Medical Specialties Commons^™

Graduate Medical Education Annual Report 2022-2023, 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.

Research Annual Report Fy2023, Children's Mercy Kansas City

Research Annual Reports

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

Severe Thromboembolic Events In Two Pediatric Patients Diagnosed With Ulcerative Colitis (Uc) And Recently Initiated Adalimumab Therapy: A Case Series, Kelly Powell, Shreya Patel, Megan Tate, Abby Alaine Unger, Abigail Haythorn

South Atlantic Division GME Research Day 2023

No abstract provided.

Pancytopenia, Enterovirus Infection, And Pcr Testing, Stephen Mock, Salome Herzstein, Andrea Horbey

East Florida Division GME Research Day 2023

Introduction: This is a case of a patient presenting with fever, rash, and vomiting. Upon further studies, patient was found to have pancytopenia which started an extensive hospital work up.

Case Description: A previously healthy 9- year-old female presented to the emergency department with 3 days of tactile fever, 2 days of rash, and 1 day of nonbilious nonbloody emesis. The rash initially appeared on the trunk and by the day of admission, had begun to spread peripherally to the extremities. The rash on the abdomen was described as mild, generalized, blanchable and maculopapular. The rash on the extremities was …

Pandas Exacerbation Post-Tonsillectomy, Acute Response To Fentanyl & Dexamethasone, Austin Peralta-Fogle, Jeffrey Ramsey, Natasha Fazel, Ryan Spilman

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Stones Cause Pediatric Moans Too: A Case Of Ureterolithiasis With Classic Sonographic Artifacts, Samantha Stoner, Courtney Mariner, Russ Richardson, Casey Wilson

South Atlantic Division GME Research Day 2023

No abstract provided.

Empowering Kinship Caregivers In Texas: A Call To Action For Policy Change, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Kinship care refers to the care of children and adolescents by relatives or close family friends, who are referred to as fictive kin. These relationships can be formal, meaning the child has been removed from a parent and placed by Child Protective Services (CPS) into the care of a relative or family friend, or informal, meaning the relationship occurs without any involvement from CPS. This brief focuses on the former and uses the term kinship care to refer to formal kinship caregiving.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Factors Associated With Clinically Significant Hyperbilirubinemia Among Abo-Incompatible Newborns At A Tertiary Care Hospital In Kenya., Wandera Ivy Mwenesi

Master of Medicine in Paediatrics and Child Health

Background: ABO incompatibility is one of the most common causes of immune-mediated neonatal jaundice. It occurs in approximately 20-25% of all pregnancies. Literature shows that 60- 80% of newborns will develop physiological jaundice within the first week of life. Globally, the incidence ranges from 10-41%. Early detection of newborns with ABO incompatibility-related jaundice can prevent the incidence of bilirubin-induced neurological dysfunction. Whereas there have been extensive published data on rhesus isoimmunization, very few studies have examined ABO incompatibility and isoimmunization. From the published literature, there has been no known study that has assessed risk factors for developing clinically significant jaundice …

Health-Related Quality Of Life Of Children With Gastro-Oesophageal Reflux Disease After Nissen Fundoplication And Gastrostomy Tube Insertion, Felix Musibi, Stanley Mugambi, Pauline Samia, Waceke Nganga

Paediatrics and Child Health, East Africa

Introduction: Severe gastro‑oesophageal reflux disease (GERD) is associated with a poor health‑related quality of life (HRQoL). Nissen fundoplication is the most common surgical procedure for patients with GERD. A feeding gastrostomy tube may be inserted at the same time in selected patients where there are unsafe swallowing and/or feeding difficulties. The goals of surgery are to eliminate symptoms, prevent reflux complications and ultimately improve the quality of life. The main objective of this study was to assess the HRQoL of children with GERD after Nissen fundoplication and gastrostomy tube insertion.

Materials and Methods: This was an observational retrospective cohort study …

Creating Change In Pediatric Health Disparities: Utilizing Systemsbased Thinking To Overcome Disparities Affecting Pediatric Type 1 Diabetes In Kentucky, Sydney Speed

Lewis Honors College Thesis Collection

Healthcare disparities are perpetuated and upheld for patients with type 1 diabetes (T1D) in rural and underserved urban areas of Kentucky. By adopting systems-based thinking, we can identify areas of the healthcare system to change to eliminate these disparities. Namely, key leverage points of this system include distribution and utilization of resources, finances and the movement of money, and communication pathways. To address the disparities surrounding pediatric T1D in Kentucky, a state-wide medical event called Kentucky Diabetes Family Day (KDFD) was hosted. The focus of this event was to lessen the effects of these specific healthcare disparities by altering key …

Evaluation Of Academic Detailing To Educate Clinicians Regarding Childhood Lead Poisoning Prevention: A Pilot Study, Nicholas C. Newman, Jacqueline M. Knapke, Rachael Kiniyalocts, John Belt, Erin N. Haynes

