Medicine and Health Sciences Commons^™

Understanding Perceptions And Practices For Designing An Appropriate Community-Based Kangaroo Mother Care Implementation Package: Qualitative Exploratory Study, Shabina Ariff, Ikram Maznani, Maria Asif Bhura, Zahid Memon, Tayyaba Arshad, Tariq Ahmed Samejo, Shujaat Zaidi, Muhammad Umer, Imran Ahmed, Muhammad Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Low birth weight (LBW) is a common outcome of preterm birth, which increases the risk of an infant's morbidity and mortality. Approximately 20 million infants are born with LBW globally per year. Since a significant number of births in Pakistan take place at home, it is important to focus on the use of kangaroo mother care (KMC), the practice of skin-to-skin contact, in communities to prevent neonatal mortality and morbidity.
Objective: We employed a formative research approach to understand the context of communities and facilities with regard to neonatal care and KMC practice. The broader aims were to inform …

Implementation Of The Comprehensive Unit-Based Safety Program To Improve Infection Prevention And Control Practices In Four Neonatal Intensive Care Units In Pune, India, Julia Johnson, Asad Latif, Bharat Randive, Abhay Kadam, Uday Rajput, Aarti Kinikar, Nandini Malshe, Sanjay Lalwani, Tushar B. Parikh, Umesh Vaidya

Department of Anaesthesia

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.
Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate …

Industry 4.0 Technologies For The Manufacturing And Distribution Of Covid-19 Vaccines, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Aminah Abdul Razzack, Shehar Bano, Sarabjot Singh Makkar, Sindhu Thevuthasan, Trissa Paul, Muhammad Khawar Sana, Nishwa Azeem

Department of Paediatrics and Child Health

Background: The evolutionary stages of manufacturing have led us to conceptualize the use of Industry 4.0 for COVID-19 (coronavirus disease 2019), powered by Industry 4.0 technologies. Using applications of integrated process optimizations reliant on digitized data, we propose novel intelligent networks along the vaccine value chain. Vaccine 4.0 may enable maintenance processes, streamline logistics, and enable optimal production of COVID-19 vaccines.
Vaccine 4.0 framework: The challenge in applying Vaccine 4.0 includes the requirement of large-scale technologies for digitally transforming manufacturing, producing, rolling-out, and distributing vaccines. With our framework, Vaccine 4.0 analytics will target process performance, process development, process stability, compliance, …

Cost-Effectiveness Analysis Of Implementing An Integrated Neonatal Care Kit To Reduce Neonatal Infection In Rural Pakistan, Fiona Muttalib, Karen Chung, Lisa Grace Pell, Shabina Ariff, Sajid Soofi, Shaun K. Morris, Beate Sander

Department of Paediatrics and Child Health

Objective:
To evaluate the cost-effectiveness of distribution of the integrated neonatal care kit (iNCK) by community health workers from the healthcare payer perspective in Rahimyar Khan, Pakistan.
Setting:
Rahimyar Khan, Pakistan.
Participants:
N/A.
Intervention:
Cost-utility analysis using a Markov model based on cluster randomised controlled trial (cRCT: NCT02130856) data and a literature review. We compared distribution of the iNCK to pregnant mothers to local standard of care and followed infants over a lifetime horizon.
Primary and secondary outcome measures:
The primary outcome was incremental net monetary benefit (INMB, at a cost-effectiveness threshold of US$15.50), discounted at 3%. Secondary outcomes …

Nutritional Support And Prophylaxis Of Azithromycin For Pregnant Women To Improve Birth Outcomes In Peri-Urban Slums Of Karachi, Pakistan-A Protocol Of Multi-Arm Assessor-Blinded Randomized Controlled Trial (Mumta Pw Trial), Ameer Muhammad, Zoha Zahid Fazal, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan, Yasir Shafiq

