Pediatrics Commons^™

A Scoping Review Of Sexual And Reproductive Health Interventions With Youth In U.S. Juvenile Facilities., April Mcneill-Johnson, Jason Glenn, Nekia Ivory Daniel, Mira Menon, Basil H. Aboul-Enein, Patricia J. Kelly, Megha Ramaswamy

Manuscripts, Articles, Book Chapters and Other Papers

Youth placed in U.S. juvenile detention facilities face multilevel barriers that contribute to disparate sexual and reproductive health (SRH) outcomes when compared to their peers in the general adolescent population. Minimal information is available about evidence-based interventions that have been effective in changing these outcomes. The aim of this scoping review was to focus on the current state of SRH and identify recommendations for SRH care. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines, we searched electronic databases for publications published through March 2024. The search terms were designed to find intervention studies focusing …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Utility And Safety Of Romiplostim As An Alternative To Platelet Transfusion For Neonates, Rachel N. Zeno, Sara Awad, Harry Lesmana

Student Scholarship

Thrombocytopenia is a common challenge in the neonatal intensive care unit, traditionally managed with platelet transfusions. However, transfusions are associated with significant risks, including increased mortality and neurodevelopmental impairment. This case series highlights the use of romiplostim, a thrombopoietin receptor agonist, in three neonates with thrombocytopenia. Each case demonstrated notable improvements in platelet counts without adverse events, reducing dependency on transfusions. These findings underscore romiplostim's potential as a safer alternative for managing neonatal thrombocytopenia. This report advocates for further research to explore romiplostim's efficacy and safety in this vulnerable population, emphasizing its promise in improving neonatal outcomes.

Evaluation Of Depression Screening Tools For Utilization In Adolescents: A Scoping Review, Helen Whitaker Bsn, Rn, Jade Bray Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Anxiety and depression are prevalent mood disorders among the adolescent population with significant impacts on academic performance, social interactions, and mental well-being. With depression rates continuing to rise and suicide among the leading causes of death in adolescents, there is an urgent need for effective screening and intervention. While depression screening is recommended in the primary care setting, many adolescents do not have regular access to healthcare, complicating early identification and treatment. The purpose of this scoping review is to compare the effectiveness of two depression screening tools, the Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Association Between Maternal Hematologic Parameters And Risk Of Pregnancy Loss In Pregnancies Treated For Iron Deficiency Anemia, Simal Thind, Mbchb, Mph, Rupsa Boelig, Md, Mrutyunjaya B. Bellad, Md, Manjunath S. Sommannavar, Md, S. Yogeshkumar, Md, Benjamin Leidy, Phd, Rebecca Hartman, Mph, Zubair H. Aghai, Md, Praveen Patil, Phd, Chander Shekhar, Md, Umesh Y. Ramadurg, Md, Michael K. Georgieff, Md, Richard Derman, Md, Mph

Global Health Posters

Background

• Maternal iron deficiency anemia (IDA) is associated with an increased risk of infant complications including stillbirth, pregnancy loss, and low birthweight (LBW).
• It is unclear how treatment of maternal IDA can mitigate the infant related complications.

How Long Must We Wait? A Review Of Adherence To Established Npo Guidelines, Ellen C. Bouaziai, Anthony S. Hernandez, Shashi Sahai, Kerry Peters Mychaliska

Conference Presentation Abstracts

Background: Patients undergoing a procedure with anesthesia are required to be nil per os (NPO) for a defined period to reduce the risk of aspiration of gastric contents. In 2017, the American Society of Anesthesiologists (ASA) published guidelines for preoperative fasting, which allow for consumption of a full meal 8 hours before a procedure; non-human milk, light meal, and infant formulas 6 hours prior; breastmilk 4 hours prior; and clear liquids 2 hours prior to procedure. It is well known that these NPO guidelines are inconsistently applied to pediatric patients. The purpose of this study is to determine the percentage …

Historical Perspectives On Bloodletting In The Management Of Asthma In Children And Adults, Joudeh B. Freij, Bishara J. Freij