UK CARES Faculty Publications

Context: Environmental exposures are associated with approximately 19% of disease globally, and exposure to neurotoxic chemicals is estimated to cost the United States $50 billion per year. Despite calls from the Institute of Medicine to increase training for clinicians regarding environmental health since the 1990s, there is still little instruction in environmental health for clinicians. This leaves gaps in knowledge that need to be bridged through outreach and education to practicing clinicians. Academic detailing (AD) is an educational intervention associated with improved prescribing practices in healthcare professionals but has not been applied to preventive or environmental health. Childhood lead exposure …

Feasibility And Reliability Of Health-Related Physical Fitness Tests In Children And Adolescents With Hearing Impairment, Jiafu Huang, Jianmei Yang, Justin A. Haegele, Lijuan Wang, Sitong Chen, Chunxiao Li

Human Movement Studies & Special Education Faculty Publications

Although research supports the feasibility and reliability of health-related physical fitness (HRPF) tests in typically developing children and adolescents, little is known regarding the feasibility and reliability of these tests for those with hearing impairments (HI). The aim of this study was to evaluate the feasibility and reliability of a HRPF test battery for children and adolescents with HI. A test–retest design with a one-week interval was conducted with 26 participants with HI (mean age: 12.7 ± 2.8 years; 9 male). The feasibility and reliability of seven field-based HRPF tests (i.e., body mass index, grip strength, standing long jump, vital …

A Story Of Hope: How A Community Project Is Transforming The Lives Of Filipino Children With Intellectual And Developmental Disabilities, Lance Vincent C. Sese, Ma Celina L. Guillermo

Ateneo School of Medicine and Public Health Publications

The issue of social inequality became more prevalent during the pandemic and with it, the call for preferential option toward the vulnerable. 1 Not only do we protect them from sickness and death, but we are also called to improve their quality of life. Thus, it is imperative that in this call for inclusivity, we address the gap, one group at a time—for example, children with special needs. The project discussed in this perspective article exemplifies the importance of collaboration in bridging the gap to create a more holistic environment for Filipino children with special needs. This article then serves …

An Iceberg I Can’T Handle: A Qualitative Inquiry On Perceptions Towards Paediatric Rheumatology Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen E. Foster, Peter Muriuki, Adelaide Lusambili, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Delay in diagnosis and access to specialist care is a major problem for many children and young people with rheumatic disease in sub-Saharan Africa. Most children with symptoms of rheumatic disease present to nonspecialists for care. There is an urgent need to understand and scale-up paediatric rheumatology knowledge and skills amongst non-specialist healthcare workers to promote early diagnosis, prompt referral, and management.

Purpose: We evaluated the knowledge, attitudes and practices towards diagnosis and care of paediatric rheumatology patients among health care workers in Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (third-tier community health …

Clinical Features And Outcomes In Pediatric Severe Scald Burn Patients, Ashley Daniel

Presentations

Introduction/Hypothesis Young children with scald burns experience severe complications compared to older children. A paucity of data exists to support these observations. This study compares clinical features and complications of younger versus older pediatric patients with scald burns at four children’s hospitals participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC). This collaborative includes five pediatric burn centers that utilize research to improve quality of burn care. 485 Methods This is a retrospective cohort study of scald burn patients admitted from 2010 to 2020 to four pediatric hospitals participating in PIQIC. Patients with total body surface area (TBSA) < 15% were excluded. Patients were categorized by age into three groups: toddlers (0–3 years), children (3-10 years), and adolescents (>10 years). …

Evaluation Of Standard Dose Ibuprofen In Combination With Acetaminophen For Patent Ductus Arteriosus (Pda) Treatment In Preterm Neonates, Jennifer Lee, Samantha Tatz, Douglas Hanes

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2023

No abstract provided.

Knowledge Attitudes And Priorities Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Clinic Administrators And Clinicians In Outpatient Medical Centres In Kenya: A Qualitative Study, Mary Wanjiru Kaniu

Master of Medicine in Paediatrics and Child Health

Introduction: Antimicrobial resistance is an important global health threat and it is estimated that by 2050 it will account for 10 million deaths globally. Low and middle income countries are disproportionately affected by the burden of antimicrobial resistance. One of the major causes of antimicrobial resistance is irrational and overuse of antibiotics. Understanding the knowledge, attitudes and priorities of healthcare workers and healthcare administrators on antimicrobial resistance and antimicrobial stewardship is pivotal in implementation of strategies to curb the spread of antimicrobial resistance. Methods: A qualitative study using in-depth semi-structured interviews was conducted among clinicians and clinic administrators in 12 …

Seeing Is Believing: Implementation Of An Usgpiv Training Curriculum In Pediatric Medical Providers, Matthew Toma, Allyn Parker, Sunil Keshwah

South Atlantic Division GME Research Day 2023

No abstract provided.

Descriptive Assessment Of The Pediatric Emergency Team System: The Memorial Health University Medical Center Experience, Ashley Cheek, Lauren Hebert, Sunil Keshwah, Jessica Lee

South Atlantic Division GME Research Day 2023

No abstract provided.

