Education Commons^™

Management Of Primary Spontaneous Pneumothorax In Children: A Single Institution Protocol Analysis, Shai Stewart Md, James Fraser, Nelimar Cruz-Centeno, Derek Marlor, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Tolulope A. Oyetunji, Shawn D. St.Peter

Research Days

Background: Primary spontaneous pneumothorax (PSP) affects 3.4 per 100,000 children in the United States. Regardless of the initial management, additional procedures, and prolonged hospital length of stay (LOS) may occur. There is currently no consensus in the pediatric surgical community on the optimal management of these patients, which has resulted in marked variability in management. The Midwest Pediatric Surgery Consortium (MWPSC), of which our site is a participant, suggested a management algorithm to include simple aspiration upon presentation, and if this fails, VATS should be considered.

Objectives/Goal: The purpose of this study was to evaluate the outcomes of instituting a …

A Novel Approach For Laparoscopic Direct Inguinal Hernia Repair In Children, Shai Stewart Md, Charlene Dekonenko, Nelimar Cruz-Centeno, Derek Marlor, Jason D. Fraser

Research Days

Background: Inguinal hernia repair is one of the most common operations performed by pediatric surgeons, and the frequency of laparoscopy for repair is increasing. The vast majority of these are indirect hernias and therefore how to best repair a direct defect when seen during laparoscopy is still unknown. Simple high ligation of the hernia sac (as is done in an indirect hernia) does not repair the inguinal floor weakness/defect seen in a direct hernia.

Objectives/Goal: We therefore present a case of laparoscopic bilateral indirect and direct inguinal hernia repair, commonly known as pantaloon hernia, repaired without mesh and utilizing the …

Antibiotic Monotherapy Vs Dual-Drug Therapy In Perforated Appendicitis: Single Center Retrospective Review, Shai Stewart Md, Nelimar Cruz-Centeno, Derek Marlor, Dae H. Kim, Shawn D. St Peter, Tolulope A. Oyetunji Md Mph

Research Days

Background: The optimal antibiotic regimen in perforated appendicitis to reduce intraabdominal abscess (IAA) formation has not yet been agreed upon in the pediatric surgery community. We aimed to evaluate the outcomes of patients with perforated appendicitis when intravenous antibiotic monotherapy with Piperacillin-Tazobactam (PT) versus dual-drug therapy with Ceftriaxone and Metronidazole (CM) are administered. We hypothesized there is no difference in the rate of IAA formation with antibiotic monotherapy, as opposed to our once-daily dosed, institutional standard dual-drug therapy.

Objectives/Goal: The goal was to determine if our current management protocols for acute appendicitis were delivering the best possible results for our …

Institutional Outcomes Of Blunt Liver & Splenic Injury In The Atomac Era, Shai Stewart Md, James Fraser, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St.Peter, Tolulope A. Oyetunji

Research Days

Background: The Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) practice management guideline (PMG) was created to standardize management of blunt liver or spleen injury (BLSI) across pediatric trauma centers. Evaluations of institutional outcomes after its adoption remain scarce. We describe our outcomes since PMG adoption at our institution.

Objectives/Goal: The purpose of this study was to assess patient outcomes and resource utilization after implementation of this protocol. We hypothesized there is no difference in length of stay (LOS) or complications regardless of grade of isolated injuries to the liver or spleen. In addition, there is limited guidance on the management of concurrent injuries to …

A Comparison Of Large Tbsa Scald Versus Flame Burns In Young Children, Ashley Daniel

Research Days

Background: It is generally accepted that of children with the same total body surface area of burns, those with flame burns seem to have longer lengths of stay and more complications than those with scald burns. Anecdotally we have seen the opposite to be true. Among a consortium of five US pediatric burn centers participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC), young children with scald burns seem to experience disproportionately more frequent and severe complications compared to their older counterparts and compared to patients of a similar age with flame burns.