Conference Presentation Abstracts

Background: Current asthma management consists of a combination of drugs with different mechanisms of action. Ancient asthma care, by contrast, focused on loosening the humours using remedies such as drinking animal blood, eating rabbit fat and fox lungs, inhaling or consuming certain herbs and plants, bloodletting (including wet cupping), diet (eating raisins, dried figs, vegetables, barley, capers, bread, cake), steaming, baths, wet compresses, and moderate helpings of wine with dinner. Bloodletting was believed to purge the body of noxious humours that caused human disease and thereby reduce inflammation. Here we address the use of bloodletting in asthma management over the …

Low Serum Alkaline Phosphatase Concentrations At Hospital Admission As Markers For Severe Pediatric Sars-Cov-2-Related Acute Illnesses, Sneha Jayadeep, Julie A. George, Bishara J. Freij

Conference Presentation Abstracts

Background: Alkaline phosphatase (ALP) is composed of several isoenzymes. The measured serum (total) ALP is mostly of bone and liver origin. ALP activity changes with growth and puberty, and its level is affected by age and sex. Abnormal ALP levels have been noted in COVID19 patients but its use as a marker of severity has not been assessed to our knowledge.

Objective: Assess if low serum ALP is a marker of disease severity in acute Pediatric SARS-CoV-2-related illnesses.

Design/Methods: Retrospective observational study of children 0-18 years of age hospitalized at Beaumont Children’s Hospital from 3/1/2020-3/31/2022 with positive PCR for SARS-CoV-2 …

Reducing Antibiotic Duration For Pneumonia And Sinusitis In The Emergency Department: A Quality Improvement Approach, Joshua Saucedo, Leslie Hueschen, Amanda Nedved, Marsha Dannenburg, Patricia Phillips, Jennifer Floyd, Alaina N. Burns, Rana El Feghaly

Presentations

Background: Limiting antibiotic duration is one of the pillars of antimicrobial stewardship programs (ASP) as it reduces unnecessary antibiotic exposure. In our emergency department (ED), >90% of respiratory infections are treated with first-line guideline-recommended antibiotics; however, duration continues to be prolonged especially for community acquired pneumonia (CAP) and acute bacterial rhinosinusitis (ABRS). Institutional guidance recommends shortening antibiotic durations to 3-5 days for CAP and 5-7 days for ABRS, however only 13% of discharged ED patients receive the recommended duration. Objective: Our aim is to increase the percentage of children discharged home from the ED with a diagnosis of CAP or …

Content Analysis Of Food Items In Youtube Videos Viewed By Children, Julie M. Zaituna, Tiffany Munzer, Sarah Morris, Jane Harness, Megan H. Pesch

Conference Presentation Abstracts

Background: Children have historically been a target of the food advertising industry because their preferences for certain foods are known to be shaped by food portrayals in digital media. In the most popular YouTube videos with child influencers, 90% featured ultra-processed and branded food products. Given the algorithmic specificity in YouTube, some children may be differentially exposed to more ultra-processed or branded food content; however, no studies have examined YouTube video characteristics or family characteristics associated with such food content.

Objective: To examine YouTube video characteristics and child and caregiver characteristics associated with greater exposures to ultra-processed or branded food …

Use Of Procalcitonin In Therapeutic Decisions In The Pediatric Intensive Care Unit, Pierre Tissières, Elisabeth Esteban Torné, Johannes Hübner, Adrienne Randolph, Corsino Rey Galán, Scott Weiss

Department of Medicine Faculty Papers

Procalcitonin (PCT) is frequently used by clinicians in children with suspected bacterial infections and sepsis. However interpretation in the critically ill child may be challenging due to the complexity of underlying conditions and its impact on PCT values. Herein, we propose a guidance for the use of procalcitonin in critically ill children, supported by a comprehensive analysis of the literature, to help the clinician for interpreting PCT in the various clinical conditions encountered in pediatric intensive care units. We describe the importance of the clinical context, timing of measurement and evidence on PCT values in diagnosing sepsis and to guide …

Biallelic Fgf4 Variants Linked To Thoracic Dystrophy And Respiratory Insufficiency, Laura M. Watts, Esther Kinning, Donald R. Latner, Marla Johnston, Jessica Patrick-Esteve, Gregory M. Cooper, Stephen R.F. Twigg, Alistair T. Pagnamenta, Jenny C. Taylor