Medical College Documents

Background: Maternal undernutrition is critical in the etiology of poor perinatal outcomes and accounts for 20% of small-for-gestational-age (SGA) births. High levels of food insecurity, antenatal undernourishment, and childhood undernutrition necessitate the supplementation of fortified balanced energy protein (BEP) during pregnancy in low-income settings especially with scarce literature available in this subject. Hence, this paper extensively covers the protocol of such a trial conducted in an urban slum of Karachi, Pakistan.
Methods: The trial is community-based, open-labelled, four-arm, and randomized controlled that will include parallel group assignments with a 1:1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. …

Predictors Of Circuit Health In Neonatal Patients Receiving Extracorporeal Membrane Oxygenation (Ecmo), Rita Hazboun, Nada Darwish, Gianna Rotyliano Sykes, Nayef Chahin, Jie Xu, John Miller, Christos Calaritis, Leroy Thacker, Russell Moores, Karen Hendricks-Muñoz

Pediatrics Publications

To identify predictors of neonatal ECMO circuit health, a retrospective analysis of circuit functional pressure and flow parameters as well as infant clotting values were collected 48 h prior to and 24 h post circuit change. Circuit impairment was defined as need for partial or total circuit change. Statistical analysis used multivariate statistics and non-parametric Mann–Whitney U-test with possible non-normality of measurements. A total of 9764 ECMO circuit and clotting values in 21 circuits were analyzed. Circuit delta-P mean, and maximum values increased from 8.62 to 48.59 mmHg (p < 0.011) and 16.00 to 53.00 mmHg (p < 0.0128) respectively prior to need for circuit change. Maximum and mean Pump Flow Revolutions per minute (RPM) increased by 75% (p < 0.0043) and 81% (p < 0.0057), respectively. Mean plasma free hemoglobin (pfHb) increased from 26.45 to 76.00 mg/dl, (p < 0.0209). Sweep, venous pressure, and clotting parameters were unaffected. ECMO circuit delta-P, RPM, and pfHb were early predictors of circuit impairment.

Firearm Curriculum For Pediatric Residents Improves Safe Storage Counseling, Hannah Hollon Md, Darina Dinov Do, Benjamin Sandifer Md, Scott Risney Md, Heemali Kamdar Do, Christopher Ferrante Do, Leroy Thacker Phd, Michael S. Ryan Md, Mehp, Elizabeth Wolf Md, Mph

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Objectives

Firearms are the leading cause of death among children and adolescents. Despite evidence to support physician training in firearm safety counseling, formal curricula are limited in pediatric residency programs. We sought to develop and implement a resident-led, feasible, sustainable, and impactful firearm safety curriculum for pediatric residents.

Methods

A firearm safety curriculum was developed by pediatric residents using Kern’s curriculum development framework and delivered to their peers at a single academic center from 2019 - 2020. The three-part series included workshops on basic firearm safety counseling principles, case-based practice, and advocacy training and a gun lock program in collaboration …

Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap

Theses, Dissertations and Capstones

Introduction: Obesity was defined as a Body Mass Index (BMI) over the 95th percentile as determined by the Centers for Disease Control and Prevention (CDC). Childhood obesity has been a worldwide concern, but has disproportionately affected the socioeconomically disadvantaged, racial/ethical minorities, and rural children. The presence of Adverse Childhood Experiences (ACEs) contributed to social and health problems. ACEs included the areas of domestic violence, mental illness, neighborhood violence, parent or guardian death, divorce or separation, parent or guardian incarceration, and substance misuse.

Purpose of Study: The purpose of this research was to compare the ACEs scores with childhood …

Research Annual Report Fy2022, Children's Mercy Kansas City

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Screening For Adverse Childhood Experiences In Primary Care, Michelle Mckay, Logan Shetlar

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Cancer Care Annual Report 2020-2021, Children's Mercy Kansas City

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Kansas City, a pediatric medical center. This year’s report focuses on Hodgkin Lymphoma.

Exploring Practice-Based Clinical–Research Partnerships In Speech-Language Pathology: A Scoping Review, Lisa Archibald

Data and Test Instruments

No abstract provided.

