Pediatrics Commons^™

Decreasing Time To Narcotic Pain Medication In Patients With Sickle Cell Disease Presenting With Acute Pain Crises In A Pediatric Emergency Department: A Quality Improvement Initiative, Allison Adam, Lina Patel, Christopher Kaberline, Ibad Siddiqi, Leslie Hueschen

Posters

No abstract provided.

Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi

Master of Medicine in Paediatrics and Child Health

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and …

Protective Factors Against Child Maltreatment Among Postpartum Mothers, Maggie Mann, Elizabeth Grady, Matthew Hall, Cristy Toburen, Ann Mattison, Jennifer Anderson, Katie J. Hocker, Francesca Donohue, Heather Williams, Jessica Sprague-Jones, James Anderst, Henry T. Puls

Presentations

No abstract provided.

Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine A. Campbell, Lori Frasier, Chris Greenley, Danielle Horton, Nicole R. Johnson, Jan Leonard, Megan M. Letson, Dan M. Lindberg, Caitlin R. Mcnamara, Shalon M. Nienow, Ashley K. Sherman, Joanne N. Wood, James Anderst Md, Msci

Presentations

In cases where Child Abuse Pediatricians (CAPs) diagnose abusive head trauma (AHT) in young children, some factors surrounding the diagnosis have been challenged including causative shaking, necessity of external signs of impact, or concomitant suspicious injuries. Evaluation of CAP diagnoses in children with subdural hemorrhage (SDH) can give insight into factors related to the frequency of abusive head trauma (AHT) diagnoses. Additionally, characterization of those with SDH+CSI without evidence of impact may inform controversies around AHT diagnoses. Objective We aim to compare CAP diagnoses in subjects with SDH across clinical presentations and in the context of evidence of head impact. …

Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster, Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls

Presentations

Background: Mental health (MH) diagnoses are known to complicate outcomes of underlying medical conditions in pediatrics, but the prevalence of MH diagnoses across the array of medically complex and/or chronic conditions are not well known. Objective: To compare prevalence of MH diagnoses across levels of medical complexity and chronicity, and identify factors associated with MH diagnoses among children with complex chronic conditions (CCC). Methods: This retrospective cross-sectional study included children ages 5-17 years with at least 11 months of continuous Medicaid enrollment in 2022 from the Merative Marketscan Medicaid Database which collects data from all children with Medicaid in the …

Variation In Blood Culture Testing For Three Common Infections, Smit Shah, Jennifer Goldman, Matt Hall, Jillian Cotter, Samantha A. House, Matthew J. Molloy, Michelle Polich, Michael J. Steiner, John R. Stephens, Michael J. Tchou, Ronald J. Teufel Ii, Irma Ugalde, Andrew Yu, Jessica L. Markham

Presentations

Background: Routine blood culture (BC) testing in uncomplicated community-acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) has demonstrated low clinical utility. Objectives: To evaluate hospital-level BC testing trends and their association with clinical outcome differences for children hospitalized with CAP, SSTI, and UTI. Methods: This retrospective cohort study used the Pediatric Health Information System database to identify hospitalizations of children aged 3 months-18 years admitted with CAP, SSTI, or UTI from 2016-2023. We excluded patients with complicated infections, medical complexity, ICU admission, or length of stay (LOS) >7 days. Hospital-level BC testing rates were …

Maternal Guilt Following Pediatric Burn Injury, Sabrina Ung, Abby Dugan, Casey Lawless, Mallory Netz, Alec Bernstein, Carisa Parrish

Posters

Background: Previous research has shown that parental guilt is a risk factor for poor parental adjustment (e.g., depression, posttraumatic stress) following a pediatric burn injury (Hawkins et al., 2019). However, few studies have examined risk factors for parental guilt. Objectives/Goal: The current study aimed to examine relationships among demographic variables, burn characteristics, maternal mental health, with maternal guilt following their child’s burn injury. Methods/Design: Mothers of 147 children who experienced a burn injury (mean child age = 6.28 years, 46% female, 44.7% White, 19.2% Black or African American, 9.6% Hispanic, 1.3% Asian, 11.9% multiracial, total body surface area range .10 …

Facilitators, Barriers, & Recommendations For Pediatric Research Sites Conducting Decentralized Clinical Trials (Dcts), Abby Kietzman