Objectives/Goal: In this multi-institutional study, we compared …

Relationship Between Rurality And Access To Care For Families Of Hospitalized Children, Zoetta L. Mcloughlin Md

Research Days

Background: At Children’s Mercy Hospital, greater than 1 in 5 hospitalized children are from rural areas. Rural families often travel long distances for hospitalization at free-standing children’s hospitals, a median of 70 miles according to recent work. Rural families are more likely than non-rural families to experience financial insecurity, and these baseline hardships may be intensified during hospitalization due to out-of-pocket costs, lost work, inability to meet family needs, and removal from social support. However, little is known about the differences in healthcare access and resulting burdens between rural and non-rural families.

Objectives/Goal: To describe differences in demographics, health care …

Rural And Urban Caregiver Experiences Of Financial Strain And Food Insecurity During Pediatric Hospitalizations, Rachel E. Granberg

Research Days

Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.

Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.

Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was …

Female Authorship Concordance In Academic Pediatrics, Roxana Guggenmous, Jessica L. Bettenhausen, Jessica L. Markham

Research Days

Background: Gender disparities are well described in medicine and academia. Despite a catalyzed movement towards gender equity, female physician-scientists remain at risk for experiencing biases in hiring practices, compensation, promotion, appointment to leadership positions, and achievement of extramural funding through the National Institutes of Health. In pediatrics, the female workforce has grown consistently over time, with female physicians comprising 72.3% of the workforce as of 2021, yet prior work suggests that this growth is not fully reflected in academic publications. Achieving gender parity in academic publication may help reduce gender-based disparities impacting career advancement. Therefore, we sought to describe the …

Socioeconomic Factors And Picu Interventions In High Mortality Risk Asthmatics, Hanh Ho, Paul N. Bauer, Jade B. Tam-Williams

Research Days

Background: Asthma mortality rates are overall lower in children, but studies estimate 5-10% of asthmatics have refractory mortality prone asthma. Asthmatics with repeat pediatric intensive care unit (PICU) admissions are believed to be at high mortality risk with increased health care utilization and socio-economic challenges.

Objectives/Goal: We aim to identify patients with repeat PICU admissions for status asthmaticus and characterize the levels of interventions and socio-economic status.

Methods: A retrospective chart review was done on patients with the following inclusion criteria: age 0- 18, PICU admission between January 2010 to December 2015, and a diagnosis of status asthmaticus on admission. …

Supporting Families Impacted By Adverse Childhood Experiences (Aces), Jennifer Paumen, Laura Plencner, Jacqueline Kitchen

Research Days

Background: Adverse childhood experiences (ACEs) impact a majority of individuals, with approximately two-thirds of adults having experienced 1 or more ACE.1 The health consequences of ACEs are significant, including cardiovascular disease, cancer, autoimmune diseases, and mental illnesses.1 These health impacts can even start as early as childhood, leading to an increased risk of learning and behavioral concerns.2,3 Recent evidence has also identified the impact that parental ACEs may have on parenting and child development,4,5,6 which in turn may lead to an intergenerational transmission of ACEs.4,7 As a nurturing caregiver relationship is key for buffering adversity,2,8 it is imperative to address …

Influencing Influenza Immunization: Qi Project In A Pediatric Resident Continuity Clinic, Brittany Moore

Research Days

Problem Statement/Question: There have been a multitude of approaches to vaccine hesitancy in regard to childhood vaccinations. In light of the COVID-19 pandemic there was a noticeable decline in influenza vaccination among children aged 6 months to 18 years. The influenza vaccination rate in the pediatric resident continuity clinic at Children’s Mercy Hospital was below the national average for pediatric patients.

Background/Project Intent (Aim Statement): The aim of this study is to increase the percentage of patients aged 6 month and older currently enrolled in ROYAL clinic receiving at least one influenza vaccine from 38.6% to 55% by January 1, …

Increasing Utilization Of Gestational Age Based Table For Initial Intubation In A Level Iv Neonatal Intensive Care Unit, Maribel Martinez, Dianne Lee, Christopher R. Nitkin

Research Days

Problem Statement/Question: Most providers in our unit are not using the NRP recommended method to determine the initial ETT insertion depth in neonates.

