Pediatrics Commons^™

Development And Evaluation Of A Training Program On Pain Assessments For Pediatric Care Teams In Skilled Nursing Facilities, Rudy Velasquez-Correa

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project was a program development and quality improvement initiative at Silver State Pediatrics focused on improving consistency and confidence of pediatric care staff in assessing and documenting pain in children, particularly those who are non-speaking and medically complex. Although validated tools such as the Face, Legs, Activity, Cry, Consolability (FLACC), revised-FLACC (R-FLACC), and Non-communicating Children’s Pain Checklist-Revised (NCCPC-R) exists, inconsistent training and limited interdisciplinary communication have led to variability in clinical practice. This project involved implementing a brief, 20-30-minute interdisciplinary training session for nursing and rehabilitation staff on the use of validated pediatric pain assessment tools and collaborative …

Exploring Bidirectionality In Global Health Partnerships: Perspectives From U.S. Pediatric Residency Programs., Anik Patel, Pauline Kamau, Justus Simba, Ashley Combs, Adelaide Barnes, Kathy Ferrer, Heather Haq, Duncan K. Hau, Lee Morris, Brittany Murray, Amy Rule, Reena P. Tam, Lisa Umphrey, Megan S. Mchenry

Manuscripts, Articles, Book Chapters and Other Papers

Introduction Despite growing interest, little guidance exists to re-evaluate global health partnerships (GHPs) through promoting bidirectionality. This study aims to understand the perspectives of United States (U.S.) pediatric global health (GH) faculty on institutional bidirectional practices to inform future discussions with international collaborators. Methods An internally, iteratively developed REDCap-based online survey (REDCap, Vanderbilt University, Nashville, TN), by our diverse author group, collected qualitative data from January 18 to February 20, 2023. Free-text responses were reviewed and coded inductively, with findings framed to generate themes for subsequent engagement with international partners. Results Of the 88 U.S. programs that identify as having …

Level Of Comfort And Barriers To Pediatric Vaccination Among Pharmacy-Based Immunizers In California, Laressa Bethishou, Karl Hess, Richard Beuttler, Jeffery Goad

Pharmacy Faculty Articles and Research

Background

Pharmacists are increasingly recognized as accessible immunizers, yet pediatric vaccination rates in community pharmacies remain lower than those for adults, likely due to unique barriers. This study aimed to assess the comfort level of pharmacy-based immunizers in California with administering vaccines to pediatric patients and to identify barriers limiting their participation in pediatric immunization.

Methods

An IRB-approved, cross-sectional survey was distributed electronically to pharmacists, student pharmacists, and pharmacy technicians administering vaccines in California community pharmacies between November 2022 and February 2023. The survey measured comfort with vaccinating pediatric age groups, perceived barriers, and collected demographic data. Data analysis included …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Pediatric Burns: Severity, First Aid, And When To Refer, Mike Smith, Pablo Aguayo

Pediatrics in Practice: A CME Podcast

This episode explains burn depth, TBSA estimation, and practical first aid that reduces complications—essential for pediatricians and ER providers who triage children with burns. Pablo Aguayo, MD (Children’s Mercy) walks through burn classification (superficial to fourth-degree), scald burns, and American Burn Association referral criteria. Keywords: pediatric burns, burn severity, burn first aid, scald injuries, TBSA, burn center referral. For more resources and show notes, visit the Pediatrics in Practice CME Podcast page and subscribe for updates.

Click here to stream the podcast episode.

Enhancing Pediatric Resident Trauma Education In The Pediatric Emergency Department, Dina Nassar, Elizabeth Kurian

St. Chris Research Day

No abstract provided.

Reducing Use Of Computed Tomography For Diagnosing Appendicitis In A Pediatric Emergency Department, Sharmaine Ross

St. Chris Research Day

No abstract provided.

Case Study Of Influenza-Associated Acute Necrotizing Encephalitis Complicated By Atypical Hemolytic Uremic Syndrome, Hasnain Bherwani, Abhijeet Pal

St. Chris Research Day

No abstract provided.

Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi

Rowan-Virtua Research Day

No abstract provided.