Effectiveness Of Wechat-Group-Based Parental Health Education In Preventing Unintentional Injuries Among Children Aged 0-3: Randomized Controlled Trial In Shanghai, Yuheng Feng, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Kaiyue Chen, Huiping Wang, Qinghua Xia, Jicui Zheng, Jingwei Xia, Xiaohong Li

Community & Environmental Health Faculty Publications

BACKGROUND: Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0-3.

METHODS: We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for …

Spectrograms For Seizure Detection In Critically Ill Children, Saptharishi Lalgudi Ganesan, Cecil Hahn

Data and Test Instruments

No abstract provided.

Asthma Exacerbation Cpg - Dexamethasone Vs. Prednisolone Dosing For Acute Asthma Exacerbation In Children, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Heterogeneity Of Diabetes: B-Cells, Phenotypes, And Precision Medicine: Proceedings Of An International Symposium Of The Canadian Institutes Of Health Research’S Institute Of Nutrition, Metabolism And Diabetes And The U.S. National Institutes Of Health’S National Institute Of Diabetes And Digestive And Kidney Diseases, William T. Cefalu, Dana K. Andersen, Guillermo Arreaza-Rubín, Christopher L. Pin, Sheryl Sato, C. Bruce Verchere, Minna Woo, Norman D. Rosenblum

Paediatrics Publications

One hundred years have passed since the discovery of insulin—an achievement that transformed diabetes from a fatal illness into a manageable chronic condition. The decades since that momentous achievement have brought ever more rapid innovation and advancement in diabetes research and clinical care. To celebrate the important work of the past century and help to chart a course for its continuation into the next, the Canadian Institutes of Health Research’s Institute of Nutrition, Metabolism and Diabetes and the U.S. National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases recently held a joint international symposium, bringing together …

A Million Is More Than A Thousand: Children's Acquisition Of Very Large Number Words, Pierina Cheung, Daniel Ansari

Paediatrics Publications

Very large numbers words such as “hundred,” “thousand,” “million,” “billion,” and “trillion” pose a learning problem for children because they are sparse in everyday speech and children's experience with extremely large quantities is scarce. In this study, we examine when children acquire the relative ordering of very large number words as a first step toward understanding their acquisition. In Study 1, a hundred and twenty-five 5–8-year-olds participated in a verbal number comparison task involving very large number words. We found that children can judge which of two very large numbers is more as early as age 6, prior to entering …

Frequency Of Diabetes Team Contacts In Children And Adolescents Using Insulin Pumps, Funmbi T. Babalola, Michael R. Miller, Andrea R. Ens, Robert I. Stein, Patricia H. Gallego, Cheril L. Clarson

Paediatrics Publications

Background: The purpose of this study is to assess if a relationship exists between A1c within target (≤ 7.5%) and frequency of patient-initiated contact with diabetes team, in children with type 1 diabetes (T1DM) on an insulin pump. Additionally, to determine factors impacting frequency of contact. Methods: This was a retrospective study of children with T1DM on an insulin pump. Frequency of contact, type of contact, and A1c were collected. Study participants filled out a questionnaire at study entry. Results: One hundred and seventy-six participants were enrolled, with a mean age of 13 years. The median duration of T1DM was …

Impostorism And Anxiety Contribute To Burnout Among Resident Physicians, Rachel Q. Liu, Jacob Davidson, Tamara A. Van Hooren, Julie Ann M. Van Koughnett, Sarah Jones, Michael C. Ott

Paediatrics Publications

Purpose: Physician burnout is an issue that has come to the forefront in the past decade. While many factors contribute to burnout the impact of impostorism and self-doubt has largely been ignored. We investigated the relationship of anxiety and impostorism to burnout in postgraduate medical learners. Materials and methods: Postgraduate learners in four diverse training programs: Family Medicine (FM), Paediatric Medicine (PM), Anesthesiology (AN), and General Surgery (GS) were surveyed to identify the incidence of impostorism (IP), anxiety, and burnout. IP, anxiety, and burnout were evaluated using the Clance Impostor Phenomenon Scale (CIPS), Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and …

