches. Pearson’s chi-square or Fisher’s exact test …

Perfect Storm? Covid-19, Area Deprivation, And Their Association With Pediatric Trauma, Devon Pace, Paulo Castro, Julia Gong, Brandon George, Russell Mcintire, Charles Paidas, Loren Berman, Rosemary Frasso, Colin Plover

Research Day

Introduction: Social determinants of health (SDOH) affect pediatric injury patterns as vulnerable populations are likely to experience more frequent or severe injuries. This study evaluates the association of COVID-19 and area deprivation with pediatric traumatic injuries.

Methods: We retrospectively evaluated institutional level I pediatric trauma encounters from 1/2018-8/2022. Patients were assessed relative to the U.S. pandemic declaration date (3/11/2020): pre-COVID (<3/11/2020), early post-COVID (3/11/2020-3/11/2021), and late post-COVID (>3/11/2021). The Area Deprivation Index (ADI) measured SDH-related risk at a census block tract group level. Associations between ADI and COVID-19 and injury mechanism and outcomes (intensive care unit [ICU]/ventilator duration, hospital length of stay, and mortality) were assessed …

Maternal Psychiatric Functioning And Maternal-Infant Attachment Among Mothers Of Infants In The Neonatal Intensive Care Unit (Nicu), Elizabeth Greco, Alexa Bonacquisti

Research Day

Introduction: A growing body of research suggests that an infant’s admission to a neonatal intensive care unit (NICU) may adversely impact maternal psychiatric functioning, affecting quality of life, well-being, and patient outcomes. Additionally, there is accumulating evidence that stressful reproductive events related to a NICU admission) may even exacerbate pre-existing maternal psychiatric symptoms. The purpose of the current study was to examine the relationships between maternal mental health symptoms, including anxiety and stress, and maternal-infant attachment among mothers of infants in the NICU. By examining the psychiatric functioning measures both at the time of initial NICU admission and again 2-4 …

A Rare Case Of Scalp Swelling In Infancy: Delayed Subaponeurotic Fluid Collection, Shreya Dundumalla

Research Day

Delayed subaponeurotic fluid collection (DSFC) is a rare cause of scalp swelling in infants presenting weeks to months after birth. DSFC is described as a mobile and soft swelling which crosses suture lines in healthy infants with no recent history of trauma or fall. A literature search in the National Library of Medicine revealed fewer than 15 publications on the topic since 2007. The exact etiology and long term consequences of DSFC remain unclear although birth trauma has been implicated as the main mechanism. A healthy 2 month old male infant presented to the ED with a one-day history of …

Association Between Race And Early Antibiotic Use In Newborns Admitted To The Neonatal Intensive Care Unit, Rodney Morrison Jr, Alvaro Zevallos Barboza, Diana Montoya-Williams, Dustin Daniel Flannery

Research Day

Introduction: Given the risk of early-onset sepsis, providers frequently prescribe empirical antibiotics to newborns admitted to the neonatal intensive care unit (NICU). Early and prolonged use of antibiotics in uninfected newborns is associated with many adverse effects and potentially life-threatening complications, particularly among those with very low birth weight (VLBW; <1500g). Studies of neonatal antibiotic utilization often adjust for race, acknowledged as a social construct, but there is a paucity of data on whether there is an independent association between race and antibiotic use in this population. We hypothesized that Black newborns have higher antibiotic use after adjusting for confounding factors compared to other races.

Design/Methods: Retrospective cohort study including newborns admitted to a NICU from 2012-2021 included in the Premier Health database, which captures inpatient encounters from academic and community hospitals across the US. Early antibiotic initiation was defined as any parenteral antibiotic administered within the first 3 days after birth. Prolonged antibiotic duration …

The Use Of Dietary Interventions In Pediatric Patients, Shirin Madzhidova, Lusine Sedrakyan

PCOM Scholarly Papers

Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The prevalence of CAM use among US adults was estimated to be around 42% in 2015 and around 44% to 50% among adults with neurologic disorders. Studies demonstrate that children with certain chronic illnesses such as asthma, cancer, genetic disorders, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population. Although the majority of "fad" diets do not have enough supporting evidence, some dietary therapies have been utilized for …

Is Intranasal Oxytocin An Effective Treatment For Reducing Disruptive Behavior In Individuals With Prader-Willi Syndrome?, Anna C. Maraia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intranasal oxytocin is an effective treatment for reducing disruptive behavior in individuals with Prader-Willi Syndrome.