Shopping Cart–Related Injuries In Children: Brief Clinical Review And Public Health Implications, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Shopping cart–related injuries represent a common yet underrecognized mechanism of pediatric trauma. National estimates suggest approximately 24,000 children annually are treated in U.S. emergency departments for shopping cart–related injuries, with falls accounting for the majority of cases. Younger children, particularly those under 5 years of age, are disproportionately affected, and head and facial injuries predominate.

Objective:

To provide a concise clinical and public health review of shopping cart–related pediatric injuries, with emphasis on epidemiology, injury patterns, and opportunities for prevention within emergency department practice.

Methods

Narrative review of national injury surveillance data, prior epidemiologic studies, and consumer safety guidance addressing …

Preliminary Results From Assessing Medical Students’ Familiarity With Adverse Childhood Experiences (Aces) And Trauma-Informed Care (Tic), Kaylea Shoulders, Portia Tasnim Shaheed, Kartik Kannan, Rachel Silliman Cohen, Beth Cooper, Christine Schroeder, Yahaira Márquez

Rowan-Virtua Research Day

Adverse childhood experiences (ACEs) are highly prevalent and associated with significant long-term health outcomes1; however, physicians often report feeling underprepared to address trauma in clinical care. While medical education increasingly includes exposure to ACEs and trauma-informed care (TIC), limited research has examined how these topics are integrated and experienced within osteopathic medical education (OME). This project aims to assess medical students’ familiarity with ACEs and TIC at Rowan-Virtua School of Osteopathic Medicine and to potentially help inform curricular improvement efforts. This study adapts and extends prior research2 using an anonymous survey administered via Qualtrics. Recruitment targeted medical students across years …

Bacteriophage Therapy Vs. Standard Antibiotics: A Review Of Treatment Efficacy For Recurrent Pediatric S. Pyogenes (Gas) Infections, Kartik Kannan Oms-I, Karina Malhotra Oms-I, Gabrielle Coccio Oms-I, Janhavi Belwalkar Oms-I, Jason Rienzo Oms-I, Samay Shukla Oms-I, Valerie J. Carabetta Phd

Rowan-Virtua Research Day

Background: Antibiotic resistance poses a growing threat to pediatric infectious disease management, particularly in the treatment of Streptococcus pyogenes (GAS) infections.¹ While β-lactam antibiotics remain the first-line standard of care, their utility is limited by allergy prevalence and rising resistance among alternative antibiotic agents, such as macrolides, lincosamides, and tetracycline.^2,3 Given these trends, bacteriophage therapy has emerged as a promising adjunctive treatment modality, offering targeted bacterial lysis while sparing commensal microbiota.⁴

Methods: A systematic literature search was conducted across PubMed and Embase (2000–2025) using terms related to antibiotic resistance, Streptococcus pyogenes, bacteriophage therapy, and pediatric populations. …

Effects Of Vaccine Refusal On Adherence To Well-Child Visit Schedule In A Pediatric Population, Arshia Anand, Clare Stephens, Nicole Streeks-Wooden

Rowan-Virtua Research Day

Background: Hepatitis B (Hep B) vaccination at birth is a critical strategy for preventing both perinatal and horizontal transmission of the Hep B virus1 . Unfortunately, refusal of the birthdose vaccine has increased and is associated with subsequent vaccine refusal at 18 and 24 months2 . This trend raises significant concerns, that families who refuse the Hep B vaccine at birth may also engage less frequently in preventive pediatric care. However, the impact of this association on adherence to routine well-child (WC) visits remains unclear.

Hypothesis: Refusal, or incomplete uptake of the Hep B vaccine series is associated with decreased …

Examining A Positive Variation Of The Good Behavior Game With Head Start Children At Risk For Child Adversity And Externalizing Behavior Problems., Alexandra Gibson, Courtney P D Goldenberg, Malinda J. Colwell, Amelia E. Talley, Joaquín Borrego, Adam T. Schmidt

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children participating in the Head Start program in the United States are predominantly from underserved groups, have increased rates of child adversity, and are at risk for externalizing behavior problems in the classroom. The Good Behavior Game (GBG) is an effective classroom management strategy for reducing disruptive and off-task classroom behaviors. However, previous research has not examined the GBG within the Head Start context.