The 2021 Eurpean Alliance Of Associations For Rheumatology/American College Of Rheumatology Points To Consider For Diagnosis And Management Of Autoinflammatory Type I Interferonopathies: Candle/Praas, Savi And Ags, Kader Cetin Gedik, Lovro Lamot, Micol Romano, Erkan Demirkaya, David Piskin, Sofia Torreggiani, Laura A. Adang, Thais Armangue, Kathe Barchus, Devon R. Cordova, Yanick J. Crow, Russell C. Dale, Karen L. Durrant, Despina Eleftheriou, Elisa M. Fazzi, Marco Gattorno, Francesco Gavazzi, Eric P. Hanson, Min Ae Lee-Kirsch, Gina A. Montealegre Sanchez, Bénédicte Neven, Simona Orcesi, Seza Ozen, M. Cecilia Poli, Elliot Schumacher, Davide Tonduti, Katsiaryna Uss, Daniel Aletaha, Brian M. Feldman

Paediatrics Publications

Objective: Autoinflammatory type I interferonopathies, chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature/proteasome-associated autoinflammatory syndrome (CANDLE/PRAAS), stimulator of interferon genes (STING)-associated vasculopathy with onset in infancy (SAVI) and Aicardi-Goutières syndrome (AGS) are rare and clinically complex immunodysregulatory diseases. With emerging knowledge of genetic causes and targeted treatments, a Task Force was charged with the development of 'points to consider' to improve diagnosis, treatment and long-term monitoring of patients with these rare diseases. Methods: Members of a Task Force consisting of rheumatologists, neurologists, an immunologist, geneticists, patient advocates and an allied healthcare professional formulated research questions for a systematic literature …

Concordance Of Regional Hypoperfusion By Pcasl Mri And 15O-Water Pet In Frontotemporal Dementia: Is Pcasl An Efficacious Alternative?, Tracy Ssali, Lucas Narciso, Justin Hicks, Linshan Liu, Sarah Jesso, Lauryn Richardson, Matthias Günther, Simon Konstandin, Klaus Eickel, Frank Prato, Udunna C. Anazodo, Elizabeth Finger, Keith St Lawrence

Paediatrics Publications

Background: Clinical diagnosis of frontotemporal dementia (FTD) remains a challenge due to the overlap of symptoms among FTD subtypes and with other psychiatric disorders. Perfusion imaging by arterial spin labeling (ASL) is a promising non-invasive alternative to established PET techniques; however, its sensitivity to imaging parameters can hinder its ability to detect perfusion abnormalities. Purpose: This study evaluated the similarity of regional hypoperfusion patterns detected by ASL relative to the gold standard for imaging perfusion, PET with radiolabeled water (15O-water). Methods and materials: Perfusion by single-delay pseudo continuous ASL (SD-pCASL), free-lunch Hadamard encoded pCASL (FL_TE-pCASL), and 15O-water data were acquired …

Early Cognitive Predictors Of Language, Reading, And Mathematics Outcomes In The Primary Grades, Theresa Pham, Marc F. Joanisse, Daniel Ansari, Janis Oram, Christine Stager, Lisa Archibald

Data and Test Instruments

Recently, cross-domain research has shown that some early predictors of language, reading, and mathematics overlap and predict one another. This study investigated how early cognitive predictors across domains could predict future academic skills across domains using data from 563 students in kindergarten to second grade (ages 5 to 8; 288 males; largely monolingual English). The roles of verbal, symbolic, and magnitude comparison skills as predictors of later academic grades for various language and math subjects were examined. Results found that Grade 1 marks were predicted by kindergarten verbal and symbolic skills, while Grade 2 marks were predicted by verbal skills …

Characterizing Mental Health Related Service Contacts In Children And Youth: A Linkage Study Of Health Survey And Administrative Data, Kelly Anderson, Jordan Edwards, Lin Wang, Laura Duncan, Jinette Comeau, Katholiki Georgiades

Data and Test Instruments

No abstract provided.