Posters

The COVID-19 pandemic drastically altered the way clinical research is conducted through a widespread adoption of telemedicine practices to continue clinical trial procedures during peak periods of global COVID-19 spread. Using telehealth/telemedicine services allows researchers to conduct “decentralized clinical trials”, or DCTs, for all or portions of study protocol procedures while maintaining safety measures implemented for pandemic control. However, research sites are hesitant to adopt DCT policies due to concerns around digital health technology, data safety and quality, and limited information in the literature specifically assessing telemedicine use for pediatric clinical research via DCTs or how equipped pediatric research sites …

Tuberculosis Screening In The Ambulatory Setting, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Dizziness And Vertigo Ambulatory, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Behavioral Escalation In The Ed, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Suspected Abusive Head Trauma, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Comparison Of Six Handheld Ultrasound Devices By Pediatric Point Of Care Ultrasound (Pocus) Experts, Stephanie K Leung, Ria Dancel, Riya N Soni, Ariadna Perez-Sanchez, Michael J Mader, Haitham Al-Wahab, Thomas W Conlon, Maria V Fraga, Javier J Lasa, Andrea Matho, Hannah Smith, Nilam J Soni

Faculty, Staff and Student Publications

BACKGROUND: Point of care ultrasound (POCUS) use is increasing among pediatric clinicians, but lack of access to ultrasound devices is a major barrier. The availability of pocket-sized handheld ultrasound devices ("handhelds") has improved access. However, no head-to-head comparative studies of handhelds in children have been performed to guide purchasing decisions.

METHODS: This cross-sectional study compared six handhelds: Butterfly iQ+™ (Butterfly Network Inc.), Clarius® (Clarius Mobile Health™), Kosmos™(EchoNous), TE Air™ (Mindray®), Vscan Air™ SL (General Electric), and Lumify™ (Philips Healthcare). Eight pediatric POCUS experts acquired views showing the abdominal right upper quadrant (RUQ), cardiac apical 4-chamber, and superficial neck and lung …

Strengthening The Paediatric Clinical Trial Ecosystem To Better Inform Policy And Programmes, James A. Berkley, Judd L. Walson, Glenda Gray, Fiona Russell, Zulfiqar Ahmed Bhutta, Per Ashorn, Shane A. Norris, Ebunoluwa A. Adejuyigbe, Rebecca Grais, Bernhards Ogutu

Institute for Global Health and Development

The first WHO Global Clinical Trials Forum was convened in November, 2023 to develop a shared vision of an effective global clinical trial infrastructure. The Paediatric Clinical Trials Working Group was formed to provide perspectives, identify challenges, and propose solutions to strengthen the paediatric clinical trials ecosystem. Participants represented paediatric disciplines, including infectious diseases, nutrition, neonatology, pharmacology, oncology, neurodevelopment, public health, and policy. Childhood diseases have profound lifelong effects on health, livelihoods, and societies. Investment in early childhood results in highly cost-effective changes to lifelong health, productivity, and human capital returns. Yet, there remain substantial gaps in knowledge on the …

Genetic Testing Utilization In The U.S. Registry For Childhood Interstitial And Diffuse Lung Diseases., Laura A. Voss, Rebekah J. Nevel, Jennifer A. Wambach, Lawrence M. Nogee, Robin R. Deterding, Alicia M. Casey, Michael G. O'Connor, Daniel I. Craven, Jane B. Taylor, Gail H. Deutsch, Jade B. Tam-Williams, Lea C. Steffes, Steven K. Brennan, Maria T. Santiago, Sara C. Sadreameli, Andrea F. Heras, Michael R. Powers, Antonia P. Popova, Manvi Bansal, Aaron Hamvas, William A. Gower, Fernando Urrego, Lisa R. Young, Child Registry Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Childhood interstitial and diffuse lung diseases (chILD) comprise a diverse group of rare disorders. Identifying the underlying cause is crucial for treatment, prognosis, and estimating recurrence risk. The objective of this study was to assess the utilization of genetic testing for subjects enrolled in the United States National Registry for ChILD, a multicenter observational study.

METHODS: Genetic data from participating sites were reviewed and analyzed in relationship to clinical characteristics.