METHODS: The current case-controlled study evaluated the effectiveness of the GBG in six Head Start children aged 3-5. Researchers conducted daily classroom behavioral observations of disruptive behaviors, and teachers completed pre- and post-treatment assessments of …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Ebp Project In A Primary, Foster Care Medical Home: Implementation Of The Ages & Stages: Social Emotional Screener, Sara Moore

2026

Background: Children in the foster care system have increased diagnoses, mental health concerns, and developmental delays.
Purpose: The pilot used the ASQ-SE to determine if the protocol was feasible and if the screener identified social-emotional difficulties in a primary care clinic that serves children in foster care. 
Method: A pilot was created, and the ASQ-SE was administered to 33 patients during well-child visits (ages 2 months-70 months) over six weeks.
Results: Implementing a social-emotional screener was feasible in the foster care primary care clinic. The infants and toddlers screened (N=33) were grouped by referral status: 57.6 % (19) …

Sleep In Children In Foster Care: A Scoping Review, Juan Castellanos, Anna Wani, Jill Mcleigh

Health Status, Outcomes, and Literacy and Healthcare Utilization

Although the focus on sleep disturbances in children who have experienced adversity has increased, little is known about sleep among children in foster care (CFC). This study aimed to review what research tells us about the relationship between foster care experience and sleep disturbances and to identify knowledge gaps.

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

childrens.com/fostercare

Household Air Pollution Is Associated With Disease Severity In Ugandan Children Hospitalized With Hypoxemic Pneumonia, Ayla Ahmed, Sehaj Sandhu, Sophie Namasopo, Juliet Nabwire, Qaasim Mian, Andrea Conroy, Jackson Amone, Charles Olaro, Robert Opoka, Michael Hawkes

Paediatrics and Child Health, East Africa

Background Household air pollution (HAP) due to biomass fuel use is a risk factor for childhood pneumonia, a leading cause of under-five mortality globally. This study examined the relationship between HAP and disease severity in Ugandan children hospitalized with hypoxemic pneumonia.

Methods We conducted a retrospective case-control study across 20 Ugandan hospitals. PM2.5 exposure was estimated using caregiver-reported fuel use, cooking duration, kitchen structure, and ventilation. Pneumonia severity was assessed clinically, and associations were analyzed using non-parametric tests.

Results We included 735 children (median age 9 months, 42% female) hospitalized with hypoxemic pneumonia. Most households used firewood (84%) or charcoal …

Transcranial Doppler Ultrasound Velocity Measurements In Children With Sickle Cell Disease In Kenya, Catherine Mwalimu, Oscar Odhiambo, Elaine Mashisia, Teresa Mwanja, Allan Ade, Maria De Vita, Katherine Oyieke, Pauline Samia, Fenella Kirkham, Samson Gwer

Paediatrics and Child Health, East Africa

Background Sickle cell disease (SCD) is the most common inherited haemoglobinopathy and poses a high public health burden in Sub-Saharan Africa. Children with sickle cell anaemia are at a highrisk of ischemic stroke, and transcranial Doppler (TCD) ultrasonography helps identify those at highest risk for primary stroke prevention.

Objective To determine the prevalence of abnormal cerebral blood flow velocity (CBFV) in children with SCD and describe CBFV in children without SCD.

Methods We conducted a two-component study comprising a retrospective review and a cross-sectional assessment. TCD measurements from 143 children with confirmed SCD aged 2–16 years were reviewed. In a …

Cost Of Health Systems Strengthening For Small And Sick Newborn Care In Four Sub-Saharan African Countries Implemented With Nest360: Incremental Cost Analyses, Alice Tarus, Meghan Kumar, Rebecca Penzias, Rosemary Kamuyu, James Cross, Mbozu Sipalo, Edith Gicheha, Christine Bohne, George Okello, William Macharia

Paediatrics and Child Health, East Africa

Background

Methods