Medical Cannabis In Pediatric Patients With Chronic Pain And Diseases, Marissa Colombo

Nursing | Student Research Posters

Pediatric chronic pain has seen a disturbing rise which ends up affecting the child’s routine and impacting their family’s lives. Medical cannabis has Food and Drug Administration-approved derivatives, yet the studies that focus on medical cannabis do not discuss targeting pain in pediatric patients. Children who experience chronic diseases and treatment-resistant pain are not normally offered medical cannabis as a treatment option which needs to change. The purpose of this paper is to explore the impact of medical cannabis within the pediatric population. If children experience pain that is similar to adults, withholding techniques that can help alleviate their pain …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

Omega-3 Polyunsaturated Fatty Acid Levels In Maternal And Cord Plasma Are Associated With Maternal Socioeconomic Status, Alexandra Hergenrader, Matthew Van Ormer, Rebecca Slotkowski, Maranda Thompson, Alyssa Freeman, Olivia Paetz, Sarah Sweeney, Lauren Wegner, Khadijjta Ali, Nicole S. Bender, Ridhi Chaudhary, Melissa K. Thoene, Corrine K. Hanson, Ann Anderson-Berry

Journal Articles: Pediatrics

Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) play a crucial role in fetal growth and neurodevelopment, while omega-6 (n-6) PUFAs have been associated with adverse pregnancy outcomes. Previous studies have demonstrated that socioeconomic status (SES) influences dietary intake of n-3 and n-6 PUFAs, but few studies have evaluated the association between maternal and cord plasma biomarkers of PUFAs and socioeconomic markers. An IRB-approved study enrolled mother-infant pairs (n = 55) at the time of delivery. Maternal and cord plasma PUFA concentrations were analyzed using gas chromatography. Markers of SES were obtained from validated surveys …

Social Determinants Of Mental Health Considerations For Counseling Children And Adolescents, Kaprea F. Johnson, Patrick D. Cunningham, Camila Tirado, Oswaldo Moreno, Nancy N. Gillespie, Bisola Duyile, Dequindre C. Hughes, Emily Goodman Scott, Dana Brookover

Counseling & Human Services Faculty Publications

Childhood is a crucial period for developing a strong social and emotional foundation critical for mental well-being. Given that the childhood developmental period is vital for mental health, it is essential to address social determinants that can disrupt development and have lasting adverse effects on psychological and physical health. Therefore, professional counselors specializing in children and adolescent mental health care can benefit from understanding and utilizing the social determinants of mental health (SDOMH) framework in practice. This article details the SDOMH framework and considerations for SDOMH-informed treatments for professional counselors working in settings with children and adolescents.

Small Finger Reverse Ulnar Digital Artery Hypothenar Perforator Flap For Small Finger Proximal Interphalangeal Joint Reconstruction, Nicholas Kunda, Alexander Dagum

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Local flaps are commonly used for digital reconstruction for soft tissue defects. There remains a paucity of options available for small finger volar proximal interphalangeal joint coverage. The purpose of this study was to analyze perforators along the hypothenar eminence arising from the artery of the ulnar side of the small finger as it comes off the superficial palmer arch for consistency and potential to be used for perforator-based flap reconstruction of the small finger proximal interphalangeal joint.

Methods: Four cadaveric upper extremities were injected with Microfil® silicone injection compound. Dissection was performed from the superficial palmer arch to …

A Mini Review Of What Matters In The Management Of Nas, Is Esc The Best Care?, Enrique Gomez Pomar

Pediatrics Faculty Publications

As the use of opioids and polysubstance by pregnant women has increased over the years, there has also been a sharp increase in cases of neonatal abstinence syndrome (NAS). Classically, infants affected by NAS have been cared for in neonatal intensive care units resulting in an increase of healthcare expenditure and resource utilization as well as separation from the families. Consequently, the Eat, Sleep, and Console (ESC) tool was developed and promoted as a novel method that focuses on maternal/infant dyad during hospital stay while decreasing the use of pharmacological interventions and therefore decreasing the length of stay and healthcare …

San Pedro Hospital - San Pedro La Laguna, Guatemala, Jennifer Paumen

Posters

Primary objective: to learn about the healthcare system of Guatemala including the challenges and strengths.

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Prevalence Of Gastrointestinal Symptoms Among Autistic Individuals, With And Without Co-Occurring Intellectual Disability, Calliope Holingue, Danika Pfeiffer, Natasha N. Ludwig, Rachel Reetzke, Ji Su Hong, Luther G. Kalb, Rebecca Landa

Communication Disorders & Special Education Faculty Publications

Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior …

Diagnosis And Management Of Cyclic Vomiting Syndrome, Sara Read

Capstone Showcase

Cyclic vomiting syndrome (CVS) is a chronic and debilitating condition that can be encountered in a multitude of clinical settings. It is classified as a functional gastrointestinal disorder and is often misdiagnosed. Proper identification and management of this condition are crucial to patient care and quality of life. This article reviews the hypothesized etiologies, clinical presentation, and diagnosis of CVS as well as recommendations for management in a variety of settings. As an understudied and underdiagnosed condition, it is important that clinicians have a basic understanding of this disorder.