Pediatric Stroke Outcome Measures: A Systematic Review, Janice Brown, Jordan Ng, Reilly Todd, Alyssa Vo

Occupational Therapy | Graduate Student Research Posters

In collaboration with SFSU/UCSF Physical Therapy and Dominican University of California Occupational Therapy, this systematic review took a critical look at the pediatric stroke outcome measures in the current literature. By ascertaining what is currently in place,

occupational therapists as members of the interprofessional team, can better advocate for occupation centered outcome measures in research and clinical care for children and families who have experienced pediatric stroke.

Graduate Medical Education Annual Report 2021-2022, Children's Mercy Kansas City

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

What Alternative Models Are Effective In Improving Health Outcomes In Children With Obesity In The United States?, Kelsey Reineke

Theses and Graduate Projects

Background: Obesity in children has increased at an alarming rate in the past three decades and has been associated with multiple comorbidities. This literature review has been focused on pediatric obesity management research utilizing Family-Based Therapy, community-centered interventions, behavioral modifications, and implementations for management within the Primary Care setting.

Purpose: There has not been an established standard of care for children suffering from obesity. This investigation was focused on the question; What alternative models are effective in improving health outcomes in children with obesity in the United States?

Methods: A comprehensive literature review was conducted using Pub …

Intractable Pediatric Epilepsy And Dietary Therapies: A Meta-Analysis Of Trials For Seizure Reduction, Victor Figueira M Dantas

Honors Undergraduate Theses

Objective: to compare dietary treatments and their effectiveness in reducing seizures through a systematic review and meta-analysis of clinical trials Methods: Using the PRISMA Method, the Primo database was searched to find peer-reviewed articles where researchers compared one treatment against another. The treatments of choice present in all studies are the Ketogenic Diet and the Modified Atkins Diet. Due to the nature of the experiments, the Ketogenic Diet was considered the control, as it was coined first. Results: Of the 450 articles identified, 378 met the primary peer review threshold and 190 were classified as Open Access. Eight met eligibility …

Prochlorperazine Vs Metoclopramide As First Line Treatment In Intractable Headache In The Pediatric Emergency Department, Courtney Hill, Kaitlynn Small, Urvashi Baruanath, Erica Junqueira, Brandon Carter, Anita Datta, Ameer Hassoun, Zuhair Ali

Gulf Coast Division GME Research Day 2022

No abstract provided.

Child Life Student Approaches To And Purposes Of Play, Taylor L. Brower

Graduate Theses/Dissertations

The aim of this study was to research and gain a greater understanding of what child life students are learning about play. Qualitative data was collected via Qualtrics. Participants reported learning child-led play, structured play, and expressive play as learned approaches to play. Students reported the most learned purpose of play being self–expression, and normalization. Participants provided self-given definitions of the theories and concepts of play as the survey prompted in keeping with the researcher’s goals. The Daisy model in the communication theory Coordinated Management of Meaning provided the theoretical framework, supporting preparation or familiarization, express emotions, process, or cope, …

Utilizing Virtual Reality Goggles During Pediatric Laceration Repairs To Reduce Perceived Pain In Pediatric Patients, Emily C. Bozzer

Graduate Theses/Dissertations

In pediatric emergency departments, several providers assess pediatric patients in need a laceration repair, require procedural sedation in order to ensure compliance and complete the laceration repair. This study explored one safe alternative to procedural sedation during pediatric laceration repairs by assessing what pain scores pediatric patients report when undergoing a laceration repair utilizing virtual reality goggles. Pediatric patients ages 6-17 years old perceived pain scores utilizing FACES pain scale was documented. This study found a majority of patients reported lower pain scores during the laceration repair in comparison to their baseline pain score.