Background/Project Intent (Aim Statement): Endotracheal tube (ETT) depth in neonates is of critical importance due to significant adverse events when malpositioned. While randomized trials comparing different methods have not shown superiority of any particular method, the weight-based method (weight (kg) +6) has been found to be highly inaccurate in extremely low birth weight neonates. Furthermore, the Neonatal Resuscitation Program (NRP) recommends using gestational age (GA)-based table (Kempley ST, et al, Resuscitation 2008) or nasal-tragal length for initial …

Hypereosinophilia With An Anterior Mediastinal Mass, Sonya Parashar, Aarti Pandya

Research Days

Background: Hypereosinophilia is defined as 1500 eosinophils/mL or above with evidence of end-organ damage due to the eosinophils at least 4 weeks apart.

Objectives/Goal: We describe a case of steroid resistant hypereosinophilia.

Methods/Design: A 3-year-old male was admitted for newly found anterior mediastinal mass and left pleural effusion. About 6 weeks prior to admission, he was seen in his primary care office for difficulty breathing. Despite the appropriate treatment for his symptoms, the patient continued to have significant respiratory symptoms and a chest x-ray showed a large left pleural effusion. He was immediately transferred to a tertiary care center and …

Improving Frequency Of Peer Review Of Abnormal Genital Exam Findings In Patients Undergoing Sexual Abuse Evaluation, Lyndsey Hultman, Julia G. Harris, Terra N. Frazier, Jennifer B. Hansen

Research Days

Problem Statement/Question: Child Advocacy Centers (CACs) coordinate child abuse MDTs, and 2023 CAC accreditation standards require that “all medical professionals providing services to CAC clients must demonstrate that 100% of all findings deemed abnormal or “diagnostic” of trauma from sexual abuse have undergone expert review by an advanced medical consultant.” Scheduled Case Review occurs among Children’s Mercy child abuse pediatricians (CAPs), but current practice is to review cases only upon CAP request.

Background/Project Intent (Aim Statement): Appropriate interpretation of sexual abuse exam findings is crucial for accurate diagnosis and provision of medical information to multidisciplinary child protection teams (MDTs). Medical …

Unique Endoscopic Retrieval Of A Large Rectal Foreign Body, Laurie Mccann, Jose Cocjin

Research Days

Introduction: Large rectal foreign bodies are usually difficult to extract, usually requiring operative management.

Case: A 14-year-old male presented to the ER for a rectal foreign body. Earlier in the day, he had rectal itching and inflammation. He used a cylindrical reusable ice stick (for water bottles) for topical relief, which did not work, so he placed the tube in his rectum, then he was unable to retrieve it and sought medical help. Physical exam was significant for lower abdominal pain and palpable mass just below his umbilicus, which was painful to palpate. CT abdomen/pelvis showed a large foreign body …

Improving Fluid Management Of Extreme Premature Infants By Providing A Restrictive Fluid Management Algorithm In The Nicu, Jacob S. Ward, Dena Hubbard, Nicholas Clark

Research Days

Problem Statement/Question: At our institution we found wide variability in and a lack of an evidence-based standard for fluid management in premature infants.

Background/Project Intent (Aim Statement): Excessive fluid intake in premature infants during the first week of life increases the risk of adverse events and overall mortality. Fluid restriction is recommended to help decrease morbidity and mortality in this patient population. We aimed to improve the fluid management of premature infants born < 29 weeks gestation admitted to our intensive care nursery (ICN) by implementing a fluid restriction protocol with the goal of >70% compliance over a 16-month period.

Methods (include PDSA cycles): Institution of daily weights started at beginning of baseline period. In April of 2021, we implemented a …

Creating And Evaluating Dimensional Analysis Software For University Students, Ac Hýbl

Campus Research Day

Most scientific disciplines depend on mathematics to varying degrees. Real-world problems often include quantifiable measurements with units. For example, chemistry, physics, and pharmacology require flawless unit conversions and dimensional homogeneity to obtain acceptable results. Students often choose to ignore units until the end of the problem-solving process, but this introduces errors and robs students of a deep understanding of units. Current tools for teaching dimensional analysis are limited both in scope and accessibility. Unit Playground addresses this issue by providing an interactive interface to experiment with units and their relationships.