STUDY DESIGN: This is a systematic review of two randomized controlled crossover trials and one randomized controlled pilot study, all of which were double-blind and placebo-controlled. All articles were peer-reviewed, written in English and published between 2011 and 2016.

DATA SOURCES: The three articles used in this systematic review were found in PubMed based on their relevance to the objective of the study, the inclusion of patient-oriented problems and published within …

Is Amitriptyline Effective In Reducing Headache Days In Pediatric Patients With Migraines And Chronic Headaches Compared To Topiramate, Propranolol, Or No Treatment?, Megan N. Hall

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is amitriptyline effective in reducing headache days in pediatric patients with migraines and chronic headaches compared to topiramate, propranolol, or no treatment?”

Study design: Systematic review of two randomized control trials (RCTs) and one case series published in peer-reviewed journals in English after 2007.

Data Sources: Two RCTs and one case series were found using PubMed.

Outcome(s) Measured: Headache frequency was measured using a headache diary or calendar. A secondary objective included headache severity that was measured using a ten-point scale or …

Is Sublingual Buprenorphine Treatment Effective And Efficient When Compared To Traditional Neonatal Opium Solution (Morphine) In Treating Newborns With Neonatal Abstinence Syndrome?, Abigail G. Stefanides

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether sublingual buprenorphine treatment is effective and efficient when compared to traditional neonatal opium solution (morphine) in treating newborns with neonatal abstinence syndrome (NAS).

Study Design: Review of one randomized active-control clinical trial, one randomized doubleblind, double-dummy clinical trial, and one retrospective cohort analysis.

Data Sources: All articles were published in English between the years of 2011 and 2017. Articles were obtained from peer-reviewed journals and databases using PubMed and Embase.

Outcomes: Outcomes measured were length of stay using the neonates birth date and hospital discharge date as well …

Is Bovine Lactoferrin Effective In Preventing Diarrhea In Infants And Toddlers?, Kateryna Toganov

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence-based medicine (EBM) review is to determine whether bovine lactoferrin is effective in preventing diarrhea in infants and toddlers.

Study design: Review of three English-language primary randomized controlled trials published between 2007 and 2016.

Data sources: Three double-blind controlled trials comparing bovine lactoferrin to placebo were found using PubMed.

Outcomes measured: Incidence and incidence rate of diarrhea in episodes/child/year were measured using the information provided by the caregivers and the healthcare records obtained from a hospital or clinic.

Results: King et al. found that there was no statistically significant difference in incidence of diarrhea …

Is Virtual Reality An Effective Tool For Reducing Procedural Pain In Pediatric Patients?, Rachel M. Wiegand

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence-based medicine review is to determine whether or not, “Is virtual reality an effective tool for reducing procedural pain in pediatric patients?”

STUDY DESIGN: Included the review of three English language primary studies, published between 2014 and 2018. Articles were selected based on outcomes measured and relevance to the objective.

DATA SOURCES: PubMed was utilized to find two randomized controlled trials and one quasiexperimental study. The selected studies analyzed how the use of virtual reality impacted the amount of pain experienced by the pediatric patient undergoing either a venipuncture or burn wound care procedure. …

Does Lactobacillus Reuteri Dsm 17938 Reduce Daily Crying Times In Infants With Colic?, Taylor Kolle

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Does Lactobacillus reuteri DSM 17938 reduce daily crying times in infants with colic?”

Study Design: Review of all English language primary studies published in 2010, 2013, 2015.

Data Sources: Three randomized, double blind, placebo controlled clinical trials found using PubMed.

Outcomes Measured: Daily average crying times were measured by parents who documented these in a journal.

Results: In all three randomized control studies by Chaeu et al. (2015), Savino et al, (2010), and Szajewska et al. (2013), they found that infants …

Is Non-Nutritive Sucking An Effective Method Of Providing Analgesia To Newborns Undergoing Painful Procedures?, Eric B. Hooper

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: “The objective of this selective EBM review is to determine whether or not nonnutritive sucking is an effective method of providing analgesia to infants undergoing painful procedures.”

STUDY DESIGN: A systematic review of three blinded randomized-controlled trials (RCT’s), published from 2011 to 2013. All were published in English, one of which was translated from its original Spanish version to an English publication. DATA

SOURCES: Three RCT’s were found using the PubMed database and all were published in peer-reviewed journals.