RESULTS: Of 609 children enrolled from 22 centers, genetic testing was performed for 55.5% (n = 338). Genetic testing results were positive (diagnostic) for 22.8% (n = 77), negative …

Factors Associated With Shock At Presentation In Kawasaki Disease Versus Multisystem Inflammatory Syndrome In Children Associated With Covid-19., Supriya S. Jain, Ashraf S. Harahsheh, Simon Lee, Geetha Raghuveer, Nagib Dahdah, Michael Khoury, Michael A. Portman, Melissa Wehrmann, Arash A. Sabati, Marianna Fabi, Deepika Thacker, Nilanjana Misra, Mark D. Hicar, Nadine F. Choueiter, Matthew D. Elias, Audrey Dionne, William B. Orr, Jacqueline R. Szmuszkovicz, Seda Selamet Tierney, Luis Martin Garrido-Garcia, Frederic Dallaire, Balasubramanian Sundaram, Deepa Prasad, Tyler H. Harris, Elizabeth Braunlin, Elisa Fernandez Cooke, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: While clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.

METHODS: The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023. Demographics, clinical features and presentation, management, laboratory values, and outcomes were compared between the diagnosis and shock groups.

RESULTS: Shock at presentation was noted for 19 of 672 KD patients (2.8%) and 653 of …

Symptom Documentation In Unstructured Palliative Care Notes Of Children And Adolescents With Cancer., Katherine Bernier Carney, Jacob Wilkes, Tumilara Aderibigbe, Kristin Stegenga, Holly Spraker-Perlman, Lauri A. Linder

Manuscripts, Articles, Book Chapters and Other Papers

CONTEXT: Children and adolescents with cancer experiencing complex symptoms can benefit from subspeciality palliative care. However, standardized methods of symptom documentation by pediatric palliative care teams are lacking. Understanding current approaches to symptom documentation will inform next steps to optimize symptom support.

OBJECTIVE: To explore the documentation of symptom prevalence and characteristics in unstructured clinical notes by pediatric palliative care clinicians caring for children and adolescents with cancer.

METHODS: We reviewed unstructured clinical notes documented by the pediatric palliative care team for 115 children and adolescents with cancer. Symptom-related data were abstracted and evaluated using content analysis based on the …

Opioid Prescribing Patterns And The Effect Of Chronic Kidney Disease In Pediatric Urology Population: A Retrospective Cohort Analysis., Kristen M. Meier, Darren Ha, Carter Sevick, Eliza D. Blanchette, Megan A. Brockel, Vijaya M. Vemulakonda, Kyle O. Rove

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Significant efforts have been undertaken to decrease opioid prescribing, but there is little research into patient-specific factors presenting as barriers in the pediatric surgical population. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be a safe and effective alternative to opioids for pain control, however, concerns about their impact on renal function limit their use in patients with chronic kidney disease (CKD). Data is limited on the interplay of CKD on opioid prescribing.

OBJECTIVE: We hypothesized that opioid reduction efforts were successful, but patients with CKD would be more likely to receive an opioid prescription than those without CKD. …

O The Places Rural Children Will Go…To Get Physical Activity: A Cross Sectional Analysis., Bethany Forseth, Jordan A. Carlson, Adrian Ortega, Chelsea Steel, Brittany Lancaster, Lauren Fitzpatrick, Qianxia Jiang, Ann M. Davis

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Youth living in rural areas have higher risk for overweight/obesity. It is important to understand where these children engage in moderate-to-vigorous physical activity (MVPA) and sedentary time to encourage or intervene on activity in specific locations. This study compared MVPA and sedentary time across locations among children with overweight/obesity in the rural Midwest of the U.S.

METHODS: Participants wore an accelerometer and Global Positioning System tracker over 7-days to collect data on MVPA, sedentary time, and location. Locations were categorized as Home, Home Neighborhood, School, School Neighborhood, and 'Other'. Differences based on school and non-school days were examined.

RESULTS: …

Introducing Kids To Cultural Cuisines, Maggie Mckay, Rachel Finn

Parent-ish Podcast

While it can be easy to lean on your tried and true, family-favorite recipes, introducing children to diverse cuisines is a wonderful way to expand their understanding of different cultures while also trying new foods. As parents, we have the unique opportunity to use food as a tool for education and connection. Rachel Finn, chef/educator at Children's Mercy Kansas City, discusses how to involve kids in the process and make discovering new cuisines fun and nutritious for the whole family!

Click here to stream the podcast episode.