Mindfulness To Reduce Math Anxiety And Improve Math Performance, Hannah Murch

Liberty University Research Week

No abstract provided.

A Growth Mindset: Fostering Resilience And Success In The Middle School Mathematics Classroom, Mary Jicha

Liberty University Research Week

Undergraduate

Applied

Simulating Function Generators And Oscilloscopes In A Virtual Laboratory Environment, Yiyang Li, Yuzhong Shen, Charles I. Sukenik

Modeling, Simulation and Visualization Student Capstone Conference

This paper discusses the development of a virtual laboratory for simulating electronic instruments commonly used in science and engineering courses, such as function generators and digital storage oscilloscopes. Mathematical equations are used to represent continuous signals and ensure signal integrity, while C# delegates are adopted to enable communication between simulated devices. The approach allows for loose coupling between software components and high cohesion of individual components, and can be applied to other virtual laboratory developments. The virtual laboratory provides a means for students to gain hands-on experience with electronic instruments and improve their understanding of theoretical concepts.

Digital Game-Based Approach To Math Learning For Students, Gul Ayaz, Katherine Smith

Modeling, Simulation and Visualization Student Capstone Conference

Mathematics is an important subject that is pervasive across many disciplines. It is also a subject that has proven to be challenging to both teach and learn. Students face many challenges with learning math such as a lack of motivation and anxiety. To address these challenges, game-based learning has become a popular approach to stimulate students and create a more positive classroom environment. It can serve as an alternative or supplement to traditional teaching and can better engage students while developing a positive attitude toward learning. The use of games in a classroom can create a more exciting and engaging …

Promoting Skills In Children And Teens With Autism Spectrum Disorder Through Play And Steam, Meaghan Mcleod Mozingo, Krzysztof J. Rechowicz

Modeling, Simulation and Visualization Student Capstone Conference

Individuals with autism spectrum disorder (ASD) have a low employment rate. This is caused by a lack of support from employment resources and the negative stigma associated with common characteristics associated with ASD. With limited career-building activities and events, it is difficult for individuals with ASD to identify their skills, strengths, and career opportunities. Parental support is crucial when seeking employment opportunities for their children. Through the use of play, children with ASD engaged and explored their skills with science, technology, engineering, arts, and math-centered activities. This paper highlights the events and shows the proposed redesign for an additional workshop.

Specifications Grading Has Improved My Courses!, Bruce J. Heyen

Scholar Week 2016 - present

Specifications grading is a way of "restoring rigor, motivating students, and saving faculty time" as stated in the title of Linda Nilson's book promoting this method. While there are many variations across disciplines, I will present how I am using specifications grading in my Organic Chemistry courses. I label course objectives as essential or non-essential, and students must master these with a quiz score of 80% or greater to obtain the points. Students are allowed multiple attempts to master course objectives.

Literature Review Of Practical Insights Into The Use Of Brain Science And Learning Technology To Enhance Stem Student Learning, Keith Schimmel

Scholar Week 2016 - present

In recent years, college students, including those at Olivet Nazarene University, have experienced an increase in mental health challenges such as anxiety and depression. Researchers think technology is a significant contributor to this trend with social media undermining a viewer’s dignity through constant comparison and ruthless competition for attention. However, social media and teaching/learning technologies also have the potential to enhance efficient, effective student learning. This paper will present the best practices for use of social media and teaching/learning technologies based on a literature review in these areas.