OUTCOMES MEASURED: The incidence and severity of pain were measured during procedures using the Premature Infant Pain Profile (PIPP) and/or …

Pediatric Obesity Class: Teaching Kids How To Live Healthy Lifestyle, Sara Wilson Reece

Scholarly Posters

Childhood obesity has reached epidemic proportions in the United States. At The Longstreet Clinic, PC, Diabetes Education and Medical Nutritional Therapy Department, and Pediatric Department have joined together to create the Pediatric Obesity Class to address the epidemic of pediatric obesity in the local community. In the class, the child and parent are taught about calories, how to develop healthy eating habits and become physically active as a family. Visual aids as well as hands on activities for both nutritional and physical activity components of class are utilized. Thus far, approximately 120 children along with their parent(s) have participated in …

Does Neonatal Massage Lead To Reduced Stress Behavior In Medically Stable Preterm Infants In The Nicu?, Sarah E. Werner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not neonatal massage leads to reduced stress behavior in medically stable preterm infants in the NICU.

STUDY DESIGN: Review of three English language primary studies published in 1996, 2005 and 2007.

DATA SOURCES: Three randomized control trials comparing stress behavior in preterm infants receiving massage to a control group that did not receive massage were found using PubMed and Medline databases.

OUTCOMES MEASURED: Researcher recorded stress behavior as behavioral distress activity and motor activity via direct observations and a time sampling method. Motor …

Does Parent And Therapist Delivered Qigong Massage Therapy Decrease Sensory And Self-Regulation Impairments In Children Ages 3-6 Years Old With Autism?, Lisa A. White

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not parent and therapist delivered Qigong massage therapy decreases sensory and self-regulation impairments in children ages 3-6 years old with autism.

STUDY DESIGN: Reviewed three English primary studies published in 2005, 2009 and 2011.

DATA SOURCES: All studies were randomized controlled trials that compared a group of children with autism who received Qigong massage treatments to a controlled group of children with autism who did not receive the treatments. All studies were found using PubMED and Cochrane research databases.

OUTCOMES MEASURED: Overall reduction …

Is Topiramate Effective In Preventing Pediatric Migraines?, Krystina Zeliff

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Topiramate is effective in the prevention of pediatric migraines.
Study Design: Review of three English language randomized control trials published in 2005, 2007, and 2009.

DATA SOURCES: Three double-blind, placebo-controlled, randomized trials comparing various doses of Topiramate to placebo were found using PubMed, OVID, and Cochrane Library databases.

OUTCOME(S) MEASURED: The frequency of migraines in patients under the age of 18 years old was documented with headache diaries. The patient’s parent would record the number, severity, duration, associated symptoms, and use of acute …

Is Kangaroo Care Effective In Reducing Procedural Pain In Neonates?, Sara A. Deringer-Kohorst

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether Kangaroo Care is effective in reducing procedural pain in neonates.

Is A Musical Intervention Effective In The Reduction Of Needle Related Procedural Pain In Children?, Heather B. Good

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE:Trypanophobia, or the fear of needles and needle pain is a very common occurrence in children, one that can have significant impacts into adulthood and on an individual’s lifelong healthcare. The objective of this systematic review is to determine whether or not a musical intervention is effective in the reduction of needle-related procedural pain in children. The author searched OVID Medline and Cochrane databases for peer-reviewed articles and systematic reviews addressing the topic, published in English after 1996. Three randomized controlled trials were selected on the basis of their being POEM’s and not included in previous systematic reviews, the results …

How Safe And Effective Is Infliximab In The Treatment Of Children With Moderate To Severe Crohn’S Disease?, Jackie Linh

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not “how safe and effective is infliximab in treatment of children with moderate to severe Crohn’s disease?”

Does Massage Therapy Promote Weight Gain In Preterm Infants?, Tyler Rychlewski

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not massage therapy promotes weight gain in preterm infants.

The Effectiveness And Safety Of Antibiotic Treatment In Healing Tympanic Membrane Perforation In Aboriginal Children, Shannon M. Rice

PCOM Physician Assistant Studies Student Scholarship

The objective of this systematic review is to determine whether or not antibiotic treatment is safe and effective in healing tympanic membrane (TM) perforation in Aboriginal children diagnosed with chronic suppurative otitis media and otitis media with effusion less than 16 years of age.

Is Clofibrate (Atromid-S) A Safe And Effective Adjunctive Treatment To Phototherapy For Neonatal Jaundice?, Nicole Tindall

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine, “Is clofibrate a safe and effective adjunctive treatment to phototherapy for neonatal jaundice?”

Are Proton Pump Inhibitors A Safe And Effective Treatment For Gastroesophageal Reflux Disease In Infants Less Than Twelve Months Old?, Mariah Smith

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not proton pump inhibitors are a safe and effective treatment for gastroesophageal reflux disease in infants less than twelve months old.