School of Medicine Faculty Publications

The thoracic dystrophies are inherited skeletal conditions where abnormal embryonic development of the thoracic skeleton results in a narrow chest, pulmonary hypoplasia, and respiratory insufficiency, which can be severe or lethal. The majority of thoracic dystrophies are due to biallelic alterations in genes needed for normal ciliary function. However, despite the identification of over 20 genes as causal for the thoracic dystrophy phenotype, around 20% of patients remain without a molecular diagnosis. We present two unrelated families with a clinical diagnosis of thoracic dystrophy with associated respiratory insufficiency without a molecular diagnosis on previous genetic testing. Both harbor rare biallelic …

Prenatal Exercise: The Importance Of Patient-Provider Communication, Stephanie Patton

Doctorate in Kinesiology

There is a low adherence to prenatal exercise guidelines which may be affected by several barriers including a lack of knowledge regarding the benefits to, safety of, and general guidelines for prenatal exercise. This study sought to investigate the communication that occurs in prenatal appointments and the barriers associated with low exercise rates. Data was collected from 54 pregnant and postpartum women between the ages of 18-40 through an anonymous survey and analyzed through SPSS software. Twenty-four (44.4%) respondents indicated discussion regarding exercise recommendations occurred and five (9.3%) shared that resources for exercise recommendations were provided. Twenty-three (42.6%) participants were …

Longitudinal Assessment Of Moral Distress And Burnout During Pediatric Residency In A Canadian Site: Low Prevalence But Notable Risk Of Attrition, Kenneth S. Lee, Dianna C. Louie, Elaine O. Cheung, Peter Dodek, Dylan King, Kimee Chong

Journal of Wellness

Introduction: Although more than half of pediatric residents report burnout, the incidence of moral distress, the course of moral distress and burnout during residency, and associations between this course and personal characteristics of residents are unknown. The purpose of this work was to examine the incidence, temporal course, and associations of moral distress and burnout in pediatric residents.

Methods: In the pediatric training program of British Columbia Children’s Hospital, all residents were invited to complete the Moral Distress Scale-Revised thrice yearly, and the Maslach Burnout Inventory annually, between July 2016 and October 2018. In addition, residents reported a measure of …

Virtual Reality Respiratory Biofeedback In An Outpatient Pediatric Pain Rehabilitation Program: Mixed Methods Pilot Study, Kristin Recker, Julia Silliman, Karolina Gifford, Parth Patel, Lisgelia Santana, Aimee K. Hildenbrand, Shreela Palit, Rachel Wasserman

Department of Pediatrics Faculty Papers

BACKGROUND: Chronic pain in adolescents is a significant and growing concern, as it can have negative implications on physical and psychosocial development. Management can be complicated by the increasing risks associated with opioid misuse, highlighting the need for effective nonpharmacological interventions. Biofeedback is an empirically supported behavioral intervention for chronic pain that targets the self-regulation of physiological responses. Virtual reality (VR) is a novel delivery method for biofeedback that could serve as an engaging and effective platform for adolescents.

OBJECTIVE: The goal of this study was to assess the feasibility, acceptability, and preliminary effectiveness of integrating a VR-delivered respiratory biofeedback …

Vasoactive Selection For Pediatric Septic Shock-Where To Begin?, Scott L. Weiss

Department of Pediatrics Faculty Papers

No abstract provided.

Total Intestinal Atresia In A Neonate: A Case Report., Cory Nonnemacher, Seth Saylors, Naomi-Liza Denning, Vatche Melkonian, Pablo Aguayo

Manuscripts, Articles, Book Chapters and Other Papers

Intestinal atresias are a common cause of neonatal intestinal obstruction. An extremely rare variant is total intestinal atresia, where no lumen is appreciable from the duodenum through the colon. We describe a case of a 33-week female who was born at an outside hospital and underwent laparotomy for concern for intrauterine perforation and proximal intestinal obstruction. Laparotomy revealed a duodenal perforation and an atresia in the proximal jejunum. Resection of this segment revealed no intestinal lumen distally, and the patient was left in discontinuity and transferred to our tertiary children's hospital. Repeat laparotomy revealed atretic bowel with no lumen through …