The literature review will seek to tie together knowledge and best practices …

Problem Of The Week: A Student-Led Initiative To Bring Mathematics To A Broader Audience, Jordan M. Sahs, Brad Horner

UNO Student Research and Creative Activity Fair

Problem of the Week (POW!) is a weekly undergraduate mathematics competition hosted by two graduate students from the UNO Math Department. It started with the goal to showcase variety, creativity, and intrigue in math to those who normally feel math is dry, rote, and formulaic. Problems shine light on both hidden gems and popular recreational math, both math history and contemporary research, both iconic topics and nontraditional ones, both pure abstraction and real-world application. Now POW! aims to increase availability and visibility in Omaha and beyond. Select problems from Fall 2021 to Spring 2023 are highlighted here: these received noteworthy …

Sea-Phages Course-Based Undergraduate Research Experience For Creating A Biotechnology Workforce Development Pipeline, Daphne Fauber, Kari Clase, Carol Weaver

Graduate Industrial Research Symposium

Purdue University has been a member of the SEA-PHAGES (Science Education Alliance-Phage Hunters Advancing Genomics and Evolutionary Science) program since 2011. This program, created in conjunction with the Howard Hughes Medical Institute (HHMI), facilitates undergraduate curriculum for the authentic discovery of novel bacteriophages within the classroom. Since joining the program, undergraduates at Purdue have harnessed wet lab and bioinformatics principles to contribute over 200 previously uncharacterized bacteriophages and 25 novel genomes to the wider scientific literature. The SEA-PHAGES classes at Purdue have resulted in tangible professional deliverables for students through conference presentations and publications. Student outcomes also include transferable skills …

Workforce Of The Future Begins With Aviation Stem, Lyndsay Digneo

National Training Aircraft Symposium (NTAS)

The United States has always been a world leader in aviation. This leadership position relies on the strength of the American STEM workforce and the quality of the nation’s educational, industrial, and government institutions. Therefore, it is imperative to nurture today’s students to become a well-trained STEM workforce in the future.

The Federal Aviation Administration (FAA) William J. Hughes Technical Center (WJHTC) recognizes that in pursuing its mission of aviation research, engineering, development, and test and evaluation, it is in a unique position to support aviation STEM activities for schools (K-12), post-secondary institutions, and community organizations. In 2016, the Technical …

Developing Sustainability Related Attitudes And 21st Century Skills Through Informal Learning Opportunities, Shamila Janakiraman

Indiana STEM Education Conference

Informal learning environments, like libraries and museums, are known to improve student achievement and motivation (Bartels 2001). A meta-analysis reports on the strong positive effects of after-school programs on feelings and attitudes and school performance (Durlak et al, 2007). When working on after-school programs, middle and high school students may develop skills like communication, collaboration, creativity, critical thinking, information literacy, and digital literacy. Such a program was offered by a 501c(3) organization as an informal learning opportunity. As part of this program, high school student volunteers living in the United States (US) designed and delivered learning experiences for elementary and …

The Story Within Lessons: Highlighting Moments Of Student Inquiry, Amanda Huffman Hayes

Indiana STEM Education Conference

The curricular decisions of K-12 mathematics teachers affect student learning. One way to make sense of this is to find the story within the lesson. Writing the story of a lesson by identifying the plot, characters, settings, and actions reveals the questions that drive student mathematical curiosity and inquiry (Dietiker, 2015). Drawing attention to these moments provides a new perspective for teachers as they plan, teach, and reflect on their lessons and work to improve their instruction for their students as they see the possible advantages and disadvantages of the ordering of mathematical tasks. This work extends Dietiker’s thinking through …

Growing In Stem: Hands-On Education Via Tower Gardening, Jeffrey A. Nowak, Shelby Johnston-Werling

Indiana STEM Education Conference

Sole use of a textbook as the primary source of learning in the middle school setting has been linked to potentially limit students’ conceptual understanding of complex content (Driscoll et al., 1994), while the positive impact of hands-on learning has been well documented (Ekwueme et al., 2015; Satterthwait, 2010). Ideally, when a textbook is used in conjunction with content applied in a hands-on manner, student engagement and understanding of standards-based content are increased. In a grant funded collaboration between the Northeast Indiana STEM Education Resource Center housed at Purdue University Fort Wayne and an East Allen Community Schools middle school …